[Federal Register Volume 65, Number 68 (Friday, April 7, 2000)]
[Rules and Regulations]
[Pages 18434-18820]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-8215]



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Part II





Department of Health and Human Services





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Health Care Financing Administration



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42 CFR Parts 409, et al.



Office of the Inspector General; Medicare Program Prospective Payment 
System for Hospital Outpatient Services; Final Rule

  Federal Register / Vol. 65, No. 68 / Friday, April 7, 2000 / Rules 
and Regulations  

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

42 CFR Parts 409, 410, 411, 412, 413, 419, 424, 489, 498, and 1003

[HCFA-1005-FC]
RIN 0938-AI56


Office of Inspector General; Medicare Program; Prospective 
Payment System for Hospital Outpatient Services

AGENCY: Health Care Financing Administration (HCFA), HHS, and Office of 
Inspector General (OIG), HHS.

ACTION: Final rule with comment period.

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SUMMARY: This final rule with comment period implements a prospective 
payment system for hospital outpatient services furnished to Medicare 
beneficiaries, as set forth in section 1833(t) of the Social Security 
Act. It also establishes requirements for provider departments and 
provider-based entities, and it implements section 9343(c) of the 
Omnibus Budget Reconciliation Act of 1986, which prohibits Medicare 
payment for nonphysician services furnished to a hospital outpatient by 
a provider or supplier other than a hospital, unless the services are 
furnished under an arrangement with the hospital. In addition, this 
rule establishes in regulations the extension of reductions in payment 
for costs of hospital outpatient services required by section 4522 of 
the Balanced Budget Act of 1997, as amended by section 201(k) of the 
Balanced Budget Refinement Act of 1999.

DATES: Effective date: July 1, 2000, except that the changes to 
Sec. 412.24(d)(6), new Sec. 413.65, and the changes to Sec. 489.24(h), 
Sec. 498.2, and Sec. 498.3 are effective October 10, 2000.
    Applicability date: For Medicare services furnished by all 
hospitals, including hospitals excluded from the inpatient prospective 
payment system, and by community mental health centers, the 
applicability date for implementation of the hospital outpatient 
prospective payment system is July 1, 2000.
    Comment date: Comments on the provisions of this rule resulting 
from the Balanced Budget Refinement Act of 1999 will be considered if 
we receive them at the appropriate address, as provided below, no later 
than 5 p.m. on June 6, 2000. We will not consider comments concerning 
provisions that remain unchanged from the September 8, 1998 proposed 
rule or that were revised based on public comment.
    See section VIII for a more detailed discussion of the provisions 
subject to comment.

ADDRESSES: Mail written comments (one original and three copies) to the 
following address ONLY: Health Care Financing Administration, 
Department of Health and Human Services, Attention: HCFA-1005-FC, P.O. 
Box 8013, Baltimore, MD 21244-8013.
    If you prefer, you may deliver, by courier, your written comments 
(one original and three copies) to one of the following addresses:

Room 443-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., 
Washington, DC 20201, or
C5-14-03, Central Building, 7500 Security Boulevard, Baltimore, MD 
21244-1850.

Comments mailed to those addresses may be delayed and could be 
considered late.
    Because of staffing and resource limitations, we cannot accept 
comments by facsimile (FAX) transmission. In commenting, please refer 
to file code HCFA-1005-FC.
    Comments received timely will be available for public inspection as 
they are received, generally beginning approximately 3 weeks after 
publication of a document, in Room 443-G of the Department's offices at 
200 Independence Avenue, SW., Washington, DC, on Monday through Friday 
of each week from 8:30 a.m. to 5 p.m. (Phone (202) 690-7890).
    For comments that relate to information collection requirements, 
mail a copy of comments to:

Health Care Financing Administration, Office of Information Services, 
Security and Standards Group, Division of HCFA Enterprise Standards, 
Room N2-14-26, 7500 Security Boulevard, Baltimore, MD 21244-1850, Attn: 
John Burke, HCFA-1005-FC; and
Lauren Oliven, HCFA Desk Officer, Office of Information and Regulatory 
Affairs, Room 3001, New Executive Office Building, Washington, DC 
20503.

    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 $8. 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.

FOR FURTHER INFORMATION CONTACT:

Janet Wellham, (410) 786-4510 or Chuck Braver, (410) 786-6719 (for 
general information)
Joel Schaer (OIG), (202) 619-0089 (for information concerning civil 
money penalties)
Kitty Ahern, (410) 786-4515 (for information related to the 
classification of services into ambulatory payment classification (APC) 
groups)
George Morey (410) 786-4653 (for information related to the 
determination of provider-based status)
Janet Samen (410) 786-9161 (for information on the application of APCs 
to community mental health centers)

SUPPLEMENTARY INFORMATION: To assist readers in referencing sections 
contained in this document, we are providing the following table of 
contents. Within each section, we summarize pertinent material from our 
proposed rule of September 8, 1998 (63 FR 47552) followed by public 
comments and our responses.

Table of Contents

      I. Background
    A. General and Legislative History
    B. Summary of Provisions of the Balanced Budget Act of 1997 (the 
BBA 1997)
    1. Prospective Payment System (PPS)
    2. Elimination of Formula-Driven Overpayment
    3. Extension of Cost Reductions
    C. The September 8, 1998 Proposed Rule
    D. Overview of Public Comments
    E. Summary of Relevant Provisions in the Balanced Budget 
Refinement Act of 1999 (the BBRA 1999)
    1. Outlier Adjustment
    2. Transitional Pass-Through for Additional Costs of Innovative 
Medical Devices, Drugs, and Biologicals
    3. Budget Neutrality Applied to New Adjustments
    4. Limitation on Judicial Review
    5. Inclusion in the Hospital Outpatient PPS of Certain 
Implantable Items
    6. Payment Weights Based on Mean Hospital Costs
    7. Limitation on Variation of Costs of Services Classified 
Within a Group
    8. Annual Review of the Hospital Outpatient PPS Components
    9. Coinsurance Not Affected by Pass-Throughs

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    10. Extension of Cost Reductions
    11. Clarification of Congressional Intent Regarding Base Amounts 
Used in Determining the Hospital Outpatient PPS
    12. Transitional Corridors For Application of Outpatient PPS
    13. Limitation on Coinsurance for a Procedure
    14. Reclassification of Certain Hospitals
II. Prohibition Against Unbundling of Hospital Outpatient Services
    A. Background
    B. Office of Inspector General (OIG) Civil Money Penalty 
Authority and Civil Money Penalties for Unbundling Hospital 
Outpatient Services
    C. Summary of Final Regulations on Bundling of Hospital 
Outpatient Services
    D. Comments and Responses
III. Hospital Outpatient Prospective Payment System (PPS)
    A. Hospitals Included In or Excluded From the Outpatient PPS
    B. Scope of Facility Services
    1. Services Excluded from the Scope of Services Paid Under the 
Hospital Outpatient PPS
    a. Background
    b. Comments and Responses
    c. Payment for Certain Implantable Items Under the BBRA 1999
    d. Summary of Final Action
    2. Services Included Within the Scope of the Hospital Outpatient 
PPS
    a. Services for Patients Who Have Exhausted Their Part A 
Benefits
    b. Partial Hospitalization Services
    c. Services Designated by the Secretary
    d. Summary of Final Action
    3. Hospital Outpatient PPS Payment Indicators
    C. Description of the Ambulatory Payment Classification (APC) 
Groups
    1. Setting Payment Rates Based on Groups of Services Rather than 
on Individual Services
    2. Packaging Under the APC System
    a. Summary of Proposal
    b. General Comments and Responses (Supporting or Objecting to 
Packaging)
    c. Packaging of Casts and Splints
    d. Packaging of Observation Services
    e. Packaging Costs of Procuring Corneal Tissue
    f. Packaging Costs of Blood and Blood Products
    g. Packaging Costs for Drugs, Pharmaceuticals, and Biologicals
    h. Summary of Final Action
    3. Treatment of Clinic and Emergency Department Visits
    a. Provisions of the Proposed Rule
    b. Comments and Responses
    4. Treatment of Partial Hospitalization Services
    5. Inpatient Only Procedures
    6. Modification of APC Groups
    a. How the Groups Were Constructed
    b. Comments on Classification of Procedures and Services Within 
APC Groups
    c. Effect of the BBRA 1999 on Final APC Groups
    d. Summary of APC Modifications
    e. Exceptions to the BBRA 1999 Limit on Variation of Costs 
Within APC Groups
    7. Discounting of Surgical Procedures
    8. Payment for New Technology Services
    a. Background
    b. Comments and Responses
    D. Transitional Pass-Through for Innovative Medical Devices, 
Drugs, and Biologicals
    1. Statutory Basis
    2. Identifying Eligible Pass-Through Items
    a. Drugs and Biologicals
    b. Medical Devices
    3. Criteria to Define New or Innovative Medical Devices Eligible 
for Pass-through Payments
    4. Determination of ``Not Insignificant'' Cost of New Items
    5. Calculating the Additional Payment
    6. Process to Identify Items and to Obtain Codes for Items 
Subject to Transitional Pass-Throughs
    E. Calculation of Group Weights and Conversion Factor
    1. Group Weights (Includes Table 1, Packaged Services by Revenue 
Center)
    2. Conversion Factor
    a. Calculating Aggregate Calendar Year 1996 Medicare and 
Beneficiary Payments for Hospital Outpatient Services (Pre-PPS)
    b. Sum of the Relative Weights
    F. Calculation of Coinsurance Payments and Medicare Payments 
Under the PPS
    1. Background
    2. Determining the Unadjusted Coinsurance Amount and Program 
Payment Percentage
    a. Calculating the Unadjusted Coinsurance Amount for Each APC 
Group
    b. Calculating the Program Payment Percentage (Pre-deductible 
Payment Percentage)
    3. Calculating the Medicare Payment Amount and Beneficiary 
Coinsurance Amount
    a. Calculating the Medicare Payment Amount
    b. Calculating the Coinsurance Amount
    4. Hospital Election to Offer Reduced Coinsurance
    G. Adjustment for Area Wage Differences
    1. Proposed Wage Index
    2. Labor-Related Portion of Hospital Outpatient Department PPS 
Payment Rates
    3. Adjustment of Hospital Outpatient Department PPS Payment and 
Coinsurance Amounts for Geographic Wage Variations
    4. Special Rules Under the BBRA 1999
    H. Other Adjustments
    1. Outlier Payments
    2. Transitional Corridors/Interim Payments
    3. Cancer Centers and Small Rural Hospitals
    I. Annual Updates
    1. Revisions to APC Groups, Weights and the Wage and Other 
Adjustments
    2. Annual Update to the Conversion Factor
    3. Advisory Panel for APC Updates
    J. Volume Control Measures
    K. Claims Submission and Processing and Medical Review
    L. Prohibition Against Administrative or Judicial Review
IV. Provider-Based Status
    A. Background
    B. Provisions of the Proposed Rule
    C. Comments and Responses
    D. Requirements for Payment
V. Summary of and Response to MedPAC Recommendations
VI. Provisions of the Final Rule
VII. Collection of Information Requirements
VIII. Response to Comments
IX. Regulatory Impact Analysis
    A. Introduction
    B. Estimated Impact on the Medicare Program
    C. Objectives
    D. Limitations of Our Analysis
    E. Hospitals Included In and Excluded From the Prospective 
Payment System
    F. Quantitative Analysis of the Impact of Policy Changes on 
Payment Under the Hospital Outpatient PPS: Basis and Methodology of 
Estimates
    G. Estimated Impact of the New APC System (Includes Table 2, 
Annual Impact of Hospital Outpatient Prospective Payment System in 
CY2000-CY2001)
X. Federalism
XI. Waiver of Proposed Rulemaking Regulations Text

Addenda

Addendum A--List of Hospital Outpatient Ambulatory Payment 
Classification Groups with Status Indicators, Relative Weights, 
Payment Rates, and Coinsurance Amounts
Addendum B--Hospital Outpatient Department (HOPD) Payment Rates and 
Payment Status by HCPCS, and Related Information
Addendum C--Hospital Outpatient Payment for Procedures by APC
Addendum D--1996 HCPCS Codes Used to Calculate Payment Rates That 
Are Not Active CY 2000 Codes
Addendum E--CPT Codes Which Will Be Paid Only As Inpatient 
Procedures
Addendum F--Status Indicators
Addendum G--Service Mix Indices by Hospital
Addendum H--Wage Index for Urban Areas
Addendum I--Wage Index for Rural Areas
Addendum J--Wage Index for Hospitals That Are Reclassified
Addendum K--Drugs, Biologicals, and Medical Devices Subject to 
Transitional Pass-Through Payment

Alphabetical List of Acronyms Appearing in the Final Rule

APC  Ambulatory payment classification
APG  Ambulatory patient group
ASC  Ambulatory surgical center
AWP  Average wholesale price
BBA 1997  Balanced Budget Act of 1997
BBRA 1999  Balanced Budget Refinement Act of 1999
CAH  Critical access hospital
CAT  Computerized axial tomography
CCI  [HCFA's] Correct Coding Initiative
CCR  Cost center specific cost-to-charge ratio
CCU  Coronary care unit
CMHC  Community mental health center
CMP  Civil money penalty
CORF  Comprehensive outpatient rehabilitation facility
CPI  Consumer Price Index
CPT  [Physicians'] Current Procedural Terminology, 4th Edition, 
2000,

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copyrighted by the American Medical Association
DME  Durable medical equipment
DMEPOS  DME, orthotics, prosthetics, prosthetic devices, prosthetic 
implants and supplies
DRG  Diagnosis-related group
DSH  Disproportionate share hospital
EACH  Essential access community hospital
EBAA  Eye Bank Association of America
ED  Emergency department
EMS  Emergency medical services
EMTALA  Emergency Medical Treatment and Active Labor Act
ENT  Ear/Nose/Throat
ESRD  End-stage renal disease
FDA  Food and Drug Administration
FDO  Formula-driven overpayment
FQHC  Federally qualified health center
HCPCS  HCFA Common Procedure Coding System
HHA  Home health agency
HRSA  Health Resources and Services Administration
ICD-9-CM  International Classification of Diseases, Ninth Edition, 
Clinical Modification
ICU  Intensive care unit
IHS  Indian Health Service
IME  Indirect medical education
IOL  Intraocular lens
JCAHO  Joint Commission on Accreditation of Healthcare Organizations
LTH  Long-term hospital
MDH  Medicare-dependent hospital
MedPAC  Medicare Payment Advisory Commission
MRI  Magnetic resonance imaging
MSA  Metropolitan statistical area
NECMA  New England County Metropolitan Area
OBRA  Omnibus Budget Reconciliation Act
OT  Occupational therapy
PPO  Preferred provider organization
PPS  Prospective payment system
RFA  Regulatory Flexibility Act
RHC  Rural health clinic
RPCH  Rural primary care hospital
RRC  Rural referral center
SCH  Sole community hospital
SGR  Sustainable growth rate
SNF  Skilled nursing facility
TEFRA  Tax Equity and Fiscal Responsibility Act of 1982
TPA  Tissue Plasminogen Activator
Y2K  Year 2000

I. Background

A. General and Legislative History

    When the Medicare program was first implemented, it paid for 
hospital services (inpatient and outpatient) based on hospital-specific 
reasonable costs attributable to serving Medicare beneficiaries. Later, 
the law was amended to limit payment to the lesser of a hospital's 
reasonable costs or its customary charges. In 1983, section 601 of the 
Social Security Amendments of 1983 (Pub. L. 98-21) completely revised 
the cost-based payment system for most hospital inpatient services by 
enacting section 1886(d) of the Social Security Act (the Act). This 
section provided for a prospective payment system (PPS) for acute 
hospital inpatient stays, effective with hospital cost reporting 
periods beginning on or after October 1, 1983.
    Although payment for most inpatient services became subject to the 
PPS, Medicare hospital outpatient services continued to be paid based 
on hospital-specific costs, which provided little incentive for 
hospitals to furnish outpatient services efficiently. At the same time, 
advances in medical technology and changes in practice patterns were 
bringing about a shift in the site of medical care from the inpatient 
to the outpatient setting. During the 1980s, the Congress took steps to 
control the escalating costs of providing outpatient care. The Congress 
amended the statute to implement across-the-board reductions of 5.8 
percent and 10 percent to the amounts otherwise payable by Medicare for 
hospital operating costs and capital costs, respectively, and enacted a 
number of different payment methods for specific types of hospital 
outpatient services. These methods included fee schedules for clinical 
diagnostic laboratory tests, orthotics, prosthetics, and durable 
medical equipment (DME); composite rate payment for dialysis for 
persons with end-stage renal disease (ESRD); and payments based on 
blends of hospital costs and the rates paid in other ambulatory 
settings such as separately certified ambulatory surgical centers 
(ASCs) or physician offices for certain surgery, radiology, and other 
diagnostic procedures. However, Medicare payment for services performed 
in the hospital outpatient setting remains largely cost-based.
    In the Omnibus Budget Reconciliation Act of 1986 (OBRA 1986) (Pub. 
L. 99-509), the Congress paved the way for development of a PPS for 
hospital outpatient services. Section 9343(g) of OBRA 1986 mandated 
that fiscal intermediaries require hospitals to report claims for 
services under the HCFA Common Procedure Coding System (HCPCS). Section 
9343(c) of OBRA 1986 extended the prohibition against unbundling of 
hospital services under section 1862(a)(14) of the Act to include 
outpatient services as well as inpatient services. The HCPCS coding 
enabled us to determine which specific procedures and services were 
being billed, while the extension of the prohibition against unbundling 
ensured that all nonphysician services provided to hospital outpatients 
would be billed only by the hospital, not by an outside supplier, and, 
therefore, would be reported on hospital bills and captured in the 
hospital outpatient data that could be used to develop an outpatient 
PPS.
    A proposed rule to implement section 9343(c) was published in the 
Federal Register on August 5, 1988. However, those regulations were 
never published as a final rule, so we included them in the hospital 
outpatient PPS proposed rule published in the Federal Register on 
September 8, 1998 (63 FR 47552) and will implement them as part of this 
final rule.
    Section 1866(g) of the Act, as added by section 9343(c) of OBRA 
1986, and amended by section 4085(i)(17) of the Omnibus Budget 
Reconciliation Act of 1987 (OBRA 1987) (Pub. L. 100-203), authorizes 
the Department of Health and Human Services' Office of Inspector 
General to impose a civil money penalty (CMP), not to exceed $2,000, 
against any individual or entity who knowingly and willfully presents a 
bill in violation of an arrangement (as defined in section 1861(w)(1) 
of the Act).
    In section 9343(f) of the OBRA 1986 and section 4151(b)(2) of the 
Omnibus Budget Reconciliation Act of 1990 (Pub. L. 101-508), the 
Congress required that we develop a proposal to replace the current 
hospital outpatient payment system with a PPS and submit a report to 
the Congress on the proposed system.
    The Secretary submitted a report to the Congress on March 17, 1995, 
summarizing the research we conducted searching for a way to classify 
outpatient services for purposes of developing an outpatient PPS. The 
report cited ambulatory patient groups (APGs), developed by 3M-Health 
Information Systems (3M-HIS) under a cooperative grant with HCFA, as 
the most promising classification system for grouping outpatient 
services and recommended that APG-like groups be used in designing a 
hospital outpatient PPS.
    The report also presented a number of options that could be used, 
once a PPS was in place, for addressing the issue of rapidly growing 
beneficiary coinsurance. As a separate issue, we recommended that the 
Congress amend the provisions of the law pertaining to the blended 
payment methods for ASC surgery, radiology, and other diagnostic 
services to correct an anomaly that resulted in a less than full 
recognition of the amount paid by the beneficiary in calculating 
program payment (referred to as the formula-driven overpayment).
    Three sections of the Balanced Budget Act of 1997 (the BBA 1997) 
(Pub. L. 105-33), enacted on August 5, 1997, affect Medicare payment 
for hospital outpatient services. Section 4521 of the BBA 1997 
eliminates the formula-driven overpayment for ambulatory surgical

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center procedures, radiology services, and diagnostic procedures 
furnished on or after October 1, 1997. In November 1998, we issued cost 
report instructions (Provider Reimbursement Manual, Part II, Chapter 
36, Transmittal 4) that implemented this provision for services 
furnished on or after October 1, 1997. Section 4522 of the BBA 1997 
amends section 1861(v)(1)(S)(ii) of the Act by extending cost 
reductions in payment for hospital outpatient operating costs and 
hospital capital costs, 5.8 percent and 10 percent respectively, before 
January 1, 2000. Section 4523 of the BBA 1997 amends section 1833 of 
the Act by adding subsection (t), which provides for implementation of 
a PPS for outpatient services. (Under Section 4523 of the BBA 1997 the 
outpatient PPS does not apply to cancer hospitals before January 1, 
2000.) Set forth below in section I.B is a detailed description of the 
changes made by the BBA 1997.
    On November 29, 1999, the Balanced Budget Refinement Act of 1999 
(the BBRA 1999), Pub. L. 106-113, was enacted. This Act made major 
changes that affect the proposed hospital outpatient PPS. The 
legislative changes are summarized in section I.E, below. More specific 
details on individual provisions that we are implementing in this final 
rule with comment period are included under the various sections of 
this preamble.

B. Summary of Provisions in the Balanced Budget Act of 1997 (the BBA 
1997)

1. Prospective Payment System (PPS)
    Section 4523 of the BBA 1997 amended section 1833 of the Act by 
adding subsection (t), which provides for a PPS for hospital outpatient 
department services. (The following citations reflect the statute as 
enacted by the BBA 1997.) Section 1833(t)(1)(B) of the Act authorizes 
the Secretary to designate the hospital outpatient services that would 
be paid under the PPS. That section also requires that the hospital 
outpatient PPS include hospital inpatient services designated by the 
Secretary that are covered under Part B for beneficiaries who are 
entitled to Part A benefits but who have exhausted them or otherwise 
are not entitled to them. Section 1833(t)(1)(B)(iii) of the Act 
specifically excludes ambulance, physical and occupational therapy, and 
speech-language pathology services, for which payment is made under a 
fee schedule.
    Section 1833(t)(2) of the Act sets forth certain requirements for 
the hospital outpatient PPS. The Secretary is required to develop a 
classification system for covered outpatient services that may consist 
of groups arranged so that the services within each group are 
comparable clinically and with respect to the use of resources.
    Section 1833(t)(2)(C) of the Act specifies data requirements for 
establishing relative payment weights. The weights are to be based on 
the median hospital costs determined by 1996 claims data and data from 
the most recent available cost reports. Section 1833(t)(2)(D) of the 
Act requires that the portion of the Medicare payment and the 
beneficiary coinsurance that are attributable to labor and labor-
related costs be adjusted for geographic wage differences in a budget 
neutral manner.
    The Secretary is authorized under section 1833(t)(2)(E) of the Act 
to establish, in a budget neutral manner, other adjustments, such as 
outlier adjustments or adjustments for certain classes of hospitals, 
that are necessary to ensure equitable payments. Section 1833(t)(2)(F) 
of the Act requires the Secretary to develop a method for controlling 
unnecessary increases in the volume of covered outpatient services.
    Section 1833(t)(3) of the Act specifies how beneficiary deductibles 
are to be treated in calculating the Medicare payment and beneficiary 
coinsurance amounts and requires that rules be established regarding 
determination of coinsurance amounts for covered services that were not 
furnished in 1996. The statute freezes beneficiary coinsurance at 20 
percent of the national median charges for covered services (or group 
of covered services) furnished during 1996 and updated to 1999 using 
the Secretary's estimated charge growth from 1996 to 1999.
    Section 1833(t)(3) of the Act also prescribes the formula for 
calculating the initial conversion factor used to determine Medicare 
payment amounts for 1999 and the method for updating the conversion 
factor in subsequent years.
    Sections 1833(t)(4) and (t)(5) of the Act describe the method for 
determining the Medicare payment amount and the beneficiary coinsurance 
amount for services covered under the outpatient PPS. Section 
1833(t)(5)(B) of the Act requires the Secretary to establish a 
procedure whereby hospitals may voluntarily elect to reduce beneficiary 
coinsurance for some or all covered services to an amount not less than 
20 percent of the Medicare payment amount. Hospitals are further 
allowed to disseminate information on any such reductions of 
coinsurance amounts. Section 4451 of the BBA 1997 added section 
1861(v)(1)(T) to the Act, which provides that any reduction in 
coinsurance must not be treated as a bad debt.
    Section 1833(t)(6) authorizes periodic review and revision of the 
payment groups, relative payment weights, wage index, and conversion 
factor.
    Section 1833(t)(7) of the Act describes how payment is to be made 
for ambulance services, which are specifically excluded from the 
outpatient PPS under section 1833(t)(1)(B) of the Act.
    Section 1833(t)(8) of the Act provides that the Secretary may 
establish a separate conversion factor for services furnished by cancer 
hospitals that are excluded from hospital inpatient PPS.
    Section 1833(t)(9) of the Act prohibits administrative or judicial 
review of the hospital outpatient PPS classification system, the 
groups, relative payment weights, wage adjustment factors, other 
adjustments, calculation of base amounts, periodic adjustments, and the 
establishment of a separate conversion factor for those cancer 
hospitals excluded from hospital inpatient PPS.
    Section 4523(d) of the BBA 1997 made a conforming
    amendment to section 1833(a)(2)(B) of the Act to provide for 
payment under the hospital outpatient PPS for some services described 
in section 1832(a)(2) that are currently paid on a cost basis and 
furnished by providers of services, such as comprehensive outpatient 
rehabilitation facilities (CORFs), home health agencies (HHAs), 
hospices, and community mental health centers (CMHCs). This amendment 
provides that partial hospitalization services furnished by CMHCs be 
paid under the PPS.
2. Elimination of Formula-Driven Overpayment
    Before enactment of section 4521(b) of the BBA 1997, using the 
blended payment formulas for ASC procedures, radiology, and other 
diagnostic services, the ASC or physician fee schedule portion was 
calculated as if the beneficiary paid 20 percent of the ASC rate or 
physician fee schedule amount instead of the actual amount paid, which 
was 20 percent of the hospital's billed charges. Section 4521(b), which 
amended sections 1833(i)(3)(B)(i)(II) and 1833(n)(1)(B)(i) of the Act, 
corrects this anomaly by changing the blended calculations so that all 
amounts paid by the beneficiary are subtracted from the total payment 
in the calculation to determine the amount due from the program. 
Effective for services furnished on or after October 1, 1997, payment 
for surgery, radiology, and other diagnostic services calculated by 
blended payment methods is now calculated by

[[Page 18438]]

subtracting the full amount of coinsurance due from the beneficiary 
(based on 20 percent of the hospital's billed charges).
3. Extension of Cost Reductions
    Section 1861(v)(1)(S)(ii) of the Act was amended by section 4522 of 
the BBA 1997 to require that the amounts otherwise payable for hospital 
outpatient operating costs and capital costs be reduced by 5.8 percent 
and 10 percent, respectively, through December 31, 1999.

C. The September 8, 1998 Proposed Rule

    We published a proposed rule in the Federal Register on September 
8, 1998 (63 FR 47552) setting forth the proposed PPS for hospital 
outpatient services. In that proposed rule, we explained that, due to 
Year 2000 (Y2K) systems concerns, implementation of the new payment 
system would be delayed until after January 1, 1999. (The statement in 
the rule that the statute requires implementation ``effective January 
1, 1999,'' and other similar statements in other rules, were not 
intended to mean that the statute requires retroactive implementation 
of the hospital outpatient PPS. As noted elsewhere in this rule, the 
statute does not impose such a requirement.) As noted in that document, 
the scope of systems changes required to implement the hospital 
outpatient PPS is so enormous as to be impossible to accomplish 
concurrently with the critical work that we, our contractors, and our 
provider-partners had to perform to ensure that all of our respective 
systems were Y2K compliant. Section XI of the proposed rule (63 FR 
47605) explains in greater detail the reasons for delaying 
implementation.
    The proposed rule originally provided for a 60-day comment period. 
However, the comment period was extended four times, ultimately ending 
on July 30, 1999. (See 63 FR 63429, November 13, 1998; 64 FR 1784, 
January 12, 1999; 64 FR 12277, March 12, 1999; and 64 FR 36320; July 6, 
1999.)
    On June 30, 1999, we published a correction notice (64 FR 35258) to 
correct a number of technical and typographical errors contained in the 
September 8, 1998 proposed rule. The numerical values in the proposed 
rule reflected incorrect data and data programming. Among other 
corrections, the notice set forth revised numerical values for the 
current payment, total services (total units), relative weights, 
proposed payment rates, national unadjusted coinsurance, minimum 
unadjusted coinsurance, and service-mix index.

D. Overview of Public Comments

    We received approximately 10,500 comments in response to our 
September 8, 1998 proposed rule. That count includes the numerous 
requests from hospital and other interested groups and organizations 
that we extend the public comment period to allow additional time for 
analysis of the impact of our proposals. As we explain above, we 
extended the comment period four times, to end finally on July 30, 
1999.
    In addition to receiving comments from a number of organizations 
representing the full spectrum of the hospital industry, we received 
comments from beneficiaries and their families, physicians, health care 
workers, individual hospitals, professional associations and societies, 
legal and nonlegal representatives and spokespersons for beneficiaries 
and hospitals, members of the Congress, and other interested citizens. 
The majority of comments addressed our proposals regarding payment for: 
Corneal tissue; payment for high-cost technologies, both existing and 
future; payment for blood and blood products; and payment for high cost 
drugs, including chemotherapy agents. We also received numerous 
comments addressing: Our approach to ratesetting using the ambulatory 
payment classification (APC) system; our method of calculating the 
payment conversion factor; and the potentially negative impact of the 
proposed hospital outpatient PPS on hospital revenues. In addition, we 
received many comments concerning the proposed regulations for 
provider-based entities.
    We carefully reviewed and considered all comments received timely. 
The many modifications that we made to our proposed regulations in 
response to commenters' suggestions and recommendations are reflected 
in the provisions of this final rule. Comments and our responses are 
addressed by topic in the sections that follow.

E. Summary of Relevant Provisions in the Balanced Budget Refinement Act 
of 1999 (the BBRA 1999)

    As noted above, subsequent to publication of the proposed rule, the 
BBRA 1999 was enacted on November 29, 1999. The BBRA 1999 made major 
changes that affect the proposed hospital outpatient PPS. Because these 
changes are effective with the implementation of the PPS, we have had 
to make some revisions from the September 8, 1998 proposed rule. The 
provisions of the BBRA 1999 that we are implementing in this final rule 
with comment period follow.
1. Outlier Adjustment
    Section 201(a) of the BBRA 1999 amends section 1833(t) by 
redesignating paragraphs (5) through (9) as paragraphs (7) through (11) 
and adding a new paragraph (5). New section 1833(t)(5) of the Act 
provides that the Secretary will make payment adjustments for covered 
services whose costs exceed a given threshold (that is, an outlier 
payment). This section describes how the additional payments are to be 
calculated and caps the projected outlier payments at no more than 2.5 
percent of the total projected payments (sum of both Medicare and 
beneficiary payments to the hospital) made under hospital outpatient 
PPS for years before 2004 and 3.0 percent of the total projected 
payments for 2004 and subsequent years.
2. Transitional Pass-Through for Additional Costs of Innovative Medical 
Devices, Drugs, and Biologicals
    Section 201(b) of the BBRA 1999 adds new section 1833(t)(6) to the 
Act, establishing transitional pass-through payments for certain 
medical devices, drugs, and biologicals. This provision does the 
following: Specifies the types of items for which additional payments 
must be made; describes the amount of the additional payment; limits 
these payments to at least 2 years but not more than 3 years; and caps 
the projected payment adjustments annually at 2.5 percent of the total 
projected payments for hospital outpatient services each year before 
2004 and no more than 2.0 percent in subsequent years. Under this 
provision, the Secretary has the authority to reduce pro rata the 
amount of the additional payments if, before the beginning of a year, 
she estimates that these payments would otherwise exceed the caps.
3. Budget Neutrality Applied to New Adjustments
    Section 201(c) of the BBRA 1999 amends section 1833(t)(2)(E) of the 
Act to require that the establishment of outlier and transitional pass-
through payment adjustments is to be made in a budget neutral manner.
4. Limitation on Judicial Review
    Section 201(d) of the BBRA 1999 amends redesignated section 
1833(t)(11) of the Act by extending the prohibition of administrative 
or judicial review to include the factors for determining outlier 
payments (that is, the fixed multiple, or a fixed dollar cutoff amount, 
the marginal cost of care, or applicable total payment percentage), and 
the determination of additional payments for certain medical devices,

[[Page 18439]]

drugs, and biologicals, the insignificant cost determination for these 
items, the duration of the additional payment or portion of the PPS 
payment amount associated with particular devices, drugs, or 
biologicals, and any pro rata reduction.
5. Inclusion in the Hospital Outpatient PPS of Certain Implantable 
Items
    Section 201(e) of the BBRA 1999 amends section 1833(t)(1)(B) of the 
Act to include as covered outpatient services implantable prosthetics 
and DME and diagnostic x-ray, laboratory, and other tests associated 
with those implantable items.
6. Payment Weights Based on Mean Hospital Costs
    Section 201(f) of the BBRA 1999 amends section 1833(t)(2)(C) of the 
Act, which specifies data requirements for establishing relative 
payment weights, to allow the Secretary the discretion to base the 
weights on either the median or mean hospital costs determined by data 
from the most recent available cost reports.
7. Limitation on Variation of Costs of Services Classified Within a 
Group
    Section 201(g) of the BBRA 1999 amends section 1833(t)(2) of the 
Act to limit the variation of costs of services within each payment 
classification group by providing that the highest median (or mean 
cost, if elected by the Secretary) for an item or service within the 
group cannot be more than 2 times greater than the lowest median (or 
mean) cost for an item or service within the group. The provision 
allows the Secretary to make exceptions in unusual cases, such as for 
low volume items and services.
8. Annual Review of the Hospital Outpatient PPS Components
    Section 201(h) of the BBRA 1999 amends redesignated section 
1833(t)(8) of the Act to require at least annual review of the groups, 
relative payment weights, and the wage and other adjustments made by 
the Secretary to take into account changes in medical practice, the 
addition of new services, new cost data, and other relevant information 
and factors. That section of the Act is further amended to require the 
Secretary to consult with an expert outside advisory panel composed of 
an appropriate selection of provider representatives who will review 
the clinical integrity of the groups and weights and advise the 
Secretary accordingly. The panel may use data other than those 
collected or developed by the Department of HHS for the review and 
advisory purposes.
9. Coinsurance Not Affected by Pass-Throughs
    Section 201(i) of the BBRA 1999 amends redesignated section 
1833(t)(7) of the Act to provide that the beneficiary coinsurance 
amount will be calculated as if the outlier and transitional pass-
throughs had not occurred; that is, there will be no coinsurance 
collected from beneficiaries for the additional payments made to 
hospitals by Medicare for these adjustments.
10. Extension of Cost Reductions
    Section 201(k) of the BBRA 1999 amends section 1861(v)(1)(S)(ii) of 
the Act to extend until the first date that the hospital outpatient PPS 
is implemented, the 5.8 and 10 percent reductions for hospital 
operating and capital costs, respectively.
11. Clarification of Congressional Intent Regarding Base Amounts Used 
in Determining the Hospital Outpatient PPS
    Section 201(l) of the BBRA 1999 provides that, ``With respect to 
determining the amount of copayments described in paragraph (3)(A)(ii) 
of section 1833(t) of the Social Security Act, as added by section 
4523(a) of the BBA, Congress finds that such amount should be 
determined without regard to such section, in a budget neutral manner 
with respect to aggregate payments to hospitals, and that the Secretary 
of Health and Human Services has the authority to determine such amount 
without regard to such section.'' Pursuant to this provision, we are 
calculating the aggregate PPS payment to hospitals in a budget neutral 
manner.
12. Transitional Corridors for Application of Outpatient PPS
    Section 202 of the BBRA 1999 amends section 1833(t) of the Act by 
redesignating paragraphs (7) through (11) as paragraphs (8) through 
(12), and adding a new paragraph (7), which provides for a transitional 
adjustment to limit payment reductions under the hospital outpatient 
PPS. More specifically, for the years 2000 through 2003, a provider, 
including a CMHC, will receive an adjustment if its payment-to-cost 
ratio for outpatient services furnished during the year is less than a 
set percentage of its payment-to-cost ratio for those services in its 
cost reporting period ending in 1996 (the base year). Two categories of 
hospitals, rural hospitals with 100 or fewer beds and cancer hospitals, 
will be held harmless under this provision. Small rural hospitals, for 
services furnished before January 1, 2004, will be maintained at the 
same payment-to-cost ratio as their base year cost report if their PPS 
payment-to-cost ratio is less. The hold-harmless provision applies 
permanently to cancer centers. Section 202 also requires the Secretary 
to make interim payments to affected hospitals subject to retrospective 
adjustments and requires that the provisions of this section do not 
affect beneficiary coinsurance. Finally, this provision is not subject 
to budget neutrality.
13. Limitation on Coinsurance for a Procedure
    Section 204 of the BBRA 1999 amends redesignated section 1833(t)(8) 
of the Act to provide that the coinsurance amount for a procedure 
performed in a year cannot exceed the hospital inpatient deductible for 
that year.
14. Reclassification of Certain Hospitals
    Section 401 of the BBRA 1999 adds section 1886(d)(8)(E) to the Act 
to permit reclassification of certain urban hospitals as rural 
hospitals. Section 401 adds section 1833(t)(13) to the Act to provide 
that a hospital being treated as a rural hospital under section 
1886(d)(8)(E) also be treated as a rural hospital under the hospital 
outpatient PPS.

II. Prohibition Against Unbundling of Hospital Outpatient Services

A. Background

    Sections 9343(c)(1) and (c)(2) of OBRA 1986 amended sections 
1862(a)(14) and 1866(a)(1)(H) of the Act, respectively. As revised, 
section 1862(a)(14) of the Act prohibits payment for nonphysician 
services furnished to hospital patients (inpatients and outpatients), 
unless the services are furnished by the hospital, either directly or 
under an arrangement (as defined in section 1861(w)(1) of the Act). As 
revised, section 1866(a)(1)(H) of the Act requires each Medicare-
participating hospital to agree to furnish directly all covered 
nonphysician services required by its patients (inpatients and 
outpatients) or to have the services furnished under an arrangement (as 
defined in section 1861(w)(1) of the Act). Section 9338(a)(3) of OBRA 
1986 affected implementation of the bundling mandate by amending 
section 1861(s)(2)(K) of the Act to permit services of physician 
assistants to be covered and billed separately. Sections 4511(a)(2)(C) 
and (D) of the BBA 1997 further revised sections 1862(a)(14) and 
1866(a)(1)(H) of the Act, respectively, to exclude services of nurse 
practitioners

[[Page 18440]]

and clinical nurse specialists, described in section 1861(s)(2)(K)(ii) 
of the Act, from the bundling requirement.

B. Office of Inspector General (OIG) Civil Money Penalty Authority and 
Civil Money Penalties for Unbundling Hospital Outpatient Services

    In order to deter the unbundling of nonphysician hospital services, 
section 9343(c)(3) of OBRA 1986 added section 1866(g) to the Act to 
provide for the imposition of civil money penalties (CMPs), not to 
exceed $2,000, against any person who knowingly and willfully presents, 
or causes to be presented, a bill or request for payment for a hospital 
outpatient service under Part B of Medicare that violates the 
requirement for billing under arrangements specified in section 
1866(a)(1)(H) of the Act. In addition, section 1866(g) includes 
authorization to impose a CMP, in the same manner as other CMPs are 
imposed under section 1128A of the Act when arrangements should have 
been made but were not. Section 4085(i)(17) of OBRA 1987 amended 
section 1866(g) of the Act by deleting all references to hospital 
outpatient services under Part B of Medicare. The result of this 
amendment is that the CMP is now applicable for services furnished to 
hospital patients, whether paid for under Medicare Part A or B.
    In order to implement section 1866(g) of the Act, we proposed in 
our August 5, 1988 proposed rule that the OIG would impose a CMP 
against any person who knowingly and willfully presents, or causes to 
be presented, a bill or request for payment for a hospital outpatient 
service under Part B of Medicare that violates the billing arrangement 
under section 1866(a)(1)(H) of the Act or the requirement for an 
arrangement. The amount of the CMP is to be limited to $2,000 for each 
improper bill or request, even if the bill or request included more 
than one item or service.

C. Summary of Final Regulations on Bundling of Hospital Outpatient 
Services

    In our September 8, 1998 proposed rule, we proposed to make final 
most of the provisions of the August 5, 1988 proposed rule but with a 
number of revisions that we describe in detail in the proposed rule (63 
FR 47558 through 47559). We are adopting as final regulations what we 
proposed in the September 8, 1998 rule with the following additional 
changes:
     We are adding a new paragraph (b)(7) to Sec. 410.42 
(Limitations on coverage of certain services furnished to hospital 
outpatients) to provide an exception to the hospital bundling 
requirements for services hospitals furnish to SNF residents as defined 
in Sec. 411.15(p). (Section 410.42 has been redesignated from 
Sec. 410.39 in the proposed rule.)
     We are making a minor change to newly redesignated 
paragraph (m)(2) (this language was formerly included in paragraph 
(m)(1)) in Sec. 411.15 (Particular services excluded from coverage) to 
make it clearer that the exclusion discussed in this section is 
referring to excluding certain services from coverage.
     Except for minor wording changes in introductory paragraph 
(b) of Sec. 1003.102 (Basis for civil money penalties and assessments), 
that section remains as it appeared in the August 5, 1988 proposed 
rule. Paragraph (b)(15) is redesignated from proposed paragraph (b)(4) 
in the August 5, 1988 proposed rule and (b)(14) in the September 8, 
1998 proposed rule. Paragraphs (b)(12) through (b)(14) of Sec. 1003.102 
are reserved.
     We are adding a new paragraph (k) to Sec. 1003.103 (Amount 
of penalty) to indicate that the OIG may impose a penalty of not more 
than $2,000 for each bill or request for items and services furnished 
to hospital patients in violation of the bundling requirements.
     We are also amending Sec. 1003.105 (Exclusion from 
participation in Medicare, Medicaid and other Federal health care 
programs) by revising paragraph (a)(1)(i) to reflect that the basis for 
imposition of a CMP is also a basis for exclusion from participation in 
Medicare, Medicaid and other Federal health care programs.

D. Comments and Responses

    Comment: One association requested that we clarify whether lab 
tests are subject to the bundling requirement or whether those services 
are included in the definition of diagnostic tests that are not 
required to be bundled. If lab tests are bundled, the association asked 
that we seek a legislative change to permit a provider, other than the 
lab that performs the test, to bill for the test.
    Response: Laboratory tests, like all other services furnished to 
hospital patients, must be provided directly or under arrangements by 
the hospital and only the hospital may bill the program. Section 
1833(h)(5)(A)(iii) of the Act provides an exception to the requirement 
that payment for a clinical diagnostic lab may be made only to the 
person or entity that performed or supervised the performance of the 
test. This section provides that in the case of a clinical diagnostic 
laboratory test provided under arrangement made by a hospital or CAH, 
payment is made to the hospital.
    All diagnostic tests that are furnished by a hospital, directly or 
under arrangements, to a registered hospital outpatient during an 
encounter at a hospital are subject to the bundling requirements. The 
hospital is not responsible for billing for the diagnostic test if a 
hospital patient leaves the hospital and goes elsewhere to obtain the 
diagnostic test.
    Comment: The same association asked us to clarify that services 
billed to skilled nursing facilities (SNFs) under the consolidated 
billing requirement would be exempt from the bundling requirement for 
hospital outpatient services.
    Response: We agree that in situations where a beneficiary receives 
outpatient services from a Medicare participating hospital or CAH while 
temporarily absent from the SNF, the beneficiary continues to be 
considered a SNF resident specifically with regard to the comprehensive 
care plan required under Sec. 483.20(b). Such services are, therefore, 
subject to the SNF consolidated billing provision and should be exempt 
from the hospital outpatient bundling requirements. The final 
regulations at Sec. 410.42(b)(7) reflect this exception.
    We note that the SNF consolidated billing requirements, under 
Sec. 411.15(p)(3)(iii), do not apply to a limited number of 
exceptionally intensive hospital outpatient services that lie well 
beyond the scope of care that SNFs would ordinarily furnish, and thus 
beyond the ordinary scope of SNF care plans. The hospital outpatient 
services that are currently included in this policy are: Cardiac 
catheterization; computerized axial tomography (CAT) scans; MRIs; 
ambulatory surgery involving the use of an operating room; emergency 
room services; radiation therapy; angiography; and lymphatic and venous 
procedures. When a hospital or CAH provides these services to a 
beneficiary, the beneficiary's status as a SNF resident ends, but only 
with respect to these services. The beneficiary is now considered to be 
a hospital outpatient and the services are subject to hospital 
outpatient bundling requirements. In November 1998, we issued Program 
Memorandum transmittal number A-98-37, which provides additional 
clarification on this exclusion as well as a list of specific HCPCS 
codes that identify the services that are excluded from SNF 
consolidated billing but subject to hospital outpatient bundling.
    Comment: One commenter understood that the proposed rule

[[Page 18441]]

would permit payment for all diagnostic tests that are furnished by a 
hospital or other entity if the patient leaves the hospital and obtains 
the service elsewhere; however, the commenter requested clarification 
as to the treatment of ``outsourced'' hospital departments. The 
commenter stated that hospitals are increasingly outsourcing 
departments to providers that can furnish services efficiently. Often 
these providers do not operate as ``under arrangements'' providers to 
the hospital, but as free-standing providers offering outpatient 
services on hospital grounds. The commenter specifically asked whether 
a free-standing entity providing outpatient services on hospital 
grounds, but operated independently of the hospital is able to bill 
separately for services furnished or is the entity considered to be 
part of the hospital and required to furnish services ``under 
arrangement.''
    Response: A free-standing entity, that is, one that is not 
provider-based, may bill for services furnished to beneficiaries who do 
not meet the definition of a hospital outpatient at the time the 
service is furnished. Our bundling requirements apply to services 
furnished to a ``hospital outpatient,'' as defined in Sec. 410.2, 
during an ``encounter,'' also defined in Sec. 410.2.
    Comment: One commenter indicated that while the proposed revision 
to Sec. 1003.102(b) accurately reflected the statutory directive that 
the basis for imposing a CMP is a ``bill or request for payment,'' the 
proposed amendment to Sec. 1003.103(a) regarding the appropriate 
penalty amount to be imposed for bundling violations was in error. The 
commenter indicated that the OIG lacks the authority to impose a CMP in 
the amount of $10,000 for these violations, and that such a penalty 
should be not more than $2,000 for each violation.
    Response: The commenter is correct. While section 231(c) of the 
Health Insurance Portability and Accountability Act of 1996, Pub. L. 
104-191, increased the CMP maximum amount from $2,000 to $10,000, the 
statute sets forth ``items or services'' as the basis upon which a 
higher CMP amount may be assessed. However, with regard to bundling 
violations, the Secretary may impose a CMP only on the basis of a 
``bill or request for payment'' rather than ``for each item and 
service'' as stated in the proposed revision to Sec. 1003.103. We are 
correcting this error by adding a new Sec. 1003.103(k) to indicate that 
the OIG may impose a penalty of not more than $2,000 for each bill or 
request for items and services furnished to hospital patients in 
violation of the bundling requirements.

III. Hospital Outpatient Prospective Payment System (PPS)

    In this section, we designate the services for which Medicare will 
make payment under the hospital outpatient PPS, the payment rates set 
for those services, and the method by which we determined the 
outpatient PPS payment and coinsurance amounts.
    We explain the structure of the hospital outpatient PPS, respond to 
comments that we received about the proposed PPS, and describe 
modifications that we made to the proposed PPS in response to comments, 
such as provisions we are making to expedite appropriate payment for 
new technologies and provisions to pay for blood and blood products.
    In this section, we also discuss how we will implement requirements 
enacted by the BBRA 1999, including transitional payment corridors and 
other payment adjustments such as outliers and transitional pass-
throughs.

A. Hospitals Included In or Excluded From the Outpatient PPS

    This PPS applies to covered hospital outpatient services furnished 
by all hospitals participating in the Medicare program, except as noted 
below. Partial hospitalization services in community mental health 
centers (CMHCs) are also paid under this PPS. Exclusions from 
outpatient PPS are different and more limited than exclusions from 
inpatient PPS. Thus, hospitals or distinct parts of hospitals that are 
excluded from the inpatient PPS are included in the outpatient PPS, to 
the extent that the hospital or distinct part furnishes outpatient 
services. For example, we will make payment under the outpatient PPS 
for outpatient psychiatric services. The outpatient services provided 
by hospitals of the Indian Health Service (IHS) will continue to be 
paid under separately established rates which are published annually in 
the Federal Register. We intend to develop a plan that will help these 
facilities transition to the PPS and will consult with the IHS to 
develop this plan.
    The following hospitals are excluded from the outpatient PPS:
     Certain hospitals in Maryland qualify under section 
1814(b)(3) of the Act for payment under the State's payment system. The 
excluded services are limited to those paid under the State's payment 
system as described in section 1814(b)(3) of the Act. Any other 
outpatient services furnished by the hospital are paid under the 
outpatient PPS.
     Critical access hospitals that are paid under a reasonable 
cost based system, as required under section 1834(g) of the Act.
    Comment: National and State associations representing children's 
hospitals and a number of individual children's hospitals located 
across the country strongly recommended that their hospitals be 
excluded from the hospital outpatient PPS just as they have been 
excluded from the hospital inpatient PPS. These commenters argued that 
the exclusion should apply to outpatient services furnished by 
children's hospitals because these hospitals treat a unique patient 
group whose health needs are different from those of adult 
beneficiaries entitled to Medicare benefits. The commenters further 
argued that services to Medicare patients are, on average, only 1 
percent of the total inpatient and outpatient services that children's 
hospitals furnish and that these services are largely ESRD services 
that are already excluded from the hospital outpatient PPS. The 
commenters were concerned that the resources required to implement and 
comply with the new system would be disproportionately high relative to 
the small number of patients who would be affected by the new system. 
In addition, the impact analysis that accompanied the proposed rule 
estimated that children's hospitals would lose more than 20 percent of 
their Medicare revenues under the new system. Commenters expressed 
great concern about this loss of revenue.
    Response: Our most recent analysis of the impact on hospitals of 
the PPS shows a negative effect for children's hospitals of 11.9 
percent, which is significantly less than what we estimated in the 
proposed rule. However, the transitional corridor payments provided by 
the BBRA 1999 will protect these hospitals from even this level of loss 
through 2004. The estimated loss for CY 2000-2001 for children's 
hospitals is only 3.2 percent. (See Table 2 in section IX of this 
preamble.) As we discuss in section III.H.2 below, we will conduct 
extensive analyses during the first years of implementation of the PPS 
to determine whether we should propose adjustments for certain types of 
hospitals, including children's hospitals, when the transitional 
corridor provision expires. In the meantime, we are not excluding any 
special class of hospital from the PPS.

B. Scope of Facility Services

    Section 1833(t)(1)(B)(i) of the Act gives us the authority to 
designate the services to be covered under the hospital outpatient PPS. 
In this section of the final rule, we designate the types

[[Page 18442]]

of services included or excluded under the hospital outpatient PPS.
1. Services Excluded From the Scope of Services Paid Under the Hospital 
Outpatient PPS

a. Background

    In developing a hospital outpatient PPS, we want to ensure that all 
services furnished in a hospital outpatient setting will be paid on a 
prospective basis. We have already been paying, in part, for some 
hospital outpatient services such as clinical diagnostic laboratory 
services, orthotics, and end-stage renal disease (ESRD) dialysis 
services based on fee schedules or other prospectively determined rates 
that also apply across other sites of ambulatory care. Rather than 
duplicate existing payment systems that are effectively achieving 
consistency of payments across different service delivery sites, we 
proposed to exclude from the outpatient PPS those services furnished in 
a hospital outpatient setting that were already subject to an existing 
fee schedule or other prospectively determined payment rate. The 
similar payments across various settings create a more level playing 
field in which Medicare makes virtually the same payment for the same 
service, without regard to where the service is furnished.
    We therefore proposed to exclude from the scope of services paid 
under the hospital outpatient PPS the following:
     Services already paid under fee schedules or other payment 
systems including, but not limited to: screening mammographies, 
services for patients with ESRD that are paid for under the ESRD 
composite rate; the professional services of physicians and non-
physician practitioners paid under the Medicare physician fee schedule; 
laboratory services paid under the clinical diagnostic laboratory fee 
schedule; and DME, orthotics, prosthetics, and prosthetics devices, 
prosthetic implants, and supplies (DMEPOS) paid under the DMEPOS fee 
schedule when the hospital is acting as a supplier of these items. An 
item such as crutches or a walker that is given to the patient to take 
home, but that may also be used while the patient is at the hospital, 
would be billed to the DME regional carrier rather than paid for under 
the hospital outpatient PPS.
     Hospital outpatient services furnished to SNF inpatients 
as part of his or her resident assessment or comprehensive care plan 
(and thus included under the SNF PPS) that are furnished by the 
hospital ``under arrangements'' but billable only by the SNF, 
regardless of whether or not the patient is in a Part A SNF stay.
     Services and procedures that require inpatient care.
    The statute excludes from the definition of ``covered OPD 
services'' ambulance services, physical and occupational therapy, and 
speech-language pathology services, specified in section 
1833(t)(1)(B)(iii) of the Act (redesignated as section 
1833(t)(1)(B)(iv) by section 201(e) of the BBRA 1999). These services 
are to be paid under fee schedules in all settings.

b. Comments and Responses

    Comment: One commenter urged that we exclude services furnished to 
ESRD patients from the scope of the hospital outpatient PPS.
    Response: Services furnished to ESRD patients include dialysis, 
Epoietin (EPO), drugs, and supplies provided outside the composite 
rate, surgery specific to access grafts, and many other medical 
services related to renal disease or to other coexisting conditions. We 
will continue to base payment for dialysis services on the composite 
rate, and we will continue to pay for EPO based on the current rate 
established for that service. The drugs and supplies that are used 
within a dialysis session, but for which payment is not included in the 
composite rate, are paid outside that rate. We have to conduct further 
analyses in order to develop appropriate APC groups upon which to base 
payment. In the meantime, we will continue to pay on a reasonable cost 
basis for dialysis related drugs and supplies that are paid outside the 
composite rate.
    Comment: A hospital industry association took exception to the 
requirement that hospitals obtain a separate supplier number, post a 
bond, and bill separately to the DME regional carrier for DME supplies 
such as crutches. They believe that this is an unnecessary requirement 
that results in additional costs for small rural hospitals. The 
commenter recommended that we include within the PPS rate supplies such 
as crutches that are directly related to the provison of the hospital 
outpatient services or that we permit hospitals to bill under the DME 
fee schedule without having to obtain a DME supplier number or post a 
bond.
    Response: Section 1834(j)(1)(A) of the Act provides that no payment 
may be made for items furnished by a supplier of medical equipment and 
supplies unless the supplier obtains a supplier number. Section 
1834(a)(1)(C) of the Act provides that payment for DME can be made only 
under the DME fee schedule. Therefore, to receive payment for DME under 
Medicare, a hospital must obtain a supplier number and must meet the 
other requirements set by applicable Medicare rules and regulations.
    Comment: Several major hospital associations and a number of other 
commenters opposed our proposal to exclude from payment certain 
procedures that we designate as ``inpatient only.'' Other commenters, 
including a physician professional society, agree that many of the 
procedures that we designated in the proposed rule as ``inpatient 
only'' are currently performed appropriately and safely only in the 
inpatient setting. However, these commenters believe that our explicit 
exclusion of individual procedures, besides being unnecessary, could 
have an adverse effect on advances in surgical care. Some commenters 
alleged that we provided no concrete support for designating procedures 
as ``inpatient only.'' A number of commenters argued that medicine is 
not practiced uniformly across the nation and that some services listed 
among the exclusions are currently being performed on an outpatient 
basis in various parts of the country with positive outcomes.
    An industry association stated that we failed to consider surgical 
judgment and patient choice in determining the appropriate treatment 
setting for certain services that we proposed to exclude from coverage. 
Other commenters believe that the appropriate site for performing a 
medical service is best determined by physicians and their patients. 
One professional society stated that case law including medical 
malpractice case law is sufficient to ensure that medical services are 
delivered in the appropriate treatment setting and in conformance with 
prevailing medical standards.
    Response: We recognize and acknowledge that our assigning 
``inpatient only'' status to certain services and procedures raises 
numerous questions and concerns, and that some individual 
determinations can be reasonably debated. However, section 
1833(t)(1)(B) of the Act explicitly authorizes the Secretary to 
designate which hospital outpatient services are to be ``covered OPD 
services'' subject to payment under the hospital outpatient PPS. 
Therefore, we have had to select from the universe of possible services 
those that we determine are reasonable, necessary, and appropriate for 
Medicare payment under the hospital outpatient PPS. We note that our 
designation of a service as ``inpatient only'' does not necessarily 
preclude the service from being furnished in a hospital outpatient

[[Page 18443]]

setting, but means only that Medicare will not make payment for the 
service were it to be furnished to a Medicare beneficiary in that 
setting. This unfortunately leaves the beneficiary liable for payment 
if the procedure is in fact performed in the outpatient setting. We 
hope that hospitals will advise beneficiaries of the consequences if 
procedures on the inpatient list are provided as outpatient services 
(that is, denial of Medicare payment with concomitant beneficiary 
liability). In section III.C.5 of this preamble, we discuss in greater 
detail our rationale for designating specific procedures as ``inpatient 
only.'' In response to comments, we have removed the ``inpatient only'' 
status from a number of services, which will allow them to be paid 
under the hospital outpatient PPS. We emphasize our intention to review 
annually, in consultation with hospital and professional societies and 
associations and the expert outside advisory panel mandated by the BBRA 
1999, those procedures classified as ``inpatient only'' to ensure that 
the designation remains consistent with current standards of practice.
    Comment: One industry association contends that the statutory and 
regulatory authorities that we cite in the proposed rule (section 
1862(a)(1)(A) of the Act and 42 CFR 411.15(k)(1), respectively) do not 
support the proposed medical services exclusions. The commenter argues 
that those provisions are the basis for prohibiting coverage for 
services that are not reasonable and necessary for the diagnosis or 
treatment of an illness or injury or to improve the functioning of a 
malformed body member. The commenter states that these provisions are 
not the basis upon which we identified services for the ``inpatient 
only'' list. The commenter further states that use of these provisions 
as a basis for denying coverage of the services would be confusing to 
beneficiaries.
    Response: The commenter is correct that the proper citations are 
not section 1862(a)(1) of the Act and 42 CFR 411.15(k)(1). In fact, the 
basis for our designating certain procedures as ``inpatient only'' is 
dependent on medical judgment regarding the proper site of service, and 
the proper citation for such designation is section 1833(t)(1)(B) of 
the Act. In some instances, the identification of services to be 
included or excluded from this PPS was perfectly clear. For example, 
emergency departments (EDs) are outpatient departments of hospitals. 
Thus emergency services rendered in EDs qualify as outpatient services. 
On the other hand, coronary artery bypass graft surgery (CABG) requires 
many hours in surgery, part of the time with the patient's life being 
sustained by artificial means; a period of hours, if not days, in the 
surgical intensive care unit (ICU); and further care in an inpatient 
unit with frequent nursing attention. It clearly cannot be an 
outpatient procedure, and it would not be reasonable to consider it for 
inclusion in this PPS. There are many procedures which require similar 
intensity of care, including periods in specialty ICUs and several days 
of intense nursing attention.
    Some procedures formerly performed only in the inpatient setting, 
however, have moved to the outpatient site of service. This movement 
has taken place due to new, less-invasive surgical techniques, such as 
laparoscopy, or new anesthesia agents that clear from the body more 
rapidly, allowing some patients to have general anesthesia in the 
morning and return home that afternoon. Thus we have had to decide 
which procedures may reasonably be performed in the outpatient setting, 
and which cannot. We have been guided in this decision by our medical 
advisors' clinical judgment regarding what is reasonable in various 
settings, comments we received in response to the proposed rule, and 
bill data which shows movement from one site to another. In section 
III.C.5, we discuss the criteria we considered in defining ``inpatient 
only'' procedures.
    Comment: One hospital asked how we would pay a hospital that 
routinely performs on an outpatient basis a procedure that we proposed 
to designate as ``inpatient only.'' The commenter recommended that a 
specific billing mechanism be used to guarantee payment in these 
situations.
    Response: Services designated as ``inpatient only'' will be 
excluded from Medicare payment under the hospital outpatient PPS. If 
the service is performed on an outpatient basis and a claim is 
submitted, the claim will be denied, and the beneficiary may be billed 
for the service. We would consider this a very poor policy on the 
hospital's part, and would hope that hospitals decide to abide by the 
constraints of the inpatient list.
    Comment: One commenter noted that hospital outpatient departments 
have never been limited to a list of approved procedures as are 
Medicare participating ASCs. The commenter stated that the ``inpatient 
only'' policy would exclude payment for a significant number of 
procedures that have traditionally been performed in the hospital 
outpatient setting. The commenter stated that some of the excluded 
procedures incorporate an observation stay in a recovery care center. 
The commenter contended that many of the excluded procedures could be 
safely performed in the outpatient setting particularly if a 24 to 72 
hour recovery care center is part of the outpatient surgical care 
provided.
    Response: Routinely billing an observation stay for patients 
recovering from outpatient surgery is not allowed under current 
Medicare rules nor will it be allowed under the hospital outpatient 
PPS. As we state in section III.C.5 of this preamble, one of the 
primary factors we considered as an indicator for the ``inpatient 
only'' designation is the need for at least 24 hours of postoperative 
care.
    Comment: One commenter asked what option a hospital has if a 
beneficiary's secondary insurer requires that a procedure included on 
the Medicare inpatient only list be performed on an outpatient basis.
    Response: Upon implementation, the provisions of this final rule 
will govern payment for Medicare covered outpatient services furnished 
by hospitals to Medicare beneficiaries. Medicare payment policy and 
rules are not binding on employer-provided retiree coverage that may 
supplement Medicare coverage. Medigap insurers, however, must follow 
Medicare's coverage determinations.

c. Payment for Certain Implantable Items Under the BBRA 1999

    In the course of identifying items and services whose costs we 
proposed to designate for payment under the hospital outpatient PPS, we 
gave considerable thought to including implantable items and services 
because these items and services are such an integral part of the 
procedure by which they are inserted or implanted. However, a number of 
the more common implants such as aqueous shunts, hallux valgus 
implants, infusion pumps, and neurostimulators, are classified as 
implantable prosthetics or DME. The statutory language governing 
payment for DMEPOS provides that, notwithstanding any other provision 
of the Medicare statute, DMEPOS must be paid for using the DMEPOS fee 
schedule. Therefore, under the proposed rule, the scope of services 
paid under the hospital outpatient PPS did not include implantable 
prosthetics and DME paid under the DMEPOS fee schedule. However, we did 
propose to package payment for implanted items such as stents, vascular 
catheters, and venous ports within the APC payment rate for the 
procedure related to the insertion of these items because we

[[Page 18444]]

define these items as supplies rather than as prosthetic implants or 
implantable DME.
    Section 201(e) of the BBRA 1999 amends section 1833(t)(1)(B) of the 
Act to provide that ``covered OPD services'' include implantable items 
described in paragraph (3), (6), or (8) of section 1861(s) of the Act. 
The conference report accompanying the BBRA 1999, H. R. Rep. No. 436 
(Part I), 106th Cong., 1st Sess. (1999), expresses the belief of the 
conferees that the current DMEPOS fee schedule is not appropriate for 
certain implantable medical items such as pacemakers, defibrillators, 
cardiac sensors, venous grafts, drug pumps, stents, neurostimulators, 
and orthopedic implants as well as items that come into contact with 
internal human tissue during invasive medical procedures, but are not 
permanently implanted. In the conference report agreement, the 
conferees state their intention that payment for these items be made 
through the outpatient PPS, regardless of how these products might be 
classified on current HCFA fee schedules. The implantable items 
affected by this BBRA 1999 requirement include prosthetic implants 
(other than dental) that replace all or part of an internal body organ 
(including colostomy bags and supplies directly related to colostomy 
care and including replacement of these devices); implantable DME; and 
implantable items used in performing diagnostic x-rays, diagnostic 
laboratory tests, and other diagnostic tests.
    Comment: A number of commenters disagreed with our proposal to pay 
under the DMEPOS fee schedule for implantable items and devices that 
require surgical insertion. We received comments on specific 
implantable items, including Vitrasert (a drug delivery system that is 
implanted in the eye); cochlear devices, which allow the profoundly 
deaf to hear sound and in some cases recognize speech; nerve 
stimulators that treat intractable epilepsy and other diseases; new 
technology intraocular lenses implanted following cataract surgery; and 
access devices for dialysis treatment. Commenters were also concerned 
that the costs of some implantable devices not paid under the DMEPOS 
fee schedule, which we packaged in our proposed rule, were not properly 
recognized in the APC payment.
    Response: As we explain above, the amendments made to the statute 
by section 201(e) of the BBRA 1999 provide for payment to be made under 
the hospital outpatient PPS for implantable items that are part of 
diagnostic x-rays, diagnostic laboratory tests, and other diagnostic 
tests; implantable durable medical equipment; and implantable 
prosthetic devices (other than dental). This BBRA 1999 provision 
requires that an implantable item be classified to the group that 
includes the service to which the item relates. Thus, under this final 
rule with comment period, we are including within the scope of the 
hospital outpatient PPS items such as aqueous shunts that would, absent 
the BBRA 1999 provision, have been paid under the DMEPOS fee schedule. 
Because implantable items are now packaged into the APC payment rate 
for the service or procedure with which they are associated, certain 
items may be candidates for the transitional pass-through payment, 
which is discussed in detail in section III.D of this preamble. The APC 
rates may not in every case perfectly recognize the cost of implantable 
items. We will continue to review the impact of packaging implantables 
in future updates.

 d. Summary of Final Action

    We are modifying proposed Sec. 419.22 to remove prosthetic implants 
from the list of services excluded from payment under the hospital 
outpatient PPS. We are adding subparagraphs (9), (10), and (11) to 
proposed Sec. 419.2(b), to include the following in the list of items 
and services whose costs are included in hospital outpatient PPS 
payment rates: prosthetic implants (other than dental) that replace all 
or part of an internal body organ (including colostomy bags and 
supplies directly related to colostomy care), and including replacement 
of these devices; implantable DME; and implantable items used in 
performing diagnostic x-rays, diagnostic laboratory tests, and other 
diagnostic tests.
2. Services Included Within the Scope of the Hospital Outpatient PPS
    We proposed to include three categories of services within the 
scope of the outpatient PPS, as follows:

a. Services for Patients Who Have Exhausted Their Part A Benefits

    Section 1833(t)(1)(B)(ii) of the Act provides for Medicare payment 
under the hospital outpatient PPS for certain services designated by 
the Secretary that are furnished to inpatients who have exhausted their 
Part A benefits or who are otherwise not in a covered Part A stay. 
Examples of services covered under this provision include diagnostic x-
rays and certain other diagnostic services and radiation therapy 
covered under section 1832 of the Act.

b. Partial Hospitalization Services

    Section 1833(a)(2)(B) of the Act provides that partial 
hospitalization services furnished in CMHCs be paid under the hospital 
outpatient PPS. Partial hospitalization is a distinct and organized 
intensive psychiatric outpatient day treatment program, designed to 
provide patients who have profound and disabling mental health 
conditions with an individualized, coordinated, comprehensive, and 
multidisciplinary treatment program.

c. Services Designated by the Secretary

    We proposed to designate the following services to be paid under 
the hospital outpatient PPS:
     All hospital outpatient services, except those that are 
identified as excluded, above, in section III.B.1 of this final rule. 
The types of services subject to payment under the hospital outpatient 
PPS include the following: surgical procedures; radiology, including 
radiation therapy; clinic visits; emergency department visits; 
diagnostic services and other diagnostic tests; partial hospitalization 
for the mentally ill; surgical pathology; and cancer chemotherapy.
     Specific hospital outpatient services furnished to a 
beneficiary who is admitted to a Medicare-participating SNF but who is 
not considered to be a SNF resident, for purposes of SNF consolidated 
billing, with respect to those services that are beyond the scope of 
SNF comprehensive care plans. The specific hospital outpatient services 
that are excluded from SNF consolidated billing are cardiac 
catheterization, computerized axial tomography (CAT) scans, MRIs, 
ambulatory surgery involving the use of an operating room, emergency 
room services, radiation therapy, angiography, and lymphatic and venous 
procedures.
     Supplies such as surgical dressings used during surgery or 
other treatments in the hospital outpatient setting that are also paid 
under the DMEPOS fee schedule. Payment for these supplies, when they 
are furnished in a hospital outpatient setting, is packaged into the 
APC payment rate for the procedure or service with which the items are 
associated.
     Certain preventive services furnished to healthy persons, 
such as colorectal cancer screening.
    Section 4523(d)(3) of the BBA 1997 amended section 1833(a)(2)(B) of 
the Act to provide that we discontinue reasonable cost based payment 
and instead make Part B payment under the hospital outpatient PPS for 
certain medical and other health services when

[[Page 18445]]

they are furnished by other providers such as hospices, SNFs, and HHAs. 
Specifically, we proposed to pay under the hospital outpatient PPS for 
the following medical and other health services when they are furnished 
by a provider of services:
     Antigens (as defined in 1861(s)(2)(G) of the Act);
     Splints and casts (1861(s)(5) of the Act);
     Pneumococcal vaccine, influenza vaccine, hepatitis B 
vaccine (1861(s)(10) of the Act).
    Upon implementation of the hospital outpatient PPS, we would make 
Part B payment for the above services under the outpatient PPS when 
they are furnished by an HHA or hospice program. We would also make 
payment for antigens and the vaccines under the PPS when they are 
furnished by CORFs. (Splints and casts furnished by CORFs are paid 
under the rehabilitation fee schedule.) However, this provision would 
not apply to services furnished by a CORF that fall within the 
definition of CORF services at section 1861(cc)(1) of the Act. It also 
would not apply to services furnished by a hospice within the scope of 
the hospice benefit. Nor would it apply to services furnished by HHAs 
to individuals under an HHA plan of treatment within the scope of the 
home health benefit.

d. Summary of Final Action

    We received no comments about the services we proposed to include 
within the scope of the hospital outpatient PPS. As noted in the 
preceding section III.B.1, we added certain implantable items to 
Sec. 419.2(b) to implement section 201(e) of the BBRA 1999.
3. Hospital Outpatient PPS Payment Indicators
    In the September 8, 1998 proposed rule in the Federal Register, we 
proposed a payment status indicator for every code in the HCPCS to 
identify how the service or procedure described by the code would be 
paid under the hospital outpatient PPS. We received no comments on our 
proposal to assign a payment status indicator to every HCPCS code. (In 
section III.C.6, below, we respond to commenters who disagreed with the 
payment status indicator that we proposed for individual codes.) 
Therefore, we are implementing payment status indicators as part of the 
hospital outpatient PPS. Addendum B displays the final payment status 
indicator for each HCPCS code, including codes for incidental services 
that are packaged into APC payment rates. Addendum E identifies the 
HCPCS codes to which we have assigned payment status indicator ``C'' to 
identify inpatient services that are not payable under outpatient PPS 
as implemented by this final rule. We respond below, in section 
III.C.5, to public comments about the specific codes we classified as 
inpatient services in the proposed rule and our final determination 
regarding the payment status of those codes.
    The following are the payment status indicators and description of 
the particular services each indicator identifies:
     We use ``A'' to indicate services that are paid under some 
other method such as the DMEPOS fee schedule or the physician fee 
schedule.
     We use ``C'' to indicate inpatient services that are not 
paid under the outpatient PPS.
     We use ``E'' to indicate services for which payment is not 
allowed under the hospital outpatient PPS. In some instances, the 
service is not covered by Medicare. In other instances, Medicare does 
not use the code in question, but does use another code to describe the 
service.
     We use ``F'' to indicate corneal tissue acquisition costs, 
which are paid separately.
     We use ``G'' to indicate a current drug or biological for 
which payment is made under the transitional pass-through.
     We use ``H'' to indicate a device for which payment is 
made under the transitional pass-through.
     We use ``J'' to indicate a new drug or biological for 
which payment is made under the transitional pass-through.
     We use ``N'' to indicate services that are incidental, 
with payment packaged into another service or APC group.
     We use ``P'' to indicate services that are paid only in 
partial hospitalization programs.
     We use ``S'' to indicate significant procedures for which 
payment is allowed under the hospital outpatient PPS but to which the 
multiple procedure reduction does not apply.
     We use ``T'' to indicate surgical services for which 
payment is allowed under the hospital outpatient PPS. Services with 
this payment indicator are the only services to which the multiple 
procedure payment reduction applies.
     We use ``V'' to indicate medical visits for which payment 
is allowed under the hospital outpatient PPS.
     We use ``X'' to indicate ancillary services for which 
payment is allowed under the hospital outpatient PPS.
    The table below lists types of services, the hospital outpatient 
PPS payment status indicator assigned to each type of service, and the 
basis for Medicare payment for the service.

Medicare Hospital Outpatient PPS Payment Status Indicators: How Medicare
 Pays for Various Services When They Are Billed for Hospital Outpatients
------------------------------------------------------------------------
      Indicator                Service                   Status
------------------------------------------------------------------------
A...................  Pulmonary                 Not paid.
                       Rehabilitation;
                       Clinical Trial.
C...................  Inpatient Procedures....  Not paid.
A...................  Orthotics, and Non-       DMEPOS Fee Schedule.
                       implantable Durable
                       Medical Equipment and
                       Prosthetics.
E...................  Nonallowed Items and      Not paid.
                       Services.
A...................  Physical, Occupational    Rehab Fee Schedule.
                       and Speech Therapy.
A...................  Ambulance...............  Reasonable cost or
                                                 charge or, when
                                                 implemented, Ambulance
                                                 Fee Schedule.
A...................  EPO for ESRD Patients...  National Rate.
A...................  Clinical Diagnostic       Lab Fee Schedule.
                       Laboratory Services.
A...................  Physician Services for    Bill to Carrier.
                       ESRD Patients.
A...................  Screening Mammography...  Lower of Charge or
                                                 National Rate.
N...................  Incidental Services,      Packaged; No Additional
                       Packaged into APC Rate.   Payment Allowed.
P...................  Partial Hospitalization   Paid Per Diem.
                       Services.
S...................  Significant Procedure,    Paid Under Hospital
                       Not Reduced When          Outpatient PPS (APC
                       Multiple Procedures       Rate).
                       Performed.
T...................  Significant Procedure,    Hospital Paid Under
                       Multiple Procedure        Outpatient PPS (APC
                       Reduction Applies.        Rate).

[[Page 18446]]

 
V...................  Visit to Clinic or        Paid Under Hospital
                       Emergency Department.     Outpatient PPS (APC
                                                 Rate).
X...................  Ancillary Service.......  Paid Under Hospital
                                                 Outpatient PPS (APC
                                                 Rate).
F...................  Acquisition of Corneal    Paid at reasonable cost.
                       Tissue.
G...................  Current Drug/Biological   Additional payment.
                       Pass-Through.
H...................  Device Pass-Through.....  Additional payment.
J...................  New Drug/Biological Pass- Additional payment.
                       Through.
------------------------------------------------------------------------

C. Description of the Ambulatory Payment Classification (APC) Groups

1. Setting Payment Rates Based on Groups of Services Rather Than on 
Individual Services
    In our March 17, 1995 report to Congress, we recommended that 
groups similar to the ambulatory patient groups (APGs) developed by 3M 
Health Information Systems (3M) be used as the basis for the hospital 
outpatient PPS. We made this recommendation after examining a number of 
other payment systems that were already in place or under development, 
including DRGs that are the basis for Medicare payment for hospital 
inpatient services, the Medicare physician fee schedule that was 
implemented in 1992, and the payment groups that have been the basis 
for Medicare payments for ambulatory surgical center (ASC) facility 
services since 1982.
    As provided by the BBA 1997, section 1833(t)(2)(A) of the Act 
requires the Secretary to develop a classification system for covered 
outpatient services. Section 1833(t)(2)(B) provides that this 
classification system may be composed of groups, so that services 
within each group are comparable clinically and with respect to the use 
of resources. The statute refers to ``each such service (or group of 
services),'' confirming that the Secretary may choose or not choose to 
group services.
    We explain in our proposed rule that we revised the APGs, based on 
more recent Medicare data than that used by 3M, to create the 
ambulatory payment classification (APC) system. We proposed to group 
services identified by HCPCS codes and descriptors within APC groups as 
the basis for setting payment rates under the hospital outpatient PPS. 
We indicated that we organized the APC groups so that the services 
within each group would be homogeneous both clinically and in terms of 
resource utilization. We invited comments on our proposal to set rates 
on the basis of groups of services rather than on individual codes.
    Comments: Some commenters claimed that basing payment on APC groups 
rather than on individual services would result in underpayment for 
services that are more resource intensive, causing hospitals with a 
more resource intensive case mix to lose money. An organization 
representing physicians strongly opposed the use of APCs, because it 
believes that it is not possible to achieve an incentive-neutral, 
``level playing field'' payment system using groups of codes or 
services. This organization favored replacing the APC system with a fee 
schedule based on individual services, similar to the Medicare 
physician fee schedule, as MedPAC recommends in its 1999 report to 
Congress. (We address the MedPAC recommendation later in this section.) 
The same physician organization is concerned that the broad range of 
services included in each APC will create an incentive for hospitals to 
provide lower cost services, even though a patient might require higher 
cost services. This organization expressed concern about the negative 
impact on physicians if a payment methodology similar to the APC system 
were applied to payment for physician services. To facilitate pricing 
new codes using individual services rather than APC groups, the same 
organization suggested that we establish a ``relative value 
relationship in direct costs'' between the new code and a comparable 
code, or that we consult AMA's Specialty Society RVS Updating Committee 
(RUC) for advice on relative cost relationships.
    One major hospital association expressed its preference for a 
service-specific fee schedule because of the wide variation in costs 
represented by groups of codes. Another hospital association advocated 
using individual services rather than groups of services as the basis 
for ratesetting, but recommended, if we were to use some form of 
grouping, that we apply tight limits on the variations of costs for 
services within a group.
    Response: We understand the concerns of commenters that setting 
payment weights using groups of services rather than individual 
services could result in payment for particular services that might not 
fully offset the costs that hospitals incur when they furnish 
expensive, resource-intensive services. However, we believe these 
concerns are in large measure addressed by the provisions of this final 
rule. As we explain in section III.C.6, we significantly restructured 
the proposed APC groups, first in response to comments and, second, to 
comply with section 1833(t)(2) of the Act, as amended by the BBRA 1999, 
which limits the variation of costs of services classified within a 
group. The result is more APC groups with fewer codes and a narrower 
range of costs in each group. In addition, other provisions of the BBRA 
1999, such as the transitional pass-throughs (see section III.D, 
below), and outlier payments and transitional corridors (see section 
III.H, below) protect hospital revenues while hospitals gain experience 
with the PPS.
Medicare Payment Advisory Commission (MedPAC) Recommendation
    In both its March 1998 and March 1999 reports to the Congress on 
Medicare payment policy, MedPAC recommends that payment rates under the 
hospital outpatient PPS be based upon costs of individual services 
rather than groups of similar services to help ensure consistent 
payments across ambulatory settings. In its March 1999 report, MedPAC 
asserts its belief that the burden imposed by our proposed APC system 
outweighs its benefits in ambulatory settings. MedPAC gives several 
reasons to support its position.
     The use of groups to calculate weights masks questionable 
cost data for low volume and new procedures.
     Different classes of hospitals face disproportionate 
impacts, suggesting APC groups may not be as homogeneous as we believe.
     Grouping services will likely create additional 
administrative burdens for hospitals, because hospitals may have to 
purchase or develop new software and will experience additional 
education and training costs.
    Response: We carefully reviewed the concerns about using groups of 
services

[[Page 18447]]

expressed by MedPAC in its March 1998 report, and we responded to those 
concerns in our proposed rule (63 FR 47562). Even though MedPAC 
concedes in its March 1999 report that using groups to set rates has 
certain potential advantages, MedPAC continues to oppose using groups 
because, according to MedPAC, they entail considerable costs and 
drawbacks and necessitate ``a much more complicated design logic'' than 
would be required using a service-level fee schedule.
    We do not share MedPAC's concerns. We have a high level of 
confidence in the ratesetting method using APC groups that we implement 
in this final rule with comment period. As we explain below, in section 
III.C.6, we have extensively restructured the APC groups to respond to 
comments on the proposed rule, to incorporate specific provisions of 
the BBRA 1999, and to correct some errors that had come to our 
attention. We believe that by using median costs in the calculation of 
group weights, we limit the extent to which infrequently performed 
services with suspect costs can affect the payment rate of an APC 
group.
    As discussed below in the impact analysis (section IX of this 
preamble), the provisions of this final rule with comment period, which 
include setting rates using APC groups, alleviate to a large extent the 
disproportionate impacts on different classes of hospitals estimated in 
our proposed rule. In addition, as we explain in section III.C.6, when 
we restructured the APC groups, we were particularly attentive to the 
degree of provider concentration associated with the individual 
services within a group in order to avoid biasing the payment system 
against any subset of hospitals.
    Finally, none of the commenters cited increased administrative 
burden as an argument against using groups. Even though we are using 
APC groups to set rates under the hospital outpatient PPS, hospitals 
will bill for services using HCPCS codes (not APCs) using the same 
claims forms that they use currently. Although to receive payment under 
the new system, hospitals will have to more fully code the services 
they furnish, they will not have to know to which APC the service is 
assigned in order to determine the payment amount. We are publishing 
the payment rate applicable to each HCPCS code in Addendum B of this 
final rule. Any burdens on hospitals necessitating additional technical 
assistance, training, or systems changes are more a function of 
implementing an entirely new payment system than of our setting rates 
on the basis of groups of services.
    Final Action: The payment rates implemented by this final rule with 
comment period are determined based on APC groups that use HCPCS codes 
to describe individual services. The codes assigned to an APC group are 
comparable clinically and in terms of resource use.
2. Packaging Under the APC System

a. Summary of Proposal

    In our proposed rule, we described packaged services as those items 
or services that we recognized as contributing to the cost of the 
procedures or services in an APC group, and for which we would not make 
separate payment. We proposed to include as packaged services use of 
the operating room and recovery room, anesthesia, medical/surgical 
supplies, pharmaceuticals, observation, blood, intraocular lenses, 
casts and splints, the costs of acquiring tissue such as corneal tissue 
for surgical insertion and various incidental services such as 
venipuncture. We packaged the services (and their costs) within the APC 
group of procedures with which they were delivered in the base year. 
For a list of proposed packaged services grouped by hospital revenue 
centers, refer to the June 30, 1999 correction notice (64 FR 35258).

b. General Comments and Responses (Supporting or Objecting to 
Packaging)

    Comment: Few commenters disagreed with our proposal to aggregate 
into one payment the costs for a ``package'' of services variously 
related to a procedure or to the principal service being furnished. 
However, many commenters did object to our packaging costs for certain 
specific items such as expensive drugs and pharmaceuticals, observation 
services in the emergency department, blood and blood products, corneal 
tissue acquisition costs, and chemotherapy and supportive drugs. 
Commenters, fearful that packaging items and services will result in 
lower payments that do not offset the high costs of particularly 
expensive items, raised the prospect of dire consequences such as 
forcing hospitals to use only the cheapest drugs, being unable to 
employ oncology nurses, eliminating otherwise clinically necessary 
ancillary services, or not being able to hold emergency room patients 
for observation.
    Response: We are persuaded by commenters' arguments that packaging 
payment for certain expensive items and services into an APC group rate 
could have such a potentially negative impact as to jeopardize 
beneficiary access to these items and services in the hospital 
outpatient setting. Therefore, in response to comments, we are not 
packaging within an APC payment rate the costs associated with certain 
specified items and services. Instead, we will make a separate APC 
payment for these particular items and services under the outpatient 
PPS. However, as we explain in section III.C.2.d, we do not concur with 
commenters who urge separate payment for observation services; rather, 
we are packaging the costs in the APC for each service with which 
observation services were billed in our 1996 database. We discuss in 
further detail below, in section III.C.2.d through section III.C.2.g, 
and in section III.C.6, the changes that we are making to the packaging 
we originally proposed. We address in section III.B.1, above, the BBRA 
1999 provision that requires us to package into APC group rates payment 
for certain implantable items and devices. In section III.D, below, we 
describe additional payments for certain packaged medical devices, 
drugs, and biologicals that are provided as transitional pass-throughs 
under section 201(b) of the BBRA 1999.
    As we gain experience with and collect additional cost data under 
the hospital outpatient PPS, we will review our policy to pay 
separately for certain items and services that would otherwise be 
packaged into the APC payment. Should we decide to modify this policy, 
we will do so through the rulemaking process as part of our annual 
hospital outpatient PPS update.
    MedPAC Recommendation: In its March 1999 report to the Congress, 
MedPAC cites two models that Medicare uses to define a unit of payment: 
the DRG-based payment model for hospital inpatient services, and the 
Medicare physician fee schedule. MedPAC contends that services provided 
in the hospital outpatient setting more closely parallel those 
furnished in an office-based setting than those furnished as part of a 
hospital inpatient admission. Therefore, MedPAC recommends that, in 
establishing ambulatory care prospective payment systems in general, we 
define the unit of payment for ambulatory care facilities as an 
individually coded service, consisting of the primary service that is 
the reason for the encounter, and the necessary and essential ancillary 
services and supplies integral to it, including limited follow-up care 
if it is integral to the primary service, but not including physicians' 
services. MedPAC further recommends that the unit of payment be defined 
consistently across all ambulatory care settings.

[[Page 18448]]

    Response: The packaging that we proposed as the basis for 
determining APC payment rates and that we will implement under the 
hospital outpatient PPS is generally consistent with MedPAC's 
recommendation. However, we did not propose to include ``limited 
follow-up services'' in our packaged groups under the hospital 
outpatient PPS because of the difficulty of matching in our database 
the costs of these services with their associated primary encounter. 
For now, hospitals are to bill follow-up care, such as suture removal, 
using an appropriate medical visit code. We did not propose, nor have 
we included in this final rule with comment period, provision for a 
global period for hospital outpatient services analogous to the global 
period affecting payments for professional services made under the 
Medicare physician fee schedule.

c. Packaging of Casts and Splints

    Comment: One commenter stated that we should not package costs for 
casts and splints with other procedures.
    Response: We proposed to assign payment status indicator ``N'' to 
CPT codes for strapping and casting services (CPT codes 29000-29750) to 
designate that these are incidental services for which payment is 
packaged into the APC rate for another service or procedure, in this 
case, the repair or reduction of a fracture or dislocation. After 
further review, we determined that strapping and casting services can 
be performed independently, for example, when a cast placed as a part 
of a procedure must later be replaced with another cast. Therefore, we 
have decided that strapping and casting services will not be packaged 
and we are creating two APCs (0058 and 0059) to pay for these services. 
The BBA 1997 required that we pay under the outpatient PPS for casting 
and strapping services furnished in HHAs and hospices, to the extent 
that these services are provided and are not within the patient's plan 
of care.

d. Packaging of Observation Services

    We received many comments urging us to pay separately for 
observation services, particularly when patients are seen in the 
emergency department. Observation service is placing a patient in an 
inpatient area, adjacent to the emergency department, or, according to 
some comments, in the intensive care unit (ICU) or coronary care unit 
(CCU), in order to monitor the patient while determining whether he or 
she needs to be admitted, have further outpatient treatment, or be 
discharged. After 1983, many hospitals began to rely heavily on the use 
of observation services when peer review organizations questioned 
admissions under the hospital inpatient prospective payment system. 
However, in some cases, patients were kept in ``outpatient'' 
observation for days or even weeks at a time. This resulted in excess 
payments both from the Medicare program and from beneficiaries who 
generally paid a higher coinsurance. In response to this practice, in 
November 1996, we issued instructions limiting covered observation 
services to no more than 48 hours except in the most extreme 
circumstances. However, the cost data upon which the APC system is 
based contain all costs for observation in 1996, including those that 
exceeded the 48-hour limit imposed at the end of that year. We have 
packaged those costs into the service with which they were furnished in 
the base year. Thus, APC payments for emergency room visits include the 
costs of observation within the payment.
    Comment: Some commenters acknowledged that being paid separately 
for observation following a surgical procedure was not necessary; the 
packaged recovery room and observation services were sufficient. 
However, a major concern of commenters was observation of patients with 
chest pain who had equivocal results on initial diagnostic testing. 
Commenters were concerned that the APC payment for these cases would 
not be adequate.
    Response: We assume that chest pain patients, such as those 
described by the commenters, are sent to the CCU or ICU for 
observation. We believe that, in general, if a patient needs to be 
monitored in the ICU or CCU for any length of time, then that patient 
should be admitted as an inpatient. Furthermore, we have never 
considered care furnished in an ICU or CCU to be outpatient services. 
Existing cost reporting instructions allow for the use of these 
specialty beds during a shortage of regular inpatient beds, but charges 
are to reflect routine care, not intensive care.
    Although, as noted above, we received many comments urging that 
observation services be covered as a separate APC, we continue to 
believe that these services have been used so inappropriately in the 
past that we will have to gather data under the PPS before considering 
constructing a separate APC. We have packaged observation wherever it 
was billed. Roughly $139 million was identified by revenue code 762 as 
representing observation services. An additional $253 million was 
identified in revenue codes 760, 761, and 769, which could be used for 
either observation or treatment room use. That $253 million is also 
packaged. (Both figures are in 1996 dollars.)
    Further analyses will be necessary on the use of observation as an 
adjunct to emergency treatment, as in the case of chest pain. In order 
to ensure that we will have sufficient data for our future analyses, 
hospitals must continue to bill for observation using revenue center 
762 and showing hours in the units field. Observation that is billed 
must represent some level of active monitoring by medical personnel. It 
must not be billed as a way to capture room and board for outpatients. 
During our first review of the APC groups, we will assess whether 
patients with certain conditions use observation services that should 
be separately recognized. Thus, correct diagnosis coding is required.
e. Packaging Costs of Procuring Corneal Tissue
    Comment: We received about 2,000 comments from physicians, eye 
banks, and health care associations opposing our proposal to package 
corneal tissue acquisition costs into the APC payment for corneal 
transplant procedures. Most commenters argued that the payment for the 
procedures in proposed APC group 670, Corneal transplant, is grossly 
inadequate and that we have failed to recognize the high costs 
associated with tissue screening and testing procedures required by the 
Food and Drug Administration that are reflected in the fees charged by 
eye banks. In addition, commenters contended that we failed to 
recognize the wide variation in tissue acquisition costs resulting from 
the level of philanthropic contributions in different areas of the 
country and in different years. Commenters asserted that by packaging 
corneal tissue acquisition costs with the payment for corneal 
transplant surgery, we would limit beneficiary access to quality care, 
force eye banks that are nonprofit, low-cost operations to close, 
provide disincentives for philanthropic contributions, and impede our 
goal to increase tissue availability.
    As part of their comments, the Eye Bank Association of America 
(EBAA) submitted a report of a study the EBAA commissioned on corneal 
tissue acquisition costs. The study was conducted by the Lewin Group 
which collected and analyzed data on corneal tissue acquisition costs 
incurred by 74 of EBAA's 100 members that are charitable nonprofit 
organizations. The report states that these 74 eye banks supplied 
approximately 82 percent of the corneal tissue distributed

[[Page 18449]]

throughout the United States in 1997. Based on the data that they 
collected, the Lewin Group found that the median gross acquisition cost 
per transplant is $1,689 in 1999 dollars. Of this amount, approximately 
$233 represents the national median value of donated in-kind services 
such as volunteer staff. The Lewin Group concluded that the proposed 
hospital outpatient PPS payment of $1,583 did not adequately reflect 
the cost of procuring corneal tissue.
    Additionally, the report states that ``fund raising and in-kind 
service values are not as well centered on their median values as the 
underlying cost data. Variability in fund raising and in-kind 
contributions not only exists between eye banks, but from year to year, 
within the same eye bank.'' According to the study, charitable 
contributions in the form of cash and in-kind services represented 28 
percent of the eye banks' total gross cost for tissues furnished in 
1997. The Lewin Group finds that ``If HCFA were to move to fee schedule 
or other fixed-payment rate, and pays the adjusted median Gross cost 
Per Transplant * * * payment of $1689, HCFA would overpay some banks 
and underpay others, depending on philanthropy and in-kind services 
which varies from community to community and from year to year. The 
variation is too extreme to determine a fair rate-based system, without 
destroying the philanthropy the community is built upon.''
    Response: Based on the concerns raised by the commenters and the 
data presented in the Lewin Group study, we have decided not to package 
payment for corneal tissue acquisition costs with the APC payment for 
corneal transplant surgical procedures at this time. Instead, we will 
make separate payment, based on the hospital's reasonable costs 
incurred to acquire corneal tissue. Final payment will be subject to 
cost report settlement. To receive payment for corneal acquisition 
costs, hospitals must submit a bill using HCPCS code V2785, Processing, 
preserving and transporting corneal tissue, and indicate the 
acquisition cost rather than the hospital's charge on the bill. We 
intend to review this policy after we have acquired updated data on 
corneal procedures.

f. Packaging Costs of Blood and Blood Products

    Comment: Many commenters, including the American Red Cross, a major 
medical association, teaching hospitals, and community oncology 
centers, believe that the payments we proposed for blood and blood-
related products and for APCs that required the use of blood and blood-
related products, were too low. Commenters claimed that the proposed 
payments are so much lower than actual costs that hospitals might be 
forced to stop providing a range of blood services, especially those 
more complex than a simple transfusion. The commenters were concerned 
that our proposed payment would not allow hospitals to furnish the most 
clinically appropriate blood products and services. The commenters also 
stated that blood and blood product exchange were not assigned to 
appropriate APCs, thus skewing payment rates and not recognizing the 
true costs of services with which blood and blood product exchange are 
associated. Commenters attributed this deficiency to the fact that 
certain blood-related products were incorrectly billed in the 1996 data 
we used as the basis for pricing APCs. Commenters were also concerned 
that we excluded procedures whose costs fell outside 3 standard 
deviations of the mean cost. One major organization recommended that we 
separate payment for blood and blood products from the service with 
which it is associated. This commenter also recommended separate 
payment for infusible blood-derived drugs, and that we base payment for 
transfusable blood products on costs. Some commenters recommended a 
transition period prior to full implementation of the proposed PPS.
    Response: Based on the recommendations of commenters, we have 
created separate APC groups to pay for blood and blood products. We 
agree with the commenters that blood use varies enough that packaging 
blood units with their administration could lead to inequities. Because 
we were not able to capture enough claims data in the base year to 
accurately price the blood and blood-product APCs, we have based 
payment rates for these APCs on data provided by commenters, including 
suppliers of blood and blood products. We have based payment on current 
costs rather than 1996 costs so that we recognize the costs of recently 
developed blood safety tests. The safety of the nation's blood supply 
is a major concern of the Department of Health and Human Services, and 
we want to encourage appropriate testing and follow-up care.

g. Packaging Costs for Drugs, Pharmaceuticals, and Biologicals

    We proposed to package the cost of drugs, pharmaceuticals, and 
biologicals with APC groups because we believe drugs are usually 
provided in connection with some other treatment or procedure. We 
collected aggregate cost data on all drugs that were billed with HCPCS 
codes and those billed with revenue center codes, whether or not a 
HCPCS was entered. By so doing, we captured historical patterns of drug 
use within the APC groups with which the drugs were billed during the 
base year. However, because we did not require HCPCS coding of drugs, 
we could not isolate costs associated with individual drugs, some of 
which are very expensive even though they are rarely used and may be 
used by only a few hospitals. As a result, we acknowledge that our 
proposed APC payment rates may not fully reflect costs of very 
expensive drugs or biologicals.
    We also proposed to create separate drug groups for 
chemotherapeutic agents because those were separately identified in the 
APG system designed by 3M. However, because we did not have bills that 
were coded to identify drugs individually, we were concerned that the 
APC groups for chemotherapeutic groups may not have completely 
reflected the costs of these drugs.
    Comment: Many commenters criticized the proposed APC payment rates 
because they were developed using cost data from 1996 that do not 
reflect the cost of many new drugs, pharmaceuticals, and biologicals. 
Some commenters expressed particular concern about oncology drugs such 
as paclitaxil (Taxol) and topotecan. Some advised that Taxol and 
carboplatin chemotherapy have become the standard treatment for ovarian 
carcinoma. A number of commenters believe that our proposal did not 
provide sufficient financial incentives to dissuade hospitals from 
using the older less effective chemotherapy regimens even though there 
is significantly greater toxicity and reduced chances of favorable 
outcomes associated with their use. Many commenters strongly suggested 
that we carve out new drugs and biologicals and those introduced after 
1996 from the PPS and pay for them on a reasonable cost basis. Several 
commenters asserted that packaging drugs and pharmaceuticals within the 
APC groups understates their cost to hospitals and their value to 
patients.
    Response: We believe the commenters' concerns have, to a great 
extent, been addressed by implementation of the BBRA 1999 pass-through 
provisions for drugs and biologicals. Addendum K includes a complete 
list of all drugs, biologicals, and medical devices that are eligible 
for pass-through payments. We encourage interested parties to follow 
the process outlined below in section III.I.4 of this

[[Page 18450]]

preamble to submit requests for consideration of drugs, biologicals, 
and medical devices that may be eligible for additional payment under 
the transitional pass-through provision but that are not listed in 
Addendum K.

h. Summary of Final Action

    After consideration of comments received about packaging of 
services and of the requirements set forth in the amendments made to 
section 1833(t) of the Act by section 201(b) and section 201(e) of the 
BBRA 1999, we have revised the package of services directly related and 
integral to performing a procedure or furnishing a service on an 
outpatient basis whose costs will determine the national payment rate 
for that procedure or service under the hospital outpatient PPS.
     We will package into the APC payment rate for a given 
procedure or service any costs incurred to furnish the following items 
and services: Use of an operating suite, procedure room or treatment 
room; use of the recovery room or area; use of an observation bed; 
anesthesia; medical and surgical supplies and equipment; surgical 
dressings; supplies and equipment for administering and monitoring 
anesthesia or sedation; intraocular lenses; capital-related costs; 
costs incurred to procure donor tissue other than corneal tissue; and, 
various incidental services such as venipuncture.
     In general, we will package the cost of drugs, 
pharmaceuticals and biologicals into the APC payment rate for the 
primary procedure or treatment with which they are used. Additional 
payment for some drugs, pharmaceuticals, and biologics may be allowed 
under the transitional pass-through provisions, which we explain below, 
in section III.D.
     We will not package payment for corneal tissue acquisition 
costs into the payment rate for corneal transplant surgical procedures 
at this time. We will make separate payment for these acquisition costs 
based on the hospital's reasonable costs incurred to acquire corneal 
tissue.
     We will not package into the APC payment rate for another 
procedure or service costs incurred to furnish the following items and 
services: blood and blood products, including anti-hemophilic agents; 
casting, splinting, and strapping services; immunosuppressive drugs for 
patients following organ transplant; and certain other high cost drugs 
that are infrequently administered. We have created new APC groups for 
these items and services, which allows separate payment to be made for 
them.
3. Treatment of Clinic and Emergency Department Visits

a. Provisions of the Proposed Rule

    As we discussed in our proposed rule, determining payment for 
hospital clinic and emergency department (ED) visits requires a variety 
of considerations such as the following:
     The impact of packaging on setting payment rates.
     How to code visits in a manner that recognizes variations 
in service intensity and levels of resource consumption.
     How to keep the system administratively manageable.
     How to define critical care in terms of facility as 
opposed to physician input.
     Data problems associated with identifying costs from 
claims that list multiple services.
     How to move toward greater uniformity of payments across 
ambulatory settings so as to remove payment as an incentive for 
determining site of service.
    The major issue we faced in determining payment for hospital clinic 
and ED visits is whether to include diagnosis as well as Physicians' 
Current Procedural Terminology (CPT) codes in setting payment rates.
    In our proposed rule, we considered several approaches to setting 
prospective payment rates for hospital clinic and ED visits. Potential 
options included: (1) Using diagnosis codes only; (2) using CPT codes 
only; and (3) using a CPT-diagnosis code hybrid. We solicited comments 
on these approaches to setting payment rates for clinic and ED visits 
as well as comments on alternative approaches that we did not set forth 
in the proposed rule. In the proposed rule, we discussed in detail our 
assessment of the advantages and disadvantages of each approach.
    In addition, we proposed to create a HCPCS code that would be used 
to bill when a patient presents to an ED, requests a screening, and is 
screened in accordance with section 1867(a) of the Act. Payment for 
this new code would be minimal because we included no treatment costs 
in the screening service. Payment for the screening APC would be made 
only when no additional services were furnished by the emergency 
department. If nonemergency treatment was furnished, the appropriate 
emergency department visit would be billed, and not the screening. 
Similarly, if the screening reveals that an emergency does exist and 
treatment is instituted immediately, the screening would not be billed 
because we would consider payment to be subsumed into the payment for 
further treatment.
    We proposed paying for critical care as the highest level of 
``visit.'' In our proposed rule, we stated that hospitals would use CPT 
code 99291 to bill for outpatient encounters in which critical care 
services are furnished.
    We used the CPT definition of ``critical care'' which is the 
evaluation and management of the critically ill or injured patient. 
Under the outpatient PPS, we would allow the hospital to use CPT code 
99291 in place of, but not in addition to, a code for a medical visit 
or for an emergency department service. Although the CPT system allows 
the physician to bill in 30-minute increments following the first 74-
minute period of providing critical care, we proposed to pay separately 
for only the initial period (CPT code 99291), packaging the few 
instances in which the 30-minute increments (CPT code 99292) were 
billed. If other services, such as surgery, x-rays, or cardiopulmonary 
resuscitation, were furnished on the same day as the critical care 
services, we would allow the hospital to bill for them separately.

b. Comments and Responses

    Comment: The major hospital associations argued that none of our 
three proposed approaches fully explains facility resource use in 
connection with clinic and emergency visits. Hospitals did not see a 
clear benefit in the payment ranges created by using the CPT and 
diagnosis hybrid approach. A major medical association adamantly 
opposed the use of diagnosis codes. One major HMO that does not 
currently use CPT codes was opposed to the use of CPT codes to describe 
clinic and emergency visits.
    Response: In this final rule, we are not using patient diagnosis 
codes to compute payment rates for medical visits to clinics and 
emergency departments under the outpatient PPS because a number of 
concerns were raised about basing payment for medical visits on both 
HCPCS codes and ICD-9 diagnosis codes. The final payment groups for 
medical visits are constructed using CPT procedure codes only, which is 
consistent with our overall PPS grouping strategy and with the approach 
we have followed to establish payment groups for surgical and 
diagnostic services. However, we will continue to require hospitals to 
provide accurate diagnosis coding on claims for payment. We will 
continue to assess the value of using patient diagnosis for application

[[Page 18451]]

to our payment system for possible use in the future.
    In developing medical visit APCs based on CPT procedure codes only 
(a change from the proposed rule), we are collapsing 31 CPT codes that 
define clinic and emergency visits into six groups, three each for the 
clinics and the emergency department. The final APC groups for clinic 
and emergency visits are as follows: APC 0600, Low Level Clinic Visits; 
APC 0601, Mid-Level Clinic Visits; APC 0602, High Level Clinic Visits; 
APC 0603, Interdisciplinary Team Conference; APC 0610, Low Level 
Emergency Visits; APC 0611, Mid-Level Emergency Visits; APC 0612, High 
Level Emergency Visits; and APC 0620, Critical Care.
    When basing payment on CPT codes alone, the range of costs reflects 
hospitals' billing patterns in increasing level of intensity. However, 
those increasing increments are due largely to hospitals' use of 
``chargemaster'' systems, which generate bills using predetermined 
charges for codes. Thus, billing patterns reflect standard bills, not 
the resources used in any particular case.
    We had been concerned that certain hospitals' use of the lowest 
level code, CPT code 99201, to bill for all clinic visits would distort 
the data, causing inflation in both the volume and cost of low-level 
clinic visits, and a corresponding underreporting of mid- and high-
level visits. (Costs for mid- and high-level visits would presumably 
have been correct, because individual hospitals would have reported 
appropriate charges with these codes; there simply would have been 
fewer reported visits at those levels.)
    We have developed the weights for clinic visits by using claims 
data only from a subset of hospitals that billed a wider range of 
visits rather than relying solely on claims with CPT code 99201. We 
chose to use this subset of hospitals (for this purpose only) because 
we do not know what CPT code 99201 indicates when hospitals use it 
exclusively to bill all visits.
    We emphasize the importance of hospitals assessing from the outset 
the intensity of their clinic visits and reporting codes properly based 
on internal assessment of the charges for those codes, rather than 
failing to distinguish between low-and mid-level visits ``because the 
payment is the same.'' The billing information that hospitals report 
during the first years of implementation of the hospital outpatient PPS 
will be vitally important to our revision of weights and other 
adjustments that affect payment in future years. We realize that while 
these HCPCS codes appropriately represent different levels of physician 
effort, they do not adequately describe nonphysician resources. 
However, in the same way that each HCPCS code represents a different 
degree of physician effort, the same concept can be applied to each 
code in terms of the differences in resource utilization. Therefore, 
each facility should develop a system for mapping the provided services 
or combination of services furnished to the different levels of effort 
represented by the codes. (The meaning of ``new'' and ``established'' 
pertain to whether or not the patient already has a hospital medical 
record number.)
    We will hold each facility accountable for following its own system 
for assigning the different levels of HCPCS codes. As long as the 
services furnished are documented and medically necessary and the 
facility is following its own system, which reasonably relates the 
intensity of hospital resources to the different levels of HCPCS codes, 
we will assume that it is in compliance with these reporting 
requirements as they relate to the clinic/emergency department visit 
code reported on the bill. Therefore, we would not expect to see a high 
degree of correlation between the code reported by the physician and 
that reported by the facility.
    Hospitals are required to use HCPCS code 99291 to report outpatient 
encounters in which critical care services are furnished. (See the 
American Medical Association's CPT 2000 coding manual for the 
definition of this code.) The hospital is required to use HCPCS code 
99291 in place of, but not in addition to, a code for a medical visit 
or for an emergency department service.
    We will work with the American Hospital Association and the 
American Medical Association to propose the establishment of 
appropriate facility-based patient visit codes in time for the next 
proposed rule.
    Comment: Several commenters expressed concern that resources 
expended in the emergency department are not fully explained by the 
codes at their disposal. One commenter pointed out that some hospitals 
use internal coding systems to capture differing charges based on 
whether or not a case requires one-on-one nursing care.
    Response: While we share commenters' concerns on this point, we 
remind hospitals that they can receive additional payment under the 
outpatient PPS for services such as diagnostic testing and 
administration of infused drugs, and for therapeutic procedures 
including resuscitation that are furnished during the course of an 
emergency visit. We will also pay separately for certain high cost 
drugs, such as the expensive ``clotbuster'' drugs that must be given 
within a short period of time following a heart attack or stroke, if 
these drugs are furnished during an emergency visit. Even though some 
ED patients will be transferred to another hospital for inpatient 
treatment, the hospital that administers the drugs will be paid for 
them. Cases that fall far outside the normal range of costs will be 
eligible for an outlier adjustment established by section 201(a) of the 
BBRA 1999. (See section III.H, below.) In addition, one of the first 
topics of review to be addressed by the expert outside advisory panel, 
required by section 201(h)(1)(B) of the BBRA 1999, will be to determine 
if emergency department visits can be categorized in a way that better 
recognizes the underlying resources, especially nursing resources, 
involved in the visit.
    Comment: Several commenters expressed concern about the appropriate 
level of payment for patients who die in the ED. One commenter believes 
that services furnished to these patients are resource-intensive and 
recommends that we continue to pay for the services on a reasonable 
cost basis.
    Response: We are directing fiscal intermediaries to use the 
following guidelines in determining how to make payment when a patient 
dies in the ED or is sent directly to surgery and dies there.
     If the patient dies in the ED, make payment under the 
outpatient PPS for services furnished.
     If the ED or other physician orders the patient to the 
operating room for a surgical procedure, and the patient dies in 
surgery, payment will be made based on the status of the patient. If 
the patient had been admitted as an inpatient, pay under the hospital 
inpatient PPS (a DRG-based payment). If the patient was not admitted as 
an inpatient, pay under the outpatient PPS (an APC-based payment). If 
the patient was not admitted as an inpatient and the procedure is 
designated as an inpatient-only procedure (payment status indicator 
``C''), no Medicare payment will be made for the procedure, but payment 
will be made for ED services.
    Comment: Some commenters objected to our proposal to restrict 
payment for critical care services to CPT code 99291 and not allow 
payment for CPT code 99292. One commenter recommended that we create an 
APC group for the additional increments of time a physician spends in 
critical care for which the physician may bill.

[[Page 18452]]

    Response: We do not believe that paying hospitals for incremental 
time as critical care would better reflect facility resources. The most 
resource-intensive period for the hospital is generally the first hour 
of critical care. In addition, we believe it would be burdensome for 
hospitals to keep track of minutes for billing purposes. Therefore, we 
will pay for critical care as the most resource-intensive visit 
possible as defined by CPT code 99291. Critical care services will be 
assigned to APC 0620.
    Comment: Several commenters advised that a screening code was not 
necessary because an emergency visit code could be billed for ED 
screening services.
    Response: We agree with the commenters, and we will instead use the 
appropriate emergency department codes for screening services (as 
defined in section 1867(a) of the Act). If no treatment is furnished, 
we would expect screening to be billed with a low-level emergency 
department code.
    Comment: Some commenters expressed concern about our proposal to 
allow hospitals to create a separate claim for each visit when two or 
more medical visits occur on the same day for different diagnoses. 
Commenters feared that this would result in our paying under the 
outpatient PPS for clinic care furnished at sites other than hospital 
outpatient departments, and that we are promoting fragmented care. One 
commenter was concerned that, to the extent that patients see multiple 
specialists, tests will be repeated unnecessarily, hospitalizations 
will rise, and beneficiaries and the Medicare program will be burdened 
with additional, unnecessary costs.
    Response: Our decision not to use diagnosis codes as a factor in 
determining payment for clinic visits largely negates these concerns 
because the need to prepare different claims for visits for different 
diagnoses has been eliminated. When patients are seen in different 
clinics on the same day, hospitals should bill using the proper codes 
for the level of the visits, using the units field if appropriate to 
reflect more than one visit at the same level.
    However, we note that the comment did prompt us to develop a code 
for billing those visits during which numerous physicians see a patient 
concurrently, for example, a surgeon, medical oncologist, and radiation 
oncologist for a cancer patient, to discuss treatment options and to 
ensure that the patient is fully informed. In this instance, each 
physician is addressing the patient's care from a unique perspective. 
If several physicians see a patient concurrently in the same clinic for 
the same reason, the hospital would bill for one clinic visit using an 
appropriate visit code even though each physician would bill 
individually for his or her professional services. We have established 
a code for hospitals to use in reporting a scheduled medical conference 
with the patient involving a combination of at least three health care 
professionals, at least one of whom is a physician. That code is G0175, 
Scheduled interdisciplinary team conference (minimum of three, 
exclusive of patient care nursing staff) with patient present.
4. Treatment of Partial Hospitalization Services
    As we explained in the proposed rule, partial hospitalization is an 
intensive outpatient program of psychiatric services provided to 
patients in lieu of inpatient psychiatric care. Partial hospitalization 
may be provided by a hospital to its outpatients or by a Medicare-
certified community mental health center (CMHC). It is important to 
note that the services of physicians, clinical psychologists, clinical 
nurse specialists (CNSs), nurse practitioners (NPs), and physician 
assistants (PAs) furnished to partial hospitalization patients would 
continue to be billed separately to the carrier as professional 
services and are not considered to be partial hospitalization services. 
Thus, payment for partial hospitalization services represents the 
provider's overhead costs, support staff, and the services of clinical 
social workers (CSWs) and occupational therapists (OTs), whose 
professional services are considered to be partial hospitalization 
services for which payment is made to the provider. Including CSW and 
OT services reflects historical patterns of treatment billed during the 
base year.
    Because a day of care is the unit that defines the structure and 
scheduling of partial hospitalization services, we proposed a per diem 
payment methodology for the partial hospitalization APC. We analyzed 
the service components billed by hospitals over the course of a billing 
period and determined the median hospital cost of furnishing a day of 
partial hospitalization. As noted in the June 30, 1999 correction 
notice, this analysis resulted in a proposed APC payment rate of 
$206.71 per day, of which $46.78 is the beneficiary's coinsurance.
    We also solicited comments on a number of issues related to partial 
hospitalization. We asked for information on the mix of services that 
constitute a typical partial hospitalization day and average duration 
of a partial hospitalization episode, whether we should impose a 
minimum number of services for each covered partial hospitalization 
day, and whether we should establish a limit on routine outpatient 
mental health services furnished on a given day to equal the partial 
hospitalization per diem amount. Finally, we indicated that we are 
considering specifying a timeframe for physician recertification of 
need for partial hospitalization services as a method of ensuring that 
a patient's condition continues to require the intensity of a partial 
hospitalization program.
    We did not receive a significant number of public comments on this 
issue. A summary of the comments we received and our responses follow.
    Comment: We received many similar comments from rural hospitals 
that operate partial hospitalization programs. The hospitals indicated 
that the proposed per diem amount does not cover their direct cost of 
providing services. Each commenter included an estimate of their 
partial hospitalization program cost (without depreciation or 
allocation of overhead costs). The estimates range from $270 to $325 
per patient per day. The commenters indicated that approximately 65 to 
70 percent of the costs are personnel-related.
    Response: The commenters did not indicate why their costs were 
higher than the per diem amount, but only that a significant proportion 
of their costs are related to personnel. In the future, we are 
committed to assessing the extent to which the per diem reflects 
special needs of rural hospitals. In the meantime, the BBRA 1999 
includes provisions that offer relief to rural hospitals during the 
early years of the outpatient PPS. (See section III.H of this 
preamble.)
    Comment: We received several other comments regarding the proposed 
per diem amount. One commenter stated that the proposed per diem rate 
is equivalent to 3.3 psychotherapy units. The commenter believed this 
is an inadequate level of therapy for partial hospitalization patients 
and suggested that a per diem rate equal to 4 psychotherapy units would 
provide payment for a more appropriate level of service intensity. 
Several other commenters suggested that we set a single rate using a 
therapeutic hour of treatment (for example, the group psychotherapy APC 
rate) as the unit of service coupled with an overall aggregate limit 
for a course of treatment. These commenters estimated that a typical 
partial hospitalization day costs $275. Another commenter, a national 
association, conducted a survey of its

[[Page 18453]]

member hospitals which showed that the median cost per day of treatment 
was approximately $210. Other commenters urged us to establish separate 
per diem amounts for partial hospitalization programs serving geriatric 
beneficiaries and those serving disabled beneficiaries under age 65. 
They indicated that programs designed to serve geriatric beneficiaries 
consist of different treatment modalities that are costlier than 
programs that serve younger beneficiaries. One commenter stated that 
programs serving younger beneficiaries typically average high patient 
volume and therefore have much lower costs per patient day than do the 
programs that serve geriatric patients. Other commenters urged us to 
establish a half day rate, although some stated that a half-day benefit 
does not reduce administrative costs appreciably.
    Response: In accordance with section 1833(t)(2)(C) of the Act, the 
proposed per diem amount represents the national median cost of 
providing partial hospitalization services. We used all the data from 
hospital bills that included the condition code 41, which identifies 
the claim as partial hospitalization. Because providers do not report 
on the claim the specific services provided each day, we do not 
currently have data that would permit us to establish an aggregate 
limit for a course of treatment or to analyze differences in the mix of 
services provided to various populations. As discussed in the preamble 
to the proposed rule and in Transmittal 7 of the CMHC Manual (issued 
November 1999) and Transmittal 747 of the Hospital Manual (issued 
December 1999), beginning April 1, 2000, hospitals and CMHCs will be 
required to indicate line item dates of service on claims. Once we have 
accumulated these data, we will be better able to determine if 
refinements to the per diem methodology are warranted, including the 
extent to which half-days are utilized.
    Comment: Several commenters expressed concern that no CMHC data 
were used to establish the partial hospitalization per diem payment 
rate. The commenters stated that CMHC costs are significantly different 
from hospital-based programs and urged us to collect CMHC cost data and 
base payments to CMHCs on CMHC-specific information. Another commenter 
stated that implementing PPS for partial hospitalization services 
provided by CMHCs is intended to contain costs and urged us to track 
the impact of the PPS on CMHCs. Still another commenter expressed 
concern that the per diem amount is insufficient for CMHCs to provide 
quality services. The commenter admitted, however, that historically 
their service area has had limited resources to provide minimum support 
for the persistent and chronically mentally ill. Two commenters 
expressed concern about certification requirements for CMHCs. One urged 
us to require accreditation by a national accrediting body and another 
commenter noted that reliance on the statutory definition established 
for CMHCs under the Public Health Service Act in 1963 is no longer 
appropriate and urged us to redefine a CMHC for Medicare certification 
purposes.
    Response: Partial hospitalization services are covered services 
under the hospital outpatient PPS. Section 1833(a)(2)(B) of the Act 
provides that partial hospitalization services furnished by CMHCs are 
to be paid under the hospital outpatient PPS. And, section 
1833(t)(2)(C) of the Act requires that we establish relative payment 
weights based on median (or mean, at the election of the Secretary) 
hospital costs determined by 1996 claims data and data from the most 
recent available cost reports. As stated above, we are committed to 
analyzing future data from hospitals and CMHCs to determine if 
refinements to the per diem are warranted. As we noted in the proposed 
rule, the Medicare partial hospitalization benefit is designed to 
furnish services to patients who have been discharged from inpatient 
psychiatric care, and partial hospitalization services are provided in 
lieu of continued inpatient treatment, and for patients who exhibit 
disabling psychiatric/psychological symptoms or experience an acute 
exacerbation of a severe and persistent mental disorder. Because the 
statute requires a physician to certify that the patient would 
otherwise require inpatient psychiatric care in the absence of the 
partial hospitalization services, we do not believe the Medicare 
partial hospitalization benefit was intended to provide support for the 
persistent and chronically mentally ill except when they are in an 
acute phase of their mental illness. With regard to accreditation 
requirements for CMHCs and substantively revising the definition of a 
CMHC, this final rule is not the appropriate vehicle in which to 
address these issues. We are, however, amending Sec. 410.2 to remove an 
obsolete provision from the definition of a CMHC.
    Comment: Several commenters questioned whether the proposed per 
diem approach meets the definition of an APC, that is, a group of 
services that are comparable clinically and in resource use. They 
believed that partial hospitalizations vary widely in their treatment 
approach and cost. Therefore, creating one payment amount for all 
partial hospitalization days is not consistent with our proposed 
classification system.
    Response: We continue to believe that the structure of the average 
partial hospitalization day is more similar than the commenters 
believe. We followed the basic analytical methodology used to establish 
all the APC payment amounts, except that we determined that, for 
partial hospitalization services, the unit of service is a day. 
Nonetheless, requiring providers to submit claims by date of service 
and by service provided will allow for future analysis to determine if 
the APC grouping for partial hospitalization can be improved.
    Comment: One commenter expressed concern about the use of 1996 data 
as the basis for the per diem amount. They referenced testimony by the 
Inspector General that indicated a significant improvement in the 
accuracy of provider billing in 1998 audits. They urged us to use 1997 
or 1998 cost reports by region to develop the APC rate.
    Response: Section 1833(t)(2)(C) of the Act requires that we use 
1996 claims data and the most recent cost reports as the basis for 
ratesetting under the hospital outpatient PPS. For purposes of the 
final rule, we primarily used cost reports for periods beginning in FY 
1997.
    Comment: Several commenters, including national industry 
associations, expressed concern that partial hospitalization programs 
are required by their individual fiscal intermediaries to meet 
different medical necessity and programmatic requirements. For this 
reason, programs vary widely in program content and resultant cost. The 
commenters urged us to establish national coverage criteria before 
implementing a PPS for partial hospitalization services. Another 
commenter urged us to rely on more recent claims data that identify all 
services provided on each date of service in order to determine the 
relative resource cost of various outpatient mental health treatment 
programs.
    Response: Section 1833(a)(2)(B) of the Act provides that partial 
hospitalization services are paid under section 1833(t). We will refine 
the system, as needed, based on our review of more specific bill data. 
Movement to a per diem payment methodology will necessitate changes in 
the medical review approach used by fiscal intermediaries. It will 
become necessary to ensure that all patients receive the level of 
service their

[[Page 18454]]

individual condition requires. Some patients will require days of 
service that cost the provider more than the per diem payment amount. 
Other patients may require less intensive days of service during an 
acute episode of partial hospitalization care or as they transition out 
of the partial hospitalization program. We will be developing medical 
review guidance for fiscal intermediaries, which we believe will lead 
to more consistency in medical review.
    Comment: One commenter noted that, in the past, a daily or partial-
day payment approach was commonly used and was abandoned in favor of 
component billing for each partial hospitalization service. The 
commenter now believes that component billing provides a more accurate 
indication of the services provided to individual patients.
    Response: We believe that a per diem payment approach is a more 
appropriate methodology than billing for each program component. This 
approach is supported by the major industry groups involved with 
partial hospitalization and is used by other governmental and private 
insurers to pay for partial hospitalization program services. A per 
diem approach also incorporates and recognizes the cost of services 
that are not separately billable as outpatient psychiatric services, 
such as nursing services, training and education services, activity 
therapy, and support staff costs.
    Comment: Several commenters requested additional information on the 
HCPCS codes to which the partial hospitalization indicator applies and 
questioned how codes will group to APC 20 rather than grouping to 
psychotherapy APCs 91 through 94. They also asked whether substance 
abuse day programs will group to APC 20.
    Response: We issued revised billing instructions for partial 
hospitalization services provided by CMHCs in November 1999 and for 
hospital programs in December 1999. We instructed CMHCs to use HCPCS 
codes to bill for their partial hospitalization services; we required 
hospitals and CMHCs to report line item dates of service; and we 
established new HCPCS codes for occupational therapy and training and 
educational services furnished as a component of a partial 
hospitalization treatment program. We included in the instructions a 
complete listing of the revenue codes and HCPCS codes that may be 
billed as partial hospitalization services as follows:

------------------------------------------------------------------------
    Revenue codes            Description               HCPCS code
------------------------------------------------------------------------
43X.................  Occupational Therapy      G0129.
                       (Partial
                       Hospitalization).
904.................  Activity Therapy          Q0082.
                       (Partial
                       Hospitalization).
910.................  Psychiatric General       90801, 90802, 90875,
                       Services.                 90876, 90899, or 97770.
914.................  Individual Psychotherapy  90816, 90818, 90821,
                                                 90823, 90826, or 90828.
915.................  Group Psychotherapy.....  90849, 90853, or 90857.
916.................  Family Psychotherapy....  90846, 90847, or 90849.
918.................  Psychiatric Testing.....  96100, 96115, or 96117.
942.................  Education Training        G0172.
                       (Partial
                       Hospitalization).
------------------------------------------------------------------------

    To bill for partial hospitalization services under the hospital 
outpatient PPS, hospitals are to use these HCPCS and revenue codes and 
are to specify condition code 41 on the HCFA-1450 claim form. Before 
assigning a claim for payment to APC 0033 (the final APC for partial 
hospitalization services), the outpatient code editor (OCE) will check 
for errors; for example, the OCE will verify that the claim includes a 
mental health diagnosis, and at least three partial hospitalization 
HCPCS codes for each day of service, one of which must be a 
psychotherapy HCPCS code (other than brief). Claims that do not pass 
the OCE edits will undergo further prepayment review.
    With regard to the comments regarding substance abuse day programs, 
the Medicare benefit category is partial hospitalization services. 
Because there is no separate benefit category for substance abuse 
programs, any such program would have to meet requirements established 
for partial hospitalization programs in order for claims to group to 
APC 0033, including the requirements that a physician certify that the 
patient would otherwise require inpatient psychiatric care in the 
absence of the partial hospitalization services and that the program 
provides active treatment.
    Comment: In regard to physician recertification, we received 
several comments expressing support for establishing a specific 
timeframe and recommending a range from 7 to 31 days.
    Response: We agree that physicians should initially certify a 
patient's need for partial hospitalization services and recertify 
continued need for this intensive level of treatment. Because partial 
hospitalization is the outpatient substitute for inpatient psychiatric 
care, we believe it is appropriate to adopt the standard currently used 
for inpatient psychiatric care. Therefore, in this final rule, we are 
amending Sec. 424.24(e) to establish physician recertification 
requirements for partial hospitalization services. The initial 
physician certification establishing the need for partial 
hospitalization must be received by the partial hospitalization program 
upon admission. Thus, services provided to establish a patient's need 
for partial hospitalization services would continue to be billed to the 
carrier as professional services. The first recertification is required 
as of the 18th day of services and subsequent recertifications are 
required no less frequently than every 30 days. Each recertification 
must address the patient's response to the intensive, therapeutic 
interventions provided by the active treatment program which make up 
partial hospitalization services, changes in functioning and status of 
the serious psychiatric symptoms that place the patient at risk of 
hospitalization, and treatment plan and goals for coordination of 
services such as community supports and less intensive treatment 
options to facilitate discharge from the partial hospitalization 
program.
    Comment: We received several comments regarding our proposal to 
limit payment for less intensive outpatient mental health treatment at 
the partial hospitalization per diem rate. One commenter did not 
believe the law supports establishment of a payment ceiling and that 
any such action is arbitrary. Other commenters believe that treatment 
should be determined by the clinical needs of each patient. However, 
the commenters conceded that additional requirements may have to be 
added to the final rule to prevent duplication or overlap of partial

[[Page 18455]]

hospitalization and routine outpatient mental health services.
    Response: Our rationale for this proposal was that the costs 
associated with administering a partial hospitalization program 
represent the most resource intensive of all outpatient mental health 
treatment and, therefore, we should not pay more for a day of 
individual services. We are also concerned that a provider may 
disregard a patient's need for the intensive active treatment offered 
by a partial hospitalization program and opt to bill for individual 
services. In addition, the per diem amount represents the cost of an 
average day of partial hospitalization because the data used to 
calculate the per diem were derived from all the partial 
hospitalization data and include the most and the least intensive days. 
It would not be appropriate for a provider to obtain more payment 
through component billing.
    Comment: Several commenters expressed concern about staffing 
services that are bundled in the per diem payment and other staffing 
issues. One commenter stated that due to increased medical review by 
the fiscal intermediary, no partial hospitalization services may be 
furnished by unlicensed personnel. The commenter urged that the 
necessity for upgrades in staffing be taken into consideration in 
establishing a per diem rate. One commenter believes that all services, 
except for physician services, should be bundled into the per diem 
rate.
    Response: The list of covered partial hospitalization services is 
located in section 1861(ff) of the Act. The list includes several 
services such as patient education and training and activity therapy 
that may be provided by unlicensed but qualified staff who are 
specifically trained to work with the mentally ill. We note that the 
billing instructions issued in November 1999 (for CMHCs) and in 
December 1999 (for hospitals) announced a new HCPCS code for patient 
training and education services as a component of a partial 
hospitalization program. (A HCPCS code for activity therapy as part of 
a partial hospitalization program has been in place for several years.) 
Although the list also specifically references the services of social 
workers, trained psychiatric nurses, and other staff trained to work 
with psychiatric patients, there are no specific HCPCS codes for these 
services. Certain other partial hospitalization services, for example, 
individual and group psychotherapy, family counseling, occupational 
therapy (OT), and diagnostic services, must be provided by licensed 
staff, authorized by the State to provide these services.
    With regard to the content and staffing of partial hospitalization 
programs, we believe that all the covered services listed in section 
1861(ff) of the Act and the disciplines of the staff who provide the 
services, that is, the multidisciplinary team, are an important element 
in creating the therapeutic milieu that distinguishes partial 
hospitalization programs from other outpatient mental health treatment. 
We believe it would be inappropriate if providers no longer offered the 
full range of partial hospitalization services, especially services 
such as OT that continue to be bundled in the per diem amount. We plan 
to monitor the extent to which providers change their programming in 
response to implementation of the PPS. Because the data on which the 
per diem was based included the full range of services and the use of 
certain bundled professionals, we will monitor changes in services or 
increased use of unbundled practitioners to evaluate and update the per 
diem rate. In response to the comment recommending that we bundle more 
professional services into the per diem rate, we captured historical 
patterns of treatment and staffing during the base year. Thus, the 
partial hospitalization per diem amount is limited to the provider's 
overhead costs, support staff, and the services of clinical social 
workers and occupational therapists, whose professional services are 
defined as partial hospitalization services. We have amended 
Sec. 410.43(b) to update the list of services that are not paid as 
partial hospitalization services.
    Comment: One commenter took issue with our characterizing partial 
hospitalization to be the result of an acute exacerbation of a 
beneficiary's severe and persistent mental illness for which partial 
hospitalization services are provided in lieu of an inpatient 
psychiatric admission. They urged us to clarify that admission to a 
partial hospitalization is based on a physician certification that the 
patient would otherwise require inpatient psychiatric care, but 
continued stay in a partial hospitalization program would serve as a 
maintenance program for the chronically mentally ill. The commenter 
raised many other concerns about how we described partial 
hospitalization in the proposed rule, noting specific concern with 
regard to active treatment, community-based support, and frequency and 
duration of services.
    Response: It was not our intention in the proposed rule to generate 
public comment on the nature and coverage of partial hospitalization 
under the Medicare program. Rather, the information presented has 
appeared in various program memoranda and was included to describe the 
benefit and explain the per diem payment methodology. We continue to 
believe that partial hospitalization is a covered Medicare benefit 
category only when provided as an alternative to inpatient psychiatric 
care for acutely mentally ill beneficiaries.
Result of Evaluation of Comments
    We are adopting as final our proposal to--
     Establish a per diem payment of $202.19 for the partial 
hospitalization APC (APC 0033); and
     Limit the payment for outpatient mental health treatment 
furnished on a day of services to the partial hospitalization APC 
payment amount.
    In addition, we are amending Sec. 424.24(e) to establish 
requirements for physician recertification for partial hospitalization 
services.
5. Inpatient Only Procedures
    In our proposed rule, we assigned payment status indicator ``C'' to 
1,803 codes that represent procedures that our medical advisors and 
staff determined require inpatient care because of the invasive nature 
of the procedure, the need for postoperative care, or the underlying 
physical condition of the patient who would require the surgery. We did 
not assign these procedures to an APC group, and we proposed to make no 
payment for these services under the hospital outpatient PPS. Above, in 
section III.B.1.b of this preamble, we respond to the numerous general 
comments we received challenging both our classification of various 
procedures as inpatient procedures and our exclusion of these 
procedures from the scope of services paid under the hospital 
outpatient PPS.
    Comment: Commenters objected on the grounds that medical practice 
and new technology have allowed many procedures that formerly were 
performed only in the inpatient setting to be safely and effectively 
performed on an outpatient basis. In addition, they believe we are 
making decisions that should be left to the discretion of surgeons and 
their patients. Finally, the commenters believe that it is better for 
the patient if procedures are performed on an outpatient basis whenever 
possible. Commenters requested that we remove the payment status 
indicator of ``inpatient only'' from 195 codes and include them in an 
appropriate APC.
    Response: Under section 1833(t)(1)(B)(i) of the Act, the Secretary 
has broad authority to designate which

[[Page 18456]]

services fall within the definition of ``covered OPD [outpatient 
department] services'' that will be subject to payment under the 
prospective payment system. We believe that certain surgically invasive 
procedures on the brain, heart, and abdomen, such as craniotomies, 
coronary-artery bypass grafting, and laparotomies, indisputably require 
inpatient care, and therefore are outside the scope of outpatient 
services. Certain other procedures that we proposed as ``inpatient 
only'' may not be so clearly classified as such, but they are performed 
virtually always on an inpatient basis for the Medicare population. We 
acknowledge that emerging new technologies and innovative medical 
practice are blurring the difference between the need for inpatient 
care and the sufficiency of outpatient care for many procedures, 
although we are concerned that some of the procedures that commenters 
claim to be performing on an outpatient basis may actually have been 
performed with overnight postoperative care furnished in observation 
units. And, regardless of how a procedure is classified for purposes of 
payment, we expect, as we stated in our proposed rule, that in every 
case the surgeon and the hospital will assess the risk of a procedure 
or service to the individual patient, taking site of service into 
account, and will act in that patient's best interests.
    After a careful review of comments by our medical advisors and 
staff, we have assigned to APC groups certain procedures that we had 
proposed as inpatient only. We made some changes because we were 
convinced by commenters' arguments that certain procedures are often 
performed safely in the outpatient setting; others because we believe 
that the simplest procedure described by the code may be performed 
safely in the outpatient setting; and yet others because they were 
related to codes we moved (for example, the radiologic part of an 
interventional cardiology procedure). The procedures we moved to the 
outpatient APCs include codes from within the following families: 
Explorations of penetrating wounds; repairs of some cranial and facial 
fractures; planned tracheostomies; diagnostic thoracoscopies; some 
insertion/removal/replacement of pacemakers, pulse generators, 
electrodes and cardioverter-defibrillators; embolectomies and 
thrombectomies; transluminal balloon angioplasty and peripheral 
atherectomy; transcatheter therapies; bone marrow transplantation; 
gastrostomies; percutaneous nephrostolithotomy; surgical laparoscopies, 
including cholecystectomies; ovarian biopsies; and surgeries on the 
orbit. Although we are moving these procedures into APC groups and they 
can receive outpatient payment, we emphasize that we expect only the 
simplest and least resource intensive procedures of each type to be 
performed in the outpatient setting. For example, several codes could 
be used to describe initial insertion of a pacemaker or replacement of 
the pacemaker or its electrodes. We believe most initial pacemaker 
insertions are performed on an inpatient basis, so codes billed in this 
range are most likely to be for replacement of a pacemaker, which 
requires fewer facility resources.
    Because of the risk involved with invasive cardiovascular 
procedures, including angioplasty and atherectomy, we are placing an 
additional requirement on their performance that we do not think is 
necessary with other procedures. That is, Medicare will pay for these 
procedures only in those settings in which the patient can immediately 
be placed on cardiopulmonary bypass in the event of a complication such 
as perforation of a coronary artery, which would require an immediate 
thoracotomy.
    When our medical advisors and staff disagreed with the 
recommendation of commenters to reclassify a particular procedure, they 
based their decision to retain a procedure as ``inpatient only'' on 
several considerations. In general terms, as stated above, we define 
inpatient procedures as those that require inpatient care because of 
the invasive nature of the procedure, the need for at least 24 hours of 
postoperative recovery time or monitoring before the patient can be 
safely discharged, or the underlying physical condition of the patient 
who would require the surgery. In other words, inpatient procedures are 
those that, in the judgment of our medical advisors and staff, would 
not be safe, appropriate, or considered to fall within the boundaries 
of acceptable medical practice if they were performed on other than a 
hospital inpatient basis.
    Among the procedures cited by commenters that we believe should 
remain as ``inpatient only'' are: Breast reconstruction using 
myocutaneous flaps; radical resections of tumors of the mandible; open 
treatment of certain craniofacial fractures; osteotomies of the femur 
and tibia; sinus endoscopy with repair of cerebrospinal fluid leaks; 
carinal reconstruction; surgical thoracoscopies; pacemaker procedures 
by thoracotomy; certain thromboendarterectomies; excision of 
mediastinal cysts and tumors; excisions of stomach tumors; 
enterostomies; hepatotomies; ureterotomies and ureteral endoscopies 
through ureterotomies; transcranial approaches to the orbit; and 
laminectomies. Our medical advisors and staff, as well as consulting 
physicians, believe these procedures are too invasive (for example, 
thoracotomies), too extensive (for example, breast reconstruction with 
myocutaneous flaps), or too risky by virtue of proximity to major 
organs (for example, repairs of spinal fluid leaks and carinal 
reconstruction) to be performed on an outpatient basis. The procedures 
that we exclude from outpatient payment because we believe they should 
be performed on an inpatient basis are listed in Addendum E. This list 
represents national Medicare policy and is binding on fiscal 
intermediaries and peer review organizations as well as on hospitals 
and Medicare participating ASCs. Note, however, that services included 
in outpatient PPS and assigned to an APC may be performed on an 
inpatient basis when the patient's condition warrants inpatient 
admission.
    In the future, as part of our annual update process, we will be 
working with professional societies and hospital associations, as well 
as with the expert outside advisory panel that we will be convening as 
required by new section 1833(t)(9)(A) of the Act, to reevaluate 
procedures on the ``inpatient only'' list and we will propose to move 
procedures to the outpatient setting whenever we determine it to be 
appropriate. For example, a decreasing length of inpatient stay for a 
procedure may signal that it is appropriate for consideration for 
payment under the outpatient PPS. If hospitals find that surgeons are 
discharging patients successfully on the day of surgery, they should 
bring this to our attention as well, because hospitals may become aware 
of this trend before our payment data disclose it. Thus, assignment of 
a ``C'' payment status indicator in this final rule should not be 
considered as a permanent or irrevocable designation.
    Comment: One professional society recommended that we assign 
payment status indicator ``C'' to CPT codes 21343, open treatment of 
depressed frontal sinus fracture, 42842, radical resection of tonsil, 
tonsillar pillars, and/or retromolar trigone--without closure, and 
69150, radical excision external auditory canal lesion--without neck 
dissection, because these procedures require inpatient care.
    Response: We accepted the commenters' recommendation that these CPT 
codes should not be performed in an outpatient setting. We also 
reclassified as an inpatient procedure

[[Page 18457]]

CPT code 94762, noninvasive ear or pulse oximetry for oxygen 
saturation; by continuous overnight monitoring (separate procedure), 
because it requires an overnight stay.
    Comment: One commenter noted that, to the extent that we require 
that certain surgical procedures be performed in an inpatient setting 
in order to receive Medicare payment, the beneficiary will incur the 
higher deductible associated with a hospital inpatient service.
    Response: The commenter is correct that the Part A hospital 
inpatient deductible amount that a beneficiary will have to pay may be 
higher than coinsurance and deductibles the beneficiary would have paid 
as an outpatient for a surgical procedure. However, our decisions 
concerning whether to pay for certain surgical procedures under the PPS 
are based on patient safety concerns and the medical appropriateness of 
performing the procedures in the hospital inpatient versus outpatient 
setting.
Final Action
    Under the hospital outpatient PPS, we will not make payment for 
procedures that are designated as ``inpatient only.'' We have, however, 
revised the list of procedures that are designated as ``inpatient 
only'' based on comments. (See Addendum E.)
6. Modification of APC Groups

a. How the Groups Were Constructed

    Section 1833(t)(2)(A) of the Act requires the Secretary to develop 
a classification system for covered outpatient services. Within that 
classification system, the Secretary is given the authority under 
section 1833(t)(2)(B) of the Act to establish groups of covered 
services so that the services within each group are comparable 
clinically and with respect to the use of resources. In the proposed 
rule, we explain how we constructed the APC groups that are the basis 
for ratesetting under the hospital outpatient PPS.
    Our medical advisors and staff used the ambulatory patient groups 
(APGs) developed by 3M-Health Information Systems as a starting point 
for the APC groups, but we modified the APGs to take into account 1996 
outpatient claims data, data collected in a 1994 survey of ambulatory 
surgical center (ASC) costs and charges, data collected in 1995 and 
1996 to establish resource-based practice expense relative values under 
the Medicare physician fee schedule, and comments offered by a broad 
range of professional and trade societies and associations. For a more 
detailed discussion of this process, see section V.B of the proposed 
rule (63 FR 47561).

b. Comments on Classification of Procedures and Services Within APC 
Groups

    In the proposed rule, we invited comments on the composition of the 
APC groups, and we requested that commenters support their 
recommendations for changes with resource cost data and clinical 
arguments. We received a large number of comments on our proposed 
grouping of individual procedures and services. The most common comment 
was that the APC groups generally lacked consistency in terms of 
clinical characteristics and resource utilization. Below, in section 
III.C.6.d of this preamble, we address recommendations from commenters 
that specific HCPCS codes be assigned to a group other than the one we 
proposed. In addition to reviewing the APC groups that were the subject 
of comments, our medical advisors and staff reviewed every APC group to 
take into account the effect across all related groups of commenters' 
recommended changes.
Criteria for Evaluating Changes Recommended by Commenters
    In determining whether or not to accept a recommended change, we 
focused on five criteria that are fundamental to the definition of a 
group within the APC system. The decision to accept or decline a 
modification to an APC group was measured by whether the change 
enhanced, detracted from, or had no effect on the integrity of an APC 
group within the context of these five criteria. The five criteria are 
as follows:
     Resource Homogeneity
    The amount and type of facility resources, for example, operating 
room time, medical surgical supplies, and equipment, that are used to 
furnish or perform the individual procedures or services within each 
APC should be homogeneous. That is, the resources used are relatively 
constant across all procedures or services even though resource use may 
vary somewhat among individual patients. If the procedures within an 
APC require widely varying resources, it would be difficult to develop 
equitable payment rates. Aggregated payments to a facility that 
performed a disproportionate share of either the expensive or 
inexpensive procedures within an APC would be distorted. Further, the 
facility might be encouraged to furnish only the less costly procedures 
within the APC, resulting in a potential access problem for the more 
costly services.
    It is important to note that procedures within an individual HCPCS 
code can vary widely in resource use. The coefficient of variation of 
cost for the procedures within one HCPCS code can be as high as the 
overall coefficient of variation across all the HCPCS codes that 
comprise an APC group. Thus, a significant amount of the variability in 
resource use within some APC groups can be attributed to the 
variability of resources within individual HCPCS codes. Nevertheless, 
if resource use is reasonably homogeneous among the HCPCS codes within 
an APC group, the average pattern of resource use among a group of 
cases in an APC can be accurately predicted. In section III.C.6.c, 
below, we discuss the BBRA 1999 provision that sets limits on the 
variation in resource cost within an APC.
     Clinical Homogeneity
    The definition of each APC group should be ``clinically 
meaningful,'' that is, the procedures or services included within the 
APC group relate generally to a common organ system or etiology, have 
the same degree of extensiveness, and utilize the same method of 
treatment, for example, surgical, endoscopic, etc. The definition of 
clinical meaningfulness is, of course, dependent on the goal of the 
classification system. For APCs, the definition of clinical 
meaningfulness relates to the medical rationale for differences in 
resource use. If, on the other hand, classifying patient prognosis were 
the goal, the definition of patient characteristics that were 
clinically meaningful might be different.
     Provider Concentration
    We considered the degree of provider concentration associated with 
the individual services that comprise the APC. If a particular service 
is offered only in a limited number of hospitals, then the impact of 
payment for the service is concentrated in a subset of hospitals. 
Therefore, it is particularly important to have an accurate payment 
level for services with a high degree of provider concentration. 
Conversely, the accuracy of payment levels for services that are 
routinely offered by most hospitals does not bias the payment system 
against any subset of hospitals. Thus, differences in the resource 
requirements for individual services within an APC are of less 
significance if all the services within the APC are routinely offered 
by most hospitals because the impact of the difference should average 
out at the hospital level.
     Frequency of Service
    Unless we found a high degree of provider concentration, we avoided 
creating separate APC groups for

[[Page 18458]]

services that are infrequently performed. It is difficult to establish 
reliable payment rates for low volume APC groups. Therefore, we 
assigned the HCPCS codes to the APC that was the most similar in terms 
of resource use and clinical coherence.
    Some procedures, such as craniotomies, are clearly inpatient 
procedures, and are rarely performed in an outpatient setting. However, 
there are some procedures that, while they are normally performed on an 
inpatient basis, can also be safely performed on an outpatient basis. 
The performance of those procedures on an outpatient basis is 
infrequent and is limited to the simplest cases. Therefore, when we 
included these procedures in APC groups, we assumed a level of resource 
use that would apply only to the simplest cases rather than that 
typical of more complex cases that would be performed on an inpatient 
basis.
     Minimal Opportunities for Upcoding and Code Fragmentation
    The APC system is intended to discourage using a code in a higher 
paying group to define a case. That is, putting two related codes, such 
as the codes for excising a lesion of 1.1 cm and one of 1.0 cm, in 
different APC groups may create an incentive to exaggerate the size of 
the lesions in order to justify the incrementally higher payment. APC 
groups based on subtle distinctions would be susceptible to this kind 
of upcoding. Therefore, we kept the APC groups as broad and inclusive 
as possible without sacrificing resource or clinical homogeneity.
    In general, HCPCS codes that are nonspecific (such as 20999, 
``unlisted procedure, musculoskeletal system, general'') were assigned 
to the lowest paying APC that was consistent with the clinical 
characteristics of the service. In the case of 20999, the codes to 
which it is related are in the range 20000-20979. The APCs to which 
they group range from 0004, with a payment rate of $89.22, to 0050, 
with a payment rate of $1,024.53. We placed 20999 in the lowest paying, 
related group, 0004.

c. Effect of the BBRA 1999 on Final APC Groups

    Section 201(g) of the BBRA 1999 amends section 1833(t)(2) of the 
Act to limit the variation in resource use among the procedures or 
services within an APC group. Specifically, section 1833(t)(2) of the 
Act now provides that the items and services within a group cannot be 
considered comparable with respect to the use of resources if the 
highest cost item or service within a group is more than 2 times 
greater than the lowest cost item or service within the same group. The 
Secretary is to use either the mean or median cost of the item or 
service. We are using the median cost because we have continued to set 
the relative payment weights for each APC based on median hospital 
costs in this final rule. (See the discussion in section III.E of this 
preamble.)
    Section 1833(t)(2) of the Act as amended also allows the Secretary 
to make exceptions to this limit on the variation of costs within each 
group in unusual cases such as low volume items and services, although 
we may not make such an exception in the case of a drug or biological 
that has been designated as an orphan drug under section 526 of the 
Federal Food, Drug, and Cosmetic Act. See the discussion of the 
classification of orphan drugs in section II.D of this preamble and the 
discussion of APC groups that we excepted from the ``2 times'' limit in 
section III.C.6.e.
    We applied the limit on variation on median costs required by 
section 201(g) to the revised APC groups. (See section C.6.d, below.) 
As a result of our analysis of the array of median costs within the 
revised APC groups, we had to split some otherwise clinically 
homogeneous APC groups into smaller groups. We are concerned that this 
further subdivision of groups may create vulnerabilities for upcoding, 
which conflicts with one of the five criteria described above that we 
used to evaluate the construction of the APC groups. We will be 
examining the extent to which the APC reorganization due to the ``2 
times'' rule results in upcoding.

d. Summary of APC Modifications

    In this section, we summarize and explain our response to comments 
on individual or serial APCs. We use the APC number that appeared in 
the proposed rule to identify a group that was changed. In most 
instances, we moved a HCPCS code from its proposed APC group to a 
different APC group either in response to comments or to comply with 
section 1833(t)(2)(C) of the Act. In some cases, we moved codes when a 
change in response to a comment or the cost variation limit resulted in 
a grouping that seriously compromised one of the criteria we used to 
evaluate changes recommended by commenters. Because we made so many 
changes in the APC groups, we renumbered all the groups and, in many 
cases, renamed groups. In our response to comments in connection with 
an APC, the final designation for a HCPCS code corresponds to the 
renumbered APC group found in the addenda.
APC 121: Level I Needle Biopsy/Aspiration
    Comment: One specialty society commented that there was significant 
variation in resource consumption for the procedures performed in this 
APC and that the proposed payment rate of $33.95 for APC 121 does not 
accurately reflect the preparation, examination, and consultation 
expenses for a pathologist to thoroughly perform these procedures. The 
commenter recommended including CPT codes 85095, 85102, 88170, and 
88171 in proposed APC 122.
    Response: The procedures we proposed to classify in APC 121 were 
considered sufficiently similar from a clinical perspective. We found 
no provider concentration associated with the procedures proposed for 
this APC. Therefore, any variation in cost across the procedures in 
this APC should average out at the hospital level. However, to be 
consistent with the BBRA 1999 ``two times'' provision concerning 
comparable resources, we have moved CPT codes 85095 and 85102 to final 
APC 0003, and CPT codes 88170 and 88171 remain in final APC 0002.
APC 122: Level II Needle Biopsy/Aspiration
    Comment: A number of commenters indicated that there was 
significant variation in resource consumption for the procedures 
proposed in this APC group. For example, one commenter stated that 
although all the codes within this group are needle biopsies, they 
range dramatically in complexity, they are quite dissimilar in terms of 
resource use, they are not clinically similar, and the proposed 
grouping results in inappropriate payment for the more complex 
procedures.
    Response: We decided that CPT code 67415, Fine needle aspiration of 
orbital contents, was more appropriately grouped from a clinical 
perspective with ophthalmic procedures in final APC 0239. We further 
divided the codes in proposed APC groups 121 and 122 for needle biopsy/
aspiration into final APC groups 0002, 0003, 0004, and 0005 to be 
consistent with the BBRA 1999 ``two times'' requirement.
APC 131: Level I incision & drainage
    Although we received no comments on proposed APC group 131, based 
on internal review of this APC, we moved CPT code 11976, Removal, 
implantable contraceptive capsules, to final APC 019 because this 
procedure represents an excision rather than an incision. We divided 
proposed APC 131 into final

[[Page 18459]]

APC groups 0006, 0007, and 0008 to be consistent with the BBRA 1999 
``two times'' requirement.
APC 141: Level I Destruction of lesion
APC 142: Level II Destruction of lesion
    Comment: One commenter questioned our proposed assignment of CPT 
codes 17106 through 17108, which describe destruction of cutaneous 
vascular proliferative lesions, to APC groups 141 and 142.
    Response: We moved CPT code 17106 to final APC 0011 because its 
median cost is significantly higher than the other codes in 0010. 
However, the median cost for that code is greater than we would have 
expected it to be. We will review the appropriateness of this placement 
in the course of future updates of the APC groups.
APC 151: Level I debridement/destruction
APC 152: Level II debridement/destruction
    Comment: We received general comments questioning the resource 
homogeneity of the proposed skin APC groups. One commenter recommended 
including removal of skin lesion with laser on other body parts in 
proposed APC 152 rather than restricting the APC to vulva, anus, and 
penis procedures. The commenter believes that removal of these benign 
lesions, including papillomas, should include other areas of the body.
    Response: We agree with commenters' general concerns about resource 
homogeneity. We reclassified the codes in proposed APCs 151 and 152 
into final APC groups 00012 through 00017 to better differentiate 
resource use and clinical characteristics and to be consistent with the 
``two times'' BBRA 1999 requirement. We also moved CPT code 42809, 
Removal of foreign body from pharynx, to final APC 251 because it is an 
otorhinolaryngology (Ear/Nose/Throat (ENT)) procedure.
APC 161: Level I excision/biopsy
APC 162: Level II excision/biopsy
APC 163: Level III excision/biopsy
    Comment: Numerous commenters were concerned about the variation of 
resource use among the procedures in proposed APC groups 161, 162, and 
163. Commenters requested that we consider classifying procedures in 
these groups based on anatomic location where functionality is of high 
importance in combination with the size of excision.
    Response: We made a number of modifications to the excision APC 
groups to satisfy the BBRA 1999 ``two times'' requirement, resulting in 
final APC groups 0018 through 0022. We reclassified CPT codes 11043 and 
11044 to APC groups 0016 and 0017 because these codes describe 
debridement of skin, subcutaneous tissue, muscle, and bone.
    In the final excision/biopsy APC groups, we endeavored to make 
distinctions based on the location and size of the excision. For 
example, excisions of malignant lesions from the face, ears, eyelids, 
nose, lips greater than 4 cm were placed in an APC requiring more 
resource use than excisions of malignant lesions from the trunk, arms 
or legs greater than 4 cm because ``functionality'' is of greater 
importance when the site is the face, ears, eyelids, nose, or lips. We 
moved excisions involving the eye to ophthalmic procedure APCs. We did 
not make grouping distinctions between benign and malignant lesions of 
the same size and location because resource use for both types is 
similar.
    We moved benign and malignant excisions larger than 2 cm to final 
APC group 0020 because these excisions require more resources than, for 
example, excisions smaller than 1 cm.
    We moved CPT code 20220, superficial biopsy of bone (e.g., ilium, 
sternum, spinous process, ribs) with trocar or needle, to final APC 
0019, because the resources used in connection with this procedure are 
similar to those required for excisions of small benign or malignant 
lesions.
    As noted above, we classified two debridement procedures (CPT codes 
11043 and 11044) to final APC groups 0016 and 0017, respectively.
    We also moved seven codes from proposed APC 162 to the ophthalmic 
APC groups.
APC 181: Level I skin repair
APC 182: Level II skin repair
APC 183: Level III skin repair
APC 184: Level IV skin repair
    Comment: We received numerous comments expressing concern about the 
consistency of resource use and clinical homogeneity of the procedures 
in the four proposed skin repair APC groups. Many commenters 
recommended moving more complex procedures, such as large layer 
closures, to an APC with a higher payment rate because the procedures 
require more operating room and recovery time. Some commenters 
recommended moving some of the skin repair codes to other body systems.
    Response: Our review of proposed APC groups 181, 182, 183, and 184 
resulted in our regrouping the skin repair codes based more on cost 
than on clinical considerations. The volume of claims in most of the 
codes, however, is quite low. In addition, we moved CPT code 33222, 
Revision or relocation of skin pocket for pacemaker, from proposed APC 
360 to final APC 0026, because this procedure is so similar to the 
other skin repair procedures in terms of clinical content and resource 
consumption. We will review these groups carefully as data become 
available.
APC 197: Incision/excision breast
APC 198: Breast reconstruction/mastectomy
    Comment: One commenter observed that the procedures in proposed APC 
group 198 are related both to the definitive treatment of breast cancer 
and to plastic and reconstructive operations of the breast. The 
commenter recommended moving CPT code 19162, Mastectomy, partial with 
axillary lymphadenectomy, and CPT code 19182, Mastectomy, subcutaneous, 
into an APC group with a higher payment rate because both procedures 
are more complex and involve more time and resources than the other 
procedures in proposed APC group 198. Another commenter stated that CPT 
code 19162, and CPT code 19318, Reduction mammoplasty, require 
significantly longer operating times than the other procedures in 
proposed APC group 198. The same commenter further observed that CPT 
code 19162 essentially involves performing two procedures.
    Response: Our medical advisors and staff carefully reviewed the 
comments submitted in connection with the procedures in proposed APC 
group 198 within the context of the criteria that we discuss at the 
beginning of this section. They concluded that, although reduction 
mammoplasty (CPT code 19318) could require slightly more resources, a 
reduction mammoplasty is still fundamentally similar to other 
procedures in proposed APC 198 such as CPT code 19162, Partial 
mastectomy with axillary lymphadenectomy. Our medical advisors and 
staff concluded that the procedures in proposed APC groups 197 and 198 
were sufficiently similar clinically and in terms of resource use to 
retain the proposed groupings. Therefore, we are retaining our proposed 
grouping in final APC groups 0029 and 0030.
APC 207: Closed treatment fracture finger/toe/trunk
    Although we did not receive comments about this APC group, our 
medical advisors and staff determined that treatment of closed 
fractures

[[Page 18460]]

pertaining to the larynx should be moved to the ENT APC groups because 
they are more similar from a clinical and resource use perspective to 
ENT procedures. The larynx procedures do not involve casts and, more 
importantly, they require completely different resources and ancillary 
personnel than, for example, the setting of a finger fracture. Proposed 
APC 207 is renumbered final APC 0043.
APC 209: Closed treatment fracture/dislocation except finger/toe/trunk
    Comment: One commenter objected to including multiple procedures 
for dislocation and fractures in proposed APC group 209, when the cost 
of drugs and supplies alone for these procedures probably exceeds $100. 
The commenter believed that the proposed payment rate for APC 209 was 
$71.00.
    Response: We note that the proposed payment for APC 209 was $98.75, 
rather than $71.00, as the commenter quoted. Although we included in 
proposed APC 209 some procedures that could involve considerable time 
and resources, only the simplest cases of these potentially more 
complex procedures would be performed on an outpatient basis, with 
proportionally lower costs than would be incurred when the procedures 
are performed in an inpatient setting. Therefore, we retained in final 
APC 0044 the codes in proposed APC 209, except we moved CPT code 31586, 
Treatment of closed laryngeal fracture, to final APC 0256, because this 
is primarily an ENT procedure.
APC 216: Open/percutaneous treatment fracture or dislocation
    Comment: Numerous commenters took issue with the variation in 
resource use among the procedures that include the open treatment of 
almost all bone fractures, ranging from relatively simple finger and 
toe fractures to major long bone fractures.
    Response: We expect that only the simplest of the procedures 
proposed in APC group 216 would be performed on an outpatient basis. 
Therefore, we kept open/percutaneous treatment of fractures in one APC 
rather than splitting these procedures into multiple APCs. We find it 
unlikely that one provider would specialize in, for example, only open 
fractures of fingers or only open fractures of long bones. Because the 
CPT code descriptors for so many procedures in this APC group indicate 
``with and/or without internal fixation,'' it is impossible to make 
distinctions based on whether or not internal fixation is applied. 
Proposed APC 216 is renumbered final APC 0046.
APC 226: Maxillofacial prostheses
APC 231: Level I skull and facial bone procedures
APC 232: Level II skull and facial bone procedures
    Although we did not receive specific recommendations for these 
APCs, our medical advisors and staff determined that the procedures in 
these groups are more similar to ENT procedures from a clinical and 
resource use perspective. Therefore, we moved all of the procedures in 
these proposed APC groups to the final APCs 0251 through 0256, the ENT 
APCs.
APC 251: Level I Musculoskeletal Procedures
APC 252: Level II Musculoskeletal Procedures
    Comment: One commenter expressed concerns about the clinical 
homogeneity of the codes in these two groups. The commenter stated that 
proposed APC 251 contains 77 widely disparate procedures, including CPT 
code 23100 and CPT code 24100, which describe arthrotomies with 
biopsies, CPT code 25248, Exploration with removal of deep foreign 
body, forearm or wrist, and CPT code 27704, Removal of ankle implant. 
The commenter further stated that proposed APC 252 contains equally 
diverse procedures ranging from: CPT code 20900, Bone graft, any donor 
area; minor or small, to CPT code 25251, Removal of wrist prosthesis; 
complicated, including ``total wrist,'' to CPT codes 27396, 27580, and 
27665, which are different types of tendon procedures. The commenter 
recommended that procedures that require specialized equipment and more 
operating room time be moved into a group with a higher payment rate.
    Response: Our medical advisors and staff, after careful 
consideration of the commenter's concerns and after reviewing 
alternative groupings of the numerous codes in these two proposed 
musculoskeletal APC groups, concluded that splitting these groups to 
address the disparities cited by the commenter would result in too many 
small, low-volume groups for which we would be unable to establish 
reliable payment rates. The broad inclusiveness of these two APC groups 
is in part a reflection of the magnitude of the musculoskeletal system. 
Given the homogeneity of resource use across the many procedures within 
each group, we concluded that the factors supporting retention of the 
two groups outweighed the concerns raised by the commenter. We did, 
however, move CPT code 27086, Removal of foreign body, pelvis or hip; 
subcutaneous tissue, to final APC 0019.
APC 280: Diagnostic Arthroscopy
APC 281: Level I Surgical Arthroscopy
APC 282: Level II Surgical Arthroscopy
    Comment: A number of commenters expressed concerns about the 
homogeneity of codes in the proposed surgical arthroscopy APC groups. 
In particular, commenters stated that while an arthroscope is needed 
for all the procedures assigned to proposed APC group 281, the nature 
of the repair may mandate different additional equipment and differing 
times to complete. Commenters did not find the procedures in proposed 
APC 281 to be homogeneous with respect to the time required to perform 
the procedures nor their associated costs. Commenters specifically 
recommended transferring complex elbow and wrist procedures represented 
by CPT codes 29826, 29838, 29839, 29846, 29847, 29848, 29861, 29862, 
and 29863 into an APC group with a higher payment rate.
    Response: Upon revisiting the assignment of codes to proposed APC 
groups 280, 281, and 282, and considering the concerns expressed by 
commenters, our medical advisors and staff concluded that collapsing 
the three proposed APC groups into a single group would result in a 
more homogeneous grouping in terms of resource use. Hence, final APC 
0041 contains the codes proposed as APC groups 280, 281, and 282. The 
relatively low volume of many of the procedures in the proposed APCs 
supports combining them into a single group. Further, we found that, 
from a facility perspective, the resource use for all the codes in 
final APC 0041 is similar. For example, we had proposed to place CPT 
code 29881, Arthroscopy, knee, surgical; with meniscectomy (medial or 
lateral, including any meniscal shaving), and CPT code 29882, 
Arthroscopy, knee, surgical; with meniscus repair (medial or lateral), 
in two different APC groups. However, the resources required for these 
two procedures is sufficiently comparable to warrant placing both into 
the same APC.
APC 286: Arthroscopically-Aided Procedures
    We considered including the procedures in proposed APC group 286 
with the other arthroscopic procedures in final APC 0041 because they 
are so infrequently performed in an outpatient setting for Medicare 
beneficiaries. However, the resources required to perform the 
procedures in proposed

[[Page 18461]]

APC 286 are so strikingly distinct from those used in connection with 
the procedures in final APC group 0041 as to warrant being retained in 
a separate group. Further, it is unlikely that an individual provider 
specializes in the particular type of arthroscopic procedure contained 
in this APC, so separating all of the codes in final APC 042 from those 
in APC 041 should not disadvantage any one hospital.
APC 311: Level I ENT Procedures
APC 312: Level II ENT Procedures
APC 313: Level III ENT Procedures
APC 314: Level IV ENT Procedures
    We received numerous comments about the composition of the four 
proposed ENT APC groups. After careful review of the comments, our 
medical advisors and staff recognized the need for a major 
reorganization of the groups we proposed for ENT procedures. The 
outcome of our review was the creation of five final APC groups for ENT 
procedures: APC groups 0251, 0252, 0253, 0254, and 0256. We moved a 
large number of bone procedures involving the facial and ENT areas from 
musculoskeletal groups to ENT groups. We transferred some codes out of 
the ENT groups altogether, and we shifted codes among the five final 
ENT groups to comply with the BBRA 1999 ``two times'' requirement. We 
respond to recommendations regarding specific codes below.
    Comment: One commenter observed that CPT codes 31603 and 31605, 
emergency tracheostomy procedures, are risky and life-threatening no 
matter how quickly they are performed, and, as such, they should not be 
grouped with procedures for removing a foreign body from the ear canal 
or removing cerumen (proposed APC 311).
    Response: We agree. We created new APC group 0340 to which we 
assigned CPT code 69200, removal of foreign body from external auditory 
canal; without general anesthesia, and CPT code 69210, Removal impacted 
cerumen (separate procedure), one or both ears. We shifted these two 
procedures to the Minor Ancillary Procedures APC group because of their 
relative high frequency, their low cost in terms of resource use with 
low disposable equipment cost, and because these procedures generally 
do not require scheduling. Removing CPT code 69210 from the final ENT 
groups also corrects any pricing distortions that may have resulted 
from the disproportionately high volume of that procedure.
    We also moved the tracheostomy emergency procedures to final APC 
0254.
    We moved several other procedures such as CPT code 41870, 
Periodontal mucosal grafting, to final APC 0253, a group with higher 
cost procedures.
    We moved several abscess drainage procedures such as CPT code 
41800, Drainage of abscess, cyst, hematoma from dentoalveolar 
structures, to final APC group 0251 because of their relatively low 
cost.
    Comment: One commenter stated that all the procedures in proposed 
APC 312 appear to be reasonably priced with the exception of CPT code 
69436, Tympanostomy (requiring insertion of ventilating tube), general 
anesthesia. In the view of the commenter, the extra supplies and time 
required for this procedure necessitate a higher payment.
    Response: We moved CPT code 69433, Tympanostomy (requiring 
insertion of ventilating tube, local or topical anesthesia), to final 
APC 0252 because of its lower resource use relative to CPT code 69436. 
CPT code 69436 is assigned to final APC 0253.
    We moved a large number of procedures such as CPT code 42335, 
Sialolithotomy; submandibular (submaxillary), complicated, intraoral 
from original APC 313 to final APC 0253 to reflect a similarity of 
resource use. In terms of resource use, CPT code 30115, Excision, nasal 
polyp(s), extensive, is more similar to CPT code 42300, Drainage of 
abscess, parotid, simple, than it is to CPT 42410, Excision of parotid 
tumor or parotid gland; lateral lobe without nerve dissection.
    We shifted CPT code 21040, Excision of benign cyst or tumor of 
mandible, from the musculoskeletal group to final APC 0253 with other 
ENT procedures.
    Comment: One commenter stated that procedures directed towards 
cancer treatment were inappropriately assigned to proposed APC 313. As 
examples, the commenter cited CPT codes 30150 and 30160, rhinectomy 
procedures; CPT code 41120, Glossectomy; less than one-half tongue; and 
CPT code 69210, Excision external ear, complete amputation. The 
commenter also indicated concern that proposed APC group 313 includes a 
disproportionately large percentage of resource-consuming ENT 
procedures and commonly performed sinus procedures. Other commenters 
recommended that more complex otorhinolaryngology procedures in the 
group that have longer operating and recovery room times be moved to a 
group with a higher payment rate.
    Response: We moved CPT code 69210 to final APC group 0340, and we 
assigned CPT codes 30150, 30160, and 41120 to final APC group 0256. We 
also moved CPT code 42215, Palatoplasty for cleft palate; major 
revision to final APC group 0256.
    Comment: One commenter suggested placing certain thyroid procedures 
in the ENT groups.
    Response: While we agree that CPT code 60280, Thyroglossal cyst 
excisions, is somewhat similar to CPT code 42440, Excision of 
submandibular, submaxillary gland, we nonetheless believe that the 
former type of excision is more appropriately placed from a clinical 
perspective with other thyroid procedures.
APC 318: Nasal Cauterization/Packing
    Comment: A number of commenters addressed generally the range of 
resource use among the procedures within this proposed APC. One 
commenter observed that CPT code 30901 is almost always a simple office 
procedure within the context of an otolaryngology practice. The same 
commenter indicated that CPT codes 30903, 30905, and 30906 frequently 
require several hours of direct physician contact and monitoring and 
recommended that we consider reclassifying CPT codes 30903, 30905, and 
30906 to proposed APC group 332, Level II Endoscopy Upper Airway. 
Another commenter was concerned that CPT codes 30905 and 30906 stand 
out as inappropriate for this APC level because they require much more 
time and expertise and are used in more life-threatening situations 
than the other codes in the group.
    Response: While there is a range of procedures in this APC 
pertaining to control of nasal hemorrhage, hospitals normally treat the 
entire range of these procedures, and there is no concentration of 
certain of these procedures in a subset of hospitals. Our medical 
advisors and staff also found that there can be a range of resource 
consumption within many of the procedures themselves as well as across 
procedures in this APC. We therefore are not reassigning the codes.
    We did, however, move CPT codes 30999 and 42999 for unlisted 
procedures to final APC 0251 and 0252, respectively, to be consistent 
with our policy of placing unlisted codes in the lowest paid related 
group.
APC 331: Level I Endoscopy Upper Airway
    Comment: One commenter noted that the relative weight and payment 
rate proposed for APC group 331 approximated the relative weight and 
payment rate proposed for APC groups 997 or 987. The commenter stated 
that CPT codes 31575 and 31579 should have a higher relative weight and

[[Page 18462]]

payment rate than that proposed for APC 331 because both procedures 
require more time, higher skill levels, and more equipment than the 
procedures in APC 997 or 987. A professional association, echoing the 
first commenter, noted that CPT codes 31575 and 31579 are the most 
complex of all noninvasive laryngeal diagnostic procedures performed by 
otolaryngologists and speech language pathologists, further justifying 
a higher relative weight and payment rate for these procedures.
    Response: Proposed APC groups 997 and 987, Manipulation therapy and 
Subcutaneous chemotherapy, respectively, are clinically very different 
from proposed APC group 331. The professional skill and expertise of 
the physician performing the laryngoscopy are recognized separately and 
are not costs that are packaged with the payment rate for services 
furnished by the hospital in connection with the procedure. Further, it 
is very unlikely that there will be systematic differences among 
facilities with some only doing the most difficult of the basic 
laryngoscopies that are contained in this group and others only 
specializing in the simplest variety. However, we have reorganized the 
proposed endoscopy, upper airway groups into final APC groups 0071 
through 0075 to be consistent with the BBRA 1999 ``two times'' 
requirement.
APC 341: Level I Needle and Catheter Placement
APC 342: Level II Needle and Catheter Placement
APC 343: Level III Needle and Catheter Placement
APC 347: Injection Procedures for Interventional Radiology
    Based on our cost data, our medical advisors and staff determined 
that the codes in these proposed APC groups should be assigned status 
indicator ``N,'' which designates incidental services whose costs are 
packaged into the APC payment rate. Injection procedures themselves are 
low cost but, more importantly, they are an integral portion of another 
procedure. The needle and catheter placement are typically an integral 
portion of interventional radiology procedures. An exception was made 
for CPT code 36420, cutdown on a child under age one, which was placed 
in final APC 0032, to recognize its infrequent use but high median 
cost.
APC 360: Removal/Revision, Pacemaker/Vascular Device
    Comment: Most commenters recommended changing a number of pacemaker 
codes from ``inpatient only'' payment status to allow payment under the 
hospital outpatient PPS. One commenter noted that whereas we proposed 
to exclude most pacemaker and implantable cardioverter defibrillator 
(ICD) replacement procedures from the outpatient PPS, we did include 
pacemaker revision/removal procedures in proposed APC 360 even though 
both types of procedures require very similar steps to perform. The 
commenter is concerned that by not paying for pacemaker replacement 
procedures under the outpatient PPS, we are forcing physicians to 
perform these replacement procedures on an inpatient basis. By so 
doing, the commenter suggested that we are adding costs to the entire 
system that could be saved, because the pacemaker replacement 
procedures can be safely performed in the outpatient setting, with less 
inconvenience to the patient.
    Response: After careful consideration of commenters' 
recommendations, our medical advisors and staff agreed that paying for 
pacemaker insertion or replacement codes under the outpatient PPS is 
appropriate if the outpatient setting is determined to be reasonable 
and medically necessary for the individual beneficiary. We assigned 
procedures for revising or removing implanted infusion pumps and venous 
access ports in proposed APC 360 and pacemaker insertion or replacement 
codes payable under the outpatient PPS to final APCs 0089 and 0090. 
Also, we moved CPT code 33222, Revision or relocation of skin pocket 
for pacemaker, and CPT code 33223, Revision or relocation of skin 
pocket for implantable cardioverter-defibrillator, to final APC 0026 
because the resource use for these two procedures is similar to that of 
the skin repair procedures in APC 0027.
APC 367: Vascular Ligation
    Comment: One commenter wrote that the procedures in proposed APC 
367 include ligation of major arteries and veins, which are usually 
performed as emergencies in the inpatient setting, and elective 
ligation and stripping of lower extremity varicose veins of variable 
complexity. The commenter contended that costs for these procedures 
vary dramatically, with simple ligation and division of the saphenous 
vein at the low end of the cost scale, and the stripping of long and 
saphenous veins at the high end.
    Response: We split proposed APC 367 into two groups, final APCs 
0091 and 0092, to conform with the BBRA 1999 ``two times'' requirement. 
Although we are not sure to which codes the comment refers, codes 37780 
and 37730 are now in different groups. These represent ligation and 
division of the short saphenous vein, and ligation, division and 
stripping of long and short saphenous veins, respectively.
APC 368: Vascular Repair/Fistula Construction
    Comment: Commenters disagreed with the codes assigned to proposed 
APC 368, especially services related to insertion of implantable 
hemodialysis access ports. Commenters did not find the services in APC 
368 to be comparable clinically. In particular, they recommended moving 
cannula insertion and declotting procedures to proposed APC groups 341, 
342, and 343, which consist of needle and catheter placement 
procedures.
    Response: We split the codes in proposed APC 368 into APC groups 
0088, 0090, 0092, and 0093. The resulting classifications are more 
clinically homogeneous, and they meet the BBRA 1999 ``two times'' 
requirement. We also moved CPT code 35875, Thrombectomy of arterial or 
venous graft (other than hemodialysis graft or fistula), into final APC 
0088.
APC 369: Blood and Blood Product Exchange
    Comments: As we noted in section III.C.2.f, above, many commenters 
disagreed with both our proposed payment rates and our proposed 
classification for blood and blood-related products. Most commenters 
disagreed with our classifying in one APC group therapeutic apheresis, 
stem cell procedures, and blood transfusion services. The commenters 
stated that therapeutic apheresis and stem cell procedures are very 
costly and resource intensive procedures which cost more than 3 times 
the proposed payment rate for APC 369, yet we are proposing to pay a 
median amount for these services that is appropriate for blood 
transfusions only. Commenters questioned whether we had taken into 
account the costs associated with the specialized equipment, supplies 
and personnel that are required to perform therapeutic apheresis and 
stem cell procedures. Commenters stated that the payment rate proposed 
for APC 369 would not offset the costs hospitals incur to furnish 
therapeutic apheresis services because outpatient apheresis procedures 
often combine dissimilar kinds and combinations of plasma replacement 
products, causing widely differing costs per service.
    A major association representing community cancer centers stated 
that our data for stem cell harvesting claims (CPT 38231) include a 
range of costs so

[[Page 18463]]

large as to suggest that there are errors in the data. The commenter 
believes that the very small sample of claims (reduced by HCFA's 
exclusion of multiple procedure claims and claims without codes) 
further renders the data unreliable. The same commenter cited bone 
marrow harvesting (CPT 38230) as an example to argue that our data, 
which indicates a median cost of $18.00 for what is normally a lengthy 
procedure performed under general anesthesia, are problematic.
    Some commenters stated that the proposed payment rate was not 
sufficient for transfusion services if the rate was supposed to pay for 
both the blood product and the transfusion procedure, because even 
though outpatient transfusion services are relatively simple and low-
cost, they are associated with a costly blood product that is far more 
variable.
    Commenters expressed concern that the proposed payment rate for APC 
369 was insufficient to pay for extracorporeal photopheresis (CPT 
36522), whose actual cost is approximately $1,000, and would have an 
especially negative impact for patients with cutaneous T-cell lymphoma.
    A major organization recommended that we separate payment for a 
service from payment for the blood product associated with that 
service. The same commenter also recommends separate payment for 
infusible blood-derived drugs, and that payment for transfusable blood 
products be based on costs. This organization recommends that APC 369 
be split into several APCs because payment for services such as 
transfusion services, therapeutic apheresis, stem cell collection, 
Staph column pheresis, and others are distinct, and deserve separate 
APC payments. The same commenter also recommended that we accelerate 
the HCPCS coding process for blood-related products.
    Response: In response to commenters' recommendations, we are 
creating different APC groups for blood-related procedures and 
transfusions, and we are paying for blood and blood products 
separately, instead of packaging them with the procedures or services 
with which they are associated. We were convinced by commenters' 
illustrations of the variability in the use of blood and blood products 
in various procedures, and by our desire to recognize the costs of 
tests now being performed on donated blood that were not captured in 
our 1996 data. The procedures we proposed in APC 369 are split among 
final APC groups 0109, 0110, 0111, and 0112. We have also created 
individual APC groups for blood and blood related products. The final 
APC 0109 that we created to capture bone marrow harvesting and bone 
marrow/stem cell transplant had a median cost of only $15.00. This is 
due to the few, highly variable claims in our database. Based on the 
information available to us at this time, we have assigned a rate of 
$200.00, and will adjust the rate to reflect actual claims as we 
collect data under PPS.
APC 407: Esophagoscopy
APC 417: Diagnostic Upper GI Endoscopy
APC 418: Therapeutic Upper GI Endoscopy
    Comment: Commenters were concerned about low payment rates set for 
these three proposed APC groups.
    Response: Our medical advisors reviewed the proposed groups and 
determined that combining the codes into a single APC group for upper 
gastrointestinal endoscopic procedures conformed with the criteria we 
used to define APC coherence and resulted in a reasonable payment rate 
supported by cost data. Resource use for all procedures in final APC 
0141 is similar because each procedure involves an endoscopic 
examination. In addition, most of the procedures involve diagnostic and 
therapeutic tests such as brushings or fulgurations.
APC 426: Diagnostic Lower GI Endoscopy
APC 427: Therapeutic Lower GI Endoscopy
    Comment: Commenters were concerned that the payment rates proposed 
for APC groups 426 and 427 were too low to offset costs incurred to 
perform these procedures. One commenter indicated that a diagnostic 
colonoscopy (CPT code 45379), without any mark up or consideration of 
room time and equipment use, costs $350, with additional costs if a 
polyp has to be removed ($155 just for a bicap). The commenter 
indicated that the current cost of a hot biopsy forceps is $45. Given 
these costs, the provider would necessarily incur a loss when 
performing these procedures.
    Response: Our medical advisors and staff, after reviewing the cost 
data for these two proposed groups, combined the diagnostic and 
therapeutic APCs into a single group, final APC 0143. Resource use for 
the procedures in this APC is similar because they all involve an 
endoscopic examination. More importantly, even though resource use may 
vary relative to the clinical requirements of individual cases, 
facilities are not likely to specialize in just therapeutic or 
diagnostic endoscopic services. Therefore, costs should even out across 
all cases.
    Comment: One commenter found the low rate proposed for CPT code 
45378, Diagnostic colonoscopy, to be inconsistent with our major policy 
initiative to screen persons at high risk for colorectal cancer.
    Response: We moved HCPCS code G0105, Colorectal Cancer Screening: 
Colonoscopy,to its own group, final APC 0158, because it is preventive 
rather than diagnostic or therapeutic in nature.
APC 446: Diagnostic Sigmoidoscopy
APC 447: Therapeutic Proctosigmoidoscopy
APC 448: Therapeutic Flexible Sigmoidoscopy
    We reassigned the different types of sigmoidoscopy procedures into 
two groups, final APC 0146 and final APC 0147. The procedures within 
each group are similar both clinically and in terms of resource use. We 
moved HCPCS code G0104, CA screening; flexible sigmoidoscopy, to its 
own group, final APC 0159, because it is preventive rather than 
diagnostic or therapeutic in nature.
APC 451: Level I Anal/Rectal Procedures
APC 452: Level II Anal/Rectal Procedures
    To conform with the BBRA 1999 ``two times'' requirement, our 
medical advisors and staff reclassified procedures in the proposed APC 
groups resulting in final APC groups 0148 and 0149. We believe the 
final APC groups are more consistent both clinically and in terms of 
resource use.
APC 470: Tube Procedures
    Comments: We split the codes in proposed APC group 470 into final 
APC groups 0121, 0122, and 0123 to conform with the BBRA 1999 ``two 
times'' requirement. Also, we moved CPT code 50398, Change of 
nephrostomy or pyelostomy tube, from proposed APC 521 to final APC 
0122.
APC 523: Level III Cystourethroscopy and Other Genitourinary Procedures
    Comment: A number of commenters recommended moving CPT code 52240, 
Cystourethroscopy, with fulguration (including cryosurgery or laser 
surgery) and/or resection of; large bladder tumor(s), to the APC for 
Level IV Cystourethroscopy and other Genitourinary Procedures because 
the magnitude of the procedure most

[[Page 18464]]

closely resembles that of the codes in the higher payment group.
    Response: We agree with commenters' recommendations; we moved CPT 
code 52240 to final APC group 0163 because of the extensive time and 
equipment required to perform the procedure.
    Comment: One commenter recommended placing CPT codes 52335 through 
52338 in their own group, given the complexity and technical demands of 
these ureteroscopic procedures. The same commenter suggested as an 
acceptable alternative placing these codes in the APC group for Level 
IV Cystourethroscopy and other Genitourinary Procedures, to reflect 
more accurately their cost, complexity, and need for expensive single 
use items such as dilation balloons, baskets and stents. Other 
commenters recommended moving CPT codes 51020 through 51880 (cystotomy 
procedures) to the APC group for Level IV Cystourethroscopy and other 
Genitourinary Procedures.
    Response: After a careful review of comments and our cost data, our 
medical advisors and staff concluded that the cystotomy codes are 
similar enough in terms of equipment and the time required to perform 
the procedures to justify keeping them together in final APC 162. Our 
medical advisors and staff also concluded that the facility equipment 
and time duration for CPT code 52335, Cystourethroscopy, with 
ureteroscopy and/or pyeloscopy (includes dilation of the ureter and/or 
pyeloureteral junction by any method), was sufficiently similar to be 
retained with the other procedures in final APC 0162.
APC 524: Level IV Cystourethroscopy and other Genitourinary Procedures
    Comment: Numerous commenters were concerned that the payment rate 
proposed for APC 524 was insufficient to offset the costs associated 
with CPT code 53850, Transurethral destruction of prostate tissue, by 
microwave thermotherapy (TUMT). The commenters argue that TUMT is a 
very expensive procedure due to its high capital equipment costs and 
the need to construct a special microwave area, the high cost of 
disposable probes and other disposable supplies required for the 
procedure, and the need for specially trained nursing staff. The 
commenters urged us to establish a unique APC group for this procedure 
and to provide a payment rate that is consistent with its anticipated 
costs, which they predict would total approximately $2,200.
    Response: After careful consideration of comments and available 
cost data, our medical advisors and staff determined that CPT code 
53850 satisfies the criteria discussed below, in section III.C.8, as a 
new technology service. Payment for this procedure will be made under 
new technology APC 0980.
APC 529: Simple Urinary Studies and Procedures
    Comment: A number of commenters proposed that we classify CPT code 
51726, Complex cystometrogram, to its own unique APC and keep the other 
urinary study procedures together in proposed APC 529.
    Response: After a careful review of comments and our data, our 
medical advisors and staff agreed with commenters' concerns and 
subdivided proposed APC group 529. The resulting final APC groups 0164 
and 0165 are more homogeneous both in terms of clinical coherence and 
resource use. We also added simple anal procedures such as CPT code 
91122, Anorectal manometry, to final APC 0165 because of the similarity 
of resource use.
APC 546: Testes/Epididymis Procedures
    Comment: A number of commenters disagreed with our classification 
of scrotal procedures with inguinal procedures in proposed APC group 
546. The commenters observed that the scrotal procedures vary 
considerably from the inguinal procedures in terms of resource usage. 
The commenters recommended that we move CPT codes 54530, 54550, 54640, 
55520, 55530, 55535 and 55540 to proposed APC 466, Hernia/Hydrocele 
Procedures, because they all involve operating on vessels at the 
internal ring, and are therefore similar to a hernia repair.
    Response: We agree with comments that these procedures are similar 
to hernia repairs. We moved CPT codes 54530, 54550, 54640, 55535, and 
55540 to final APC group 0154.
APC 551: Level I Laparoscopy
APC 552: Level II Laparoscopy
    Comment: We received two categories of comments pertaining to 
laparoscopic procedures: Numerous commenters disagreed with our 
proposal to define certain laparoscopic procedures as inpatient only, 
and numerous commenters claimed that the resource costs among the 
procedures within proposed APC groups 551 and 552 varied too greatly 
for the groups to be considered homogeneous. Most commenters stated 
that the costs associated with the procedures in proposed APC groups 
551 and 552 exceed their respective proposed payment rates because of 
the expensive equipment and disposable supplies and the length of time 
required to perform laparoscopic procedures.
    Response: Our medical advisors and staff, after a thorough review 
and consideration of comments, agreed with commenters who claimed that 
most laparoscopic procedures can and are being safely and appropriately 
performed in an outpatient setting. We therefore moved most of the 
laparoscopic codes to which we proposed to assign a payment status 
indicator ``C,'' indicating that the procedures would not be covered 
under the hospital outpatient PPS, into an APC group with a payment 
status indicator ``T'' (significant procedure, multiple procedure 
reduction applies, payable under the outpatient PPS). In order to 
absorb these additional procedures within the APC system, we created a 
third laparoscopic APC group in order to accommodate the wide range of 
resource use and time that is required to perform the expanded list of 
laparoscopic procedures.
    Although the AMA revised the coding of laparoscopic procedures in 
CPT 2000, in order to set rates for the laparoscopy APC groups, we used 
the codes that were in our database of 1996 claims. That is, we moved 
CPT codes 56362 and 56363 to the Level I laparoscopic group, final APC 
group 0130, because the resources used in connection with these 
procedures are less compared to the Level II procedures generally. For 
example, CPT code 56362, Laparoscopy with guided transhepatic 
cholangiography, primarily involves the laparoscopy without any 
associated removal of tissue. Conversely, we shifted CPT codes 56303 
and 56304 from Level I to Level II (final APC 0131). CPT code 56303, 
Laparoscopy, surgical, with fulguration or excision of lesions of the 
ovary, pelvic viscera, or peritoneal surface, requires more resources 
than, for example, CPT code 56300, Diagnostic laparoscopy, the most 
common laparoscopic procedure within Level I, final APC group 0130.
    The new Level III laparoscopy group, final APC group 0132, consists 
largely of laparoscopic procedures that we had proposed to classify as 
inpatient. In addition, we moved CPT code 56312, Laparoscopy, surgical; 
with bilateral total pelvic lymphadenectomy, and CPT code 56313, 
Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and 
peri-aortic lymph node sampling (biopsy), single or multiple, to final 
APC group 0132 because of the extensive resources and time involved in 
performing these procedures. Refer to Current Procedural Terminology 
2000, published by the American Medical Association, for a summary of 
coding

[[Page 18465]]

changes and crosswalks for laparoscopic procedures.
APC 561: Level I Female Reproductive Procedures
APC 562: Level II Female Reproductive Procedures
APC 563: Level III Female Reproductive Procedures
    Comment: One commenter expressed concern that the payment rate for 
proposed APC group 563 would have a negative effect on certain 
treatment options for women suffering with incontinence. The commenter 
contrasted the proposed payment of $848 with a current median cost 
calculated at $1,931 for CPT code 57288, Sling operation for stress 
incontinence (e.g., fascia or synthetic).
    Response: After reviewing the procedures in proposed APCs 561, 562, 
and 563, and to be consistent with the BBRA 1999 ``two times'' 
requirement, we split the proposed groups into final APCs 0191 through 
0195. The cost of CPT code 57288, to which the commenter refers, is 
still at the high end of the highest weighted group, but the volume of 
claims for that service is so low that splitting the group again would 
be problematic. If these more intense surgeries move to the outpatient 
setting in greater numbers, we will be able to price them more 
precisely.
APC 601: Level I Nervous System Injections
APC 602: Level II Nervous System Injections
    Comment: Commenters contended that there are no similarities among 
the procedures in the proposed APC groups for nervous system 
injections.
    Response: We disagree. We find the range of services included 
within each APC group to be generally consistent from a clinical 
perspective. And, even though an injection into the subarachnoid space 
may be a more complex injection than some of the others in the group, 
no institution is likely to specialize solely in one kind of injection. 
Because all the services within the APC group are offered by most 
hospitals, the impact of the variation in resource consumption among 
the different codes should average out at the hospital level. 
Therefore, we are keeping intact in final APC groups 0211 and 0212 the 
two levels of nervous system injections that we proposed, with the 
exception of CPT codes 62194 and 62225, which we moved to final APC 
group 0121 because they are catheter replacement procedures.
APC 616: Implantation of Neurostimulator Electrodes
APC 617: Revision/Removal Neurological Device
APC 618: Implantation of Neurological Device
    Comment: One commenter was concerned that the payment rate proposed 
for APC group 616 falls far short of the costs incurred to implant a 
neurostimulator system that embodies a vagus nerve stimulator for the 
treatment of patients with refractory epilepsy. The commenter estimated 
that hospitals incur costs between $2,000 and $5,000 to surgically 
insert the Neurocybernetic Prosthesis system (NCP), which includes an 
implantable neurostimulator, pulse generator, and implantable 
electrodes. The commenter stated that the NCP costs $9,100. The 
commenter recommended that we create a separate APC group for the 
procedure to ensure appropriate payment. The commenter also expressed 
concern that the broad range of procedures in proposed APC 618 results 
in inappropriate payment rates. The commenter noted that the median 
cost of the procedures in proposed APC group 618 varies from a low of 
$269.44 to a high of $3,890.70, with a proposed payment rate of $1,274.
    Another commenter stated that vagus nerve stimulation, approved by 
the FDA in 1997, which can sometimes be performed as an outpatient 
procedure, would be inappropriately paid under our PPS. The commenter 
stated that the reported cost for the device is $6,900 for the 
implantable neurostimulator pulse generator and $2,030 for the 
implantable vagus nerve stimulator leads. A manufacturer of this new 
system, which is used in treating intractable epilepsy, also expressed 
concern that the proposed PPS will underpay hospitals for new 
technologies such as its system and deny beneficiaries access to them.
    Response: In response to these and other comments, we made several 
changes in proposed APC groups 616, 617, and 618. We moved CPT code 
63650, Percutaneous implantation of neurostimulator electrodes, 
peripheral, to final APC 0224 because the procedure is less time 
intensive and uses fewer facility resources than the implant procedures 
in final APC 0225. We also shifted CPT codes 64585 and 64595 to final 
APC 0225. We will re-evaluate APCs 0223, 0224, and 0225 as we 
accumulate data and will incorporate our findings in a subsequent 
hospital outpatient PPS rule. Additionally, we will determine whether 
the implantable neurostimulator system is eligible for treatment as a 
``pass-through'' device under section 201(b) of the BBRA 1999. The 
criteria for assessing a medical device's eligibility for additional 
payment under this provision are discussed in section III.D.4, below.
    Ophthalmic Procedures: We received numerous comments concerning the 
APC groups proposed for eye procedures. Based on their analysis of 
these comments and recommended changes, a review of our data, and 
consideration of the limit on variation within a group required by 
section 201(g) of the BBRA 1999, our medical advisors and staff have 
significantly restructured the ophthalmic APC groups. Eye procedures 
and services are assigned to final APC groups 0230 through 0248.
APC 930: Minor Eye Examinations
APC 931: Level I Eye Tests
APC 932: Level II Eye Tests
    We assigned to final APC groups 0230 and 0231 the procedures in 
proposed APC groups 930, 931, and 932 in addition to codes from 
proposed APC groups 681, 682, and 683 that are either tests or minor 
ophthalmologic procedures requiring relatively low resource use.
APC 651: Level I Anterior Segment Eye Procedure
APC 652: Level II Anterior Segment Procedure
    Comment: We received a number of comments about these proposed APC 
groups. Commenters were primarily concerned that the payment rates 
proposed for the two levels of anterior segment eye procedures are 
significantly less than the costs incurred to perform the procedures 
assigned to these groups, especially those for glaucoma surgery (CPT 
codes 66150 through 66170). One commenter indicated that the rate 
proposed for CPT 66180 is acceptable only if separate payment is made 
for the aqueous shunt and patch graft.
    Response: Based on their review of comments and to be consistent 
with the BBRA 1999 ``two times'' requirement, our medical advisors and 
staff added a third APC group for anterior segment eye procedures. The 
anterior segment eye procedures are assigned to final APC groups 0232, 
0233, and 0234. We made a number of code changes among the three 
groups. We moved CPT codes 66155, 66160, 66165, and 66170 for glaucoma 
surgery to final APC group 0234. We shifted CPT code 65800, 
Paracentesis of anterior chamber of eye (separate procedure) with 
diagnostic aspiration of aqueous, from proposed APC 683 to final APC 
0232 because the

[[Page 18466]]

instruments used in connection with CPT code 65800 are similar to those 
used in all procedures that are primarily paracentesis and because 
operating room time is likewise similar.
APC 667: Cataract Procedures
APC 668: Cataract Procedures With IOL Insert
    Based on our data, the median cost for final APC group 0245 
(cataract extraction without lens insert) was slightly higher than that 
for final APC group 0246 (cataract extraction with lens insertion). We 
attribute the discrepancy to poor coding, and we have increased the 
payment rate for APC group 0246 to equal the payment rate for APC group 
0245. Proper coding in the future should result in better 
differentiated costs between these two groups.
    Comment: One commenter objected to assigning payment status 
indicator ``T,'' Significant procedure, multiple procedure reduction 
applies, to the procedures in proposed APC group 668. The commenter 
contended that CPT code 66984, Cataract removal with lens insertion, is 
often performed in conjunction with other procedures such as CPT code 
67010, partial removal of eye fluid, CPT code 65875, incise inner eye 
adhesions, and 66170, Glaucoma surgery, which also have a ``T'' payment 
status indicator. The commenter believes that the multiple procedure 
reduction would undercompensate for these services and that all these 
procedures should be given an ``S'' payment status indicator, which 
would not subject them to the multiple procedure discount.
    Response: We disagree. When more than one surgical procedure is 
performed during a single operative session, full Medicare payment and 
the full beneficiary coinsurance payment are made for the procedure 
that has the highest payment rate. The costs associated with 
anesthesia, operating and recovery room use, and other services for any 
additional procedures are incremental and are accounted for within the 
discounted additional payment.
APC 670: Corneal Transplant
    Comment: The numerous comments that we received about this proposed 
APC focused on our proposal to package the cost of procuring corneal 
tissue as part of the costs associated with corneal transplant surgery. 
Commenters feared that this fixed payment method would underpay some 
hospitals while overpaying others because hospitals acquire corneal 
tissue from eye banks whose charges are dependent upon the amount of 
philanthropic contributions the bank receives during the course of a 
year. A national association representing eye banks reported that fee 
data from different member facilities show that the corneal tissue 
acquisition fee alone nearly consumes or, in some cases, exceeds, the 
entire payment rate proposed for APC group 670. Commenters expressed 
great concern that we would significantly reduce the supply of corneas 
available for transplant if we were to package corneal tissue 
acquisition costs within the APC rate.
    Response: Given the current basis for pricing corneal tissue, we 
are accepting commenters' recommendations that corneal tissue 
acquisition costs be paid separately and in addition to the payment 
rate for corneal transplant procedures. At least until we gather data 
regarding costs associated with the acquisition of corneal tissue, this 
will ensure that individual hospital's reasonable corneal tissue 
procurement costs are covered under the PPS. Corneal transplant 
procedures are in final APC group 0244.
APC 676: Posterior Segment Eye Procedures
    Comment: Commenters were concerned that the payment rate for 
proposed APC group 676 was too low given the costs incurred to perform 
a number of procedures in the group. For example, one commenter noted 
that CPT code 67005 requires the same draping as a cataract extraction.
    Response: In response to commenters' concerns and to be consistent 
with the BBRA 1999 ``two times'' requirement, we split the procedures 
in proposed APC group 676 into final APC groups 0235 through 0237. We 
also moved procedures such as CPT code 67025, Replace eye fluid, and 
CPT code 67027, Implant eye drug system, to final APC 0237 because of 
the similarity of resource use. CPT code 67025 involves injection of a 
vitreous substitute, usually gas, silicone, or a similar substance, and 
the procedure may also involve an aspiration.
APC 681: Level I Eye Procedure
APC 682: Level II Eye Procedure
APC 683: Level III Eye Procedure
APC 684: Level IV Eye Procedure
    Comment: Commenters were concerned about the wide variation of 
resource use and clinical characteristics among the procedures within 
proposed APC groups 681, 682, 683, and 684. Commenters noted that the 
surgical complexity of individual procedures in proposed APC group 684 
ranges from simple suturing (CPT code 67914, Repair of ectropion; 
suture) to complex eyelid reconstructions with full thickness 
tarsoconjunctival flap transfer (CPT code 67971). Commenters 
recommended that these proposed APC groups be revised and that the more 
complex procedures that require longer operating room time be paid a 
higher rate.
    Response: We agree. Guided by commenters' recommendations as well 
as the ``two times'' limit on cost variation required by the BBRA 1999, 
we created several new groups and we completely reorganized the 
procedures in proposed APC groups 681, 682, 683, and 684 into the final 
APC groups 0230 through 0234 and 0238 through 0242.
APC 690: Vitrectomy
    Comment: Several commenters were concerned that the cost of an 
intravitreal implant ($4,000, according to one commenter) would not be 
adequately recognized if payment for the device were to be packaged 
with payment for the insertion procedure (CPT code 67027, Implant eye 
drug system). Commenters were concerned that beneficiary access to this 
implant would be restricted if we did not make adequate payment. 
Commenters supported our proposal to make separate payment for the 
intravitreal implant.
    Response: We assigned all of the procedures in proposed APC 690 to 
final APC group 0237. As we explain in section III.B.1.c, above, 
section 201(e) of the BBRA 1999 requires us to classify implantable 
items to the group that includes the service to which the item relates. 
However, the intravitreal implant that dispenses ganciclovir is an 
orphan drug that qualifies for a transitional pass-through payment 
under the BBRA 1999, which is explained in section III.D, below. Thus, 
we have assigned the entire drug delivery system to its own APC, 0913. 
We believe that the payment rate set for CPT code 67027 combined with 
the additional payment for ganciclovir results in an appropriate 
payment for this service.
APC 700: Plain Film
    Comment: We received numerous comments about the structure of 
proposed APC group 700. Commenters recommended breaking down the 
proposed APC group into a number of smaller, more congruous groups. For 
example, one commenter found no justification for the assumption that 
resource costs are the same for all plain films listed in APC 700, 
noting that

[[Page 18467]]

there is a significant difference in capital costs, room costs, and 
maintenance costs between an x-ray room that is designed to take chest 
x-rays compared to an x-ray room with a table used to take abdominal x-
rays. The commenter pointed out that there is a substantial increase in 
cost when cineradiography capabilities are added. The same commenter 
questioned our assumption that therapeutic radiology port films are 
clinically similar to diagnostic radiology films or that bone density 
studies are clinically similar to and have the same resource costs as 
plain film radiography.
    Response: We agree with commenters' concerns about the composition 
of proposed APC group 700. In response to commenters' recommendations 
and applying the ``two times'' limit on cost variation required by the 
BBRA 1999, we split proposed APC group 700 into final APC groups 0260 
through 0262. We assigned CPT code 70300, Radiologic examination, 
teeth; single view; CPT code 70310, Radiologic examination, teeth; 
partial examination, less than full mouth; and, CPT code 70320, 
Radiologic examination, teeth; complete, full mouth, to their own 
group, final APC group 0262, because these procedures require minimal 
time and relatively little radiographic film and technical equipment. 
We classified the remaining codes to final APC groups 0260 and 0261. We 
believe that these two groups are sufficient to distinguish clinical 
consistency and similar resource use. Facilities perform, relatively, a 
similar proportion of the different plain film procedures, and 
hospitals do not systematically use one type of plain film over another 
type, with the exception of dental films, which we moved to a separate 
group. The absolute magnitude of the difference in resource use among 
different plain films is not as significant as the difference between 
dental and other types of plain film. Additionally, our data indicate 
minimal differences in the amount of resource use between bone density 
measurement tests and plain films.
APC 706: Miscellaneous Radiological Procedures
    Comment: A number of commenters found the tests grouped in proposed 
APC group 706 to vary significantly in the amount of time, effort, and 
costs required to provide the service.
    Response: As a result of applying the ``two times'' limit on cost 
variation required by the BBRA 1999, we divided proposed APC 706 into 
two levels: final APC 0263 and final APC 0264. We also moved CPT code 
76075, Bone Density Study, one or more sites, to final APC 0261. We 
explain below, in section III.C.6.e, why we are making an exception to 
the BBRA 1999 ``two times'' limit on cost variation in the case of 
final APC group 264.
APC 710: Computerized Axial Tomography
APC 720: Magnetic Resonance Angiography
APC 726: Magnetic Resonance Imaging
    Comment: A number of commenters believe that assigning all 
computerized axial tomography (CAT) to a single group and all magnetic 
resonance imaging (MRI) to a single group results in a lack of 
homogeneity among the procedures within each group. These commenters 
were concerned that we ignored the cost of contrast materials, labor, 
and equipment within proposed APC group 710 and proposed APC group 726 
and that combining contrast and non-contrast studies represents an 
inconsistency in resource use because an examination that uses contrast 
will be more costly than one without contrast. One commenter observed 
that an MRI examination with the use of contrast material requires 
approximately 30 percent more time and effort than an examination 
performed without contrast material and that a bilateral examination 
requires 50 percent more staff time and effort to complete. The same 
commenter expressed concern that proposed APC 720 consists of only one 
procedure, CPT code 70541, Magnetic image, head (MRA). The commenter 
recommended that we place this code and the other MRA codes that we now 
cover into two APC groups, one with and the other without contrast. A 
number of commenters recommended that we pay separately for contrast 
material, as a cost pass-through. One commenter believes that including 
diagnostic studies with placement of radiation therapy fields in 
proposed APC 710 violates the ``clinically similar'' criterion.
    Response: Our medical advisors and staff carefully reviewed our 
data for the procedures in proposed APC group 710, proposed APC group 
720, and proposed APC group 726 in light of commenters' concerns about 
the extent to which these groups take into account the costs associated 
with the use of contrast material. We concluded that costs associated 
with the use of contrast material are reflected in the payment rate in 
proportion to its frequency of use. We believe it is reasonable to have 
the CAT scans and MRIs with and without contrast together in their 
respective APC groups because facilities do not specialize based on 
whether or not they use contrast material. Further, the cost of 
contrast material relative to the overall inherent cost of CAT scans 
and MRI procedures alone is small. Moreover, the use of contrast 
material with CAT scans and MRI procedures differs significantly when 
compared to the use of contrast with plain films. Contrast comprises a 
significant portion of the cost of plain film services, and not all 
facilities perform plain films with contrast. A plain film can be 
ordered without being scheduled, but any plain film with contrast has 
to be scheduled. This scheduling distinction does not apply to a CAT or 
MRI scan with or without contrast. We did find that applying the ``two 
times'' limit on cost variation required by the BBRA 1999 resulted in 
the creation of two CAT groups, final APC groups 0282, to which we 
assigned CPT codes 70486, 76370, 76375, and 76380, and final APC 0283, 
to which the remaining codes in proposed APC group 710 are assigned. We 
further eliminated proposed APC group 720 and combined CPT code 70541, 
Magnetic image, head (MRA), with the other MRI procedures in final APC 
group 0284 because the base procedure, magnetic resonance imaging, is 
the same.
APC 716: Fluoroscopy
    Comment: A number of commenters recommended that we pay separately 
for the fluoroscopy portion of procedures that include this radiologic 
service.
    Response: We have assigned payment status indicator ``X'' to the 
procedures in final APC groups 0272 and 0273 to indicate that these are 
ancillary services that are paid separately under the hospital 
outpatient PPS.
    Comment: A professional society commented that CPT code 74340, X-
ray guide for GI tube, requires approximately 10 times the amount of 
radiologic technologist and room time, approximately 15 times the 
amount of film and many more supplies than does CPT code 71023, Chest 
x-ray and fluoroscopy. The commenter recommended that we divide 
proposed APC 716 into three separate and distinct levels based on the 
extent of the procedures and that we recalculate the relative weight 
and associated payment rate for the resulting groups.
    Response: We disagree with the commenter. Our medical advisors and 
staff, after reviewing the procedures in proposed APC group 716, 
concluded that the fluoroscopic portion of these procedures is 
sufficiently similar in terms of clinical characteristics and resource 
requirements to be grouped together. However, applying the ``two 
times'' limit on cost variation required

[[Page 18468]]

by the BBRA 1999 results in the formation of two groups, final APC 
groups 0272 and 0273.
APC 728: Myelography
    Comment: Commenters objected to assigning the same payment amount 
to procedures regardless of whether or not a contrast agent is used. 
One commenter was concerned that this payment policy will dissuade 
hospitals from utilizing contrast agents even in cases where the use of 
contrast is medically appropriate.
    Response: We agree that median costs vary more among the procedures 
in proposed APC 728 than their clinical similarities would suggest. 
However, although we found that final APC group 0274 did not satisfy 
the ``two times'' limit on cost variation required by the BBRA 1999, we 
are making an exception in this case as we explain below, in section 
III.C.6.e., and we are retaining all myelographic procedures in final 
APC 0274.
APC 730: Arthrography
    Comment: Some commenters suggested reassigning various 
arthrographic procedures that were assigned to proposed APC 730.
    Response: We find the procedures in this group to be sufficiently 
homogeneous in terms of clinical definition and resource use. The 
procedures are comparable with respect to the use of resources in that 
the highest median cost procedure is less than twice the lowest median 
cost procedure, consistent with the standard set by the BBRA 1999. 
Therefore, we are retaining the proposed grouping of arthrographic 
procedures in final APC 0275.
APC 736: Digestive Radiology
    To be consistent with the limit on cost variation required by 
section 201(g) of the BBRA 1999, we divided the procedures in proposed 
APC 736 into final APC groups 0276 and 0277.
APC 738: Therapeutic Radiologic Procedures
    To be consistent with the limit on cost variation required by 
section 201(g) of the BBRA 1999, we split the procedures in proposed 
APC 738 into final APC groups 0296 and 0297.
APC 739: Diagnostic Angiography and Venography
    Comment: Numerous commenters expressed concern about the lack of 
homogeneity among procedures in proposed APC 739. One commenter 
recommended that we divide proposed APC 739 into three groups: one for 
CPT code 75790, Angiography, arteriovenous shunt; one for all other 
angiography procedures; and one for venography procedures.
    Response: In response to these comments, we created final APC group 
0281, Venography of Extremity, to reflect the significant clinical and 
resource consumption differences between venographic procedures 
performed on extremities and diagnostic angiography and venography 
performed on other parts of the body. Venographic procedures on the 
extremities consume less time and fewer resources than other 
angiography and venography procedures. To be consistent with the limit 
on cost variation required by the BBRA 1999, we split the other 
procedures in proposed APC 739 into final APC groups 0279 and 0280. 
With respect to final APC group 0279, we explain in section III.C.6.e 
why we are making an exception to the BBRA 1999 limit on cost 
variation.
APC 747: Diagnostic Ultrasound Except Vascular
    Comment: A number of commenters suggested that we restructure 
proposed APC group 747 according to body site because the APC criterion 
of clinical homogeneity is violated by including within one group body 
sites that range from the eye to the pregnant uterus to the scrotum and 
contents.
    Response: Our medical advisors and staff carefully weighed the 
suggestion of commenters that clinical homogeneity would be better 
served if the procedures in proposed APC group 747 were divided into 
groups according to body site. We concluded that resource costs based 
on the type of technology used are what primarily dictates the 
definition of groups for various diagnostic services. Thus, we did not 
assign plain film of the chest in the same APC group with MRI of the 
chest. Because ultrasound is the type of technology common to all 
procedures in proposed APC group 747 and because resource use for the 
various procedures is similar irrespective of body site, we did not 
break this group up according to body site. However, to be consistent 
with the limit on cost variation required by the BBRA 1999, we split 
the procedures in proposed APC 747 into final APC groups 0265 and 0266.
APC 749: Guidance Under Ultrasound
    Although there is a range of sites for the procedures in proposed 
APC group 749, as we explain above in our response to the comments 
submitted in connection with proposed APC 747, we are keeping this 
group intact in final APC group 0268 because the base procedure, 
ultrasonography, is the same for all procedures. Also, the procedures 
in final APC group 0268 are comparable with respect to the use of 
resources in accordance with the ``two times'' limit on cost variation.
APC 750: Therapeutic Radiation Treatment Planning
    Comment: Commenters were concerned that radiation physics services 
are not appropriately recognized in proposed APC group 750. One 
commenter observed that proposed APC 750 lacks clinical homogeneity by 
including HCPCS codes for calculations and computer-based treatment 
planning with codes for the construction of treatment devices. Another 
commenter objected to including CPT codes 77261, 77262, 77263, 77431, 
and 77432 in proposed APC 750 because these codes are for professional 
services only and do not include a technical or facility component. As 
such, there are no facility costs associated with the codes. The 
commenter noted that if these codes were removed from proposed APC 
group 750, three medical physics consultation codes, CPT codes 77336, 
77370, and 77399 would remain in the group. The commenter suggested 
that the resource requirements for two of the three remaining codes are 
dramatically different.
    Response: We agree with commenters' concerns about proposed APC 
group 750, and we modified this group accordingly. First, we assigned 
payment status indicator ``E,'' which designates certain items and 
services that are not paid under the hospital outpatient PPS, to five 
codes that describe professional services, which would not be billed by 
hospitals: CPT code 77261, Therapeutic radiology treatment planning; 
simple; CPT code 77262, Therapeutic radiology treatment planning; 
intermediate; CPT code 77263, Therapeutic radiology treatment planning; 
complex; CPT code 77431, Radiation therapy management with complete 
course of therapy consisting of one or two factions only; and CPT code 
77432, Stereotactic radiation treatment management of cerebral 
lesion(s) (complete course of treatment consisting of one session).
    We renamed the remaining group of codes as final APC 0311, 
Radiation Physics Services. The codes specific to radiation physics 
that we classified in this APC are CPT code 77336, Continuing medical 
physics consultation, including assessment of treatment parameters, 
quality assurance of dose delivery, and review of patient treatment 
documentation in support of the radiation oncologist, reported per week 
of therapy; CPT code 77370, Special medical radiation physics

[[Page 18469]]

consultation; and CPT code 77399, Unlisted procedure, medical radiation 
physics, dosimetry and treatment devices, and special services.
APC 751: Level I Therapeutic Radiation Treatment Preparation
APC 752: Level II Therapeutic Radiation Treatment Preparation
    Comment: One commenter objected to including CPT code 77295, 
Therapeutic radiology simulation-aided field setting; three-
dimensional, in proposed APC 752 because this service has dramatically 
different resource requirements than the other CPT codes in group. 
Another commenter believes that the resources used in connection with 
simple intracavitatory applications, which are normally performed with 
re-usable Cs-137 sources, are totally dissimilar from the resources 
required for remote afterloading high intensity brachytherapy in 
proposed APC 751. This commenter noted that the equipment and room 
costs associated with remote afterloading high intensity brachytherapy 
may well exceed $500,000.
    Response: We agree. In response to commenters' concerns, we made a 
number of modifications to proposed APC group 751 and proposed APC 
group 752. First, we assigned payment status indicator ``E,'' which 
designates certain items and services that are not paid under the 
hospital outpatient PPS, to CPT code 77299, Unlisted procedure, 
therapeutic radiology clinical treatment planning, thereby removing it 
from an APC group.
    We created final APC group 0303, which consists of the following 
three codes: CPT code 77332, Unlisted procedure, therapeutic radiology 
clinical treatment planning; CPT code 77333, Treatment devices, design 
and construction; intermediate (multiple blocks, stents, bite blocks, 
special bolus); and, CPT code 77334, Treatment devices, design and 
construction; complex (irregular blocks, special shields, compensators, 
wedges, molds or casts). We created final APC 0303 because the 
resources needed for device construction are unique. We decided to put 
these three codes together in one group rather than assigning each to 
its own individual group because we could make no clear cost 
distinctions among the three codes and because we expect that 
facilities do not specialize in one type of device over another, but 
rather construct all of the types of devices encompassed within the 
three codes.
    We created final APC group 0310, to which we assigned CPT code 
77295, Therapeutic radiology simulation-aided field setting, three-
dimensional. We assigned CPT code 77295 to its own individual APC group 
because it requires significantly greater resource consumption than the 
procedures in either final APC group 0304 or final APC group 0305.
    We assigned the codes remaining in proposed APC groups 751 and 752 
to final APC groups 0304 and 0305. Both APC groups 0304 and 0305 are 
comparable with respect to the use of resources in accordance with the 
``two times'' requirement set by the BBRA 1999.
APC 757: Radiation Therapy
    Comment: We received a number of comments about the assignment to 
proposed APC 757 of CPT code 61793, Stereotactic radiosurgery, particle 
beam, gamma ray or linear accelerator, one or more sessions. Commenters 
indicated that CPT code 61793 is clinically distinct from other forms 
of radiation treatment delivery and that this service generally 
involves significantly greater treatment time and costs. One commenter 
stated that if we were to keep CPT code 61793 in proposed APC 757, we 
would be prejudicing use of this new, proven technology. Another 
commenter contended that radiation therapy is not the same as a 
surgical procedure. The commenter urged us to separate stereotactic 
radiation therapy (SRT) and intensity-modulated radiation therapy 
(IMRT) services from the conventional radiation therapy procedures in 
APC 757 and to assign them a higher payment rate due to their higher 
cost.
    Response: We created final APC group 0302, to which we assigned 
stereotactic radiosurgery, which requires significantly more costly 
resources than the procedures assigned to final APC groups 0300 and 
0301. Note that we have created two codes, G0173 and G0174, to use in 
place of CPT code 61793. They represent stereotactic radiosurgery 
completed in one session, and that which requires multiple sessions, 
respectively. We also assigned CPT code 77470 to APC 0302, since we 
believe it requires resources similar to those required for 
radiosurgery. We will continue to track the data for these codes to 
ensure their proper placement. The procedures in final APC group 300 
and in final APC group 301 are comparable with respect to the use of 
resources in accordance with the ``two times'' limit on cost variation.
APC 759: Brachytherapy and Complex Radioelement Applications
    Comment: One commenter expressed concern because we did not 
identify a payment amount for the radioactive seeds used in 
brachytherapy. Another commenter referred to low dose rate interstitial 
brachytherapy that is used to treat complex gynecologic tumors, 
prostate cancers, and head and neck cancers, noting that this type of 
radiation therapy employs single-use radioactive sources (iodine, gold, 
iridium, and palladium seeds) and various disposable applicators. The 
commenter pointed out that only a limited number of vendors produce 
these radioactive sources and that the seeds cost as much as $200 each 
with the number of implants varying depending on the size, stage, and 
location of the cancer. The commenter stated that some patients with 
prostate cancer may require as many as 100 to 150 seeds. The commenter 
asserted that we have not captured the costs of these 
radiopharmaceuticals in the APC payment.
    Response: We have changed how we pay for brachytherapy and the 
other services we proposed to classify to APC 759 in response both to 
comments and to the provisions of section 201(b) of the BBRA 1999, 
which provide for an additional payment to be made for innovative 
medical devices, including ``a (current) device of brachytherapy.'' 
(See section III.D., below.) Within this framework, we recognize the 
seeds provided during brachytherapy. For bill processing purposes, we 
have assigned brachytherapy seeds to APC 0918. We will make payment for 
brachytherapy seeds under the transitional pass-through rules explained 
in section III.D., below.
    Based on commenters' suggestions, a review of our data, and the 
BBRA 1999 ``two times'' requirement, we have classified the procedures 
in proposed APC 759 in final APC 0312, Radioelement Applications, and 
final APC 0313, Brachytherapy. APC 0313 consists of CPT code 77781, 
Remote afterloading high intensity brachytherapy; 1-4 source positions 
or catheters; CPT code 77782, Remote afterloading high intensity 
brachytherapy; 5-8 source positions or catheters; CPT code 77783, 
Remote afterloading high intensity brachytherapy; 9-12 source positions 
or catheters; CPT code 77784, Remote afterloading high intensity 
brachytherapy; over 12 source positions or catheters; and, CPT code 
77799, Unlisted procedure, clinical brachytherapy. Because these

[[Page 18470]]

procedures are all different types of brachytherapy, final APC 313 is 
more coherent clinically than was proposed APC 759.
    We moved CPT code 77750, Infusion or instillation of radioelement 
solution, to final APC 301, Level II Radiation Therapy, and CPT code 
77789, Surface application of radioelement, were moved to final APC 
300, Level I Radiation Therapy. The remaining procedures from proposed 
APC 759 constitute final APC 312, Radioelement Applications. The 
procedures in final APC group 312 and in final APC group 313 are 
comparable with respect to the use of resources in accordance with the 
``two times'' limit on cost variation.
APC 761: Standard Non-Imaging Nuclear Medicine
APC 762: Complex Non-Imaging Nuclear Medicine
APC 771: Standard Planar Nuclear Medicine
APC 772: Complex Planar Nuclear Medicine
APC 781: Standard SPECT Nuclear Medicine
APC 782: Complex SPECT Nuclear Medicine
APC 791: Standard Therapeutic Nuclear Medicine
APC 792: Complex Therapeutic Nuclear Medicine
    Comment: We received numerous comments about the proposed nuclear 
medicine APC groups. Commenters addressed what they believe to be 
discrepancies in the payment weights among the proposed groups. 
Commenters also asserted that the proposed payment levels are 
inadequate to offset the cost of radiopharmaceuticals. They believe, in 
part, that our use of single-procedure claims in constructing our 
database failed to capture the costs associated with the various 
radiopharmaceuticals that may be used in combination during multiple 
procedures performed during a single session on various patients. One 
commenter disagrees with our decision to consider therapeutic 
radiopharmaceuticals and radionuclides as incidental services, bundling 
their costs into nuclear medicine and radiation therapy procedures. The 
commenter recommended that we develop unique APC groups for 
radiopharmaceuticals and radionuclides. One manufacturer expressed 
particular concern about our proposed payment for a radiopharmaceutical 
used to relieve the pain of bone metastasis (CPT code 79400) that we 
proposed to package into APC 791 for which the proposed payment was 
$758. The commenter stated that this new radiopharmaceutical, which has 
generated a very high clinical response rate, costs more than $2,000 
per dose.
    Response: In response to these and other comments, as well as the 
changes made by the BBRA 1999 to the outpatient PPS, our medical 
advisors and staff have reconstructed the nuclear medicine APC groups. 
First, we have placed radiopharmaceuticals into a separate set of APC 
groups that are listed in Addendum K. As we state above, new section 
1833(t)(6) of the Act provides for additional payment for current and 
new radiopharmaceuticals. We list in Addendum K those 
radiopharmaceuticals that are eligible for additional payment effective 
with services furnished on or after July 1, 2000. In accordance with 
the process outlined below, in section III.D.4, we invite requests to 
consider other radiopharmaceuticals as potential candidates for 
additional pass-through payments.
    Next, we reconfigured the nuclear medicine APC groups based on the 
resources required for the procedures themselves, exclusive of costly 
radiopharmaceuticals. We took into account the fact that SPECT 
equipment, which costs significantly more than the non-SPECT equipment 
that was initially used most frequently for planar medicine, is now 
commonly used to conduct planar studies. As a final step, we further 
reorganized the groups to satisfy the requirement set by the BBRA 1999 
``two times'' requirement, resulting in final APC groups 0286, 0290, 
0291, 0292, 0294, and 0295.
    Comment: We received a number of comments concerning the clinical 
efficacy of iodine 131 tositumomab in the treatment of cancer. One 
commenter stated that iodine 131 tositumomab, which was reported to be 
pending final FDA approval, has the potential to be the first 
radioimmunotherapeutic agent to be approved for the treatment of 
cancer. The commenter expected this pharmaceutical to be the first in 
its class, and characterized it as neither a chemotherapeutic agent nor 
a radiopharmaceutical. The commenter stated that the cost of this 
pharmaceutical will be significantly higher than the payment amount 
proposed for any of the APC groups containing drugs used for cancer 
therapies. The commenter believes that we should have proposed an 
outlier policy to ensure equitable payment for pharmaceuticals such as 
iodine 131 tositumomab.
    Response: If iodine 131 tositumomab receives final FDA approval, we 
strongly encourage interested parties to submit the appropriate 
materials to us for determination of this product's eligibility for 
additional payment under the pass-through provision as described below 
in section II.D.6.
    Comment: One commenter finds our method of paying for new products 
to be flawed. The commenter sees it as highly probable that a new 
product will be inserted into an APC procedure category where the 
payment rate is significantly lower than the actual cost of the newly 
developed product. The commenter cites our proposed payment for a new 
product, In-111 Octreo Scan, which is used for tumor imaging. The 
product costs four times the payment rate for proposed APC 772, Complex 
Planar Nuclear Medicine. The commenter believes that this enormous 
discrepancy will discourage hospital outpatient departments from 
utilizing procedures that require this product and that Medicare 
beneficiaries may be denied access to the most appropriate care 
available as a result.
    Response: We are firmly committed to ensuring that the provisions 
of the hospital outpatient PPS do not in any way obstruct or limit 
Medicare beneficiaries' access to reasonable medically necessary and 
appropriate care. We further recognize that the development of new 
technology and products is a highly dynamic enterprise that is 
constantly evolving and changing the character and cost of current 
diagnostic and treatment modalities. New section 1833(t)(6) of the Act 
provides for an additional transitional pass-through payment for 
certain innovative medical devices, drugs, and biologicals. We are also 
creating a series of transitional APCs for the express purpose of 
providing appropriate payment for new technology services when they 
emerge into the marketplace while we collect data to enable us 
ultimately to incorporate the new technology service within an APC 
group, making payment adjustments as needed. We expect to continue 
working closely with hospitals and their representatives throughout 
this process to ensure that payment does not inhibit beneficiary access 
to appropriate care. We discuss the transitional pass-through payment 
groups in greater detail in section III.D and provisions for payment 
for new technology in section III.C.8.

[[Page 18471]]

APC 881: Level I Pathology
APC 882: Level II Pathology
APC 883: Level III Pathology
    Comment: We received numerous comments on the proposed pathology 
APC groups. One commenter expressed concern that our proposed 
assignment of tests among the three groups may create an incentive for 
physicians to order complex and unnecessary tests when simpler, less 
comprehensive tests may be adequate, because we have grouped together 
and are paying the same amount for tests that are clinically similar 
but that are comprehensively more difficult than one another.
    Response: Our medical advisors and staff reviewed and completely 
reorganized the grouping of pathology tests in light of commenters' 
concerns and the BBRA 1999 ``two times'' requirement. Pathology tests 
are in final APC groups 0342, 0343, and 0344.
APC 906: Infusion Therapy Except Chemotherapy
APC 907: Intramuscular Injections
    Comment: We received many comments about proposed APC groups 906 
and 907. The commenters were generally concerned that packaging payment 
for nonchemotherapeutic infused and injected drugs in the payment rates 
for the administration of nonchemotherapy drugs does not take into 
account the great variation among these products with regard to their 
indication/application and cost nor the cost of new drugs that have 
been introduced since 1996. Commenters fear that we will underpay 
hospitals and inhibit the introduction of new drugs into the system.
    Response: In response to the concerns expressed by commenters, we 
have created additional groups for certain expensive pharmaceuticals. 
These high-cost, nonchemotherapy, nonorphan drugs are captured in the 
following APCs: 0886-0891, 0907, 0908, 0911, 0914, 0915, 0917, 7007, 
7036, and 7042. We have set the rates for these high-cost drug APCs 
based on data we obtained from a contracted study of drug costs. In 
section III.D, below, we discuss the process for pricing new high cost 
drugs as they are introduced into the marketplace to assure adequate 
payment until these new drugs can be assigned to an appropriate APC. 
Final APC 120, Infusion Therapy Except Chemotherapy, and final APC 359, 
Intramuscular injections, are priced based on the resources used to 
perform the procedures, including many less expensive drugs that are 
packaged into the two APCs.
APC 957: Echocardiography
    Comment: Numerous commenters remarked on the lack of homogeneity in 
resource consumption in this APC. One commenter objected to our not 
distinguishing between procedures performed with or without contrast 
agents. Another commenter contends that proposed APC 957 does not 
account for the diversity of services in costs based on type of 
equipment, use of conscious sedation medication, and use of contrast 
agents.
    Response: Conscious sedation and contrast media were packaged where 
they were used in the base year. We believe that packaging of items 
into the payment amount is appropriate because hospitals do not 
specialize in providing only services with or only services without 
sedation or contrast. To the extent that different equipment is used 
for different procedures, and has different costs, those differing 
costs are captured and recognized in our payment algorithm.
    Comment: Several commenters referred to the fact that some of the 
echocardiograms are part of more comprehensive codes pertaining to 
echocardiograms that are in the same APC. For example, one commenter 
noted that CPT code 93880, the basic vascular ultrasound service, is 
defined as a ``duplex scan.'' The commenter stated that all duplex 
vascular ultrasound codes involve three components and that, to the 
extent all three components are incorporated into this single vascular 
code, a provider is paid for only one procedure. On the other hand, CPT 
code 93307, the basic echocardiography service, incorporates only one 
of the three types of services included in the basic vascular service, 
CPT code 93880. Other codes, CPT 93320 and 93325 are used to bill for 
the other services that are a standard part of all vascular ultrasound 
procedures like CPT code 93880. This approach results in a provider 
receiving three separate payments for an echocardiogram with Doppler 
and color flow mapping as compared to a single payment for an 
equivalent vascular study.
    Response: We agree that duplex vascular ultrasound scanning 
procedures include two dimensional and doppler signal display. However, 
for the example cited by the commenter, there is no separate code that 
includes both the two dimensional and the doppler ultrasound spectral 
analysis. To report a duplex vascular ultrasound of the heart, the only 
codes available are CPT codes 93307, 93320 and 93325, unlike the duplex 
vascular ultrasound scan of the extracranial arteries, which is coded 
with CPT code 93880. We agree that this limitation of the coding system 
affects the payment system, since the APC system is based on charges 
associated with each of the codes. We will bring this issue to the 
attention of the American Medical Association's CPT Editorial Panel.
    However, in those instances where there is a code for the 
comprehensive service and separate codes for services that are inherent 
components of the comprehensive service, the Correct Coding Initiative 
(CCI) edits, which we are incorporating into the hospital outpatient 
PPS claims processing system, will address this concern. The CCI edits 
have been in place in the Part B claims processing system since January 
1996. These edits detect when codes representing component services are 
reported with the code for the more comprehensive service. For example, 
there is an edit that prohibits the payment of CPT code 93875, a 
doppler study of the extracranial arteries when reported with CPT code 
93880, the duplex scan of the extracranial arteries.
APC 960: Cardiac Electrophysiologic Tests/Procedures APC
    Comment: Many commenters cited extreme variations in resource use 
among the procedures in proposed APC 960. One commenter noted that the 
procedures involve the use of one or more catheters, and argued that 
the proposed payment does not cover the cost of even one catheter. 
Another commenter claims that, at a minimum, the total cost of the four 
diagnostic catheters and one ablation catheter used in performing these 
procedures is $1,955.
    Response: In response to these concerns, we moved CPT code 93660, 
Evaluation of cardiovascular function with tilt table evaluation, with 
continuous ECG monitoring and intermittent blood pressure monitoring, 
with or without pharmacological intervention, to final APC 0101, and 
CPT code 93724, Electronic analysis of antitachycardia pacemaker 
system, to final APC 0100. We reclassified the remaining procedures in 
proposed CPT 960 into final APC groups 0084, 0085, 0086, and 0087 to be 
consistent with the BBRA 1999 ``two times'' requirement.
APC 966: Electronic Analysis of Pacemakers/Other Devices
    Comment: A number of commenters stated that the procedures in 
proposed APC 966 are not related clinically or in terms of resource 
cost. One commenter indicated that analyzing a spine infusion pump or 
neuroreceiver is a very different process from analyzing a

[[Page 18472]]

pacemaker or cardio/defibrillator and hence uses very different 
resources.
    Response: Although the devices that are the subject of electronic 
analysis in proposed APC group 966 differ, we believe that the resource 
use among the services in the group is, on average, relatively similar. 
We determined that the procedures in proposed APC 966 meet the ``two 
times'' test for comparability with respect to the use of resources set 
by the BBRA 1999. In addition, we find it unlikely that facilities will 
specialize in one particular type of electronic analysis of pacemakers/
other devices to the exclusion of others. Therefore, we did not change 
the procedures in final APC group 102 from what we had proposed.
APC 968: Vascular Ultrasound
    Comment: One commenter recommended removing CPT code 93875, Non-
invasive physiologic studies of extracranial arteries, complete 
bilateral study (for example, periorbital flow direction with arterial 
compression, ocular pneumoplethysmography, Doppler ultrasound spectral 
analysis), from proposed APC 968 because this study is a physiologic 
procedure and should be in the same group with other noninvasive 
physiologic vascular studies.
    Response: We agree. We moved CPT code 93875 to final APC 0096.
    Comment: One commenter recommended creating additional APC groups 
for CAT, MRI, and general ultrasound procedures to distinguish between 
diagnostic procedures that utilize contrast media and those that do 
not. The commenter believes that additional APC groups that properly 
recognize the resources required for contrast agents will encourage 
hospitals to use the procedures most suitable for the clinical needs of 
different patients.
    Response: As we explained above, in our response to comments about 
proposed APC groups 710, 720, and 726, our medical advisors and staff 
carefully reviewed our data and concluded that costs associated with 
the use of contrast material are reflected in the payment rate for 
vascular ultrasound procedures in proportion to its frequency of use. 
We believe it is reasonable to have vascular ultrasound procedures with 
and without contrast together in one group because facilities do not 
specialize based on whether or not they use contrast material. Further, 
the cost of contrast material is small relative to the overall cost of 
the ultrasound. Moreover, facilities are not likely to schedule 
ultrasound according to whether or not contrast is used. Therefore, 
with the exception of moving CPT code 93875, we did not further change 
the procedures in final APC group 0267. Final APC group 0267 is within 
the limit on cost variation required by the BBRA 1999.
APC 969: Hyperbaric Oxygen
    Comment: Many commenters were concerned that our cost data for 
hyperbaric oxygen therapy are flawed because of poor coding, and that 
the proposed payment rate is, as a consequence, inadequate. One 
commenter suggested that we did not use a common definition of 
hyperbaric oxygen therapy across all hospitals and that, due to 
ambiguity in codes, there is wide variation in how hyperbaric oxygen 
therapy services are defined for billing purposes.
    Response: We cannot subdivide final APC 0031 because we have no 
mechanism for creating clinically distinct groups related to 
differences in resource consumption among facilities within a single 
CPT code. However, we explain below, in section III.H, that we intend 
to make adjustments in future years to APC group weights, once the 
hospital outpatient PPS is implemented. If commenters believe that 
current codes are inadequate to describe these services, they should 
seek new CPT codes from the American Medical Association.
    Comment: One commenter was concerned about not only the low payment 
rate proposed for hyperbaric oxygen therapy, but also the fact that the 
proposed national unadjusted coinsurance amount exceeds the proposed 
total payment rate for the service.
    Response: We calculated the payment rate and coinsurance amount for 
APC 0031 using the same method that we followed for the other APC 
groups. Charges for hyperbaric oxygen are much higher than their costs, 
which accounts for the unusually high national unadjusted coinsurance 
rate relative to the total payment rate for CPT code 99183. Note, 
however, that hospitals may elect to offer a reduced coinsurance rate 
for the service as described below in section III.F.4.
APC 971: Level 1 Pulmonary Tests
APC 972: Level II Pulmonary Tests
APC 973: Level III Pulmonary Tests
    Comment: Commenters generally questioned the clinical consistency 
of procedures in the proposed pulmonary test APC groups and expressed 
concern about the variability of resources required to perform the 
procedures within each group. One commenter disagreed with our 
combining procedures before and after medication with procedures before 
rest and after exercise.
    Response: After carefully reviewing the assignment of codes among 
the three proposed pulmonary test groups, our medical advisors and 
staff made a number of changes. To better recognize their median costs, 
we moved CPT code 94060, Bronchospasm evaluation before and after 
bronchodilator, and CPT code 94260, Thoracic gas volume, to final APC 
group 0368, and classified CPT code 94720, Carbon monoxide diffusing 
capacity, to final APC group 0367. We made additional changes among the 
three groups to ensure comparability of resources within each pulmonary 
test APC group in accordance with the ``two times'' standard set by the 
BBRA 1999.
APC 976: Pulmonary Therapy
    Comment: Commenters generally questioned the clinical consistency 
of procedures in the proposed pulmonary therapy APC group and expressed 
concern about the variability of resources required to perform the 
procedures within the group. One professional association wrote that 
the respiratory therapy procedures in proposed APC group 976 are 
significantly different in complexity and require significantly 
different equipment and expertise to perform. The same commenter noted 
that CPT code 94657, Ventilation assist and management, initiation of 
pressure or volume preset ventilators for assisted or controlled 
breathing, subsequent days; CPT code 94660, Continuous positive airway 
pressure ventilation (CPAP), initiation and management; and, CPT code 
94662, Continuous negative pressure ventilation (CNP), initiation and 
management, all require close monitoring, more costly equipment, and, 
often, more expertise than do other therapies in proposed APC group 
976.
    Response: We agree with the commenter. We moved the CPT codes 
describing ventilation initiation and management (CPT codes 94657, 
94660, 94662) into their own APC, final APC 0079, Ventilation 
Initiation and Management, to recognize that these procedures represent 
a completely different type of clinical service and because they 
utilize resources that are materially different from those used in 
connection with other pulmonary therapy procedures. We further divided 
the procedures in proposed APC 976 to meet the definition of comparable 
resources required by the BBRA 1999, resulting in final APC groups 0077 
and 0078.

[[Page 18473]]

APC 979: Extended EEG Studies and Sleep Studies
APC 980: Electroencephalogram
APC 981: Level I Nerve and Muscle Tests
APC 982: Level II Nerve and Muscle Tests
    Comment: One commenter expressed concern about our grouping sleep 
medicine services in proposed APC 979 with EEG and Epilepsy diagnostic 
services. Another commenter is concerned about the clinical homogeneity 
of our proposed groups for the numerous different neurologic and 
neuromuscular diagnostic codes that are encompassed within the range of 
services described by CPT code 95805 through CPT code 95958. The 
commenter believes that our proposed groups do not make appropriate 
distinctions among the many different tests relating to different parts 
of the body, taking different amounts of time, using different 
equipment, and measuring different outcomes. One commenter asked that 
we add two codes created in 1998 for sleep services to the list of 
procedures in the APC system. The commenter recommended assigning CPT 
95811, Polysomnography with CPAPP, to proposed APC group 979. The 
commenter also recommended that CPT code 95806, Sleep study, unattended 
by a technologist, not be assigned to proposed APC group 979 to avoid 
creating an incentive for hospitals to use that procedure, which the 
commenter asserts is both less costly and less conclusive than other 
studies in proposed APC 979, in place of more comprehensive tests. One 
commenter claimed that the variety of neurological and neuromuscular 
diagnostic tests warrants an expansion of the number of APCs for these 
procedures to six, because the resources used vary widely. The 
commenter prefers that payments be made on a per service rather than on 
a per group basis. However, if we retain groups, the commenter 
recommended, on the basis of cost-based practice expenses, separate 
APCs for sleep and polysomnography services, for EEG studies, for EEG 
monitoring codes, for EMG codes, for nerve conduction and H reflex 
tests, and for sensory evoked potential and autonomic nerve function 
tests.
    Response: Our medical advisors and staff decided that CPT codes 
95806 and 95811 are both most appropriately assigned to final APC 0213. 
While sleep studies unattended by a technologist may consume less 
resources than those studies which involve the presence of a 
technologist, we believe that physicians are likely to order a mix of 
sleep studies, and that institutions are unlikely to specialize in 
sleep studies with or without the presence of a technologist. We added 
CPT code 95951 to APC group 0213. We believe the codes we proposed in 
APC groups 979 and 980 are sufficiently comparable clinically and in 
terms of resource use not to require further subdivision into smaller 
groups. Therefore, we retained our proposed classification in final APC 
groups 213 and 214.
    We created a third APC group for the nerve and muscle test codes, 
and we split the codes in proposed APCs 981 and 982 among final APC 
groups 0215, 0216, and 0217 to ensure comparability of resources within 
each of the three nerve and muscle test APC groups in accordance with 
the ``two times'' requirement set by section 201(g) of the BBRA 1999.
APC 987: Subcutaneous or Intramuscular Chemotherapy
APC 988: Chemotherapy except by Extended Infusion
APC 989: Chemotherapy by Extended Infusion
APC 990: Photochemotherapy
    Comments: We received numerous comments that criticized our 
proposed payments for chemotherapy services. The commenters argued that 
the proposed payment for chemotherapy and radiation therapy would 
severely reduce payments to hospitals and create perverse incentives 
for hospitals to substitute the older, less effective therapies for the 
newer ones. The commenters asserted that the proposed payment would not 
cover the costs of supportive care such as drugs to control nausea and 
vomiting. They expected that low payment rates to hospitals would force 
them to discontinue chemotherapy services, and that patients would be 
faced with trips to distant facilities to obtain services.
    Response: We believe that the concerns raised by the commenters 
have been addressed through the transitional pass-through provision set 
forth in section 1833(t)(6) of the Act, as added by section 201(b) of 
the BBRA 1999. In accordance with that provision, we have separately 
identified current drugs and biologicals used in the treatment of 
cancer. These are listed in Addendum K of this final rule, and are 
eligible for additional payment under this provision. We have obtained 
codes for any anticancer, supportive, or adjunctive drugs we could 
identify. Thus, we will pay for chemotherapy by recognizing the mode(s) 
of administration and each of the covered drugs given, whether they are 
to treat the cancer, to protect the patient against the toxic effects 
of the treatment, or to relieve the side effects of treatment. In 
section III.D.4, below, we discuss how to request codes for new drugs.
    Note that we moved CPT-based chemotherapy infusion codes into the 
``E'' (noncovered) category because HCPCS ``Q'' codes for these 
services will be used to identify chemotherapy infusions. Hospitals had 
been instructed in the past not to bill using the CPT codes.
APC 999: Therapeutic Phlebotomy
    Comment: One commenter is concerned that facilities will lose money 
because the proposed payment rate does not cover the cost incurred to 
provide the nursing care, phlebotomy bag and other supplies, overhead, 
scheduling time and disposal of hazardous waste that are all required 
to furnish this service.
    Response: We have carefully reviewed the costs associated with APC 
999 and believe that the CPT code 99195 was mistakenly used to report 
simple venipuncture in some cases, thus lowering the cost of proposed 
APC 999. However, we believe it is appropriate to base payment for this 
APC on the median amount billed, since CPT code 99195 was billed more 
than 20,000 times. Hospitals must use this code only when therapeutic 
phlebotomy is furnished, and charge an appropriate rate for the 
resources involved. Appropriate reporting will enable us to determine a 
more precise weight for this APC in future years.
Final APC 081: Non-Coronary Angioplasty or Atherectomy
Final APC 082: Coronary Atherectomy
Final APC 083: Coronary Angioplasty
    We created these three new APC groups to accommodate atherectomy 
and angioplasty procedures that we originally proposed to classify as 
inpatient only. We discuss in section III.C.5 our response to 
commenters' concerns about our proposing to designate certain 
procedures as ``inpatient only'' and our final decision to change the 
status of these atherectomy and angioplasty procedures.
Final APC 058: Strapping
Final APC 059: Casting
    We proposed to assign the procedures in these new APC groups a 
payment status indicator ``N'' as incidental services for which payment 
is packaged into the APC rate for another service or procedure. 
However, we determined

[[Page 18474]]

that the procedures in the final APC groups 0058 and 0059 could be 
performed independently, that is, the procedures for which a strapping 
has been previously applied and/or a new cast has previously been 
placed. We explain in more detail in section III.C.2.c our rationale 
for not packaging the costs associated with these services. We 
therefore created APC groups 0058 and 0059 for these codes to which we 
assigned payment status indicator ``S'' to indicate that these are 
significant procedures paid under the hospital outpatient PPS to which 
the multiple procedure discount does not apply.

e. Exceptions to BBRA 1999 Limit on Variation of Costs Within APC 
Groups

    As we note above, section 201(g) of BBRA 1999 amends section 
1833(t)(2) of the Act to define what constitutes comparable use of 
resources among the procedures or services within an ambulatory payment 
classification group under the hospital outpatient PPS. The standard 
set by section 1833(t)(2) of the Act is that the items and services 
within a group cannot be considered comparable with respect to the use 
of resources if the highest median (elected by the Secretary, as 
opposed to the mean) cost item or service within a group is more than 2 
times greater than the lowest median cost item or service within the 
same group (the ``two-times'' requirement).
    Section 1833(t)(2) of the Act allows the Secretary to make 
exceptions to the ``two-times'' requirement in unusual cases, such as 
low volume items and services, although the Secretary may not make such 
an exception in the case of a drug or biological that has been 
designated as an orphan drug under section 526 of the Federal Food, 
Drug, and Cosmetic Act. As we explain in the preceding section of this 
preamble, after we had modified the composition of the APC groups based 
on the recommendations of commenters, we made numerous additional 
changes to the APC groups to conform with the BBRA 1999 ``two times'' 
requirement. In the resulting groups, we found certain anomalies that 
were irreconcilable with the principles underlying formation of the APC 
groups. After carefully evaluating the various combinations resulting 
from further subdividing groups or reassigning codes to other groups to 
resolve the anomalies, and after reviewing our data, we decided to 
maintain the composition of certain APC groups, as exceptions to the 
``two times'' requirement. We based exceptions on factors such as low 
procedure volume, suspect or incomplete cost data, concerns about 
inaccurate or incorrect coding, or compelling clinical arguments. We 
believe that as hospitals gain experience under the hospital outpatient 
PPS, and as they refine their coding of services, a number of the 
apparent anomalies within the groups that we are treating as exceptions 
to the ``two times'' will be resolved.
    Below we list the APC groups that are exceptions to the ``two 
times'' requirement, and our reasons for the exception. We use the 
final APC number to identify the group.
APC 0016: Level IV Debridement and Destruction
    We are retaining CPT code 56501 in final APC group 0016, even 
though its median cost exceeds the ``two times limit.'' We believe the 
higher costs that are reflected in the data are the result of incorrect 
coding. The descriptor for CPT code 56501 defines the procedure as the 
simple destruction of skin and superficial subcutaneous tissues. In the 
judgment of our medical advisors, costs associated with simple 
destruction of skin and superficial subcutaneous tissues are typically 
within the range of costs associated with the other procedures in final 
APC group 0016, and the median cost that our data attribute to CPT code 
56501 is higher than the code description warrants.
APC 0030: Breast Reconstruction/Mastectomy
    Although the range of costs for procedures in final APC group 0030 
exceeds the ``two times limit,'' we believe that only the simplest 
breast procedures will be done in the outpatient setting. Most of the 
procedures with median costs over $1000 used observation services in 
order to provide an overnight stay. We expect these cases to revert to 
the more appropriate inpatient setting.
APC 0058: Level I Strapping/Casting
    The codes in final APC group 0058 are the simpler casting, 
splinting, and strapping procedures. Costs associated with the more 
resource-intensive procedures in final APC group 0059 are fairly 
uniform, but the median costs of procedures in final APC group 0058 
vary widely. We are excepting final APC group 0058 from the ``two times 
limit'' until we can review the data for the first year of the 
outpatient PPS.
APC 0060: Manipulation Therapy
    Taken collectively, the codes in final APC group 0060 are low in 
volume and erratically priced. For example, although the number of 
areas treated increases within the range of CPT codes 98925 through 
98929, suggesting progressively increasing resource utilization, our 
data show median costs associated with the codes in the range 98925-
98929 as $38, $11, $16, $17, and $19, respectively. Although costs 
associated with treating 9 to 10 body regions might not be 5 to 10 
times greater than treating one or two regions, we would still expect 
costs for the more extensive procedures to be higher than those for the 
less extensive procedures, and certainly not lower as suggested by our 
data. Nor do we expect a hospital to specialize in treating more or 
fewer body areas. Therefore, the median payment set for final APC 0060 
should average out, providing adequate payment for any number of body 
areas treated.
APC 0079: Ventilation Initiation and Management
    These codes all represent respiratory treatment and support within 
the outpatient setting. Their costs should be roughly the same, even 
though our data suggest otherwise. We are excepting final APC group 
0079 from the ``two times limit'' at this time, pending the collection 
of more conclusive cost data.
APC 0080: Diagnostic Cardiac Catheterization
    The data for CPT code 93524 reflect costs that are lower than we 
would expect. We can find no apparent explanation for the wide 
variation in costs among the cardiac catheterization codes, although we 
suspect that the accuracy of the chargemaster system, when assigning 
charges in other than the surgical suite, may be problematic. We expect 
costs to even out once hospitals decide which cases may be handled on 
an outpatient basis without requiring an overnight stay.
APC 0081: Non-Coronary Angioplasty
    We are excepting final APC group 0081 from the ``two times limit'' 
because of the low volume of cases for the codes in the group. For some 
of the codes in this group, the data reflect lower than expected median 
costs, which we attribute to low volume and to miscoding, which would 
account for the erratic sequences of costs found in our data.
APC 0093: Vascular Repair/Fistula Construction
    We believe the median costs for CPT codes 36530 and 36810 are 
aberrant. These codes are very similar clinically to the other codes in 
APC 0093, and we would expect their costs to be similar. We believe low 
volume may account for the variability in cost.

[[Page 18475]]

APC 0094: Resuscitation and Cardioversion
    We believe the median costs for CPT codes 92953 and 31500 are 
aberrant, perhaps due to misuse of the codes. Therefore, we are 
excepting this APC group from the ``two times limit,'' until we collect 
and analyze more accurate data once the hospital outpatient PPS is 
implemented.
APC 210: Spinal Tap
    The two CPT codes that comprise this group are essentially the same 
procedure, one performed for diagnostic reasons and the other 
therapeutic. We suspect the disparity in median costs is attributable 
to the much higher volume of diagnostic spinal taps. Therefore, we are 
excepting this APC group from the ``two times limit,'' until we collect 
and analyze more accurate data once the hospital outpatient PPS is 
implemented.
APC 0233: Level II Anterior Segment Eye
    We are excepting final APC group 233 from the ``two times limit'' 
because many of the codes in this APC are low volume and the coding 
seems erratic. For example, CPT designates a number of codes that are 
in final APC group 0233 as ``relatively small'' surgical procedures, 
which suggests that miscoding may have resulted in inflated cost data.
APC 0251: Level I ENT Procedures
    A combination of low volume and unlisted codes obscures the fact 
that this APC represents the least intense ENT procedures. Because 
there are so many ENT codes, consistent agreement on what the codes 
represent may be difficult to achieve. Therefore, we are excepting this 
APC group from the ``two times limit,'' until we collect more accurate 
data under outpatient PPS.
APC 0264: Level II Miscellaneous Radiology Procedures
    In the judgment of our medical advisors, the median costs for CPT 
codes 74740 and 76102 are aberrant. These procedures would be underpaid 
if they were paid separately and on the basis of what our data show to 
be their median cost. Therefore, we are excepting this APC group from 
the ``two times limit,'' until we collect more accurate cost data under 
outpatient PPS.
APC 0274: Myelography
    In the judgment of our medical advisors, the median costs for CPT 
codes 70010 and 70015 are aberrant. These codes would be underpaid if 
they were moved to their own APC and paid on the basis of their median 
cost. All codes in this APC should cluster around the same cost. 
Therefore, we are excepting this APC group from the ``two times 
limit,'' until we collect more accurate cost data under outpatient PPS.
APC 0279: Level I Diagnostic Angiography
    We believe the median costs for the codes at the low end of this 
APC may be inaccurate, because, clinically, these codes are 
homogeneous. Therefore, we are excepting this APC group from the ``two 
times limit,'' until we collect more accurate cost data under 
outpatient PPS.
APC 0302: Level III Radiation Therapy
    We are retaining CPT code 77470 in final APC group 302, because the 
median cost seems low for the code description, possibly because this 
code may have been billed improperly in the past. We are also uncertain 
of the appropriate median cost of CPT code 61793, because we have been 
told that CPT code 61793 was used for both single-session gamma knife 
procedures and for each of multiple sessions of treatment with linear 
accelerators. Therefore, we have created two codes to be used in place 
of CPT code 61793, in order to collect more reliable data: G0173 
(Stereotactic radiosurgery, complete course of therapy in one session), 
and G0174 (Stereotactic radiosurgery, requiring more than one session).
    We will initially pay both codes at the same rate; however, we 
expect differences in cost would become apparent during the first year 
or 18 months of the outpatient PPS.
APC 0311: Radiation Physics Services
    We are retaining CPT code 77370 in final APC group 0311, because we 
believe a special medical radiation physics consultation (outside the 
weekly management of a patient) is probably more costly than our data 
indicate.
APC 0341: Immunology Tests
    We think the variation in costs among the procedures within final 
APC group 0341 may be the result of erratic coding. Because these 
services are so similar clinically, we would expect their individual 
costs to cluster around the median. Therefore, we are excepting this 
APC group from the ``two times limit,'' until we collect more accurate 
cost data under outpatient PPS.
APC 0371: Allergy Injections
    We attribute the variation in median costs among the procedures 
within final APC group 0371 to erratic coding. Because these services 
are so similar clinically, we would expect their individual costs to 
cluster around the median. Therefore, we are excepting this APC group 
from the ``two times limit,'' until we collect more accurate cost data 
under outpatient PPS.
APC 0373: Neuropsychological Testing
    With one exception, the codes in final APC group 0373 are billed 
per hour, so facility costs should all cluster around the median. 
Therefore, we are excepting this APC group from the ``two times 
limit,'' until we collect more accurate cost data under outpatient PPS.
7. Discounting of Surgical Procedures
    To be consistent with Medicare policy and regulations governing 
payment for ambulatory surgical services furnished in a physician's 
office and in an ASC, we proposed under the hospital outpatient PPS to 
discount payment amounts when more than one procedure is performed 
during a single operative session or when a surgical procedure is 
terminated prior to completion. Specifically, we proposed that when 
more than one surgical procedure with payment status indicator ``T'' is 
performed during a single operative session, we would pay the full 
Medicare payment and the beneficiary would pay the coinsurance for the 
procedure having the highest payment rate. Fifty percent of the usual 
Medicare PPS payment amount and beneficiary coinsurance amount would be 
paid for all other procedures performed during the same operative 
session to reflect the savings associated with having to prepare the 
patient only once and the incremental costs associated with anesthesia, 
operating and recovery room use, and other services required for the 
second and subsequent procedures.
    We also proposed to require hospitals to use modifiers on bills to 
indicate procedures that are terminated before completion. Modifier -73 
(Discontinued Outpatient Procedure Prior to Anesthesia Administration) 
would identify a procedure that is terminated after the patient has 
been prepared for surgery, including sedation when provided, and taken 
to the room where the procedure is to be performed, but before 
anesthesia is induced (for example, local, regional block(s), or 
general anesthesia). Modifier-52 (Reduced Services) would be used to 
indicate a procedure that did not require anesthesia, but was 
terminated after the patient has been prepared for the procedure, 
including sedation when provided and taken to the room where the 
procedure is to be performed. We proposed to pay 50 percent of the 
usual Medicare PPS payment amount and

[[Page 18476]]

beneficiary coinsurance amount for a procedure terminated before 
anesthesia is induced. Modifier-74 (Discontinued Procedure) would be 
used to indicate that a surgical procedure was started but discontinued 
after the induction of anesthesia (for example, local, regional block, 
or general anesthesia), or after the procedure was started (incision 
made, intubation begun, scope inserted) due to extenuating 
circumstances or circumstances that threatened the well-being of the 
patient. To recognize the costs incurred by the hospital to prepare the 
patient for surgery and the resources expended in the operating room 
and recovery room, the hospital will receive full payment for a 
procedure that was started but discontinued after the induction of 
anesthesia or after the procedure was started, as indicated by a 
modifier-74. The elective cancellation of procedures would not be 
reported. If multiple procedures were planned, only the procedure 
actually initiated would be billed.
    Comment: Some commenters asked us to clarify how the policy would 
be applied. For example, one commenter asked whether the surgical 
discounting methodology would apply in the following situation: 
Contrast x-ray of lower spine (CPT code 72265) is followed by contrast 
CAT of the spine (CPT code 72132). Both procedures have related 
surgical codes (CPT codes 62270 and 62284). Other commenters provided 
examples that were similar in nature but involved other codes.
    Response: We proposed to apply the reduced payment for multiple 
procedures to surgical procedures only, that is, those CPT codes that 
have a payment status indicator ``T.'' Therefore, services such as CPT 
codes 72265 and 72132 that have a payment status indicator of ``S'' 
would not be subject to the multiple procedure discount, whereas CPT 
codes 62270 and 62284, which are surgical procedures and have a payment 
status indicator of ``T,'' would be subject to the multiple procedure 
discount. Hypothetically, if all four codes were provided in a single 
operative session, as suggested by this commenter, then the reduced 
payment would apply only to the surgical procedure with the lower 
payment rate. (For the record, we have responded to the commenter's 
example in order to clarify how the multiple procedure discount would 
apply in a hypothetical situation. However, we question whether the 
suggested combination of codes would be covered if actually performed 
during the course of a single patient encounter.)
    Comment: Commenters asked what factors guided our assignment of 
payment status indicator ``T'' to a code.
    Response: We generally assigned the payment status indicator ``T'' 
to surgical services. Our medical advisors and staff will continue to 
review the designation of status indicators and we may propose 
revisions in the future.
    Comment: A variety of commenters stated that the reduced payments 
for multiple procedures would inappropriately reduce payments for a 
second procedure. Some were concerned that application of the multiple 
procedure discount could result in hospitals being less likely to offer 
procedures assigned the payment status indicator ``T.'' These 
commenters recommended that we change all ``T'' payment indicators to a 
different indicator such as ``S,'' which we define as a significant 
procedure not reduced when multiple, until we have had an opportunity 
to collect reliable cost data upon which to base payment decisions 
about discounting.
    Response: We continue to believe that the proposed reduced payment 
for multiple surgical procedures is reasonable. We disagree that 
hospitals would be less likely to provide these services. We believe 
there clearly are savings achieved when more than one surgical 
procedure is performed during a single operative session. The patient 
has to be prepared for surgery only once, and the costs associated with 
anesthesia, operating and recovery room use, and other services 
required for the second procedure are incremental.
    Comment: Some commenters questioned whether the reduced payment for 
multiple procedures applied to the beneficiary coinsurance as well as 
to the Medicare program payment. Others did not understand how this 
reduced payment was accounted for in determining the conversion factor.
    Response: The reduced payment for multiple procedures would apply 
to both the beneficiary coinsurance and the Medicare payment. In order 
to do this in a ``budget neutral'' manner, we increased the conversion 
factor to account for the reduced payments for multiple procedures. In 
this way, total payments in the aggregate are not affected.
    Comment: One commenter believes we should exclude from the 
multiple-procedure discount those procedures that were subject to a 50 
percent reduction under the previous cost-based system because those 
procedures were recognized as being an adjunct to a primary procedure. 
The commenter believes that we had already factored these discounts 
into our cost determinations and would therefore be inappropriately 
reducing payment even further for these procedures.
    Response: We disagree with the commenter. In determining the 
weights for the APC groups, we included only single procedure claims. 
Multiple procedure reductions existing under the previous cost-based 
system would not have been reflected in these single procedure claims, 
and, therefore, do not affect the APC payment weights.

Final Action

    Under the hospital outpatient PPS, we will discount payment amounts 
for surgical procedures when more than one procedure is performed 
during a single operative session or when a surgical procedure is 
terminated prior to completion. Parallel discounts will apply to 
beneficiary coinsurance amounts.
8. Payment for New Technology Services

a. Background

    We proposed to price a new item or service that was assigned a new 
HCPCS code by classifying the new code to whichever existing APC group 
most closely resembled the item or service in terms of its clinical 
characteristics and estimated resource use. We proposed to use the 
group weight, payment rate, and coinsurance amount established for the 
existing APC to price the new code for at least 2 years to give us an 
opportunity to collect cost data for the new item or service.
    After we published our proposed rule, the Congress expressed 
concern in the conference report accompanying the BBRA 1999, that our 
proposed PPS does not adequately address ``issues pertaining to the 
treatment of * * * new technology.'' (See H. R. Rep. No. 436 (Part I), 
106th Cong., 1st Sess. 868 (1999).) Therefore, the Congress enacted 
``transitional pass-throughs'' in section 201(b) of the BBRA 1999 that 
provide an additional payment for ``new medical devices, drugs, and 
biologicals'' that do not otherwise meet the definition of current 
orphan drugs, or current cancer therapy drugs and biologicals and 
brachytherapy, or current radiopharmaceutical drugs and biological 
products. (See section III.D of this preamble for a discussion of how 
we are implementing the transitional pass-throughs.)

b. Comments and Responses

    Comment: The most frequent commenters regarding our treatment of 
new technology under the proposed

[[Page 18477]]

hospital outpatient PPS were device manufacturers and pharmaceutical 
companies and their trade associations. Commenters were concerned 
because the proposed APC payment rates were developed using 1996 cost 
data that do not reflect the cost of many new technologies introduced 
subsequent to 1996. Commenters believe that the proposed method of 
ratesetting under the APC system lacks the flexibility needed to 
recognize emergent technologies in a timely manner. In the view of the 
commenters, assigning new technologies to existing APC groups pending 
the collection of cost data would result in underpayment, thereby 
discouraging the adoption of new technologies.
    Commenters further stated that the proposed payment rates for 
current yet relatively new devices were too low and would favor 
continued use of older, less effective regimens on the basis of 
financial pressures rather than on the improved clinical outcomes of 
newer technology. Some commenters, concerned that we will not update 
codes or payment rates quickly enough to allow hospitals to pay for new 
technologies, recommended that we assign HCPCS codes as soon as 
products become available and alter APC group weights to account for a 
new technology. These commenters believe that the time lapse between 
coding updates is a barrier to innovation because it can take several 
years for a code to be issued for a new surgical technique, and until a 
new code is issued, facilities must bill for new surgical techniques as 
``unlisted procedures'' resulting in the lowest payment rate for the 
category of surgery.
    One commenter urged that we implement a payment carve-out for 
certain drug and biological therapies and pay for these items on a 
reasonable cost basis in order to provide timely patient access to many 
new pharmaceutical and biotechnology products. The same commenter 
recommended that if we reject a complete carve-out, then, at a minimum, 
we should pay for new products introduced after 1996 on a reasonable 
cost basis for 1 year to adequately compensate companies for developing 
new and more effective products. Another commenter recommended that we 
increase the number of APC groups to better reflect services with 
similar cost structures.
    One professional association recommended abandoning the APC group 
system altogether and pricing services individually because assigning 
new technology and most costly procedures to APC groups with 
established lower cost procedures creates a strong disincentive for 
hospitals to provide new or improved items or services and, in the case 
of newer, higher cost drugs, encourages hospitals to develop 
formularies and practice patterns based on financial considerations 
rather than on the medical value of drugs.
    Technologies that commenters cited as being inadequately addressed 
by the proposed outpatient PPS include new technologies based on 
molecular genetics; gamma knife procedures used in radiation surgery; 
and prostatic microwave thermotherapy (transurethral microwave 
thermotherapy (TUMT)) which a commenter said has a direct cost of 
$1,918 and, factoring in indirect costs, a total cost of $2,623.
    Response: The concerns expressed by commenters regarding new 
technology items and services highlight two issues. The first is 
specific to the data used to construct APC groups and calculate their 
prices at the start of the PPS. As required by section 1833(t)(2)(C) of 
the Act, we are using claims data from 1996 as the basis for 
determining APC group weights and payment rates under the new system. 
The 1996 data do not capture items and services that have emerged since 
that time and that are now in use. The second issue relates to new 
items and services that will be introduced in the future, after the 
outpatient PPS is implemented. Postponing the adjustment of APC groups 
and weights for several years to allow for the collection of cost data 
would potentially inhibit the dissemination of medically desirable 
innovations.
    We recognize the concerns raised by commenters about our proposed 
treatment of new codes under the hospital outpatient PPS. We therefore 
have developed a process that we believe will allow us to recognize new 
technologies on an ongoing basis as expeditiously as our systems 
permit. We expect that this process, which we explain below, combined 
with the transitional pass-throughs established by section 201(b) of 
the BBRA 1999 (which we describe in section III.D of this preamble), 
will provide additional payment for a significant share of new 
technologies.
    In this final rule, we have created special APC groups to 
accommodate payment for new technology services. In contrast to the 
other APC groups, the new technology APC groups do not take into 
account clinical aspects of the services they are to contain, but only 
their costs. We will assign new items and services that we determine 
cannot appropriately be placed in existing APC groups for established 
procedures and services to the new technology APC groups.
    The new technology APC groups, which are now largely unpopulated, 
are already defined in our claims processing system for the outpatient 
PPS, and we have established payment rates for the APC groups based on 
the midpoint of ranges of possible costs, for example, the payment 
amount for a new technology APC group reflecting a range of costs from 
$300 to $500 would be set at $400. The cost range for the groups 
reflects current cost distributions, and we reserve the right to modify 
the ranges as we gain experience under the outpatient PPS. The final 
APC groups for new technology are groups 0970 through 0984 and cover a 
range of costs from less than $50 to $6,000. Upon implementation of the 
outpatient PPS, we will make payment for the following new technology 
services under the new technology APCs:

53850  Transurethral destruction of prostate tissue; by microwave 
thermotherapy
53852  Transurethral destruction of prostate tissue; by 
radiofrequency thermotherapy
96570  Photodynamic therapy, first 30 minutes
96751  Photodynamic therapy, each additional 15 minutes
G0125  PET lung imaging of solitary pulmonary nodules, using 2-
(Fluorine-18)-Fluoro-2-Deoxy-D-Glucose (FDG), following CT (71250/
71260 or 71270)
G0126  PET lung imaging of solitary pulmonary nodules, using 2-
(Fluorine-18)-Fluoro-2-Deoxy-D-Glucose (FDG), following CT (71250/
71260 or 71270); initial staging of pathologically diagnosed non-
small cell lung cancer
G0163  Positron emission tomography (PET), whole body, for 
recurrence of colorectal metastatic cancer
G0164  Positron emission tomography (PET), whole body, for staging 
and characterization of lymphoma
G0165  Positron emission tomography (PET), whole body, for 
recurrence of melanoma or melanoma metastatic cancer
G0166  External counterpulsation, per treatment session
G0168  Wound closure by adhesive

    The new technology APC groups give us a mechanism for initiating 
payment at an appropriate level within a relatively short timeframe, 
and certainly less than the 2 or 3 years that we contemplated in our 
proposed rule. As in the case of items qualifying for the transitional 
pass-through payment, placement in a new technology APC will be 
temporary. After we gain information about actual hospital costs 
incurred to furnish a new technology service, we will move it to a 
clinically-related APC group with comparable resource costs. If we 
cannot move the new technology service to an existing

[[Page 18478]]

APC because it is dissimilar clinically and with respect to resource 
costs from all other APCs, we will create a separate APC for such 
service. We will retain a service within a new technology APC group for 
at least 2 years, but no more than 3 years, consistent with the time 
duration allowed for the transitional pass-through payments. Movement 
from a new technology APC to a clinically-related APC would occur as 
part of the annual update of APC groups. Beneficiary coinsurance 
amounts for items and services in the new technology APC groups are 20 
percent of the payment rate set for the new technology APCs.
    We ask that interested parties take the following steps to bring to 
our attention services that they believe merit consideration for 
pricing using the new technology APC groups. Mail requests for 
consideration of possible new technology services that have established 
HCPCS codes to the following address ONLY: PPS New Tech/Pass-Throughs, 
Division of Practitioner and Ambulatory Care, Mailstop C4-03-06, Health 
Care Financing Administration, 7500 Security Boulevard, Baltimore, MD 
21244-1850.
    To be considered, requests MUST include the following information:
     Trade/brand name of item.
     A detailed description of the clinical application of the 
item, including HCPCS code(s) to identify the procedure(s) with which 
the item is used.
     Current cost of the item to hospitals (i.e., actual cost 
paid by hospitals net of all discounts, rebates, and incentives in cash 
or in-kind). In other words, submit the best and latest information 
available that provides evidence of the hospital's actual cost for a 
specific item.
     If the item is a service, itemize the costs required to 
perform the procedure, e.g., labor, equipment, supplies, overhead, etc.
     If the item requires FDA approval/clearance, submit 
information that confirms receipt of FDA approval/clearance and the 
date obtained.
     If the item already has an assigned HCPCS code, include 
the code and its descriptor in your submission plus a dated copy of the 
HCPCS code ``recommendation application'' previously submitted for this 
item.
     If the item does not have an assigned HCPCS code, follow 
the procedure discussed, below, for obtaining HCPCS codes and submit a 
copy of the application with our payment request.
     Name, address, and telephone number of the party making 
the request.
     Other information as HCFA may require to evaluate specific 
requests.
    We believe some items not yet known to us do not yet have assigned 
HCPCS codes. We expect to use national HCPCS codes in the hospital 
outpatient PPS to the greatest extent possible. These codes are 
established by a well-ordered process that operates on an annual cycle, 
starting with submission of information by interested parties due by 
April 1 and leading to announcement of new codes in October of each 
year. This process is described, and relevant application forms are 
available, on the following HCFA website: http://www.hcfa.gov/medicare/hcpcs.htm.
    Considering the exigencies of implementing a new system, we intend 
to establish temporary codes in 2000 to permit implementation of 
additional payments for other eligible items effective beginning 
October 1, 2000. The process for submitting information will be the 
same as for national codes.
    For new technology services that DO NOT have established HCPCS 
codes, submit the regular application for a national HCPCS code in 
accordance with the instructions found on the internet at http://www.hcfa.gov/medicare/hcpcs.htm. Send applications for national HCPCS 
codes to: C. Kaye Riley, HCPCS Coordinator, Health Care Financing 
Administration, Mailstop C5-08-27, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850. A fuller discussion of the HCPCS process and 
schedule is in section III.D.6 of this preamble.
    Because of staffing and resource limitations, we cannot accept 
requests by facsimile (FAX) transmission. Because of claims processing 
systems constraints, a new technology payment rate can only be 
initiated at the start of a calendar quarter. Since we will update our 
outpatient PPS quarterly to include new technology additional services, 
October 1, 2000 is the earliest date that we will implement payment for 
additional new technology services other than for those items beginning 
on July 1, 2000. In general, we expect to be able to complete action on 
requests to assign an item or service to a new technology APC group in 
about 6 months from the date we receive the request.
    In order to be considered for assignment to a new technology APC 
group, an item or service must meet the following criteria:
     The item or service is one that could not have been billed 
to the Medicare program in 1996 or, if it was available in 1996, the 
costs of the item or service could not have been adequately represented 
in 1996 data.
     The item or service does not qualify for an additional 
payment under the transitional pass-through provided for by section 
1833(t)(6) of the Act, as amended by section 201(b) of the BBRA 1999, 
and 42 CFR 419.43(e) as a current orphan drug, as a current cancer 
therapy drug or biological or brachytherapy, as a current 
radiopharmaceutical drug or biological product, or as a new medical 
device, drug, or biological.
     The item or service has a HCPCS code. (See section III.D 
for additional information about obtaining HCPCS codes.)
     The item or service falls within the scope of Medicare 
benefits under section 1832(a) of the Act.
     The item or service has been determined to be reasonable 
and necessary in accordance with section 1862(a)(1)(A) of the Act.

Final Action

    We are initiating a method to pay for new technology services that 
are not addressed by the transitional pass-through provisions of the 
BBRA 1999.

D. Transitional Pass-Through for Innovative Medical Devices, Drugs, and 
Biologicals

1. Statutory Basis
    Section 201(b) of the BBRA 1999 amended section 1833(t) of the Act 
by adding a new section 1833(t)(6). This provision requires the 
Secretary to make additional payments to hospitals for a period of 2 to 
3 years for specific items. The items designated by the law are the 
following: current orphan drugs, as designated under section 526 of the 
Federal Food, Drug, and Cosmetic Act; current drugs, biologic agents, 
and brachytherapy devices used for treatment of cancer; current 
radiopharmaceutical drugs and biological products; and new medical 
devices, drugs, and biologic agents, in instances where the item was 
not being paid for as a hospital outpatient service as of December 31, 
1996, and where the cost of the item is ``not insignificant'' in 
relation to the hospital outpatient PPS payment amount. In this 
context, ``current'' refers to those items for which hospital 
outpatient payment is being made on the first date the new PPS is 
implemented.
    Section 1833(t)(6)(C)(i) of the Act sets the additional payment 
amounts for the drugs and biologicals as the amount by which the amount 
determined under section 1842(o) of the Act (95 percent of the average 
wholesale price (AWP)) exceeds the portion of the otherwise applicable 
hospital outpatient department fee schedule amount that

[[Page 18479]]

the Secretary determines to be associated with the drug or biological. 
Section 1833(t)(6)(C)(ii) provides that the additional payment for 
medical devices be the amount by which the hospital's charges for the 
device, adjusted to cost, exceed the portion of the otherwise 
applicable hospital outpatient department fee schedule amount 
determined by the Secretary to be associated with the device. Under 
section 1833(t)(6)(D), the total amount of pass-through payments for a 
given year cannot be projected to exceed an ``applicable percentage'' 
of total payments. For a year (or a portion of a year) before 2004, the 
applicable percentage is 2.5 percent; for 2004 and subsequent years, 
the applicable percentage is 2.0 percent. If the Secretary estimates 
that total pass-through payments would exceed the caps, the statute 
requires the Secretary to reduce the additional payments uniformly to 
ensure the ceiling is not exceeded.
    Section 201(c) of the BBRA amended section 1833(t)(2)(E) of the Act 
to require that these pass-through payments be made in a budget neutral 
manner. In accordance with section 1833(t)(7) of the Act, as amended by 
section 201(i) of the BBRA 1999, these additional payments do not 
affect the computation of the beneficiary coinsurance amount.
    Implementation of this pass-through provision requires us to--
     Identify eligible pass-through items;
     Designate a Billing Code for each;
     Determine the term ``not insignificant'' in the context of 
determining whether an additional payment is appropriate;
     Determine an appropriate cost-to-charge ratio to use to 
adjust the hospital's charges for a new medical device to cost;
     Determine the portion of the applicable APC that would be 
associated with the drug, biological or device; and
     Determine the additional payment amount.
    As with other provisions of this final rule that reflect 
implementation of the BBRA 1999, we are soliciting comments on our 
implementation of the transitional pass-through payments, as set forth 
below.
2. Identifying Eligible Pass-Through Items

a. Drugs and Biologicals

    Section 1833(t)(6)(A) of the Act establishes definitions and 
examples of the drugs and biologicals that are candidates for pass-
through payments. As indicated above, these drugs and biologicals are 
characterized as both current and new. Current refers to those drugs 
and biologicals for which payment is made on the first date the 
hospital outpatient PPS is implemented, that is, on July 1, 2000. They 
include the following:
    1. Orphan drugs. These are drugs or biologicals that have been 
designated as an orphan drug under section 526 of the Federal Food, 
Drug and Cosmetic Act.
    2. Cancer therapy drugs, biologicals, and brachytherapy. These 
items are those drugs or biologicals that are used in cancer therapy, 
including (but not limited to) chemotherapeutic agents, antiemetics, 
hematopoietic growth factors, colony stimulating factors, biological 
response modifiers, bisphosphonates, and a device of brachytherapy.
    3. Radiopharmaceutical drugs and biological products. These are 
radiopharmaceutical drug or biological products used in nuclear 
medicine for diagnostic, monitoring, or therapeutic purposes.
    A new drug or biological is defined as a product that was not paid 
as a hospital outpatient service prior to January 1, 1997 and for which 
the cost is not insignificant in relation to the payment for the APC to 
which it is assigned. These items are not reflected in the 1996 claims 
data we are required to use in developing the outpatient PPS. Before 
payment can be made for these new drugs and biologicals, a 
determination must be made that these items are reasonable and 
necessary for the diagnosis or treatment of an illness or injury or to 
improve the functioning of a malformed body member as required by 
section 1862(a)(1)(A) of the Act. Drugs that can be self-administered 
are not covered under Part B of Medicare (with specific exemptions for 
certain oral chemotherapeutic agents and antiemetics, blood-clotting 
factors, immunosuppressives, and erythropoietin for dialysis patients).

b. Medical Devices

    Under section 201(b) of the BBRA 1999, for purposes of making pass-
through payments, a new or innovative medical device is one for which 
payment as a hospital outpatient service was not being made as of 
December 31, 1996 and for which the cost of the device ``is not 
insignificant'' in relation to the hospital outpatient department fee 
schedule amount payable for the service involved. For the purpose of 
identifying ``new medical devices'' that may be eligible for pass-
through payments, we are excluding equipment, instruments, apparatuses, 
implements or items that are generally used for diagnostic or 
therapeutic purposes, that are not implanted or incorporated into a 
body part, and that are used on more than one patient (that is, are 
reusable). This material is generally considered to be hospital 
overhead costs and the depreciation expenses associated with them are 
reflected in the APC payments. The unit of payment for the outpatient 
PPS is a service or procedure. Equipment or instrumentation is a method 
or means of delivering that service. We are not establishing separate 
APC payments for equipment, instruments, apparatuses, implements, or 
items because payment for these types of devices is packaged in the APC 
payment for the service or item with which they are used. However, as 
we discuss above in section III.C.8, we have created new technology 
APCs to accommodate new technology services that may be performed using 
equipment or instrumentation that is capitalized and depreciated and 
used on more than one patient. An example of a new technology service 
is CPT code 53850, Transurethral destruction of prostate tissue; by 
microwave thermotherapy. We have assigned this procedure to new 
technology APC 0980. (See section III.C.8 of this preamble for further 
discussion of payment for new technology under the hospital outpatient 
PPS.)
    Section 201(e) of the BBRA 1999 amends section 1833(t)(1)(B) of the 
Act to include as ``covered OPD services'' implantable items described 
in paragraphs (3), (6), or (8) of section 1861(s) of the Act. Paragraph 
(3) refers to diagnostic tests including diagnostic x-rays, 
mammographies, laboratory tests, and other diagnostic tests. Paragraph 
(6) refers to implantable durable medical equipment (DME), and 
paragraph (8) refers to prosthetic devices that replace all or part of 
an internal body organ (including colostomy bags and supplies directly 
related to colostomy care). Implantables are not mentioned specifically 
in these paragraphs, but we consider a prosthetic device that replaces 
all or part of an internal body organ that is mentioned in section 
1861(s)(8) to be an implantable. The BBRA 1999 Conference Report lists 
pacemakers, defibrillators, cardiac sensors, venous grafts, drug pumps, 
stents, neurostimulators, and orthopedic implants, as well as items 
that come in contact with human tissue during invasive procedures as 
examples of implantable items.
    Implantable items covered under section 201(e) of the BBRA 1999 may 
be considered eligible for the transitional pass-through payments 
allowed under

[[Page 18480]]

section 201(b) of the BBRA 1999 to the extent that these implantables 
meet the statutory requirements set forth in section 201(b) and the 
criteria established in this final rule for payment of these devices.
    Although we are recognizing the implantable items identified in 
section 201(e) of the BBRA 1999 for possible pass-through payments, we 
are not applying the pass-through provision to any DME, orthotics, and 
prosthetic devices that are not covered under section 201(e) of the 
BBRA 1999. Rather, we will pay for these items under the DMEPOS fee 
schedule when the hospital is acting as a supplier.
3. Criteria To Define New or Innovative Medical Devices Eligible for 
Pass-Through Payments
    In summary, we will make pass-through payment for new or innovative 
medical devices that meet the following criteria:
    a. They were not recognized for payment as a hospital outpatient 
service prior to 1997.
    b. They have been approved/cleared for use by the FDA.
    c. They are determined to be reasonable and necessary for the 
diagnosis or treatment of an illness or injury or to improve the 
functioning of a malformed body part, as required by section 
1862(a)(1)(A) of the Act. We recognize that some investigational 
devices are refinements of existing technologies or replications of 
existing technologies and may be considered reasonable and necessary. 
We will consider devices for coverage under the outpatient PPS if they 
have received an FDA investigational device exemption (IDE) and are 
classified by the FDA as Category B devices. (See Secs. 405.203 to 
405.215.) However, in accordance with Sec. 405.209, payment for a 
nonexperimental investigational device ``is based on, and may not 
exceed, the amount that would have been paid for a currently used 
device serving the same medical purpose that has been approved or 
cleared for marketing by the FDA.''
    d. They are an integral and subordinate part of the procedure 
performed, are used for one patient only, are surgically implanted or 
inserted, and remain with that patient after the patient is released 
from the hospital outpatient department.
    e. The associated cost is not insignificant in relation to the APC 
payment for the service in which the innovative medical equipment is 
packaged. (See section III.D.4 below for the definition of ``not 
insignificant.'')
    f. They are not equipment, instruments, apparatuses, implements, or 
such items for which depreciation and financing expenses are recovered 
as depreciable assets as defined in Chapter 1 of the Medicare Provider 
Reimbursement Manual (HCFA Pub. 15-1). (As indicated above, these costs 
are considered overhead expenses that have been factored into the APC 
payment.)
    g. They are not materials and supplies such as sutures, clips, or 
customized surgical kits furnished incident to a service or procedure.
    h. They are not materials such as biologicals or synthetics that 
may be used to replace human skin.
    Comment: Some commenters asked how we would pay for new technology 
intraocular lenses (IOLs) under the hospital outpatient PPS.
    Response: We will use the same criteria established in the June 16, 
1999 final rule (64 FR 32198) titled ``Medicare Program; Adjustment in 
Payment Amounts for New Technology Intraocular Lenses Furnished by 
Ambulatory Surgical Centers'' to identify IOLs that may be considered 
new technology and eligible for pass-through payments. In accordance 
with that rule, IOLs must first be approved by the FDA before they can 
be considered as a new technology IOL. The rule establishes only one 
criterion for distinguishing new technology IOLs from other IOLs. 
Specifically, all claims of the IOL's clinical advantages and 
superiority over existing IOLs must have been approved by the FDA for 
labeling and advertising purposes. For further discussion on the 
reasons for relying on the FDA's determination, we refer the reader to 
the IOL proposed rule published on September 4, 1997 (62 FR 46700 
through 46701). We recognize that this criterion has been developed to 
define the characteristics that distinguish a new technology IOL from 
other IOLs in order to comply with section 141(b) of the Social 
Security Act Amendments of 1994 (Pub. L. 103-432) that is specific to 
IOLs furnished in ASCs and not hospital outpatient departments. 
However, we believe that it is appropriate to rely on an established 
approach to assist us in distinguishing this new technology since more 
than 1 million IOLs are inserted annually during or subsequent to 
cataract surgery performed in the outpatient setting. Moreover, we 
believe that consistent application of the criterion in both the ASC 
and hospital outpatient prospective payment systems is less burdensome 
to those requesting recognition of new technology IOLs. Therefore, when 
IOLs that are recognized as ``new technology IOLs'' in accordance with 
the provisions of the June 16, 1999 final rule are furnished in a 
hospital outpatient setting, we will pay for such new technology IOLs 
in accordance with the hospital outpatient PPS method for determining 
additional payments under the pass-through provision set forth in this 
final rule.
    Comment: We received many comments urging that we establish 
appropriate payments for brachytherapy seeds used in the treatment of 
prostate cancer.
    Response: In accordance with section 1833(t)(6)(A)(ii), as added by 
section 201(b) of the BBRA 1999, we will provide additional payments 
for brachytherapy seeds as an implanted device. The brachytherapy 
device is assigned to APC 0918.
4. Determination of ``Not Insignificant'' Cost of New Items
    Section 1833(t)(6)(A)(iv)(II) of the Act, as added by section 
201(b) of the BBRA 1999 provides that the transitional pass-throughs 
apply to new drugs, biologicals, and devices whose cost is not 
insignificant in relation to the hospital outpatient PPS payment 
amount. Section 1833(t)(6)(C) defines the additional payment as the 
difference between an amount specified by the law and the portion of 
the applicable fee schedule amount determined to be associated with the 
item. The objective of this section is to prevent the hospital 
outpatient PPS from creating disincentives for the diffusion of 
valuable new technology by initially paying a rate significantly below 
the costs of these items. We believe that the ``not insignificant'' 
criterion was included in recognition that: (1) The costs of some new 
technologies would not be large enough relative to the fee schedule 
amount to provide disincentives for their use in the short run; and (2) 
that an excessive number of pass-through items could place a 
substantial burden on the claims processing systems of both HCFA and 
individual hospitals in a way that could hamper the rapid processing of 
pass-through payments for those items that would be significantly more 
costly than the applicable fee schedule amount. Therefore, in order to 
be consistent with the objectives of this section, we are establishing 
the following criteria for determining whether the costs of drugs, 
biologicals, and devices are ``not insignificant'' relative to the 
hospital outpatient department fee schedule amount:
    (1) Its expected reasonable cost exceeds 25 percent of the 
applicable fee schedule amount for the associated service.

[[Page 18481]]

    (2) The expected reasonable cost of the new drug, biological, or 
device must exceed the portion of the fee schedule amount determined to 
be associated with the drug, biological, or device by 25 percent.
    (3) The difference between the expected, reasonable cost of the 
item and the portion of the hospital outpatient department fee schedule 
amount determined to be associated with the item exceed 10 percent of 
the applicable hospital outpatient department fee schedule amount.
    The following illustrates the application of these three criteria.
    Example: Let us assume that the reasonable cost of the new device 
ZZ is $32.00. ZZ is associated with HCPCS code 00000 assigned to APC 
0001. The fee schedule amount for APC 0001 is $100.00. The portion of 
the fee schedule amount included in APC 0001 that represents the cost 
associated with the former device is $25.00.
    1. (a) Multiply the fee schedule amount for APC 0001 by 25 percent

$100.00  x  .25 = $25.00

    (b) Compare the reasonable cost for ZZ to the product derived in 
Step 1

$32.00 > $25.00

    Finding: The first criterion is met.
    2. (a) Multiply the portion of the fee schedule amount for APC 0001 
that is associated with a device by 25 percent
$25.00  x  .25 = $6.25

    (b) Subtract the portion of the fee schedule amount for APC 0001 
attributable to a device from the reasonable cost for ZZ

$32.00 - $25.00 = $7.00

    (c) Compare the remainder in Step 4 to the product in Step 2(a)

$7.00 > $6.25

    Finding: The second criterion is met.
    3. (a) Multiply the fee schedule amount for APC 0001 by 10 percent

$100.00  x  .10 = $10.00

    (b) Compare the remainder in Step 3 to the product derived in Step 
3(a)

$7.00  $10.00

    Finding: The third criterion is not met. Therefore, new device ZZ 
is not eligible for transitional pass-through payment.
5. Calculating the Additional Payment
    Section 1833(t)(6)(C)(i) of the Act requires that for drugs, 
biologicals, and radiopharmaceuticals, the additional payment be 
determined as the difference between the amount determined under 
section 1842(o) of the Act (95 percent of AWP) and the portion of the 
hospital outpatient department fee schedule amount determined by the 
Secretary to be associated with those items. For devices, the 
additional payment is the difference between the hospital's charges 
adjusted to costs and the portion of the applicable hospital outpatient 
department fee schedule amount associated with the device. Under 
section 1833(t)(7) of the Act, as added by section 201(i) of the BBRA 
1999, the coinsurance amounts for beneficiaries are not affected by 
pass-through payments.
    We will determine, on an item-by-item basis, the amount of the 
applicable fee schedule amount associated with the relevant drug, 
biological, or device. To the extent possible, hospital outpatient 
department claims data will be used to make these estimates. When 
necessary, external data pertaining to the costs of the drugs, 
biologicals and devices already included in the fee schedule amounts 
will be used to make these determinations.
    Before January 1, 2002, charges for devices eligible for pass-
throughs will be adjusted to cost on each claim by applying the 
individual hospital's average cost-to-charge ratio across all 
outpatient departments. The 1996 data do not allow for determination of 
which revenue center-specific ratios might be used for this purpose. We 
will examine claims for the latter half of 2000 and for 2001 in order 
to determine if a revenue center-specific set of cost-to-charge ratios 
should be used for 2002 and beyond.
    A one-time exception to the general methodology described above 
pertains to current drugs and biologicals that will be eligible for 
transitional pass-throughs when the PPS is implemented. For this final 
rule, we revised many APC groups by removing, to the extent possible, 
many of these drugs and radiopharmaceuticals. Therefore, the payment 
rates for the APC groups with which these drugs are associated exclude 
the costs of these drugs and the total amount paid to hospitals for the 
drugs will be 95 percent of the applicable AWP. In order to be able to 
determine a coinsurance amount for these drugs, we needed to estimate 
what portion of this payment would have been included as part of the 
APC payment amount associated with these drugs and what portion would 
be the pass-through amount. Using an external survey of hospitals' drug 
acquisition costs, we determined the APC payment amount for many of 
these drugs as their average acquisition cost adjusted to year 2000 
dollars. Where valid cost data were not available for individual drugs, 
we applied the following average ratios of acquisition cost to AWP 
calculated from the survey to determine the fee schedule amount: .68 
for drugs with one manufacturer, .61 for multi-source drugs, and .43 
multi-source drugs with generic competitors. In either case, the 
coinsurance amounts were determined as 20 percent of these fee schedule 
amounts. It is important to note that these estimates do not affect the 
total payment to hospitals for these drugs (95 percent of AWP).
    Because claims data are not available for most items that will be 
eligible for transitional pass-through payments for 2000 and 2001, it 
is extremely difficult to project expenditures under this provision. 
For this reason, and because many eligible items will be added after 
the system's implementation, we cannot estimate if, and to what extent, 
these payments would exceed 2.5 percent of total payments in 2000 and 
2001. Therefore, there will be no uniform reduction factor applied to 
these payments during this period.
6. Process To Identify Items and To Obtain Codes for Items Subject to 
Transitional Pass-Throughs
    We have identified a large number of items subject to the 
transitional pass-through payment through our own data-gathering 
activities or through comments on the proposed rule. Many of them 
already have HCPCS codes, and we are taking steps to establish 
temporary codes for the remaining items. We will make additional 
payments for these items when the hospital outpatient PPS system is 
implemented on July 1. A list of the items already known to us is set 
forth in Addendum K.
    Other items potentially eligible for additional pass-through 
payments may not be known to us at this time. Because of systems 
limitations, if we do not know about an item, we will not be able to 
make additional payments for those items beginning on July 1, 2000. 
However, we will update our outpatient PPS on a quarterly basis 
beginning October 1, 2000 to add other items that are eligible for 
pass-through payments. Therefore, implementation of additional payment 
for any such item must wait until a later release of systems 
instructions, that is, in October 2000, January 2001 (annual update), 
or later.
    A manufacturer or other interested party who wishes to bring items 
that may be eligible for additional transitional pass-through payments 
to our attention should mail requests for consideration of items to the 
following address ONLY: PPS New Tech/Pass-Throughs, Division of 
Practitioner and Ambulatory Care, Mailstop C4-03-06, Health Care 
Financing Administration,

[[Page 18482]]

7500 Security Boulevard, Baltimore, MD 21244-1850.
    To be considered, requests MUST include the following information:
     Trade/brand name of item.
     A detailed description of the clinical application of the 
item, including HCPCS code(s) to identify the procedure(s) with which 
the item is used. If the item replaces or improves upon an existing 
item, identify the predecessor item by trade/brand name and HCPCS code.
     Current cost of the item to hospitals (i.e., actual cost 
paid by hospitals net of all discounts, rebates, and incentives in cash 
or in-kind). In other words, submit the best and latest information 
available that provides evidence of the hospital's actual cost for a 
specific item.
     Date of sale of first unit.
     For drugs, submit the most recent average wholesale price 
(AWP) of the drug and the date associated with the AWP quote.
     If the item requires FDA approval/clearance, submit 
information that confirms receipt of FDA approval/clearance and the 
date obtained.
     If the item already has an assigned HCPCS code, include 
the code and its descriptor in your submission plus a dated copy of the 
HCPCS code ``recommendation application'' previously submitted for this 
item.
     If the item does not have an assigned HCPCS code, follow 
the procedure discussed, below, for obtaining HCPCS codes and submit a 
copy of the application with your payment request.
     Name, address, and telephone number of the party making 
the request.
     Other information as HCFA may require to evaluate specific 
requests.
    We believe some items not yet known to us do not yet have assigned 
HCPCS codes. We expect to use national HCPCS codes in the hospital 
outpatient PPS to the greatest extent possible. These codes are 
established by a well-ordered process that operates on an annual cycle, 
starting with submission of information by interested parties due by 
April 1 and leading to announcement of new codes in October of each 
year. This process is described, and relevant application forms are 
available, on the following HCFA website: http://www.hcfa.gov/medicare/hcpcs. htm.
    Considering the exigencies of implementing a new system, we intend 
to establish temporary codes in 2000 to permit implementation of 
additional payments for other eligible items effective beginning 
October 1, 2000. The process for submitting information will be the 
same as for national codes.
    For items that might be candidates for additional transitional 
pass-through payments but that DO NOT have established HCPCS codes, 
submit the regular application for a national HCPCS code in accordance 
with the instructions found on the internet at http://www.hcfa.gov/medicare/hcpcs.htm. Send applications for national HCPCS codes to: C. 
Kaye Riley, HCPCS Coordinator, Health Care Financing Administration, 
Mailstop C5-08-27, 7500 Security Boulevard, Baltimore, Maryland 21244-
1850.
    Because of staffing and resource limitations, we cannot accept 
requests by facsimile (FAX) transmission.
    As indicated in the instructions posted at our website address 
cited above, the deadline for submission of applications for a national 
HCPCS code for the CY 2001 cycle is April 1, 2000. The HCPCS process 
will proceed to assign national codes as warranted, and we expect these 
codes will be used in the hospital outpatient PPS starting January 1, 
2001. Because the coding application will contain information vital to 
determining a specific item or product's eligibility for pass-through 
payments, we are requesting that a copy of the application be sent 
concurrently to ATTN: PPS New Tech/Pass-Throughs at the address shown 
above.
    This year, we plan to implement additional payment for appropriate 
items on October 1, 2000. Requests submitted to us with appropriate 
information will be evaluated for payment effective October 1. We will 
use the same submissions made for national HCPCS codes as the basis for 
making temporary code assignments. However, a very large volume of 
requests or systems constraints could affect our ability to achieve 
this goal.
    Any applications for HCPCS codes that are received after April 1 
will be retained for the next cycle of the national HCPCS code 
assignment process starting the following April 1. We will also 
consider these items for assignment of temporary codes that might take 
effect in January or later in the next year.
    How quickly additional payment for a new item can be implemented 
will depend on processing and systems constraints; it will in general 
require at least 6 months and may require as many as 9 or more months. 
Thus, a submission that we receive in May (which is too late for 
October implementation) might be assigned a temporary code to be used 
for implementing additional payments starting the following January.
    As previously stated, pass-through payment for each item is 
temporary. After we obtain information about actual hospital costs 
incurred to furnish a pass-through item, we will package it into the 
service with which it is clinically associated.
    Comment: A number of commenters expressed concern about the 
extensive amount of time required to obtain HCPCS codes for new items 
or services. They argued that the lag-time in coding updates creates a 
barrier to innovation, claiming that it can be several years before a 
code is issued for a new surgical technique or product. Some commenters 
noted that when facilities are forced to code new surgical techniques 
as ``unlisted procedures,'' pending issuance of a specific code for the 
procedure, it would result in the facility receiving payment for the 
lowest related APC group. Some commenters recommended that we assign 
HCPCS codes as soon as products become available.
    Response: We recognize the urgency expressed by commenters. We 
believe the process we have outlined above will assist interested 
parties in obtaining HCPCS codes for new items and services in the most 
expeditious manner possible within the constraints imposed by our 
system requirements.

E. Calculation of Group Weights and Conversion Factor

1. Group Weights (Includes Table 1, Packaged Services by Revenue 
Center)
    Section 1833(t)(2)(C) of the Act requires the Secretary to 
establish relative payment weights for covered hospital outpatient 
services. That section requires that the weights be developed using 
data on claims from 1996 and data from the most recent available 
hospital cost reports. Before enactment of the BBRA 1999, we were 
required to base the relative payment weights on median hospital costs. 
Section 201(f) of the BBRA 1999 amended section 1833(t)(2)(ii) of the 
Act to authorize the Secretary to base the relative payment weights on 
either the median or mean hospital costs. In constructing the database 
for the outpatient PPS proposed rule group weights and conversion 
factor, we used a universe of approximately 98 million calendar year 
1996 final action claims for hospital outpatient department services 
received through June 1997 to match to the most recent hospital cost 
reports available. We have decided to continue to base the relative 
payments weights in this final rule on median (as opposed to mean) 
costs because, among other things, reconstructing our database to 
evaluate the impact of using mean costs after the BBRA 1999 was

[[Page 18483]]

enacted would have delayed implementation of the hospital outpatient 
PPS.
    To derive weights based on median hospital costs for services in 
the hospital outpatient APC groups, we converted billed charges to 
costs and aggregated them to the procedure or visit level. To 
accomplish this, we first identified the cost-to-charge ratio that was 
specific to each hospital's cost centers (``cost center specific cost-
to-charge ratios'' or CCRs). We then developed a crosswalk to match the 
hospital's CCRs to revenue centers used on the hospital's 1996 
outpatient bills. The CCRs included operating and capital costs but 
excluded costs associated with direct graduate medical education and 
allied health education.
    To determine the hospital CCRs, the most recent available cost 
report from each hospital was identified. For the proposed rule, we 
used cost reports from cost reporting periods beginning on or after 
October 1, 1994 and before October 1, 1995 (referred to as PPS-12) or 
earlier. For this final rule, more recent cost reports were available 
for hospitals. We used cost reports from cost reporting periods 
beginning on or after October 1, 1996 and before October 1, 1997 (PPS-
14) for approximately 94 percent of the hospitals in our database.
    If the most recent available cost report for a hospital was one 
that had been submitted but not settled, we calculated a factor to 
adjust for the differences that generally exist between settled and 
``as submitted'' cost reports. The adjustment factor was determined by 
dividing the outpatient department cost-to-charge ratio from the 
hospital's most recent settled cost report by the outpatient department 
cost-to-charge ratio from the hospital's ``as submitted'' cost report 
for the same period. The resulting ratio was used to adjust each of the 
CCRs in the hospital's most recent ``as submitted'' cost report. We 
repeated this process for every hospital for which the most recent 
available cost report was a cost report that had not been settled.
    The Office of Inspector General (OIG) for DHHS is concerned that 
the cost reports we are using may reflect some unallowable costs. 
Therefore, the OIG, in conjunction with HCFA, is proposing to examine 
the extent to which the cost reports used reflect costs that were 
inappropriately allowed. If this examination reveals excessive 
inappropriate costs, we will address this issue in a future proposed 
rule, or perhaps seek legislation to adjust future payment rates 
downward.
    We next eliminated from the hospital CCR database 258 hospitals 
that we have identified as having reported charges on their cost 
reports that were not actual charges (for example, they make uniform 
charges for all services). These excluded hospitals were Kaiser, New 
York Health and Hospital Corporation, and all-inclusive rate hospitals. 
After removing these hospitals, we calculated the geometric mean of the 
total operating CCRs of hospitals remaining in our CCR database. We 
identified 58 hospitals whose total operating CCR exceeded the 
geometric mean by more than 3 standard deviations. These hospitals were 
also removed from our CCR database.
    After assembling and editing our new CCR database, we matched 
revenue centers from approximately 80 million claims to CCRs of 
approximately 5,700 hospitals. We excluded from the crosswalk 
approximately 15 million claims in which the bill type denoted services 
that would not be covered under the PPS (for example, bill type 72X for 
dialysis services for patients with ESRD). We also excluded almost 3 
million claims from the hospitals that we had removed or trimmed from 
the hospital CCR database. The table below shows the five cost 
reporting periods used and the percentage of the cost reports within 
each PPS period for which we were able to match 1996 claims.

------------------------------------------------------------------------
                                                              Percentage
                                                                of cost
                      Reporting period                          reports
                                                                matched
------------------------------------------------------------------------
PPS-15 (cost reporting period beginning on or after 10/1/97          0.1
 and before 10/1/98)........................................
PPS-14 (cost reporting period beginning on or after 10/1/96         94.2
 and before 10/1/97)........................................
PPS-13 (cost reporting period beginning on or after 10/1/95          3.7
 and before 10/1/96)........................................
PPS-12 (cost reporting period beginning on or after 10/1/94          1.7
 and before 10/1/95)........................................
PPS-11 (cost reporting period beginning on or after 10/1/93          0.3
 and before 10/1/94)........................................
                                                             -----------
    Total...................................................       100.0
------------------------------------------------------------------------

    Next, we took the estimated 80 million claims that we had matched 
with a cost report and separated them into two distinct groups: Single-
procedure claims and multiple-procedure claims. Single-procedure claims 
were those that included only one HCPCS code (other than laboratory and 
incidentals such as packaged drugs and venipuncture) that could be 
grouped to an APC. Multiple-procedure claims included more than one 
HCPCS code that could be mapped to an APC. There were approximately 
45.4 million single-procedure claims and 34.6 million multiple-
procedure claims.
    To calculate median costs for services within an APC, we used only 
the single-procedure bills. (Of the roughly 45.4 million single-
procedure claims, about 24 million were excluded from the conversion 
process largely because the only HCPCS codes reported on the claims 
were for laboratory procedures or other outpatient services not paid 
under the outpatient PPS.) This approach was taken because the 
information on claims does not enable us to specifically allocate 
charges or costs for packaged items and services such as anesthesia, 
recovery room, drugs, or supplies to a particular procedure when more 
than one significant procedure or medical visit was billed on a claim. 
Use of the single-procedure bills minimizes the risk of improperly 
assigning costs to the wrong procedure or visit. Although we used only 
single-procedure/visit bills to determine APC relative payment weights, 
we used multiple-procedure bills in the conversion factor and service 
mix calculations, regressions, and impact analyses.
    For each single-procedure claim, we calculated a cost for every 
billed line item charge by multiplying each revenue center charge by 
the appropriate hospital-specific CCR. If the appropriate cost center 
did not exist for a given hospital, we crosswalked the revenue center 
to a secondary cost center when possible, or to the hospital's overall 
cost-to-charge ratio for outpatient department services. We excluded 
from this calculation all charges associated with HCPCS codes 
previously defined as not paid under this PPS (for example, laboratory, 
ambulance, and therapy services).
    To calculate the per-procedure or per-visit costs, we used the 
charges shown in the revenue centers that contained items integral to 
performing the procedure or visit. These included those items that we 
previously discussed as being subject to our proposed packaging 
provision. For instance, in calculating the surgical procedure cost, we 
included charges for the operating room, treatment rooms, recovery, 
observation, medical and surgical supplies, pharmacy, anesthesia, casts 
and splints, and donor tissue, bone, and organ. For medical visit cost 
estimates, we included charges for items such as medical and surgical 
supplies, drugs, and observation. A complete listing of the revenue 
centers that we used is shown below in Table 1, Packaged Services by 
Revenue Center.

[[Page 18484]]



              Table 1.--Packaged Services by Revenue Center
                          ASC AND OTHER SURGERY
 
250  PHARMACY
251  GENERIC
252  NONGENERIC
257  NONPRESCRIPTION DRUGS
258  IV SOLUTIONS
259  OTHER PHARMACY
260  IV THERAPY, GENERAL CLASS
262  IV THERAPY/PHARMACY SERVICES
263  IV THERAPY/DRUG/SUPPLY/DELIVERY
264  IV THERAPY/SUPPLIES
269  OTHER IV THERAPY
270  M&S SUPPLIES
271  NONSTERILE SUPPLIES
272  STERILE SUPPLIES
276  INTRAOCULAR LENS
279  OTHER M&S SUPPLIES
370  ANESTHESIA
379  OTHER ANESTHESIA
390  BLOOD STORAGE AND PROCESSING
399  OTHER BLOOD STORAGE AND PROCESSING
630  DRUGS REQUIRING SPECIFIC IDENTIFICATION, GENERAL CLASS
631  SINGLE SOURCE DRUG
632  MULTIPLE SOURCE DRUG
633  RESTRICTIVE PRESCRIPTION
700  CAST ROOM
709  OTHER CAST ROOM
710  RECOVERY ROOM
719  OTHER RECOVERY ROOM
720  LABOR ROOM
721  LABOR
723  CIRCUMCISION
762  OBSERVATION ROOM
810  ORGAN ACQUISITION
819  OTHER ORGAN ACQUISITION
890  OTHER DONOR BANK
891  BONE
892  ORGAN
893  SKIN
899  OTHER DONOR BANK
 
                              MEDICAL VISIT
 
250  PHARMACY
251  GENERIC
252  NONGENERIC
257  NONPRESCRIPTION DRUGS
258  IV SOLUTIONS
259  OTHER PHARMACY
270  M&S SUPPLIES
271  NONSTERILE SUPPLIES
272  STERILE SUPPLIES
279  OTHER M&S SUPPLIES
630  DRUGS REQUIRING SPECIFIC IDENTIFICATION, GENERAL CLASS
631  SINGLE SOURCE DRUG
632  MULTIPLE SOURCE DRUG
633  RESTRICTIVE PRESCRIPTION
700  CAST ROOM
709  OTHER CAST ROOM
762  OBSERVATION ROOM
 
                   OTHER DIAGNOSTIC (BLENDED SERVICES)
 
254  PHARMACY INCIDENT TO OTHER DIAGNOSTIC
372  ANESTHESIA INCIDENT TO OTHER DIAGNOSTIC
622  SUPPLIES INCIDENT TO OTHER DIAGNOSTIC
710  RECOVERY ROOM
719  OTHER RECOVERY ROOM
762  OBSERVATION ROOM
 
        RADIOLOGY SUBJECT TO THE FEE SCHEDULE AND OTHER RADIOLOGY
 
255  PHARMACY INCIDENT TO RADIOLOGY
371  ANESTHESIA INCIDENT TO RADIOLOGY
621  SUPPLIES INCIDENT TO RADIOLOGY
710  RECOVERY ROOM
719  OTHER RECOVERY ROOM
762  OBSERVATION ROOM
 
                          ALL OTHER APC GROUPS
 
250  PHARMACY
251  GENERIC
252  NONGENERIC
257  NONPRESCRIPTION DRUGS
258  IV SOLUTIONS
259  OTHER PHARMACY
260  IV THERAPY, GENERAL CLASS
262  IV THERAPY PHARMACY SERVICES
263  IV THERAPY DRUG/SUPPLY/DELIVERY
264  IV THERAPY SUPPLIES
269  OTHER IV THERAPY
270  M&S SUPPLIES
271  NONSTERILE SUPPLIES
272  STERILE SUPPLIES
279  OTHER M&S SUPPLIES
630  DRUGS REQUIRING SPECIFIC IDENTIFICATION, GENERAL CLASS
631  SINGLE SOURCE DRUG
632  MULTIPLE SOURCE DRUG
633  RESTRICTIVE PRESCRIPTION
762  OBSERVATION ROOM
------------------------------------------------------------------------

    We then applied to these cost estimates an adjustment to calibrate 
the costs to calendar year 1996 for those services in hospitals whose 
CCRs were calculated using FY 1997 or later cost reports. On average, 
hospital charges were rising faster than costs in FY 1997. We therefore 
made this adjustment for the calculation of the weights, as well as for 
the hospital costs used in the conversion factor and impact model, to 
ensure that we did not underestimate costs and payments. We based this 
hospital specific CCR adjustment on the observed change in each 
hospital's overall CCR (total operating + total capital) from the 
proposed rule cost report database to the new final rule database. If 
applicable, we then calculated a monthly rate of change and applied it 
based on the number of months past 1996 encompassed in a hospital's 
cost reporting period; if a hospital's period coincided completely 
within calendar year 1996, no adjustment was made.
    After calibrating the costs to calendar year 1996, we standardized 
costs for geographic wage variation by dividing the labor-related 
portion of the operating and capital costs for each billed item by the 
FY 2000 hospital inpatient prospective payment system wage index 
published in the Federal Register on July 30, 1999 (64 FR 41585). As in 
the proposed rule and correction notice, we used 60 percent to 
represent our estimate of that portion of costs attributable, on 
average, to labor. A more detailed discussion of wage index adjustments 
is found below in section III.G of this document.
    The standardized labor-related cost and the nonlabor-related cost 
component were summed for each billed item to derive the total 
standardized cost for each procedure or medical visit. Extremely 
unusual costs that appeared to be errors in the data were trimmed from 
standardized procedure and visit costs. This trimming methodology is 
analogous to that used in calculating the DRG weights for the inpatient 
PPS: eliminate any bills with costs outside of 3 standard deviations 
from the geometric mean. We used the geometric mean and the associated 
standard deviation because the distribution of costs more closely 
resembles a lognormal distribution than a normal distribution: There 
are no negative costs, and the average cost is greater than the median 
cost. Use of the geometric mean minimizes the impact of the most 
unusual bills in the determination of the mean. The geometric mean is 
calculated by taking the mean of the natural logarithm cost. Because 
the distribution of the natural logarithms of a set of numbers is more 
compact than the distribution of the numbers themselves, bills with 
extreme costs do not appear as extreme as they would if non-logged 
costs were examined. This ensures that only the most aberrant data will 
be removed from the calculation.
    After trimming the procedure and visit level costs, we mapped each 
procedure or visit cost to its assigned APC and calculated the median 
cost for each APC weighted by procedure volume. Using the median APC 
costs, we calculated the relative payment weights for each APC. We 
scaled all the relative payment weights to APC 601, a mid-level clinic 
visit, because it is one of the most frequently performed services. 
This approach is consistent with that used in developing relative value 
units for the Medicare physician fee schedule. By assigning APC 601 a 
relative payment weight of 1.0, hospitals can easily compare the 
relative relationship of one APC to another. Next, we divided the 
median cost for each APC by the median cost for a mid-level clinic 
visit, APC 601, to derive the relative payment weight for each APC.

[[Page 18485]]

The median cost for APC 601 is $47.00. In the proposed rule, we also 
used a mid-level clinic visit, APC 91336, which had a median cost of 
$54.00, as the scaler of APC weights. On average, due to the reduced 
value of the scaler used for this notice, the final weights will be 
higher than those published in the proposed rule.
    Comment: Some commenters believe that the ratesetting methodology 
does not reflect complex cases because we eliminate statistical 
``outlier'' claims from the calculation of the median costs and the 
weights.
    Response: As noted above, we trimmed claims with estimated costs 
that were outside of three standard deviations from the geometric mean. 
Because we removed claims above or below the mean, we corrected for 
data errors that would have skewed the estimates of median costs and 
group weights upward or downward. We believe this trim is a valid 
method of removing extremely unusual costs that are most likely 
associated with data submission errors and do not represent actual 
costs. In addition, it is consistent with the method we use to set 
inpatient hospital diagnosis-related group (DRG) weights.
    Comment: Numerous commenters disagreed with our use of single-
procedure claims only in the calculation of the relative payment 
weights. One commenter was concerned that we could be masking 
differences in resource use attributable to patient characteristics by 
using only single-procedure claims to calculate relative weights.
    Response: We used single-procedure claims to calculate the relative 
weight for each APC because we could not accurately allocate costs to a 
particular procedure when the costs were part of a bill for multiple 
procedures. Bills with a single major procedure provided are, in most 
cases, the best estimate of relative procedure costs. It is important 
to note that for all other calculations, including calculation of the 
conversion factor, we used both single-procedure and multiple-procedure 
bills.
    We do not believe that using single-procedure bills biases the 
relative cost of any particular procedure. Although patients with more 
complex healthcare needs might have several procedures performed, 
hospital charges for an individual procedure would not be greater. Our 
most significant concern was that distribution of single bill 
procedures within an APC would not reflect the correct distribution of 
those procedure on all bills. However, careful statistical analyses 
demonstrated that the distribution of procedures within an APC group 
did not differ when single bill procedure frequencies were compared 
with all bills. It is also important to note that when items or 
services were to be packaged with a major procedure, we added their 
costs to that procedure prior to making the single bill determination. 
Therefore, the costs of contrast media, for example, are included in 
the relative weights. In some cases, we agreed with the commenters that 
this approach needed to be modified. For example, for chemotherapy, we 
are not grouping drugs, but rather paying for each one separately. 
Moreover, as a result of the transitional pass-through provisions of 
the BBRA 1999, radiopharmaceuticals will be paid separately from the 
nuclear medicine APCs.
    Comment: Several commenters expressed concern that the 1996 claims 
data are insufficient or inadequate to develop the PPS model. For 
example, some commenters asserted that the 1996 data are not recent 
enough to reflect the current mix of outpatient services. Some 
commenters also argued that undercoding in the data would lead to 
underestimates of median costs. Other commenters recommended that we 
address alleged inadequacies in the data by gathering cost data on new 
procedures and by basing payment on these data until we can determine 
whether to place a new procedure in an existing APC or create a new 
APC.
    Response: While we acknowledge limitations of setting payment rates 
with historical claims data, section 1833(t)(2)(C) of the Act requires 
us to use 1996 claims in developing the PPS. We discuss how we will 
price new procedures that are not reflected in our database in section 
III.C.8 of this preamble.
    Comment: Commenters were concerned about the cost-to-charge ratios 
used to estimate median APC costs and pre-BBA payments. For example, 
one medical organization recommended that we account for the capital-
intensive nature of radiology services by adjusting the cost-to-charge 
ratios applicable to these services for the step-down methodology that 
allocates capital expenses by square footage. The belief is that these 
allocation methods underestimate radiological equipment costs and 
certain cost-to-charge ratios, leading to underestimates of the median 
costs for relevant APC groups.
    Response: Although capital-related costs may be allocated to 
routine and ancillary service cost centers using the step-down 
methodology based on square footage, as an alternative, the ``dollar 
value'' method may be used by hospitals. This method is made available 
to hospitals in Worksheet B-1 of the hospital cost report (HCFA 2552-
96). The dollar value method more accurately distributes the capital 
costs associated with equipment to the revenue-producing cost center to 
which the equipment is assigned. We are not able to adjust the cost-to-
charge ratios of those hospitals that allocate equipment based on 
square footage because we have no way of knowing which specific 
equipment costs should be allocated to revenue-producing cost centers 
in each hospital.
2. Conversion Factor
    Section 1833(t)(3)(C)(i) of the Act requires that we establish a 
conversion factor for 1999 to determine the Medicare payment amounts 
for each covered group of services. For the proposed rule as corrected, 
we derived the conversion factor from a base amount of payments 
described in section 1833(t)(3)(A) of the Act, as enacted in the BBA 
1997. Such base amount was calculated for the services included in the 
outpatient PPS as an estimate of the sum of (1) total payments that 
would be payable from the Trust Fund under the current (non-PPS) 
payment system in 1999, plus (2) the beneficiary coinsurance that would 
have been paid under the new (PPS) system in 1999. For the final rule, 
however, we derived the conversion factor from a base amount that 
includes beneficiary coinsurance that would have been made under the 
current (non-PPS) system rather than the proposed (PPS) system. Section 
201(l) of the BBRA 1999 states: ``With respect to determining the 
amount of copayments described in paragraph (3)(A)(ii) of section 
1833(t) of the Social Security Act, as added by section 4523(a) of the 
BBA, Congress finds that such amount should be determined without 
regard to such section, in a budget neutral manner with respect to 
aggregate payments to hospitals, and that the Secretary of Health and 
Human Services has the authority to determine such amount without 
regard to such section.''
    Section 1833(t)(2)(C) of the Act requires us to project utilization 
for hospital outpatient services. We were unable to make precise 
projections of increases in the volume and intensity of services 
because we were not able to quantify some of the factors that affect 
utilization. For instance, we would anticipate that Medicare 
beneficiaries who choose to migrate to managed care plans may be 
healthier than those who choose to stay in fee-for-service plans. Thus, 
we could assume a decrease in the volume of services coupled with an 
increase in the intensity of services

[[Page 18486]]

furnished for Medicare beneficiaries in the fee-for-service program. 
Another factor that we believe will affect future utilization is the 
incentive to code billed services more accurately. Currently, hospitals 
are paid for the majority of the outpatient services they furnish on a 
cost basis, and inaccurate or improper coding does not necessarily 
affect the amount of payment. In contrast, under the PPS, hospitals are 
required to use HCPCS codes in order to receive payment. We expect that 
the frequency of some services may increase as a result of the coding 
requirements. We believe each of these assumptions will affect the 
reporting of volume and intensity of services, although we are not able 
to quantify them individually to project 1999 utilization. Therefore, 
we used what we believe to be a more reliable and valid approach to 
computing the conversion factor under the methodology described below.
    Comment: A large national trade association commented that the 
exclusion of claims for unclassified services (for example, those 
claims for which we cannot identify the service to be paid) from the 
PPS model could bias the conversion factor downward if the excluded 
claims have a disproportionate number of services with high payment to 
cost ratios, such as clinic and emergency room visits.
    Response: In order to set the conversion factor as accurately as 
possible, we used only claims for which the costs and volume of 
services could be identified on the bill. As noted by the commenter, 
this decision resulted in the exclusion of claims with unclassifiable 
services. Upon examination of these claims, we have determined that 
services with high payment to cost ratios (those that would gain under 
the PPS system) were not disproportionately represented. Therefore, we 
believe the exclusion of unclassifiable services does not bias the 
conversion factor.

Setting the Rates

    In order to convert the relative weights determined for each APC 
(see section III.E.1) into payment rates, we calculated a conversion 
factor that would result in total estimated payments to hospitals under 
the PPS in 1999 equal to the total estimated payments that would have 
been payable from the Trust Fund in 1999 if PPS had not been enacted 
plus estimated beneficiary coinsurance for the same services during the 
same period. The prospective payment rate for each APC is calculated by 
multiplying the APC's relative weight by the conversion factor. For the 
calculation of the conversion factor, we have excluded all data from 
the 58 Maryland providers that qualify under section 1814(b)(3) of the 
Act for payment under the State's payment system. We computed the 
conversion factor by first adding together the aggregate Medicare 
hospital outpatient payments made under the cost-based payment system 
(referred to in this section as pre-PPS payments) for calendar year 
1996, plus the estimated beneficiary coinsurance amounts made under 
pre-PPS law for the same services. We then divided that amount by a 
wage-adjusted sum of the relative weights for all APCs under the 
hospital outpatient PPS. The methodology we used to determine current 
law Medicare hospital outpatient payments and beneficiary coinsurance 
is discussed below in section III.E.2.a. A discussion of the sum of the 
relative weights follows in section III.E.2.b.

a. Calculating Aggregate Calendar Year 1996 Medicare and Beneficiary 
Payments for Hospital Outpatient Services (Pre-PPS)

    To calculate Medicare hospital outpatient payment amounts before 
implementation of the PPS, we first identified calendar year 1996 
single and multiple procedure bills for all the services that we will 
recognize under the outpatient PPS. As we identified services that will 
be paid under the outpatient PPS, we eliminated invalid or noncovered 
HCPCS codes.
    Hospital payments include both operating and capital costs for the 
HCPCS coded services for which payment is to be made under the 
outpatient PPS. We summed these two types of costs by HCPCS code at the 
provider level. Consolidating the data in this manner allowed us to 
simulate provider payment on an aggregate basis. Then (as required by 
section 1861(v)(1)(S)(ii) of the Act as amended by section 201(k) of 
the BBRA 1999), we applied the capital cost reductions of 10 percent 
and operating cost reductions of 5.8 percent.
    We determined for each HCPCS code the applicable payment 
methodology under the current system. Payment before implementation of 
PPS for procedures in the baseline was calculated using one of the 
following equations, as appropriate:
     For radiology procedures paid for under the radiology fee 
schedule, we determined payment in the aggregate for each provider as 
the lower of the cost, charge, or blended amount. We use the following 
equation to determine the radiology blended amount: (0.42  x  lower of 
cost or charge minus beneficiary coinsurance) + (0.58  x  ((0.62  x  
global physician fee schedule amount) - beneficiary coinsurance)).
     For surgical procedures for which Medicare pays an ASC 
facility fee, we determined payment in the aggregate for each provider 
as the lower of the cost, charge, or blended amount. We used the 
following equation to determine the ASC blended amount: (0.42  x  lower 
of cost or charge minus beneficiary coinsurance) + (0.58  x  (ASC 
payment rate - beneficiary coinsurance)).
     For diagnostic procedures paid for under the diagnostic 
fee schedule, we determined payment in the aggregate for each provider 
as the lower of the cost, charge, or blended amount. We used the 
following equation to determine the blended amount for diagnostic 
procedures: (0.50  x  lower of cost or charge minus beneficiary 
coinsurance) + (0.50  x  ((0.42  x  global physician fee schedule 
amount) - beneficiary coinsurance)).
    For all other covered services not subject to one of the blended 
payment method categories, we determined payment as the lower of costs 
or charges less beneficiary coinsurance. Because the formula-driven 
overpayment (FDO) was corrected beginning October 1, 1997, the blended 
equations eliminate FDO.
    We then determined the Medicare payment amount for each provider by 
summing the aggregate amounts computed for each of the four types of 
payment methodologies discussed above. In addition, we determined the 
amount of the beneficiary coinsurance for each provider using the 
beneficiary coinsurance amounts that would have been paid before 
implementation of PPS. The total amount (Medicare and beneficiary 
payments) reflects the amount hospitals would be paid under the PPS and 
is the numerator in the equation for calculating the unadjusted 
conversion factor.

b. Sum of the Relative Weights

    Next we summed the discounted relative weights for services that 
are within the scope of the outpatient PPS. (See discussion of 
discounting for surgical procedures in section III.C.7.) Specifically, 
we multiplied (using single and multiple procedure claims in a 
hospital) the discounted volume of procedures or visits in each APC 
group by the relative weights for each APC group; we wage-adjusted 60 
percent of this total by each hospital's wage index, and we then summed 
the wage-adjusted and nonadjusted weights across all hospitals. (The 
wage indices used are included in Addenda H, I, and J.) The resulting 
sum equals the denominator in the calculation of the conversion factor.

[[Page 18487]]

We calculated the conversion factor by dividing the sum of the 
discounted relative weights into the total payment explained in section 
III.E.2.a, above, including both Medicare payment and beneficiary 
coinsurance. We then adjusted the conversion factor so that the outlier 
and pass-through payments are implemented in a budget neutral manner, 
as described in sections III.H.1 and III.D. The adjusted calendar year 
1996 conversion factor is $43.023. To inflate the 1996 conversion 
factor to 1999, our Office of the Actuary estimated an update factor of 
1.106. Therefore, the adjusted 1999 conversion factor is $47.583.
    For calendar year 2000, we updated the conversion factor as 
specified in section 1833(t)(3)(C)(iii) of the Act. The update is the 
market basket percentage increase applied to hospital discharges 
occurring during the fiscal year ending in calendar year 2000 minus 1 
percentage point. For 2000, the updated conversion factor is $48.487.
    Comment: A number of commenters suggested that we remove the 
behavioral offset that we proposed to apply to the conversion factor. 
As proposed, the intent of the offset was to adjust for hospital coding 
changes that take place in response to reductions in beneficiary 
coinsurance.
    Response: We have decided not to include a behavioral offset to the 
conversion factor in this final rule. Hospital coding changes are 
expected to occur under the outpatient PPS; however, we believe changes 
that occur during the first PPS years will result from hospitals 
billing more accurately under the new system. A behavioral offset 
implemented in the initial PPS years may distort the incentives to bill 
accurately. We may reconsider implementation of a behavioral offset in 
future years as we gather data and gain experience under the new 
system.
    Comment: A large national trade association expressed concern that 
application of the 5.8 percent and 10.0 percent reduction to costs for 
all hospital outpatient services included in the PPS model 
underestimates the conversion factor. They recommended that we exclude 
the Part B services provided to inpatients who exhaust their Part A 
benefits from the reductions.
    Response: Our analysis shows that fewer than 5,000 of the more than 
80 million claims used to set the conversion factor were associated 
with these types of services. Total costs associated with these claims 
were less than $1.4 million, which is too small to have a measurable 
effect on the conversion factor.
    Comment: Many commenters strongly argued that we misinterpreted the 
provisions of section 1833(t)(3) of the Act in calculating beneficiary 
coinsurance for purposes of setting the base amount of the conversion 
factor. The commenters noted that this methodology contributed 
significantly to the estimated 5.7 percent reduction in Medicare 
outpatient payments to hospitals reflected in the proposed rule. Most 
commenters further argued that the Congress did not intend for this 
loss to occur and that we had the authority to interpret the 
methodology described in the statute so that no net change in payments 
would result from the conversion factor.
    Response: Section 1833(t)(3)(A) of the Act, as added by the BBA 
1997, states that, for purposes of calculating the base amount used to 
determine the conversion factor, the Secretary shall calculate ``the 
total amount of copayments estimated to be paid under this subsection. 
* * *'' (Emphasis added.) For the proposed rule, we estimated the 
coinsurance that would be paid under PPS. In section 201(l) of the BBRA 
1999, the Congress addressed the calculation of the base amount, 
stating, ``With respect to determining the amount of copayments 
described in paragraph (3)(A)(ii) of section 1833(t) of the Social 
Security Act, as added by section 4523(a) of the BBA, Congress finds 
that such amount should be determined without regard to such section, 
in a budget neutral manner with respect to aggregate payments to 
hospitals, and the Secretary of Health and Human Services has the 
authority to determine such amount without regard to such section.'' 
Therefore, for this final rule, we estimated the coinsurance that would 
have been paid if PPS had not been enacted.

F. Calculation of Coinsurance Payments and Medicare Program Payments 
Under the PPS

1. Background
    In section III.E, above, we explained how we determined APC group 
weights, calculated an outpatient PPS conversion factor, and determined 
national prospective payment rates, standardized for area wage 
variations, for the APC groups. We will now explain how we calculated 
beneficiary coinsurance amounts for each APC group.
    The outpatient PPS established by section 1833(t) of the Act 
includes a mechanism designed to eventually achieve a beneficiary 
coinsurance level equal to 20 percent of the prospectively determined 
payment rate established for the service. As discussed in the proposed 
rule, for each APC we calculate an amount referred to in section 
1833(t)(3)(B) of the Act as the ``unadjusted copayment amount.'' The 
unadjusted coinsurance amount is calculated by taking 20 percent of the 
national median charges billed in 1996 for the services that are in the 
APC, trended forward to 1999; however, the coinsurance amount cannot be 
less than 20 percent of the APC payment rate. The unadjusted 
coinsurance amount for an APC remains frozen, while the payment rate 
for the APC is increased by adjustments based on the Medicare market 
basket. As the APC rate increases and the coinsurance amount remains 
frozen, the unadjusted coinsurance amount will eventually become 20 
percent of the payment rate for all APC groups. Once the unadjusted 
coinsurance amount is 20 percent of the payment amount, both the APC 
payment rate and the unadjusted coinsurance amount will be updated by 
the annual market basket adjustment.
    In the proposed rule, we proposed to not adopt new APCs for new 
procedures or services for at least 2 years, but instead assign them to 
existing groups while accumulating data on their costs. In the final 
rule we do provide for APCs for new procedures that do not fit well 
into another APC. When an APC is added that consists of HCPCS codes for 
which we do not have 1996 charge data upon which to calculate the 
unadjusted coinsurance amount, coinsurance will be calculated as 20 
percent of the APC payment amount.
    There is an exception to the coinsurance provisions for screening 
colonoscopies and screening sigmoidoscopies. Section 4104 of the BBA 
1997 provided coverage for colorectal screening. This section, in part, 
added new sections 1834(d)(2) and (3) to the Act, which provide that 
for covered screening sigmoidoscopies and colonoscopies performed in 
hospital outpatient departments and ambulatory surgical centers (ASCs), 
payment is to be based on the lesser of the hospital or the ASC payment 
rates and coinsurance for both screening colonoscopies and screening 
sigmoidoscopies is to be 25 percent of the rate used for payment.
    Section 4104 of the BBA 1997 also allows, at the Secretary's 
discretion, coverage of screening barium enemas as a colorectal cancer 
screening tool. We are including screening barium enemas as a covered 
service under the hospital outpatient PPS. The payment rate for 
screening barium enemas is the same as for diagnostic barium enemas. 
Coinsurance for a screening barium enema is based on 20 percent of the 
APC payment rate.

[[Page 18488]]

    Sections 201(a) and (b) of the BBRA 1999 amend section 1833(t) of 
the Act to provide for additional payments to hospitals for outlier 
cases and for certain medical devices, drugs, and biologicals. These 
additional payments to hospitals will not affect coinsurance amounts. 
Redesignated section 1833(t)(8)(D) of the Act, as amended by section 
201(i) of the BBRA 1999, provides that the coinsurance amount is to be 
computed as if outlier adjustments, adjustments for certain medical 
devices, drugs, and biologicals, as well as any other adjustments we 
may establish under section 1833(t)(2)(E) of the Act, had not occurred. 
Section 202 of the BBRA 1999 adds a new section 1833(t)(7) to the Act 
to provide transitional corridor payments to certain hospitals through 
calendar year 2003 and indefinitely for certain cancer centers.
    Section 1833(t)(7)(H) of the Act provides that the transitional 
corridor payment provisions will have no effect on determining 
copayment amounts.
    Section 204(a) of the BBRA 1999 amended redesignated section 
1833(t)(8)(C) of the Act to provide that the coinsurance amount for a 
hospital outpatient procedure cannot exceed the amount of the inpatient 
hospital deductible for that year. The inpatient hospital deductible 
for calendar year 2000 is $776.00. We will apply the limitation to the 
wage adjusted coinsurance amount (not the unadjusted coinsurance 
amount) after any Part B deductible amounts are taken into account. 
Therefore, although the published unadjusted coinsurance amount for any 
APC may be higher or lower than $776.00 in 2000, the actual coinsurance 
amount for an APC, determined after any deductible amounts and 
adjustments for variations in geographic areas are taken into account, 
will be limited to the Medicare inpatient hospital deductible. Any 
reductions in copayments that occur in applying the limitation will be 
paid to hospitals as additional program payments. (See section 
III.F.3.a, below, for discussion of calculating the Medicare payment 
amount.)
    MedPAC Comment: In its March 1999 report to the Congress, MedPAC 
expressed concern that the statute's approach to addressing the 
reduction in coinsurance could mean that it will be decades before 
coinsurance is 20 percent of all APC payment rates. MedPAC recommended 
that the Secretary seek and the Congress legislate a more rapid phase-
in and that the cost be financed by increases in program spending, 
rather than through additional reductions in payments to hospitals. 
MedPAC agrees that the approach to calculating the coinsurance 
delineated in section 1833(t) of the Act is methodologically sound, but 
they recommend a shorter period to complete the coinsurance reduction.
    Response: The coinsurance reductions enacted by the BBA 1997 
already provide significantly higher levels of financial protection for 
beneficiaries than have existed in the past. While an acceleration of 
this protection might be desirable, the costs of such a policy must be 
balanced against other needs for increased Medicare spending and 
protection of the trust funds. The President's budget for FY 2001 does 
not contain such a proposal.
    Comment: Three commenters discussed the delay in implementing the 
outpatient PPS until after January 1, 2000. A hospital association 
stated that it strongly believes that the outpatient PPS should not be 
implemented until all systems are ready, and suggested that 
implementation occur at the start of a calendar year so that Medigap 
insurers did not receive an unearned windfall by reason of a midyear 
decrease in beneficiary coinsurance amounts. Stating that the delay in 
implementation was of serious concern to it, an insurance group 
strongly urged us to implement the outpatient PPS as soon as possible. 
Finally, a beneficiary advocacy group stated that it is deeply 
concerned about the delay in implementation. While stating that it 
understood the magnitude of the Y2K problem, this group urged us to 
find a way to proceed with the phase-down of beneficiary coinsurance 
or, failing that, to offer our assurance that the phase-down will not 
be delayed beyond January 1, 2000.
    Response: As noted elsewhere in this final rule, we intend to 
implement the outpatient PPS effective for services furnished on or 
after July 1, 2000. As noted in the proposed rule, we concluded that 
attempting to make the massive computer changes required to implement 
PPS at the same time we were trying to ensure that Medicare's computers 
were Y2K compliant would have jeopardized the compliance effort, which 
was HCFA's highest priority. Now that HCFA's efforts to make its 
computer systems, and those of its contractors, Y2K compliant are 
complete, we believe that July 1, 2000 is the earliest date on which we 
can feasibly implement the PPS. Pursuant to HCFA's contracts with the 
contractors responsible for maintaining its computer systems, HCFA 
makes programming changes such as those required to implement the 
outpatient PPS at the beginning of fiscal quarters. Thus, pursuant to 
this practice, after January 1, 2000, there are only three dates in 
2000 on which the programming changes necessary to implement outpatient 
PPS can be put into effect--April 1, 2000, July 1, 2000 and October 1, 
2000.
    The first step in changing HCFA's computer systems to allow for 
implementation of the outpatient PPS is to expand the claim record of 
several HCFA and contractor systems to accept and retain specific 
information related to how a service is being paid or why it is denied. 
The claim record expansion is an indispensable prerequisite to 
implementation of outpatient PPS. Once expansion of the claim form is 
completed, we can then make the remaining programming changes necessary 
to implement the outpatient PPS. As we noted in the proposed rule, 63 
FR 47605, these are massive changes that will require extensive 
testing. We anticipate that these software coding changes cannot be 
completed before the end of the second quarter of 2000. Therefore, the 
earliest possible date on which they can be installed and made 
operational is July 1, 2000.
    We do not believe that it is technically feasible to complete 
installation of both the claims-form line item expansion and the coding 
changes needed to implement PPS any sooner than July 1, 2000. Each of 
these two stages of preparing HCFA's computer system for PPS 
constitutes major systems changes in and of itself. To attempt to make 
both changes simultaneously would be to run the risk that the system 
would not function properly at all, potentially requiring 
implementation to be delayed beyond July 1, 2000. We believe that the 
two-stage approach discussed above is the only feasible way to make the 
systems changes necessary to implement PPS and to be certain that they 
will work. The soonest date on which PPS can be implemented after the 
millennium is therefore July 1, 2000.
    Despite one commenter's request that we implement the outpatient 
PPS at the start of a calendar year, we do not believe it would be 
appropriate to delay implementation beyond July 1, 2000. We see no 
reason to delay implementation beyond the time necessary for HCFA to 
have completed its Y2K efforts and make all the systems changes 
necessary for PPS. As with all of the other aspects of PPS, we believe 
that the beneficiary coinsurance reform contained in the outpatient PPS 
should be put into effect as soon as possible, so that beneficiaries 
can be subject to the lower coinsurance amounts under the new payment 
methodology at the

[[Page 18489]]

earliest date. We believe that this consideration outweighs any concern 
that Medigap insurers might receive a windfall because they set 
premiums for a given year assuming coinsurance amounts would be at one 
level only to see those amounts decrease in the middle of the year. In 
addition, we note that, if insurers received a large enough windfall 
for the reasons described by the commenter, the insurers might be 
required to refund premiums to beneficiaries or offer them a credit on 
premiums pursuant to section 1882(r) of the Act.
    While none of the commenters specifically requested that we do so, 
we have considered the possibility of applying the outpatient PPS 
payment methodology retroactively to services furnished on or after 
January 1, 1999. We have decided not to make these retroactive payments 
for the reasons described below.
    The first reason is the practical problem that the information 
needed to implement PPS retroactively does not exist in a usable form. 
Under current payment methodologies for many outpatient services, 
hospitals submit bills for furnished services based on their charges 
for the services. For these services, HCFA does not require hospitals 
to submit bills containing the HCPCS code for the furnished service and 
other data (such as the dates of service of multiple services submitted 
on the same bill) necessary to process bills under the new prospective 
payment methodology. Without the HCPCS code for a given service, we 
would be unable to determine retroactively into which APC group the 
service should be placed for payment under PPS. In turn, that would 
mean that we could not determine the appropriate payment amount for the 
service. Thus, given the information currently available to us, we 
could not now simply reprocess bills for outpatient services that had 
been furnished between January 1, 1999 and July 1, 2000 and recompute 
payment and coinsurance amounts for these services. As a result, the 
data needed to implement PPS retroactively do not exist in a form that 
would allow for such implementation.
    Nor would it have been feasible to attempt to capture the 
information necessary for retroactive application during 1999. As noted 
above, we concluded that it would not have been prudent to make the 
computer programming changes necessary to implement PPS until our Y2K 
efforts were complete. Those same changes would have been necessary to 
allow us to capture the more detailed claims data needed to perform a 
retroactive application of PPS back to January 1, 1999 once the system 
was implemented prospectively. Because we delayed those changes out of 
concern that they would interfere with our Y2K efforts, no automated 
process existed for the period January 1, 1999 through July 1, 2000 by 
which we could have captured the more detailed claims data necessary to 
effect an eventual retroactive implementation of PPS. Publication of a 
final rule before January 1, 1999 would not have altered this 
situation. Even if we had published such a rule, it could not have 
become effective until we could make the computer changes necessary to 
implement PPS--the functional equivalent of what we have done through 
publication of the proposed rule and this final rule--and until we 
could make those changes, we could not compile by computer the data 
needed to later reprocess claims under PPS.
    In theory, we might have been able to implement PPS retroactively 
despite the lack of an automated method of compiling the data necessary 
to do so. But it simply would not have been practicable to maintain and 
later process by hand such data for the period between January 1, 1999 
and July 1, 2000, given the millions of claims for outpatient services 
submitted during that period. (Based on the latest data available, we 
process approximately 160 million claims for outpatient services over 
an 18-month period.) Neither HCFA nor its contractors have the staff 
needed to accomplish such a task.
    We might also have conceivably required hospitals to maintain the 
data required for a later retroactive implementation of PPS, but this 
approach has practical difficulties. First, during the interim period 
between January 1, 1999 and implementation of PPS, hospitals themselves 
were exerting significant efforts to ensure the Y2K compliance of their 
own automated Medicare billing systems, and it is doubtful that those 
systems could have accommodated the necessary programming changes any 
more than Medicare's systems could have. Even if hospitals could have 
maintained the information (or if HCFA could have maintained it by hand 
or could obtain it from any source now), the burden associated with 
attempting to implement the new prospective payment methodology both 
retroactively and prospectively at the same time would have been 
prohibitive. As noted in the proposed rule and in this final rule, 
effecting the transition between the old payment methodologies and the 
new prospective payment methodology constitutes a massive programmatic 
undertaking. Any effort to reprocess the huge number of bills for 
outpatient services that would be involved in any attempt to 
retroactively implement PPS would compete for the same resources needed 
to implement PPS prospectively, and would compromise our ability to 
ensure the smoothest prospective implementation.
    This is especially so if paper records of claims from the interim 
period would have to be manually input into Medicare's automated 
payment systems in order to make retroactive payments for services 
furnished on or after January 1, 1999. Undertaking an effort, once PPS 
is implemented, to review hospital records of every outpatient service 
furnished between January 1, 1999 and July 1, 2000; translate those 
records into the data needed to process a Medicare claim for the 
service under PPS; and issue a retroactive payment reflecting the PPS 
rate for the service would cause a huge backlog of current bills to be 
processed (and of other carrier tasks), and thus would not be 
practicable. Therefore, there was no feasible way to have captured the 
information necessary to make PPS apply retroactively.
    In addition to the practical problems described above, the statute 
does not require retroactive application of PPS. The statutory 
requirement to implement the PPS for services furnished on or after 
January 1, 1999 is ambiguous. While section 1833(t)(1)(A)'s reference 
to outpatient services ``furnished during a year beginning with 1999'' 
might be read as imposing such a requirement, it is also true that 
section 1833(t)(1)(B)(i) does not expressly set a time limit for HCFA 
to designate which services are ``covered'' outpatient services for 
purposes of payment under PPS. Nor does it set a deadline for HCFA to 
issue regulations implementing the outpatient PPS. As a result, the 
statute can also be read to require implementation of PPS for services 
furnished in a year beginning in 1999 if HCFA has designated in its 
implementing regulations those services as covered services for 
purposes of PPS. The better reading is that the system applies 
prospectively only.
    We recognize that, under section 1833(a)(2)(B), Congress arguably 
made the old payment methodologies for outpatient services inapplicable 
to services furnished on or after January 1, 1999. Again, though, 
Congress imposed no corresponding limit on the time within which HCFA 
must designate the services that would be ``covered'' services for 
purposes of PPS. While it is therefore possible to read the statute in 
such a way that an outpatient service

[[Page 18490]]

furnished after January 1, 1999 but not yet designated as a covered 
outpatient service by HCFA for purposes of PPS would have no payment 
methodology applicable to it, we do not believe that Congress intended 
such a result. We believe that where HCFA, because of significant Y2K 
concerns, has not yet designated a given outpatient service as a 
covered service for purposes of PPS, the most appropriate reading of 
section 1833(t)(1)(A) is that it authorizes the Secretary to continue 
to pay for the service under the existing methodology until PPS can be 
implemented. If the Congress had known about the Y2K problem at the 
time it enacted the PPS statute, this is the only rational approach it 
could have adopted.
    We believe that a clear expression of Congressional intent not to 
require retroactive application of PPS can be found in the legislative 
history of amendments to section 1833(t) of the Act, enacted as 
sections 201, 202, and 204 of the BBRA 1999. In each instance, the 
legislation provides that the ``amendments made by this section shall 
be effective as if included in the enactment of the BBA,'' that is, the 
original enactment of PPS in section 1833(t) (sections 201(m), 202(b), 
and 204(c) of the BBRA 1999). This language was taken from the House 
version of the bill (H.R. Rep. No. 436 (Part I), 106th Cong., 1st Sess. 
14, 16 (1999)). The House Report stated that the outpatient payment 
reforms contained in the BBRA 1999 (and hence in the BBA 1997) were 
intended to take effect ``upon implementation of the hospital 
prospective payment system'' by HCFA, id. at 52, 55, 56, not on January 
1, 1999. The House Conference Committee Report reiterated the 
understanding that the payment and coinsurance provisions of the BBA 
and BBRA do not take effect until after implementation by HCFA. H. 
Conf. Rep. No. 479, 106th Cong., 1st Sess. 866 (1999) (''[c]urrently, 
beneficiaries pay 20% of charges for outpatient services,'' but 
``[u]nder the outpatient PPS, beneficiary coinsurance will be limited 
to frozen dollar amounts based on 20% of national median charges for 
services in 1996, updated to the year of implementation of the PPS''); 
id. at 867 (``[t]he conferees fully expect that the beneficiary 
coinsurance phase-down will commence, as scheduled, on July 1, 2000''); 
870 (``[h]ospital outpatient PPS is to be implemented simultaneously 
and in full for all services and hospitals (estimated for July 
2000)'').
    Both the House Report and the Conference Report expressly 
acknowledge, without disapproval, HCFA's decision to delay 
implementation of the outpatient PPS until after January 1, 2000. H.R. 
Rep. No. 436 (Part I) at 51 (stating that Secretary ``delayed 
implementation of the new system until after the start of CY 2000 in 
order to ensure that `year 2000' data processing problems are fully 
resolved before the new system is implemented'' and that ``HCFA 
currently estimates that the outpatient department prospective payment 
system will be implemented in July 2000''); 145 Cong. Rec. at H12529 
(daily ed. Nov. 17, 1999) (H. Conf. Rep. No. 479) (acknowledging 
``[t]here has already been a one-year delay in implementation of the 
BBA 97 provision'' and stating that conferees ``fully expect'' that the 
outpatient prospective payment system ``will commence, as scheduled, on 
July 1, 2000''). These statements indicate Congressional intent that 
payments and coinsurance for covered hospital outpatient services would 
be governed prospectively by PPS only after HCFA promulgated and made 
effective final implementing regulations.
    Finally, there is a serious question as to whether retroactive 
implementation of PPS might constitute prohibited retroactive 
rulemaking. In Bowen v. Georgetown University Hospital, 488 U.S. 204, 
208 (1988), the Supreme Court stated that a statutory grant of 
legislative rulemaking authority does not encompass the power to 
promulgate retroactive rules unless that power is conveyed by Congress 
in express terms, even where some substantial justification for 
retroactive rulemaking might exist. The Court then declined to find 
this express authorization for retroactive rulemaking in the Medicare 
statute's general grant of rulemaking authority.
    We do not find this express authorization in section 1833(t) or any 
other statutory provision concerning the outpatient PPS. Section 
1833(t)(1) requires that payment for outpatient services that are 
furnished during any calendar year beginning after January 1, 1999 and 
that are designated by HCFA as ``covered'' outpatient services shall be 
made under a prospective payment system. While Congress may have 
presumed, when it enacted section 1833(t) as part of the BBA, that HCFA 
would be able to designate covered outpatient services and implement 
the outpatient PPS by January 1, 1999, Congress did not foresee at that 
time that Y2K concerns would prevent the agency from doing so. As a 
result, the statute is silent as to what was to occur if HCFA was 
unable to designate covered outpatient services and implement PPS by 
January 1, 1999. We do not believe that this silence constitutes the 
express authorization of retroactive rulemaking required by the Supreme 
Court's Georgetown decision.
    Comment: Several commenters contended that the proposed rules for 
beneficiary coinsurance are overly complex and that the phase-in period 
is too long. One commenter asked HCFA to consider a less involved 
method and a more aggressive time period for implementation. Another 
commenter suggested using a 5-year phase-in period. One commenter 
requested that we recommend a legislative change to the Congress to 
reduce beneficiary coinsurance to 20 percent by January 1, 2003. Still 
another commenter expressed concern that calculations of coinsurance 
amounts for each hospital will be particularly burdensome to Medicare 
fiscal intermediaries and, as a result of the increased workload, 
errors may occur. The commenter also recommended a more rapid reduction 
of coinsurance to 20 percent of the payment amount.
    Response: We agree that the rules governing how coinsurance is to 
be calculated under the PPS are complex, and the phase-in to 20 percent 
coinsurance is a lengthy one. However, the methods for calculating 
coinsurance are dictated by the statute. The legislative changes were 
made in order to put some control on rapidly increasing beneficiary 
coinsurance payments, to begin to decrease the proportion of 
beneficiary liability for hospital outpatient services, and to continue 
to reduce beneficiary liability over time. As we have stated, the 
impetus to accelerate the reduction of beneficiary coinsurance has to 
be viewed within the context of other needs for increased Medicare 
expenditures and long-term protection of the trust funds. The delay in 
implementing the hospital outpatient PPS past the statutory effective 
date was unavoidable due to systems constraints imposed by Y2K 
compliance requirements.
    Comment: One commenter noted that the proposed rule set beneficiary 
coinsurance at 20 percent of median charges, but the commenter believes 
that coinsurance amounts should be recalculated to equal 20 percent of 
the average charge for the applicable APC group. The commenter 
indicates that such a change would provide some financial relief to 
hospitals.
    Response: Section 1833(t)(3)(B)(i) of the Act requires that 
unadjusted coinsurance amounts be calculated as 20 percent of the 
national median of the charges for services within the APC group.

[[Page 18491]]

    Comment: One commenter stated that because coinsurance is based on 
the median charges of the APC, some beneficiaries would pay a higher 
coinsurance than they would under the current system. The commenter 
believes that beneficiaries who require less intensive services in an 
APC group will essentially subsidize other beneficiaries who receive 
more intensive services within the group. The commenter asserted that 
fairness would dictate beneficiaries be charged coinsurance amounts 
that more appropriately reflect the services received, not an amount 
based on a median of multiple services they did not receive.
    Response: Section 1833(t)(3)(B)(ii) of the Act provides that the 
unadjusted coinsurance amounts are based on the national median of the 
charges for the ``services within'' an APC. Because an APC group 
consists of services that are both clinically similar and similar with 
respect to the resources required to perform the service, we would 
expect that charges for the services should also be fairly homogeneous. 
We believe that services within a group are homogeneous enough to 
warrant a single payment amount and a single coinsurance amount.
    In the following sections, we describe how we determined the 
beneficiary coinsurance amount and the Medicare program payment amount 
for services paid for under the hospital outpatient PPS.
2. Determining the Unadjusted Coinsurance Amount and Program Payment 
Percentage
    To calculate Medicare program payment amounts and beneficiary 
coinsurance amounts, we first determined for each APC group two base 
amounts, in accordance with statutory provisions:
     An unadjusted copayment amount, described in section 
1833(t)(3)(B) of the Act; and
     The predeductible payment percentage, which we call the 
program payment percentage, described in section 1833(t)(3)(E) of the 
Act.

a. Calculating the Unadjusted Coinsurance Amount for Each APC Group

    In the proposed rule, we described the specific steps used to 
calculate the unadjusted coinsurance amounts for each APC group as 
follows:
    (i) We determined the national median of the charges billed in 1996 
for the services that constitute an APC group after standardizing 
charges for geographic variations attributable to labor costs. (To 
determine the labor adjustment, we divided the portion of each charge 
that we estimated was attributable to labor costs (60 percent) by the 
hospital's inpatient wage index value and added the result to the 
nonlabor portion of the charge (40 percent)).
    (ii) We updated charge values to projected 1999 levels by 
multiplying the 1996 median charge for the APC group by 13.0 percent 
(increased to 14.7 percent in this final rule), which the HCFA Office 
of the Actuary estimates to be the rate of growth of charges between 
1996 and 1999.
    (iii) To obtain the unadjusted coinsurance amount for the APC 
group, we multiplied the estimated 1999 national median charge for the 
APC group by 20 percent. The unadjusted coinsurance amount is frozen at 
the 1999 level until such time as the program payment percentage (as 
determined below) equals or exceeds 80 percent (section 
1833(t)(3)(B)(ii) of the Act).

b. Calculating the Program Payment Percentage (Predeductible Payment 
Percentage)

    In the proposed rule and in this final rule, we use the term 
``program payment percentage'' to replace the term ``pre-deductible 
payment percentage,'' which is referred to in section 1833(t)(3)(E) of 
the Act. The program payment percentage is calculated annually for each 
APC group, until the value of the program payment percentage equals 80 
percent. To determine the program payment percentage for each APC 
group, we--
    (i) Subtract the APC group's unadjusted coinsurance amount from the 
payment rate set for the APC group; and
    (ii) Divide the difference (APC payment rate minus unadjusted 
coinsurance amount) by the APC payment rate, and multiply by 100.
    The program payment percentage will be recalculated each year 
because APC payment rates will change when APC rates are increased by 
annual market basket updates and whenever we revise an APC.
    Comment: One commenter expressed concern about how the coinsurance 
amounts are determined. The commenter stated that the calculation is 
flawed and penalizes beneficiaries in those States where charges for 
services tend to be lower than in other States. The commenter alleged 
that if the hospitals in those States where charges for services tend 
to be lower accept a reduced coinsurance in order to hold beneficiaries 
harmless, the hospitals will be penalized. The commenter also asserted 
that Medigap policies and Medicaid programs will also be affected. The 
commenter further stated that coinsurance should be based on regional, 
not national, charges. The commenter contended that the provision does 
not achieve the intended outcome of equalizing payment across the 
nation.
    Response: Sections 1833(t)(3) and (t)(8) of the Act prescribe how 
coinsurance amounts are to be calculated under the PPS. Our method of 
calculating unadjusted coinsurance amounts for each APC group based on 
20 percent of national median charges follows the requirements of 
section 1833(t)(3)(B) of the Act.
    Comment: A number of commenters believe that the payment system as 
proposed would create gross anomalies in coinsurance for particular 
chemotherapy drugs. For example, the proposed $36.61 coinsurance for 
fluorouracil is 10 times the hospital's cost to purchase that drug. The 
commenters asserted that this excessive coinsurance represents an abuse 
of patients and would undermine beneficiary confidence in the new 
system. They recommended that coinsurance be limited to 20 percent of 
the payment amount for each drug.
    Several other commenters noted that classifying drugs with widely 
varying costs in the same APC will have a significant negative effect 
on beneficiary coinsurance, and in some cases beneficiaries could be 
required to pay a greater percentage of coinsurance for less effective 
therapies. For example, one commenter alleged that the coinsurance for 
the drug 5-FU, which the commenter believes has a current coinsurance 
of approximately $1, would increase to $40 under the proposed system.
    Response: The coinsurance anomalies for chemotherapy drugs that 
appeared in the proposed rule are not an issue under this final rule. 
Unlike the proposed chemotherapy drug APCs, which grouped all 
chemotherapy drugs under four APCs, in this final rule, each 
chemotherapy drug is assigned to a separate APC. As discussed in 
section III.D.5 of this preamble, the unadjusted coinsurance amounts 
for these APCs is calculated as 20 percent of the APC payment rate.
    Comment: One commenter noted that the proposed national unadjusted 
coinsurance amounts for cardiovascular stress testing and perfusion 
imaging result in beneficiaries bearing 85 percent of the total payment 
for stress testing and 60 percent for perfusion imaging, which many 
beneficiaries will be unable to afford. Another commenter

[[Page 18492]]

requested that we either exclude cataract procedures and angioplasty 
from the hospital outpatient PPS or create an outlier policy that 
affords special treatment for these procedures in order to protect 
beneficiaries from excessive coinsurance amounts.
    Response: Coinsurance amounts, by law, are based on 20 percent of 
the median of the charges actually billed in 1996 (updated to 1999) for 
the services within an APC. The fact that coinsurance is a larger 
proportion of the total payment for some APCs than for others reflects 
the differences in hospital charging practices for different services. 
For example, in examining departmental cost-to-charge ratios reflected 
on hospital cost reports, we have found that most hospitals have higher 
mark-ups in charges for radiology and diagnostic services than they do 
for clinic visits.
3. Calculating the Medicare Payment Amount and Beneficiary Coinsurance 
Amount

a. Calculating the Medicare Payment Amount

    The national APC payment rate that we calculate for each APC group 
is the basis for determining the total payment (subject to wage-index 
adjustment) the hospital will receive from the beneficiary and the 
Medicare program. (A hospital that elects to reduce coinsurance, as 
described below in section III.F.4, may receive a total payment that is 
less than the APC payment rate.) The Medicare payment amount takes into 
account the wage index adjustment and the beneficiary deductible and 
coinsurance amounts. In addition, the amount calculated for an APC 
group applies to all the services that are classified within that APC 
group. The Medicare payment amount for a specific service classified 
within an APC group under the outpatient PPS is calculated as follows:
    (i) Apply the appropriate wage index adjustment to the national 
payment rate that is set annually for each APC group.
    (ii) Subtract from the adjusted APC payment rate the amount of any 
applicable deductible as provided under Sec. 410.160.
    (iii) Multiply the adjusted APC payment rate, from which the 
applicable deductible has been subtracted, by the program payment 
percentage determined for the APC group or 80 percent, whichever is 
lower. This amount is the preliminary Medicare payment amount.
    (iv) If the wage-index adjusted coinsurance amount for the APC is 
reduced because it exceeds the inpatient deductible amount for the 
calendar year, add the amount of this reduction to the amount 
determined in (iii) above. The resulting amount is the final Medicare 
payment amount.

b. Calculating the Coinsurance Amount

    A coinsurance amount is calculated annually for each APC group. The 
coinsurance amount calculated for an APC group applies to all the 
services that are classified within the APC group. The beneficiary 
coinsurance amount for an APC is calculated as follows:
    Subtract the APC group's Medicare payment amount from the adjusted 
APC group payment rate less deductible; for example, coinsurance amount 
= (adjusted APC group payment rate less deductible)--APC group 
preliminary Medicare payment amount. If the resulting amount does not 
exceed the annual hospital inpatient deductible amount for the calendar 
year, the resulting amount is the beneficiary coinsurance amount. If 
the resulting amount exceeds the annual inpatient hospital deductible 
amount, the beneficiary coinsurance amount is limited to the inpatient 
hospital deductible. For example, assume that the wage-adjusted payment 
rate for an APC is $300; the program payment percentage for the APC 
group is 70 percent; the wage-adjusted coinsurance amount for the APC 
group is $90; and the beneficiary has not yet satisfied any portion of 
his or her $100 annual Part B deductible.
    (A) Adjusted APC payment rate: $300.
    (B) Subtract the applicable deductible:

$300-$100 = $200

    (C) Multiply the remainder by the program payment percentage to 
determine the preliminary Medicare payment amount:

0.7  x  $200 = $140

    (D) Subtract the Medicare payment amount from the adjusted APC 
payment rate less deductible to determine the coinsurance amount, which 
cannot exceed the inpatient hospital deductible for the calendar year:

$200 - $140 = $60

    (E) Calculate the final Medicare payment amount by adding the 
preliminary Medicare payment amount determined in step (C) to the 
amount that the coinsurance was reduced as a result of the inpatient 
hospital deductible limitation.

$140 + $0 = $140
    In this case, the beneficiary pays a deductible of $100 and a $60 
coinsurance, and the program pays $140, for a total payment to the 
hospital of $300. Applying the program payment percentage ensures that 
the program and the beneficiary pay the same proportion of payment that 
they would have paid if no deductible were taken.
    If the annual Part B deductible has already been satisfied, the 
calculation is:
    (A) Adjusted APC payment rate: $300.
    (B) Subtract the applicable deductible:

$300 - 0 = $300

    (C) Multiply the remainder by the program payment percentage to 
determine the preliminary Medicare payment amount:

0.7  x  $300 = $210

    (D) Subtract the Medicare payment amount from the adjusted APC 
payment rate less deductible to determine the coinsurance amount. The 
coinsurance amount cannot exceed the amount of the inpatient hospital 
deductible for the calendar year:

$300 - $210= $90

    (E) Calculate the final Medicare payment amount by adding the 
preliminary Medicare payment amount determined in step (C) to the 
amount that the coinsurance was reduced as a result of the inpatient 
hospital deductible limitation.

$210 + $0 = $210

    In this case, the beneficiary makes a $90 coinsurance payment, and 
the program pays $210, for a total payment to the hospital of $300.
    The following example illustrates a case in which the inpatient 
hospital deductible limit on coinsurance amounts applies. Assume that 
the wage-adjusted payment rate for an APC is $2,000; the wage-adjusted 
coinsurance amount for the APC is $900; the program payment percentage 
is 55 percent; the inpatient hospital deductible amount for the 
calendar year is $776 and the beneficiary has not yet satisfied any 
portion of his or her $100 Part B deductible.
    (A) Adjusted APC payment rate: $2,000.
    (B) Subtract the applicable deductible:

$2000 - $100 = $1,900

    (C) Multiply the remainder by the program payment percentage to 
determine the preliminary Medicare payment amount:

0.55  x  $1,900 = $1,045

    (D) Subtract the preliminary Medicare payment amount from the 
adjusted APC payment rate less deductible to determine the coinsurance 
amount. The coinsurance amount cannot exceed the inpatient hospital 
deductible amount of $776:

$1,900 - $1,045 = $855, but coinsurance limited to $776

    (E) Calculate the final Medicare payment amount by adding the

[[Page 18493]]

preliminary Medicare payment amount determined in step (C) to the 
amount that the coinsurance was reduced as a result of the inpatient 
hospital deductible limitation ($855 - $776 = $79).

$1,045 + $79 = $1,124

    In this case, the beneficiary pays a deductible of $100 and 
coinsurance that is limited to $776. The program pays $1,124 (which 
includes the amount of the reduction in beneficiary coinsurance due to 
the inpatient hospital deductible limitation) for a total payment to 
the hospital of $2,000.
4. Hospital Election To Offer Reduced Coinsurance
    For most APCs, the transition to the standard Medicare coinsurance 
rate (20 percent of the APC payment rate) will be gradual. For those 
APC groups for which coinsurance is currently a relatively high 
proportion of the total payment, the process will be correspondingly 
lengthy. The law offers hospitals, but not CMHCs, the option of 
electing to reduce coinsurance amounts and permits hospitals to 
disseminate information on their reduced rates. In this section, we 
discuss the procedure by which hospitals can elect to offer a reduced 
coinsurance amount, and the effect of the election on calculation of 
the program payment and beneficiary coinsurance.
    Section 1833(t)(5)(B) of the Act, as added by section 4523 of the 
BBA 1997, requires the Secretary to establish a procedure under which a 
hospital, before the beginning of a year, may elect to reduce the 
coinsurance amount otherwise established for some or all hospital 
outpatient services to an amount that is not less than 20 percent of 
the hospital outpatient prospective payment amount. The statute further 
provides that the election of a reduced coinsurance amount will apply 
without change for the entire year, and that the hospital may 
disseminate information on its reduced copayments. Section 
1833(t)(5)(C) of the Act, as added by the BBA 1997, provides that 
deductibles cannot be waived. Finally, section 1861(v)(1)(T) of the Act 
(as added by section 4451 of the BBA 1997) provides that no reduction 
in coinsurance elected by the hospital under section 1833(t)(5)(B) of 
the Act may be treated as a bad debt. We note that section 1833(t)(5) 
of the Act has been redesignated as section 1833(t)(8) of the Act by 
sections 201(a) and 202(a) of the BBRA 1999.
    Elections to reduce coinsurance will not be taken into account in 
calculating transitional corridor payments to hospitals (discussed in 
section III.H.2 of this preamble). That is, a hospital's transitional 
corridor payment will be determined as if the hospital received 
unreduced coinsurance amounts from beneficiaries.
    In the proposed rule, we stated that we would require that 
hospitals make the election to reduce coinsurance on a calendar year 
basis. The proposed rule required that the hospital must notify its 
fiscal intermediary of its election to reduce coinsurance no later than 
90 days prior to the date the PPS is implemented or 90 days prior to 
the start of any subsequent calendar year and that the hospital's 
notification must be in writing. It must specifically identify the APC 
groups to which the hospital's election will apply and the coinsurance 
amount (within the limits identified below) that the hospital has 
elected for each group. The election of reduced coinsurance must remain 
in effect and unchanged during the year for which the election is made. 
Because the law states that hospitals may disseminate information on 
any reduced coinsurance amounts, we provided in the proposed rule that 
hospitals would be allowed to publicly advertise this information.
    The proposed regulations provided that a hospital may elect to 
reduce the coinsurance amount for any or all APC groups. A hospital may 
not elect to reduce the coinsurance amount for some, but not all, 
services within the same APC group.
    As proposed, a hospital may not elect a coinsurance amount for an 
APC group that is less than 20 percent of the adjusted APC payment rate 
for that hospital. In determining whether to make such an election, 
hospitals should note that the national coinsurance amount under this 
system, based on 20 percent of national median charges for each APC, 
may yield coinsurance amounts that are significantly higher or lower 
than the coinsurance that the hospital previously has collected. This 
is because the median of the national charges for an APC group, from 
which the coinsurance amount is ultimately derived, may be higher or 
lower than the hospital's historic charges. Therefore, in determining 
whether to elect lower coinsurance and the level at which to make the 
election, we advise that hospitals carefully study the wage-adjusted 
coinsurance amounts for each APC group in relation to the coinsurance 
amount that the hospital has previously collected.
    As discussed in section III.F.1, under sections 1834(d)(2)(C)(ii) 
and 1834(d)(3)(C)(ii) of the Act the coinsurance for screening 
sigmoidoscopies furnished by hospitals and screening colonoscopies 
furnished by hospital outpatient departments and ASCs is 25 percent of 
the applicable payment rate. The payment rate for these colorectal 
cancer screening tests is the lower of the hospital outpatient rate or 
the ASC payment rate. The payment rate for screening barium enemas is 
the same as that for diagnostic barium enemas. However, the coinsurance 
amount for screening barium enemas is 20 percent of the APC payment 
rate. Hospitals may not elect to reduce coinsurance for screening 
sigmoidoscopies, screening colonoscopies, or screening barium enemas.
    Calculation of coinsurance amounts on the basis of a hospital's 
election of reduced coinsurance is similar to the formula described in 
section III.F.3. For example, assume that the adjusted APC payment rate 
is $300; the program payment percentage for the APC group is 60 
percent; the hospital has elected a $60 reduced coinsurance amount for 
the APC group; and the beneficiary has not satisfied the annual Part B 
deductible.
    (A) Adjusted APC payment rate: $300.
    (B) Subtract the applicable deductible:

$300 - $100 = $200

    (C) Multiply the remainder by the program payment percentage to 
determine the Medicare payment amount:

0.6  x  $200 = $120

    (D) Beneficiary's coinsurance is the difference between the APC 
payment rate reduced by any deductible amount and the Medicare payment 
amount, but not to exceed the lesser of the reduced coinsurance amount 
or the inpatient hospital deductible amount:

$200 - $120 = $80 (limited to $60 because of the hospital-elected 
reduced coinsurance amount)

    (E) Calculate the final Medicare payment amount by adding the 
preliminary Medicare payment amount determined in step (C) to the 
amount that the coinsurance was reduced as a result of the inpatient 
hospital deductible limitation.

$120 + $0 = $120

    In this case, Medicare makes its regular payment of $120, and the 
beneficiary pays a $100 deductible and a reduced coinsurance amount of 
$60. The hospital receives a total payment of $280 instead of the $300 
that it would have received if it had not made its election to reduce 
coinsurance.
    Comment: One commenter stated that it is currently illegal to 
accept lower coinsurance amounts from beneficiaries and asked for an 
explanation as to how

[[Page 18494]]

we could propose to encourage hospitals to lower coinsurance.
    Response: Although Medicare, in general, has prohibitions against 
reducing beneficiary coinsurance, redesignated section 1833(t)(8)(B) of 
the Act specifically provides the legal authority for hospitals to make 
elections to reduce coinsurance amounts for purposes of the outpatient 
PPS. However, those coinsurance amounts cannot be reduced below 20 
percent of the adjusted APC payment rate for the hospital.
    Comment: One commenter asked whether, in view of our proposal to 
allow hospitals to elect lower coinsurance, Medigap insurance plans 
will be permitted to offer a waiver of a participating hospital's 
coinsurance. That is, can a Medigap plan act as a preferred provider 
organization (PPO) with a financial incentive to select those hospitals 
that elect to reduce coinsurance?
    Response: There are two kinds of Medigap policies--regular Medigap 
and Medicare SELECT. While regular Medigap policies must pay full 
supplemental benefits on all claims that are submitted by all Medicare 
providers and are approved by Medicare carriers and intermediaries, 
Medicare SELECT plans, which are a managed care form of Medigap, may 
restrict payment of supplemental benefits to network providers. Thus, 
by design, Medicare SELECT plans are permitted to negotiate selectively 
with hospitals. Ordinarily, Medicare SELECT plans contract with certain 
hospitals to waive the hospital deductible for inpatient services.
    Since the Congress has expressly permitted hospitals to reduce 
outpatient coinsurance to no less than 20 percent of the PPS payment 
amount, a Medicare SELECT plan is free to contract selectively with 
these hospitals. We note that a hospital's election to reduce 
coinsurance under redesignated section 1833(t)(8)(B) of the Act 
requires that the reduction be across-the-board for some or all APC 
groups. Thus, an agreement between a Medicare SELECT plan and a 
hospital to reduce coinsurance would result in coinsurance reductions 
for all beneficiaries who receive those APC group services at the 
hospital, whether or not they are enrolled in the Medicare SELECT plan.
    Comment: One commenter requested that we seek a legislative change 
to offer hospitals more flexibility under the coinsurance reduction 
provision by permitting them to review and revise coinsurance amounts 
every 3 months.
    Response: We believe that there would be a significant impact on 
contractors if hospitals were allowed to revise their reduced 
coinsurance more often than annually. More frequent coinsurance changes 
may also be confusing to beneficiaries. Because we do not have a good 
estimate of how many hospitals will make the elections and we do not 
yet know whether those hospitals that do make elections will elect to 
reduce coinsurance for just a few or for a significant number of APCs, 
we do not support allowing hospitals to make or change elections more 
often than annually. However, we may reconsider our position after we 
gain more experience under the PPS and can better assess what the 
impact of more frequent elections would be on hospitals, beneficiaries, 
and HCFA and its contractors.
    Comment: One commenter noted that if we intend to publish a final 
rule no more than 90 days before implementation of the PPS, hospitals 
would not have sufficient time to make coinsurance election decisions. 
The commenter recommended that hospitals be permitted to make the 
election 60 days before implementation of the system.
    Response: This final rule will not be published more than 90 days 
before the date of implementation of the PPS. Therefore, the final 
regulations require that hospitals inform their fiscal intermediaries 
(FIs) of their elections to reduce coinsurance not later than June 1, 
2000. Beginning with elections for calendar year 2001, elections are 
required to be made by December 1 preceding the calendar year. At this 
time, we do not know how many hospitals will choose to reduce 
coinsurance or for how many APCs these hospitals will elect reductions. 
While we want to provide hospitals sufficient time to make their 
elections, we also must provide fiscal intermediaries with enough time 
to incorporate the elections into their systems.
    Comment: Several commenters disagreed with our proposal to allow 
hospitals to advertise reduced coinsurance amounts. They noted that, 
although the BBA 1997 provision with respect to hospitals' election to 
reduce coinsurance amounts provides that hospitals may ``disseminate 
information'' on their reductions, we have interpreted that to mean 
that hospitals may ``advertise'' their reductions. Two commenters 
stated that disseminating information is not synonymous with granting 
one category of hospitals the unique opportunity to advertise to 
attract customers. They believe that this interpretation is 
antithetical to the spirit underlying provisions of the Health 
Insurance Portability and Accountability Act of 1996 (HIPAA) that 
prohibit beneficiary inducements and may conflict with State anti-
kickback laws. Some commenters were also concerned that under our 
proposal to allow hospitals to advertise, hospitals may issue a general 
advertisement of reduced coinsurance when the reduction may apply only 
to certain services. Other commenters were concerned that hospital 
advertising may lead Medicare beneficiaries to believe that hospital 
outpatient care is more economical than other ambulatory settings, even 
when that is not the case, or beneficiaries may become confused and 
believe that all ambulatory providers have the ability to reduce 
coinsurance. These commenters asked us to reconsider our proposal to 
allow hospitals to advertise rather than to disseminate information. In 
addition, they asked us to establish additional requirements for 
hospitals' dissemination of information concerning coinsurance 
reductions so that beneficiaries are made aware that reduced 
coinsurance applies only to certain specified services, that it applies 
only to coinsurance billed by hospitals for those services, and that 
the law does not permit reduced coinsurance for other Part B services 
such as physician services.
    Several other commenters stated that for the election to reduce 
coinsurance to be effective, hospitals must have the right to advertise 
and, therefore, the commenters supported our proposal to permit 
hospitals to advertise coinsurance reductions.
    Response: We believe that hospitals must be able to advertise their 
coinsurance reductions in order to achieve what we believe to be the 
intent of the BBA provision, that is, to provide hospitals with some 
ability to compete with other ambulatory settings (where coinsurance is 
already 20 percent of the applicable Medicare payment rate) and to 
reduce beneficiary coinsurance liability.
    Hospitals would have less incentive to reduce coinsurance if they 
could not advertise. In addition, beneficiaries need to be fully 
informed so that they can make informed decisions. We believe that 
advertising as a way of disseminating information has merit.
    We were persuaded by some commenters' concerns that beneficiaries 
may not understand that reduced coinsurance applies to specific 
hospital outpatient services furnished by specific hospitals that 
choose to elect reductions and that similar reductions cannot be made 
by other providers of ambulatory services. We, therefore, are amending 
the regulations to require that all

[[Page 18495]]

advertisements or other information furnished to beneficiaries must 
specify that the coinsurance reductions advertised apply only to the 
specified services of that hospital and that these coinsurance 
reductions are available only where a hospital elects to reduce 
coinsurance for hospital outpatient services and reductions are not 
allowed in other ambulatory settings or physician offices.
    Comment: One commenter, noting the complexity of the PPS 
coinsurance requirements, requested that we provide a phase-in period 
in the final rule to allow hospitals sufficient time to implement the 
changes necessary to meet the requirements.
    Response: The method required to be used in calculating coinsurance 
under the PPS results in an overall decrease in the total coinsurance 
amounts beneficiaries pay for hospital outpatient services. Total 
coinsurance is somewhat reduced in the first year of implementation and 
will be reduced even more in future years, until coinsurance for all 
PPS services equal 20 percent of the applicable APC payment rate. It is 
only by fully implementing the coinsurance provisions under section 
1833(t)(3)(B) of the Act that beneficiaries will realize these 
reductions. We, therefore, do not support a phase-in period.
    Comment: One commenter recommended that we include, as part of the 
public record, year by year estimates of the total economic burden 
placed on beneficiaries by the prolonged coinsurance phase-in period, 
assuming hospitals charge the maximum and minimum coinsurance amounts. 
The commenter believes these estimates would be useful as a basis for 
future discussions of how to remedy the coinsurance problem.
    Response: As a rule, we develop estimates of impacts for 
legislative proposals that are under consideration by the Congress and 
for final legislation as we are developing regulations to implement the 
law. Although we do not have the resources available to model any 
number of other data analyses that may have merit, our data are made 
available to the public, so the commenter and any other interested 
party may perform the coinsurance analysis.
    Comment: One commenter stated that the proposed PPS creates new 
complexities for Medicare beneficiaries in that they will have to wait 
for hospitals to do the calculations necessary to determine 
coinsurance. The beneficiaries will also receive multiple bills and 
explanations of benefits for multiple hospital visits occurring on the 
same day. The commenter stated that we will need to have an extensive 
process in place to explain why, in most cases, beneficiaries are 
paying 50 to 70 percent of their outpatient services and why they are 
receiving separate statements when they have multiple visits on the 
same day.
    Response: In the proposed rule, we assigned medical visits, that 
is, clinic and emergency room visits, to APCs based on both the level 
of visit as defined by a HCPCS code and the diagnosis of the patient. 
In order to implement that type of APC assignment, we would have to 
require hospitals to submit a separate bill for each medical visit that 
occurred on the same day; however, under the final rule, medical visits 
are assigned to APCs based solely on the HCPCS code, and it will be 
possible for hospitals to bill for multiple medical visits on the same 
bill. We agree that the way coinsurance is determined under the PPS is 
a significant change. We are developing a brochure for beneficiaries 
that will explain the new system and the policies under the outpatient 
PPS that will affect them.
    Comment: One commenter recommended that we make information 
available to beneficiaries that compares the average coinsurance for 
high volume procedures performed at hospitals in a particular 
geographic area so that beneficiaries can make informed health care 
decisions about their care.
    Response: We believe that beneficiaries will be informed about the 
coinsurance reductions elected by hospitals in their area through 
advertisements and other information made available by hospitals.
    Comment: One commenter asked whether the EOMB (Explanation of 
Medicare Benefits) notice to the beneficiary will clearly explain that 
a hospital's decision to reduce coinsurance applies to a specific 
service furnished at that specific hospital.
    Response: We are reviewing the EOMB in light of the changes in 
Medicare payments and coinsurance amounts under the PPS, but we have 
not yet finalized our work. We will take the commenter's suggestion 
into consideration as we investigate changes we will make to the EOMB.

G. Adjustment for Area Wage Differences

1. Proposed Wage Index
    Under section 1833(t)(2)(D) of the Act, the Secretary is required 
to determine a wage adjustment factor to adjust, in a budget-neutral 
manner, the portion of the payment rate and the coinsurance amount that 
is attributable to labor-related costs for relative differences in 
labor and labor-related costs across geographic regions. As stated in 
the proposed rule, we considered several options and we proposed using 
the hospital inpatient PPS wage index as the source of an adjustment 
factor for geographic wage differences for the hospital outpatient 
department PPS. We believe that using the hospital inpatient PPS wage 
index is both reasonable and logical, given the inseparable, 
subordinate status of the outpatient department within the hospital 
overall. Use of a hospital outpatient-specific wage index was not 
required by the Congress and we did not have either the time or 
resources necessary to construct one. We explained in our proposed rule 
that there are several possible versions of the hospital inpatient wage 
index that can be developed by extracting the basic wage and salary 
data from hospital cost reports, depending on the methodology that is 
applied to the data. For the hospital outpatient PPS, we proposed to 
adopt the same version that is used to determine payments to hospitals 
under the hospital inpatient PPS to adjust for relative differences in 
labor and labor-related costs across geographic areas. This version 
reflects the effect of hospital redesignation under 1886(d)(8)(B) of 
the Act and hospital reclassification under 1886(d)(10) of the Act.
    By statute, we implement the annual updates of the hospital 
inpatient PPS on a fiscal year basis. However, we proposed to update 
the hospital outpatient department PPS on a calendar year basis. 
Therefore, the hospital inpatient PPS wage index values that are 
updated annually on October 1 would be implemented for the hospital 
outpatient department PPS on the January 1 immediately following. We 
proposed this schedule so that wage index changes will be implemented 
on a calendar year basis concurrently with other revisions and updates, 
such as the conversion factor update or changes in the APC groups 
resulting from new or deleted CPT codes. Subsequent to our proposal, 
section 201(h) of the BBRA 1999 amended section 1833(t)(8)(A) of the 
Act (as redesignated by section 201(a) of the BBRA 1999) to require the 
Secretary to review and revise the outpatient PPS wage index adjustment 
factor at least annually rather than on a periodic basis. (This section 
of the Act was further redesignated as section 1833(t)(9)(A) by section 
202(a) of the BBRA 1999.)

[[Page 18496]]

2. Labor-Related Portion of Hospital Outpatient Department PPS Payment 
Rates
    We proposed to recognize 60 percent of the hospital's outpatient 
department costs as labor-related costs that would be standardized for 
geographic wage differences. We initially estimated this percentage by 
comparing the percentage of costs attributed to labor by other systems 
(that is, hospital inpatient PPS and ASC) and by considering health 
care market factors such as the shift in more complex services from the 
inpatient to the outpatient setting, which could influence labor 
intensity and costs. We stated that 60 percent represented a reasonable 
estimate of outpatient costs attributable to labor, as it fell between 
the hospital inpatient PPS operating cost labor factor of 71.1 percent 
and the ASC labor factor of 34.45 percent, and is close to the labor-
related costs under the hospital inpatient operating cost PPS 
attributed directly to wages, salaries, and employee benefits (61.4 
percent) under the rebased 1992 hospital market basket that was used to 
develop the fiscal year 1997 update factor for inpatient PPS rates 
(published August 30, 1996 at 61 FR 46187).
    We confirmed our estimate through regression analysis. Using this 
approach, we analyzed the percentage change in hospital costs 
attributable to a 1 percent increase in the wage index as expressed by 
the hospital wage index coefficient. The coefficient from a fully 
specified payment regression of the hospital cost per unit, 
standardized for the service mix on the wage index, disproportionate 
share patient percentage, modified teaching, rural, and urban 
variables, is approximately 0.60, suggesting a labor share of 60 
percent. Even though we decided not to propose additional adjustments, 
we believed that the coefficient from this specification provided the 
best estimate of the labor share for the proposed PPS. This judgment 
was based on a policy to use a labor share that reflects the 
relationship between the wage index and costs, rather than the effects 
of correlated factors.
    After calculating 60 percent of each hospital's total operating and 
capital costs, we divided that amount by the hospital's FY 1998 
hospital inpatient PPS wage index value to standardize costs to remove 
the differences that are attributable to geographic wage differences. 
Therefore, as we explained in the proposed rule, the total cost of 
performing a procedure or visit would include standardized operating 
and capital costs, as well as related costs (for example, operating 
room time, medical/surgical supplies, anesthesia, recovery room, 
observation) and minor ancillary procedures such as venipuncture that 
we packaged.
    Comment: Some commenters urged that we annually update the wage 
index applied to the outpatient PPS as we do under the hospital 
inpatient PPS.
    Response: We proposed to update the wage index annually, on a 
calendar year basis. In addition, section 1833(t)(9)(A) of the Act, 
redesignated and amended by the BBRA 1999, requires us to review and 
revise the wage adjustment at least annually.
    Comment: A professional society recommended eliminating the 
``regional variation for radiologic technologists working in small and 
rural practices'' and applying the ``same wage scale'' used for their 
urban counterparts. The commenter asserted that our wage index 
methodology is biased against rural hospital radiology departments that 
must compete with the urban areas to attract and retain radiologic 
technologists. The commenter stated that hospitals are operating in a 
very competitive labor market in which rural facilities are forced to 
match or exceed wages paid in the urban areas for reduced workloads. 
The commenter further stated that the impact of higher hourly 
technologist wages does not result in a corresponding increase in a 
higher wage index for radiologic technologists in rural hospitals 
because these wages are averaged with those for all other hospital 
inpatient personnel working in the same area.
    Response: The commenter is correct that the wage index is 
calculated based upon all of the wages paid and hours worked of 
hospital personnel within areas of the hospital that are paid under the 
inpatient PPS. The wages and hours are then totaled for a particular 
labor market area (defined as a Metropolitan Statistical Area [MSA] or 
all of the counties of a State that are not part of an MSA). We believe 
the inpatient wage index is an appropriate measure of the relative 
costs of labor across geographic areas for purposes of outpatient PPS.
    Currently, we do not have data available that would allow us to 
calculate the wage index for the costs of employing staff in particular 
occupational categories. Collecting these data would require 
significant recordkeeping and reporting efforts for hospitals, and the 
impacts of adjusting the wage index using the data are uncertain. 
Although some analyses have indicated that the wage indices of rural 
areas could rise as a result of such an adjustment, these findings are 
limited by the lack of a national database through which to fully 
assess the impacts.
    Comment: Several commenters viewed our proposal to establish a 60 
percent labor share as an arbitrary decision for which we provided no 
rational support. One commenter stated that ``Congress did not expect 
HCFA to invent a number.''
    Response: As we explained in the proposed rule (63 FR 47581), we 
used a statistical tool, that is, regression analysis, to validate the 
percentage of costs that we had initially estimated could be attributed 
to labor and, therefore, subject to the wage adjustment. We adopted 
this approach because we did not have adequate and appropriate data 
readily available through a reputable source from which we could derive 
a hospital outpatient labor share within the time allotted to develop 
our new system. While hospital outpatient costs, including labor costs, 
are reported annually on the hospital cost report, they are not 
reported in a manner and format that allow us to capture the 
statistical and cost data necessary to calculate a precise hospital 
outpatient labor share. Therefore, we decided to use regression 
analysis to test our estimate of that labor share. Within the 
constraints imposed by a lack of accessible, reliable data and the 
compressed timeframe under which we were working to develop the 
outpatient PPS, we believe our approach was appropriate and the best 
available option.
    Comment: Several commenters urged us to use more current hospital 
cost report data to determine the appropriate hospital outpatient labor 
share.
    Response: As stated above, at this time the Medicare hospital cost 
report is not a feasible data source for determining a hospital 
outpatient labor share.
    Comment: One commenter asserted that setting the labor-related 
share at 60 percent fails to recognize all labor costs associated with 
the delivery of hospital outpatient services. The commenter stated that 
the labor-related percentage for the outpatient PPS should be the same 
as that used for the hospital inpatient PPS, that is, 71.1 percent. 
Another commenter supported 60 percent as a ``maximum'' labor 
percentage on an interim basis and suggested that we reconsider our 
decision to use the inpatient PPS hospital wage index to adjust the 
outpatient PPS payments because of the commenter's concerns about flaws 
inherent in the system used to derive the inpatient PPS wage index 
values. A third commenter proposed that the

[[Page 18497]]

labor-related portion should be closer to the 34.45 percent currently 
applied to adjust ASC payment for wage variation. The latter commenter 
contended that apportioning 60 percent of the outpatient PPS payment 
rate for wage adjustment would adversely affect rural hospitals because 
the wage index values for these areas are generally below 1.0.
    Response: We note that commenters' opinions regarding an 
appropriate labor percentage are mixed. However, beyond expressing a 
preference for a percentage other than 60 percent, none of the 
commenters provided data to assist us in re-evaluating our proposal. We 
realize that rural hospitals would benefit from using a labor share 
that is less than 60 percent and that some other hospitals would derive 
advantages from a labor share greater than 60 percent. However, we 
believe the approach that we used to determine the labor share that 
will be applied to all hospitals paid under our new system is 
reasonable and the best option available at this time. We will re-
evaluate our decision as we gain more experience with the new system 
and as new data become available.
3. Adjustment of Hospital Outpatient Department PPS Payment and 
Coinsurance Amounts for Geographic Wage Variations
    In the proposed rule, we noted our intent to use fiscal year 1999 
hospital inpatient PPS wage index values to compute the initial 
outpatient PPS rates. However, we have decided to use fiscal year 2000 
inpatient PPS wage index values in determining the payment rates set 
forth in this final rule. The rationale for using the fiscal year 2000 
wage index includes availability of the more recent wage index, that it 
is more current than the 1999 wage index would have been, and that it 
is being used to calculate FY 2000 payments under the hospital 
inpatient PPS.
    We proposed to use the annually updated hospital inpatient PPS wage 
index values to adjust both program payment and coinsurance amounts 
under the outpatient PPS for area wage variations. Under our proposal, 
when intermediaries calculate actual payment amounts, they would 
multiply the prospectively determined APC payment rate and coinsurance 
amount by that labor-related percentage to determine the labor-related 
portion of the base payment rate and coinsurance amount that is to be 
adjusted using the applicable wage index factor. We proposed that the 
labor-related portion would then be multiplied by the hospital's 
inpatient PPS wage index factor, and the resulting wage-adjusted labor-
related portion would be added to the nonlabor-related portion, 
resulting in wage-adjusted payment and coinsurance rates. The wage-
adjusted coinsurance amount would then be subtracted from the wage-
adjusted APC payment rate, and the remainder would be the Medicare 
payment amount for the service or procedure. Note that even if a 
hospital elects to reduce the coinsurance or if the coinsurance is 
capped at the inpatient deductible, the full coinsurance is assumed for 
purposes of determining the Medicare payment percentage. (See section 
III.F.3 for a discussion on how Medicare program payments are 
calculated when the Part B deductible applies.)
    The following is an example of how an intermediary would calculate 
the Medicare payment for a surgical procedure with a hypothetical APC 
payment rate of $300 that is performed in the outpatient department of 
a hospital located in Heartland, USA. The coinsurance amount for the 
procedure is $120. The hospital inpatient PPS wage index value for 
hospitals located in Heartland, USA is 1.0234. The labor-related 
portion of the payment rate is $180 ($300  x  60 percent), and the 
nonlabor-related portion of the payment rate is $120 ($300  x  40 
percent). The labor-related portion of the unadjusted coinsurance 
amount is $72 ($120  x  60 percent), and the nonlabor-related portion 
of the unadjusted coinsurance amount is $48 ($120  x  40 percent). It 
is assumed that the beneficiary deductible has been met.

Wage-Adjusted Payment Rate (rounded to nearest dollar):
    = ($180  x  1.0234) + $120
    = $184 + $120
    = $304
Wage-Adjusted Coinsurance Amount (rounded to nearest dollar):
    = ($72  x  1.0234) + $48
    = $74 + $48
    = $122
Calculate Medicare Program Payment Amount:
    $304-$122 = $182
4. Special Rules Under the BBRA 1999
    We issued the federal fiscal year (FY) 2000 hospital inpatient PPS 
wage index values in the Federal Register on July 30, 1999, in a final 
rule titled ``Changes to the Hospital Inpatient Prospective Payment 
Systems and Fiscal Year 2000 Rates'' (64 FR 41490). Subsequent to that 
publication, section 152 of the BBRA 1999 reclassified certain counties 
and labor market areas for purposes of payment under the Medicare 
hospital inpatient PPS; section 153 of the BBRA 1999 enacted a ``wage 
index correction''; and section 154 of the BBRA 1999 provided for the 
calculation and application of a wage index floor for a specified area. 
These changes are effective for FY 2000 and will be explained in detail 
in an interim final rule with comment that we expect to issue in the 
Federal Register shortly. The wage index values in Addendum H, Addendum 
I, and Addendum J reflect the changes made by the BBRA 1999.

H. Other Adjustments

1. Outlier Payments
    Section 1833(t)(2)(E) of the Act, as enacted by the BBA 1997, 
authorized, but did not require, an outlier adjustment. In the proposed 
rule, we discussed our reasons for not implementing an outlier 
adjustment policy. We explained that we had reached that decision after 
carefully evaluating several factors. For the following reasons, we 
believed an outlier policy was not necessary: (a) in the proposed PPS, 
unlike the hospital inpatient PPS, we would use limited packaging of 
services and allow payment for multiple services delivered to a given 
patient on a given day; (b) payment for critical care services would 
reflect the intensity and higher costs associated with providing this 
type of medical care; and (c) we would make higher payment for serious 
medical cases even if critical care were not provided and additional 
payments would be made for any other laboratory work, x-rays, or 
surgical interventions resulting from medical visits to the emergency 
room.
    Section 201(a) of the BBRA 1999 amended section 1833(t) of the Act 
by adding an outlier adjustment provision, section 1833(t)(5). Under 
this new provision, the statute now requires that we make an additional 
payment (that is, an outlier adjustment) for outpatient services for 
which a hospital's charges, adjusted to cost, exceed a fixed multiple 
of the outpatient PPS payment as adjusted by pass-through payments. The 
Secretary determines this fixed multiple and the percent of costs above 
the threshold that is to be paid under this outlier provision. The 
statute sets a limit on projected aggregate outlier payments. Under the 
statute, projected outlier payments may not exceed an ``applicable 
percentage'' of projected total payments. The applicable percentage 
means a percentage specified by the Secretary (projected percentage of 
outlier payments relative to total payments), subject to the following 
limits: for years before 2004, the projected percentage that we specify 
cannot exceed 2.5 percent; for 2004 and later, the projected percentage 
cannot

[[Page 18498]]

exceed 3.0 percent. Section 201(c) of the BBRA 1999 amended section 
1833(t)(2)(E) of the Act to require that these payments be budget 
neutral.
    Section 1833(t)(5)(D) of the Act grants the Secretary authority 
until 2002 to identify outliers on a bill basis rather than on a 
specific service basis and to use an overall hospital cost-to-charge 
ratio (CCR) to calculate costs on the bill rather than using 
department-specific CCRs for each hospital.
    To set the threshold or fixed multiple and the payment percent of 
costs above that multiple for which an outlier payment would be made, 
we first had to determine what specified percentage of total program 
payment, up to 2.5 percent, we should select. We decided to set the 
outlier target at 2.0 percent. In order to set the fixed multiple 
outlier threshold and payment percentage, we simulated PPS payments, as 
described below in section G of the preamble. As explained further 
below, we calibrated the threshold and the payment percentage applying 
an iterative process so that the simulated outlier payments were 2.5 
percent of simulated total payments. For purposes of the simulation, we 
set a ``target'' of 2.5 percent (rather than 2.0 percent), because we 
believe that a given set of numerical criteria would result in a higher 
percentage of outlier payments under the simulation using 1996 data 
than under the PPS. This is because we believe that the 1996 data 
reflects undercoding of services, which means simulated total payments 
would likely be understated and it in turn means the percentage of 
outlier payments would be overstated. In addition, we are unable to 
fully estimate the amount and distribution of pass-through payments 
using the 1996 data. Our inability to make these estimates further 
understates the total payments under the simulation. We believe that a 
set of numerical criteria that results in simulated outlier payments of 
2.5 percent using the 1996 data would result in outlier payments of 2.0 
percent under PPS. The difference arises from the effect of undercoding 
in the historical data and the payment of pass-throughs under PPS. 
Under the budget neutrality requirement in section 1833(t)(2)(E) of the 
Act, as amended by section 201(c) of the BBRA 1999, we make a 
corresponding 2.0 percent reduction to the otherwise applicable 
conversion factor. We will monitor outlier payment and make any 
necessary refinements to the outlier methodology when we set outlier 
policies for CY 2002.
    After setting the outlier target percentage and reducing the 
unadjusted conversion factor to reflect the 2 percent outlier reduction 
and the 2.5 percent pass-through adjustment (see discussion in section 
III.D), we identified those claims in our 1996 database with at least 
one payable service under the PPS system. For these bills, we first 
calculated the total PPS payment for the bill using the reduced 
conversion factor. Next, we calculated for each claim the total charges 
attributed to services being paid under the PPS system. These charges 
were then adjusted to cost, using a hospital-specific CCR. We used the 
sum of the hospital's total operating CCR and total capital CCR as the 
hospital specific CCR. These CCRs were calculated from the most current 
cost report data available and were adjusted to calendar year 1996.
    We also identified all bills for the 1,800-plus hospitals that we 
had previously identified as having coded only the lowest level clinic 
visit code (CPT code 99201) for all visits. For these hospitals, we 
isolated those claims with at least one service with the CPT code 99201 
and one or more additional PPS covered service. Due to the undercoding 
on these bills and the inherent problem in determining a possible 
outlier condition, we excluded these bills from the calculation process 
but set aside a proportional amount of outlier payments based on the 
proportional cost of these bills to the total cost of all bills used in 
the outlier calculation.
    After determining the PPS payment and the cost for all 42 million 
claims for which there was at least one billable service under the PPS 
system, we experimented with several combinations of thresholds or 
fixed multiples and payment percent of costs over these multiples. We 
found that the combination of using a multiple of 2.5 for the threshold 
and the use of a payment percent of 75 percent of cost over this 
threshold achieved our target of a 2.5 percent outlier payment. 
Approximately 1.6 million claims in our 1996 claims database had 
calculated bill costs that exceeded the PPS payments on the claim by 
more than 2.5 times and thus qualified for an outlier payment in our 
model.
    Comment: We received several comments that supported our proposal 
not to create outlier payments. However, most commenters opposed it and 
supported including an outlier policy. Several commenters disagreed 
that multiple payment for multiple services furnished during a given 
visit would absolve the need for outliers. One commenter stated that 
outlier payments are necessary because of the limited number of APC 
groups. Several commenters believe that outlier payments are necessary 
to recognize variability in APC groups stemming from treatment options 
and patient complexity. Some argued that our own data demonstrate that 
an outlier policy is necessary to ensure equitable payments. Several 
commenters stated that the data trimming algorithm that we used, 
excluding from our PPS database claims that were greater than three 
standard deviations from the geometric mean, probably eliminated claims 
that included high cost items and services that should have been 
reflected in our data and that may have been associated with the later 
technologies. A professional association noted that an examination of 
our PPS data indicated that ``20 percent of outpatient services subject 
to the PPS (excluding clinic and emergency room visits) include maximum 
costs that are at least 10 times higher than the corresponding rate; 
100 services have maximum costs that are at least 40 times higher than 
the corresponding payment rate.''
    One commenter believes that an outlier policy is necessary for a 
payment system based on averaging to provide additional payments for 
potentially variable and expensive items such as pharmaceuticals and 
supplies. Several commenters suggested that outlier payments would be 
necessary if we did implement their option to carve out all 
pharmaceuticals and certain supplies from the hospital outpatient PPS 
and pay them separately based on reasonable costs or average wholesale 
price (AWP). Most commenters who urged establishing outlier payments 
advocated them for high cost drugs, supplies, and new technologies. 
Some commenters advised that a drug such as Activase administered to a 
cardiac patient in the emergency room prior to inpatient admission or 
transfer to another hospital for inpatient admission would be costly. 
One commenter estimated that the cost for two doses of the drug would 
exceed $4,000. One commenter urged an outlier policy that would 
adequately pay for iodine I 131 tositomomab. Another commenter 
recommended that we make an outlier payment for Hemophilia Factor 
Concentrate that could be packaged in APC 906 (Infusion Therapy, except 
Chemotherapy) or APC 907 (Intramuscular Injections) and Tissue 
Plasminogen Activator (TPA) and IV therapy drugs as outliers.
    A professional association expressed the need for an outlier policy 
for tests whose costs exceed a reasonable range of costs for similar 
procedures. They identified CPT codes 95951 and 95956 as examples of 
those tests. Another association recommended adoption of

[[Page 18499]]

an outlier policy to recognize higher costs associated with new 
technologies. The commenter suggested that the policy remain in effect 
a full year after the hospital outpatient PPS is implemented to allow 
us adequate time to collect the appropriate data for use in updating 
the payment rates. Several other commenters believe that we may need to 
adopt an outlier policy on an interim basis while data are collected to 
determine the appropriate assignment of certain services and items to 
an APC. One commenter advocated outlier payments for hospitals whose 
aggregate costs exceed total payments under the hospital outpatient PPS 
in a given year. A number of other commenters stated that the hospital 
outpatient PPS outlier policy should be similar to that currently used 
for the inpatient PPS.
    Response: As we discussed above, section 201(a) of the BBRA 1999 
amended the Act by adding a new section 1833(t)(5). This provision now 
requires the Secretary to make an additional outlier payment for 
outpatient services for which a hospital's or a CMHC's charges, 
adjusted to cost, exceed a fixed multiple of the new PPS payment as 
adjusted by pass-through payments. The Secretary is required to 
determine the fixed multiple and the percent of costs above the 
threshold that is to be paid under the outlier provision. As we explain 
above, to implement the outlier adjustment, we have determined that an 
outlier payment will be made when calculated bill costs exceed the PPS 
payments on a claim by more than 2.5 times. In addition, the provision 
of transitional pass-throughs under section 201(b) of the BBRA 1999, 
which requires the Secretary to make an additional payment for certain 
high cost medical devices, drugs, and biologicals, constitutes a kind 
of outlier adjustment (see section III.D of this preamble), and our 
decision to create special transitional payments for new technology 
items and services (see section III.C.8) will also provide additional 
payments to hospitals that incur higher costs under the outpatient PPS.
2. Transitional Corridors/Interim Payments
    As we developed the proposed rule, we conducted extensive 
regression analysis of the relationship between outpatient hospital 
costs and several factors that affect costs, such as teaching intensity 
and disproportionate share percentage, as part of the analysis to 
determine whether payment adjustments should be proposed for the 
outpatient PPS. Ultimately, we did not propose any adjustments other 
than the wage index used to adjust for local variation in labor costs. 
One of the main reasons we did not propose any special adjustments was 
that the estimated effects of measured factors on costs were small and, 
in most cases, not statistically significant. In addition, we believe 
that the negative impacts estimated in the proposed rule for certain 
classes of hospitals were partially attributable to undercoding and 
coding variations in the data because coding did not affect the payment 
of many services under the current payment system, especially medical 
visits.
    Since publication of our proposed policy, section 202(a)(3) of the 
BBRA 1999 added new paragraph (7) to section 1833(t) of the Act to 
require the Secretary to make payment adjustments during a transition 
period to limit the decline in payments under PPS for hospitals. These 
additional payments are to be implemented without regard to budget 
neutrality and are in effect through 2003.
    Under paragraphs (A), (B), and (C) of section 1833(t)(7) of the 
Act, the amount of the payment adjustment for an individual hospital 
depends on the difference between the hospital's ``PPS amount'' and the 
hospital's ``pre-BBA amount.'' Section 1833(t)(7)(E) of the Act defines 
the ``PPS amount'' as the amount payable under PPS for the hospital's 
covered outpatient department services, excluding the effects of the 
transitional corridor and including coinsurance and deductibles. For 
purposes of calculating the PPS amount, we include the full copayment 
amounts; if a hospital chooses to reduce the copayment for some or all 
of the services that it furnishes, we will count the full copayment 
amounts rather than the reduced copayment amounts. Section 
1833(t)(7)(F) of the Act defines the ``pre-BBA amount'' for a period as 
the amount equal to the product of (1) the hospital's reasonable cost 
for covered outpatient department services, and (2) the base outpatient 
department payment-to-cost ratio for the hospital. The statute defines 
``base payment-to-cost ratio'' as the ratio of (1) the hospital's 
reimbursement for covered outpatient department services during the 
cost reporting period ending in 1996, to (2) the reasonable cost of the 
services for the period. The base payment-to-cost ratio will be 
calculated as if the amendments to sections 1833(i)(3)(B)(i)(II) and 
1833(n)(1)(B)(i) of the Act made by section 4521 of the BBA 1997, to 
require that the full amount beneficiaries paid as coinsurance under 
section 1862(a)(2)(A) of the Act are taken into account in determining 
Medicare Part B Trust Fund payment to the hospital, were in effect in 
1996.
    For calendar years 2000 and 2001, payment to hospitals whose PPS 
payment is less than 100 percent, but is at least 90 percent, of the 
pre-BBA payment, is increased by 80 percent of the difference. 
Hospitals whose PPS payment is less than 90 percent, but is at least 80 
percent, of the pre-BBA payment, will receive additional payment equal 
to the amount by which 71 percent of the estimated pre-BBA payment 
exceeds 70 percent of the PPS payment. Hospitals whose PPS payment is 
less than 80 percent, but is at least 70 percent, of the pre-BBA 
payment will receive additional payment equal to the amount by which 63 
percent of the pre-BBA payment exceeds 60 percent of the PPS payment. 
Payments to hospitals whose PPS payment is less than 70 percent of the 
pre-BBA payment will be increased by 21 percent of the pre-BBA payment. 
For calendar years 2001 through 2003, the number of corridors and the 
associated percentage increases decline over time. As required by 
statute, interim payments will be made subject to retrospective 
adjustments. Section 1833(t)(7) of the Act provides special transition 
payments for cancer centers and small rural hospitals, which are 
discussed below in section III.H.3.
    Comment: Hundreds of commenters, including associations, hospitals, 
and entities providing goods and services to hospitals, expressed grave 
concerns about the estimated impact of our proposed system on certain 
classes of hospitals. Many commenters noted that the case mix and 
service mix for specific classes of hospitals such as rehabilitation, 
cancer, children's, rural, and teaching hospitals are different than 
for other hospitals. They argued that a number of these hospitals deal 
with patients who typically require more resources. The commenters 
noted that we have authority under the statute to make adjustments for 
specific classes of hospitals. Some reasoned that given our estimates 
of substantial losses for certain classes of hospitals under the 
proposed hospital outpatient PPS, we should use our authority to 
exclude these classes of hospitals from the outpatient PPS for 2 years, 
require proper coding of bills from those hospitals, and have an 
opportunity to analyze the results of the improved coding. These 
commenters urged that we examine reasons other than coding that may 
contribute to the disparity. Many commenters recommended that a 
separate conversion factor be developed

[[Page 18500]]

for the hospitals whose payments are adversely affected by the new 
system.
    Response: As discussed above, section 1833(t)(7) of the Act, as 
added by section 202(a) of the BBRA 1999, provides that, for several 
years, additional payments be made to any facility for which the PPS 
payment is less than an estimate of the hospital's pre-PPS payment and 
that these payments are in addition to the total payments under the 
PPS. Our estimate of the impacts of this change in policy along with 
other payment-related provisions of the BBRA 1999 (discussed in further 
detail in section IX) show improved payments under PPS relative to pre-
BBRA law for nearly all classes of hospitals. Our simulations show that 
hospitals overall receive an additional 4.6 percent in payments under 
PPS compared to pre-PPS law. Long-term care and children's hospitals 
show losses (1.7 percent and 3.2 percent, respectively). Moreover, 
urban hospitals with no indirect teaching or disproportionate share 
inpatient adjustments show a loss of 0.3 percent. In addition, we 
reexamined and reestimated the multivariate regression specifications 
described in the proposed rule to reflect the changes described in this 
rule. Based on the results of regression analysis, we believe further 
adjustments are not warranted at this time. We found, for example, the 
disproportionate share percentage did not have a statistically 
significant effect on unit costs standardized by service mix. In 
addition, positive and significant results did not occur for most 
teaching variables that we specified. For instance, positive and 
significant results did not occur for hospitals whose ratio of 
residents to inpatient and outpatient days was less than .28. Hospitals 
with a large number of residents to inpatient and outpatient days did 
demonstrate slightly higher standardized costs, but only when the 
regression model included independent variables for urban/rural 
location. Moreover, the parameter estimate was small and payment was 
not greatly improved when a corresponding adjustment was made to these 
teaching hospitals. Therefore, we are not making such adjustments for 
these hospital groups. We do not believe that this action will restrict 
beneficiary access to care because the projected losses are relatively 
small and could reflect undercoding on the part of these hospitals 
before PPS.
    We will begin comprehensive analyses of cost and payment 
differentials between different classes of hospitals as soon as there 
is a sufficient amount of claims data submitted under the PPS. We will 
use data from the initial years of the PPS to conduct regression and 
simulation analyses. In addition, we will carefully track and analyze 
the additional payment made to hospitals under section 1833(t)(7) of 
the Act. These analyses will be used to consider and possibly propose 
adjustments in the system, particularly beginning in 2004 when the BBRA 
1999 transition provisions expire.
    Comment: Commenters from organizations representing teaching 
hospitals recommended that we include a budget-neutral payment 
adjustment for certain classes of hospitals such as teaching hospitals. 
For example, the concern is that PPS payments are not adequate for 
academic medical centers because they provide more resource-intensive 
outpatient services than other hospital types.
    Response: As noted above, we are not making adjustments for 
specific classes of hospitals in this final rule. The primary reason 
for this decision is that section 1833(t)(7) of the Act requires 
additional payments through 2003 to all hospitals whose PPS payment 
falls below estimates of pre-PPS payment. We will conduct analyses and 
studies of cost and payment differential among different classes of 
hospitals, including teaching facilities, when sufficient data under 
the PPS have been submitted. We will carefully consider whether 
permanent adjustments should be made in the system once the BBRA 1999 
transition provisions expire.
3. Cancer Centers and Small Rural Hospitals

Cancer Centers

    In the BBA 1997, the Congress did not exclude from the hospital 
outpatient PPS the 10 cancer centers that are currently excluded from 
the inpatient PPS, but section 1833(t)(8) of the Act (as enacted in the 
BBA 1997) provides special consideration for these hospitals under the 
outpatient PPS. More specifically, that section provides that the 
outpatient PPS would not apply to the 10 cancer centers before January 
1, 2000, and that the Secretary may establish a separate conversion 
factor for cancer centers to take into account the unique costs they 
incur due to their patient population and the intensity of their 
services.
    In the proposed rule, we stated that, because we had no choice but 
to delay implementation of the PPS for all hospitals until sometime 
after January 1, 2000 due to Y2K concerns, we would begin paying cancer 
centers under hospital outpatient PPS at the same time. Also, we did 
not propose a separate conversion factor for cancer centers. Although 
our proposed impact analysis indicated that, under the PPS, the cancer 
centers could lose 32 percent of their current outpatient Medicare 
payments, we proposed to do additional work to try to explain the 
impact before we provided for a separate conversion factor or other 
payment adjustment.
    Section 1833(t)(7)(D)(ii) of the Act, as added by the BBRA 1999, 
provides that the 10 cancer centers excluded from the inpatient PPS are 
permanently held harmless with respect to their pre-BBA 1997 amount.
    Comment: The cancer centers commented that they are unlike other 
hospitals in that they treat the most difficult cases (patients often 
referred by community hospitals) and they are usually the first 
hospitals to use the latest technology related to cancer treatments. 
They also pointed out that their clinic visits often involve 
consultations with a number of physicians and therefore are longer and 
require more hospital resources than clinic visits in other hospitals. 
They believe that our proposed payments for clinic visits would 
seriously underpay them for their more comprehensive visits. The cancer 
centers also stated that any delay in recognizing and paying 
appropriately for new technology would affect them more adversely than 
it would other hospitals.
    During the comment period for the proposed rule, the cancer centers 
submitted for our consideration an alternative payment methodology. 
Under their methodology, we would calculate a separate conversion 
factor for each of the 10 centers based on their individual base year 
Medicare payments and service mix. Subsequently, the conversion factors 
would be updated using the Congressionally determined update factor 
applicable to all hospitals. Hospitals would be paid interim payment 
amounts during the year, but payment would ultimately be based on the 
lesser of--
     The PPS payments they would receive using their individual 
conversion factor; or
     The payments they would receive based on their cost 
reports by applying the current (that is, pre-PPS) outpatient services 
payment methodology.
    Capital costs would be excluded from this comparison and be paid on 
a reasonable cost pass-through basis. The proposal also envisioned some 
payment penalties and incentives similar to the penalties and 
incentives provided under the reasonable payment cost limit methodology 
applicable to hospitals excluded from the inpatient PPS.

[[Page 18501]]

    Response: As noted above, new section 1833(t)(7)(D)(ii) of the Act 
holds cancer centers harmless on a permanent basis by providing that, 
in instances where Medicare payment to a cancer center under the 
hospital outpatient PPS would be lower than a specified pre-BBA 
Medicare payment for the same services, we are to pay the full pre-BBA 
amount. Therefore, an alternative approach to paying cancer centers 
under the hospital outpatient PPS is no longer needed.
Small Rural Hospitals
    We noted in the proposed rule that rural hospitals generally 
receive a relatively high percentage of their Medicare income from 
outpatient services (greater than the national average), which 
compounds the impact of the reduction in Medicare payments to rural 
hospitals that we projected would result upon implementation of the 
hospital outpatient PPS. We attributed these reduced revenues to 
undercoding, lack of economies of scale, and reliance on the median 
instead of the geometric mean in the calculation of APC weights. 
Because our impact analysis revealed that low-volume rural hospitals 
that are sole community hospitals or Medicare-dependent hospitals could 
experience a considerable reduction in revenues under the outpatient 
PPS, we solicited comments in the proposed rule on two possible 
approaches to phasing in the outpatient PPS for these types of 
hospitals.
    Section 1833(t)(7)(D)(i) of the Act provides that hospitals located 
in a rural area with 100 or fewer beds are held harmless with respect 
to their pre-BBA 1997 amount for outpatient services furnished before 
January 1, 2004. For purposes of implementing this provision, bed size 
will be determined in the same way it is for inpatient PPS for the 
indirect medical education adjustment as defined in Sec. 412.105(b), 
Determination of number of beds. A hospital's location in a rural area 
will also be determined as it is in the inpatient PPS; see 
Sec. 412.63(b), Geographic classifications.
    Comment: Many commenters were concerned that the projected negative 
impact of the proposed outpatient PPS on rural hospitals would be 
magnified because outpatient revenues make up such a large part of 
rural hospitals' total revenues. Some commenters believe that our 
proposed PPS ratesetting method favors high volume, urban hospitals. 
Some commenters supported phasing in the outpatient PPS for rural 
disproportionate share hospitals because those facilities may not have 
the resources to improve their coding in the near future. One 
association opposed phasing in the PPS because doing so would postpone 
but not resolve the financial jeopardy imposed on rural hospitals by 
the hospital outpatient PPS. Some commenters recommended that we 
provide an ``add-on'' to the prospective rate for emergency services in 
low-volume sole community and rural disproportionate share hospitals. 
One commenter expressed concern about the numerous factors contributing 
to rural hospitals' negative margins that limit their ability to absorb 
losses, including a disproportionately high share of Medicare, 
Medicaid, and indigent patients, significant problems recruiting 
practitioners, low population density, and limited patient volume. 
Numerous commenters recommended that we establish a payment floor for 
low-volume rural hospitals. One association requested that we either 
revise the payment methodology or put in place a payment floor that 
guarantees health care services will continue to be available to 
Medicare beneficiaries served by rural hospitals.
    Response: As we discuss above, in order to limit potential 
reductions in payment to hospitals under the outpatient PPS, section 
1833(t)(7) of the Act, as added by section 202(a)(3) of the BBRA 1999, 
requires us to establish payment adjustments for hospitals whose PPS 
payments are less than our estimate of the hospital's pre-BBA payments. 
These additional payments are to be implemented in a non-budget neutral 
manner and are to be paid through 2003. Section 1833(t)(7)(D)(i) of the 
Act includes a special ``hold harmless'' provision, which is to be paid 
through 2003, for hospitals that are located in a rural area and that 
have no more than 100 beds. Under section 1833(t)(7)(D)(i) of the Act, 
as added by the BBRA 1999, small rural hospitals will be paid a 
predetermined pre-BBA amount for services covered under the outpatient 
PPS if payment under the PPS would be less than the pre-BBA amount. 
This hold harmless provision establishes a payment floor until January 
1, 2004 for small rural hospitals. During this period, we will collect 
and analyze data under the PPS in order to assess whether any special 
adjustments will need to be made for rural hospitals once the hold 
harmless provision expires.

I. Annual Updates

1. Revisions to APC Groups, Weights and the Wage and Other Adjustments
    Prior to enactment of the BBRA 1999, section 1833(t)(6)(A) of the 
Act required the Secretary to periodically review and revise the APC 
groups, the relative payment weights, and the wage and other 
adjustments to take into account changes in medical practice, changes 
in technology, the addition of new services, new cost data, and other 
relevant information and factors.
    In the proposed rule, we described our plan to update the various 
components of the outpatient PPS. We proposed to keep the composition 
of all the APC groups essentially intact from one year to the next, 
with the exception of the few changes that may be necessary as a 
consequence of annual revisions to HCPCS and ICD-9-CM (International 
Classification of Diseases, Ninth Edition, Clinical Modification) 
codes. We stated that we did not plan to routinely reclassify services 
and procedures from one APC to another. We proposed to make these 
changes based on evidence that a reassignment would improve the 
group(s) either clinically or with respect to resource consumption. 
However, we specifically solicited comments on how frequently to 
recalibrate the APC weights and on the method and data that should be 
used. We defined recalibration as the updating of all the APC group 
weights based on more recent information.
    We proposed to update the wage index values used to calculate 
program payment and coinsurance amounts on a calendar year basis, 
adopting, effective for services furnished each January 1, the wage 
index value established for a hospital under the inpatient PPS the 
previous October 1. The first update to the wage index values will be 
effective for calendar year 2001 beginning January 1, 2001.
    Section 201(h)(1)(A) of the BBRA 1999 amended section 1833(t)(8)(A) 
of the Act (as redesignated by section 201(a) of the BBRA 1999) to 
require the Secretary to review the components of the outpatient PPS 
not less often than annually and revise the groups, the relative 
payment weights, and the wage and other adjustments to take into 
account changes in medical practice, changes in technology, and the 
addition of new services, new cost data, and other relevant information 
and factors. (Section 202(a) of the BBRA 1999 further redesignated 
section 1833(t)(8) as section 1833(t)(9).)
    Section 201(h)(1)(B) of the BBRA 1999 further amended this section 
of the Act to require that the Secretary consult

[[Page 18502]]

with an expert outside advisory panel composed of an appropriate 
selection of representatives of providers to review (and advise the 
Secretary concerning) the clinical integrity of the groups and weights. 
This provision allows these experts to use data other than those 
collected or developed by us during our review of the APC groups and 
weights. Section 201(h)(2) of the BBRA 1999 requires the Secretary to 
initiate the annual review process beginning in 2001 for the PPS 
payments that would take effect January 1, 2002.
    Comment: A number of commenters urged that we adopt an annual 
update cycle for APC recalibration. Some commented that the APC update 
frequency should not be less often than the annual cycles that we have 
instituted for both the hospital inpatient PPS and physician fee 
schedule payment system. Many commenters maintained that annual 
updating is necessary to ensure that the APCs appropriately reflect 
changes in new technologies, standards of care, and other marketplace 
patterns. Several commenters stated that an annual update cycle is 
needed to take into account changes in drug prices and appropriately 
reflect advancements in nuclear medicine. Some commenters believe that 
updating the APCs less frequently than annually would adversely impact 
hospitals that would incur financial losses attributable to 
inappropriate payment for new technologies. Some commenters contended 
that infrequent updating would be a disincentive for manufacturers to 
develop new outpatient therapies.
    Response: In accordance with the amendments enacted by the BBRA 
1999, we will review and update annually, for implementation effective 
January 1 of each year, the APC groups, the relative payment weights, 
and the wage and other adjustments that are components of the 
outpatient PPS, beginning with the update to be effective January 1, 
2002.
2. Annual Update to the Conversion Factor
    We stated in the proposed rule that section 1833(t)(3)(C)(ii) of 
the Act requires us to update annually the conversion factor used to 
determine APC payment rates. Section 1833(t)(3)(C)(iii) of the Act 
provides that the update be equal to the hospital inpatient market 
basket percentage increase applicable to hospital discharges under 
section 1886(b)(3)(B)(iii) of the Act, reduced by one percentage point 
for the years 2000, 2001, and 2002. The Secretary also has the option 
(under section 1833(t)(3)(C)(iii) of the Act) of developing a market 
basket that is specific to hospital outpatient services. We advised in 
our proposed rule that we are considering this option, and specifically 
invited comments on possible sources of data that are suitable for 
constructing a market basket specific to hospital outpatient services. 
We did not receive any comments regarding potential data sources for 
constructing a hospital outpatient-specific market basket. Therefore, 
we will update the conversion factor annually by the hospital inpatient 
market basket increase (as specified in section 1886(b)(3)(B) of the 
Act), reduced by one percentage point for the years 2000, 2001, and 
2002.
3. Advisory Panel for APC Updates
    As stated above, section 1833(t)(9)(A) of the Act (as redesignated 
by section 201(a) of the BBRA 1999 and further redesignated by section 
202(a) of the BBRA 1999) requires the Secretary, beginning in 2001, to 
consult with an expert outside advisory panel of appropriately selected 
provider representatives when annually reviewing and updating the APC 
groups and the relative group weights. The statute specifies that the 
expert panel will act in an advisory capacity on matters pertaining to 
the clinical integrity of the groups and weights and that it may use 
data other than those developed or collected by us in executing this 
function. We will initiate this review process in 2001 for the hospital 
outpatient PPS payments that will take effect for services furnished on 
or after January 1, 2002. We will adopt a process for identifying and 
appropriately selecting provider representatives to serve as members of 
an expert advisory panel. We anticipate informing the hospital 
community of the formation of an expert advisory panel through timely 
notice in the Federal Register.

J. Volume Control Measures

    Section 1833(t)(2)(F) of the Act requires the Secretary to develop 
a method for controlling unnecessary increases in the volume of covered 
outpatient department services. Section 1833(t)(6)(C) of the Act, as 
added by the BBA 1997, authorizes the Secretary to adjust the update of 
the conversion factor if we determine that the volume of services paid 
for under the outpatient PPS increases beyond amounts we establish 
under section 1833(t)(2)(F) of the Act.
    In the proposed rule, we proposed a volume control measure for 
services furnished in CY 2000 only. We discussed several long-term 
alternatives to control volume for services furnished in subsequent 
years, and we solicited comments on those options. We stated that we 
would propose an appropriate volume control mechanism for services 
furnished in CY 2001 and beyond after we completed further analysis. 
Given the complexities of developing an appropriate volume control 
mechanism for hospital outpatient services, we believed additional 
study was necessary.
    For CY 2000, we proposed to use a modified version of the physician 
sustainable growth rate system (SGR), which is required under section 
1848(d)(3) of the Act, for purposes of the hospital outpatient PPS. As 
we stated in the proposed rule, this appeared to be the most feasible 
initial approach. Using this approach, we proposed to update the target 
amount specified under section 1833(t)(3)(A) for CY 1999 as an 
expenditure target for services furnished in CY 2000. We stated that we 
would update the CY 1999 target for inflation (based on the projected 
change in the hospital market basket minus one percentage point), 
estimate changes in the volume and intensity of hospital outpatient 
services, and estimate Part B fee-for-service changes in enrollment. If 
volume exceeded the target for CY 2000, we proposed to adjust the 
update to the conversion factor for CY 2002. We further stated that we 
would compare the CY 2000 target to an estimate of CY 2000 actual 
payments to hospitals as determined by our Office of the Actuary using 
the best available data. We proposed that if unnecessary volume 
increases, as reflected by expenditure levels, caused payment to exceed 
the target, we would determine the percentage by which the target is 
exceeded, and adjust the CY 2002 update to the conversion factor by the 
same percentage.
    We indicated that we would respond in the final rule to comments on 
our proposed volume control measure for services furnished in CY 2000, 
but not to comments about volume control options for services furnished 
after CY 2000, which will be addressed in a later proposed rule.
    Comment: We received many comments opposing our proposed use of an 
SGR-like system to control unnecessary volume increases under the 
hospital outpatient PPS. Most commenters strongly urged us to exercise 
the discretionary authority allowed under section 1833(t)(9)(C) of the 
Act (as redesignated) not to adjust the update to the conversion 
factor. A few commenters endorsed the provision

[[Page 18503]]

of the ``President's Plan to Modernize and Strengthen Medicare for the 
21st Century'' (issued July 2, 1999) to delay adoption of a volume 
control measure in order to give hospitals additional time to adjust to 
the new system. Several commenters, including one national physicians' 
association, contended that we did not have the statutory authority to 
establish and use an expenditure target in the manner that we had 
proposed. The physicians' association stated that the law limits use of 
the SGR system to physician services. Some commenters believe that we 
lack the expertise needed to set an accurate target amount. Others 
argued that an expenditure target is not a reliable way to distinguish 
the growth of necessary versus unnecessary services and that our 
proposal would therefore have consequences not intended by the statute 
(that is, affecting all services rather than only those that would be 
considered unnecessary). Some commenters stated that expenditure caps 
only work when they directly affect those who control the volume. These 
commenters contended that a volume control measure is unfair to 
hospitals because it is physicians, not hospitals, who order services 
and therefore control volume. Some commenters were concerned that 
adopting a volume control measure would penalize hospitals for 
increases in outpatient volume attributable to technological changes 
that appropriately shift service delivery from the inpatient to 
outpatient setting. In addition, numerous organizations recommended 
that we not implement the volume expenditure targets and control 
measures because payments would be reduced to inadequate levels and 
affect beneficiary access to care.
    Response: We are delaying implementation of a volume control 
mechanism as suggested by the ``President's Plan to Modernize and 
Strengthen Medicare for the 21st Century'' (the statute does not 
specify an implementation date). This delay gives hospitals time to 
adjust to the PPS, and it gives us additional time to study appropriate 
methods of controlling outpatient volume over the long term. We are 
currently working with a contractor to study options for volume control 
measures for outpatient services. In the future, before we make any 
final decision, we will publish a notice in which we will discuss our 
proposal and will provide a public comment period.

K. Claims Submission and Processing and Medical Review

    Comment: Numerous commenters expressed a variety of concerns 
related to information exchange processes required by the new PPS. 
Several commenters stated that the remittance advice documents will 
need to reflect all of the components used in calculating payment for 
each claim, as well as possible coinsurance reductions. The commenters 
also were concerned that, with the complexity of the APC system, 
hospitals will need the ability to verify payment. One health system 
that had experience with 3M's APGs offered the experience of their 
member hospitals to assist us by providing input on the data needed by 
hospitals to manage APCs. This same commenter stated that hospitals 
must be given detailed instructions on claims submission, changes to 
the UB-92, and changes to the Correct Coding Initiative (CCI) in 
advance to ensure that systems and personnel can comply with Medicare 
requirements.
    Response: We released specific hospital billing instructions that 
address line item reporting and reporting of service units on December 
23, 1999 (Transmittals 1787 and 747). We will be issuing final 
instructions for implementation of this PPS in a program memorandum to 
fiscal intermediaries. The program memorandum addresses a range of 
issues such as appropriate use of revenue center/HCPCS codes for 
compliance with Medicare requirements and changes to Remittance Advice 
messages and Medicare Summary Notices/EOMBs.
    All current correct coding initiative (CCI) edits with the 
exception of laboratory and anesthesiology edits have been incorporated 
in the outpatient code editor (OCE) that fiscal intermediaries use to 
process claims for hospital outpatient services for payment. We will 
address OCE changes in a program memorandum to fiscal intermediaries. 
The effective date of these edits is July 1, 2000.
    We have decided not to pursue changes to the UB-92 claim form to 
allow line item diagnosis because, as we discuss in section III.C.3, we 
will not be using diagnosis to determine payments for clinic and 
emergency visits when the PPS is first implemented. Diagnosis codes, 
however, are still required to be reported on hospital outpatient 
bills.

Medical Review Under the Hospital Outpatient PPS

    We have received inquiries regarding the anticipated medical review 
process for hospital outpatient PPS claims. The methodology of review 
for outpatient claims does not change under the PPS. The goal of 
medical review is to identify inappropriate billing and to ensure that 
payment is not made for noncovered services. Contractors may review any 
claim at any time, including requesting medical records, to ensure that 
payment is appropriate. In accordance with this final rule, Medicare 
will make payment under the PPS for hospital outpatient services 
including partial hospitalization services; certain Part B services 
furnished to inpatients who have no Part A coverage; partial 
hospitalization services furnished by CMHCs; vaccines, splints, casts 
and antigens provided by HHAs and CORFs that provide medical and other 
health services; and splints, casts and antigens provided to hospice 
patients for the treatment of a nonterminal illness. In addition, we 
expect focused reviews will include the adjustments we have made to the 
hospital outpatient PPS as a result of the enactment of the BBRA 1999, 
especially the transitional pass-through payments for innovative drugs, 
biologicals, and medical devices that are discussed in section III.D. 
Fiscal intermediaries will continue focused and random review of 
services such as ambulance, clinical diagnostic laboratory, orthotics, 
prosthetics, take home surgical dressings, chronic dialysis, screening 
mammographies, and outpatient rehabilitation (physical therapy 
including speech language pathology and occupational therapy) even 
though these services are excluded from the scope of services paid 
under the hospital outpatient PPS.

L. Prohibition Against Administrative or Judicial Review

    Section 1833(t)(9) of the Act, as added by the BBA 1997, prohibits 
administrative or judicial review of the development of the PPS 
classification system, the groups, relative payment weights, wage 
adjustment factors, other adjustments, volume control methods, 
calculation of base amounts, periodic control methods, periodic 
adjustments, and the establishment of a separate conversion factor for 
cancer hospitals. Section 201(a) of the BBRA 1999 redesignates this 
section as section 1833(t)(11) of the Act, and section 201(d) of the 
BBRA 1999 amends the section by adding the following to the list of 
adjustments subject to the limitation on judicial review: the factors 
used to determine outlier payments, that is, the fixed multiple, or a 
fixed dollar cutoff amount; the marginal cost of care, or applicable 
total payment percentage; and the factors used to determine additional 
payments for certain medical devices, drugs, and biologicals such as 
the determination of insignificant cost, the duration of the additional 
payments, the portion of the outpatient PPS

[[Page 18504]]

payment amount associated with particular devices, drugs, or 
biologicals, and any pro rata reduction. Section 202(a) of the BBRA 
1999 further redesignates section 1833(t)(11) as section 1833(t)(12).

IV. Provider-Based Status

A. Background

    The Medicare law (section 1861(u) of the Act) lists the types of 
facilities that are regarded as providers of services, but does not use 
or define the term ``provider-based.'' However, from the beginning of 
the Medicare program, some providers, which we refer to in this section 
as ``main providers,'' have owned and operated other facilities, such 
as SNFs or HHAs, that were administered financially and clinically by 
the main provider. The subordinate facilities may have been located on 
the main provider campus or may have been located away from the main 
provider. In order to accommodate the financial integration of the two 
facilities without creating an administrative burden, we have permitted 
the subordinate facility to be considered provider-based. The 
determination of provider-based status allowed the main provider to 
achieve certain economies of scale. To the extent that overhead costs 
of the main provider, such as administrative, general, housekeeping, 
etc., were shared by the subsidiary facility, these costs were allowed 
to flow to the subordinate facility through the cost allocation process 
in the cost report. This was considered appropriate because these 
facilities were also operationally integrated, and the provider-based 
facility was sharing the overhead costs and revenue producing services 
controlled by the main provider.
    Before implementation of the hospital inpatient PPS in 1983, there 
was little incentive for providers to affiliate with one another merely 
to increase Medicare revenues or to misrepresent themselves as being 
provider-based, because at that time each provider was paid primarily 
on a retrospective, cost-based system. At that time, it was in the best 
interest of both the Medicare program and the providers to allow the 
subordinate facilities to claim provider-based status, because the main 
providers achieved certain economies, primarily on overhead costs, due 
to the low incremental nature of the additional costs incurred.
    In the proposed rule, we pointed out the increase of provider-based 
facilities and the financial and organizational incentives for that 
increase since 1983. A variety of factors such as the emergence of 
integrated delivery systems and the pressure to enhance revenues have 
combined to create incentives for providers to affiliate with one 
another and to acquire control of nonprovider treatment settings, such 
as physician offices.
    We noted in the proposed rule that it is essential that we make 
decisions regarding provider-based status appropriately, and that we 
have clear rules for identifying provider-based entities. By failing to 
distinguish properly between provider-based and free-standing 
facilities or organizations, we risk increasing program payments and 
beneficiary coinsurance with no commensurate benefit to the Medicare 
program or its beneficiaries and we jeopardize the delivery of safe and 
appropriate health care services to our beneficiaries.
    Although there is no direct statutory requirement to maintain 
explicit criteria for determination of provider-based status, there are 
statutory references acknowledging the existence of this payment 
outcome. For example, section 1881(b) of the Act provides for separate 
payment rates for hospital-based ESRD facilities. There is currently no 
general definition of ``provider-based facility'' in the CFR. However, 
in the proposed rule, we cited issuances that do contain provisions for 
recognition of specific types of entities as provider-based, including 
Program Memorandum A-96-7, published on August 27, 1996, which pulled 
together instructions for specific entity types from previously 
published documents and consolidated them into a general instruction 
for the designation of provider-based status for all facilities or 
organizations. That Program Memorandum was subsequently reissued, 
without substantive change, as Program Memoranda A-98-15 and A-99-24 
and, in October 1999, was manualized by the Provider Reimbursement 
Manual, Part I, Transmittal 411 (adding new section 2446), and the 
State Operations Manual, Transmittal 11 (replacing previous section 
2003 and adding new section 2004). Our policy will continue to follow 
the principles we articulated in Program Memorandum A-96-7 and the 
Provider Reimbursement Manual and State Operations Manual sections 
cited above until October 10, 2000. After that date, we shall apply the 
policies set forth in these final regulations.

B. Provisions of the Proposed Rule

    We announced our intention to implement Secs. 413.24(d)(6)(i) and 
(ii), 413.65, 489.24(b), and 498.3, as revised based on our 
consideration of public comments, with respect to services furnished on 
or after 30 days following publication of a final rule. We describe 
these sections below and explain that we have now provided a 6-month 
delay in the effective date of the regulations on provider-based 
status.
    We proposed to add a new Sec. 413.65 on the determination of 
provider-based status. In paragraph (a), we proposed to define the 
following terms: department of a provider, free-standing facility, main 
provider, provider-based entity, and provider-based status. In 
paragraph (b), we proposed that a facility or organization would not be 
entitled to be treated as provider-based simply because it or the 
provider believe it to be provider-based. The facility or organization, 
or the provider, would have to contact HCFA and obtain an affirmative 
provider-based determination before billing of the facility's or 
organization's costs through the main provider, or inclusion of those 
costs on the main provider's cost report, is initiated. Further, we 
proposed to presume a facility not located on the campus of a hospital 
and used as a site of physician services of the kind ordinarily 
furnished in physician offices to be a free-standing facility unless we 
determined it to have provider-based status.
    We proposed to require, in paragraph (c), that a main provider that 
acquires a facility or organization for which it wishes to claim 
provider-based status must report its acquisition of the facility or 
organization to us if the facility or organization is off the campus of 
the main provider, or is located on the campus of the main provider 
and, if acquired, would increase the main provider's costs by 5 percent 
or more. The main provider must also furnish all information needed for 
a determination as to whether the facility or organization meets the 
criteria in this section for provider-based status. A main provider 
that has had one or more facilities or organizations determined to have 
provider-based status also must report to us any material change in the 
relationship between it and any department or provider-based entity, 
such as a change in ownership of the entity or entry into a new or 
different management contract, that could affect the provider-based 
status of the department or entity.
    In paragraph (d), we proposed the requirements for a determination 
of provider-based status. In paragraph (d)(1), we proposed to set forth 
licensure requirements for facilities or organizations seeking 
provider-based status.
    In paragraph (d)(2), we proposed to require that a facility or 
organization be

[[Page 18505]]

under the ownership and control of the main provider.
    In paragraph (d)(3), with respect to administration and direct 
supervision of the main provider, we proposed to require that a 
facility or organization seeking provider-based status have a reporting 
relationship to the main provider that is characterized by the same 
frequency, intensity, and level of accountability that exists in the 
relationship between the main provider and one of its departments.
    In paragraph (d)(4), we proposed that a facility or organization 
seeking provider-based status and the main provider share integrated 
clinical services, as evidenced by privileging of the professional 
staff of the department or entity at the main provider, and the main 
provider's maintenance of the same monitoring and oversight of the 
department or entity as of other departments. Also, the medical 
director of the department or entity would be required to maintain a 
day-to-day reporting relationship with the chief medical officer (or 
equivalent) of the main provider, and be under the same supervision as 
any other director of the main provider.
    In paragraph (d)(5), we proposed to require that the department or 
entity and the main provider be fully financially integrated within the 
main provider's financial system, as evidenced by the sharing of income 
and expenses. The department's or entity's costs should be reported in 
a cost center of the provider, and the department's or entity's 
financial status should be incorporated into, and readily identifiable 
in, the main provider's trial balance.
    In paragraph (d)(6), we proposed to require that the main provider 
and the facility seeking status as a department of the provider be held 
out to the public as a single entity, so that when patients enter the 
department they are aware that they are entering the provider and will 
be billed accordingly. (This requirement would not apply to a provider-
based entity that is itself a provider, such as a SNF.)
    In paragraph (d)(7), we proposed to require that the department of 
a provider or provider-based entity and the main provider be located on 
the same campus, except where requirements relating to service to the 
same patient population are met.
    Paragraph (e) would specifically prohibit the approval of provider-
based status for any proposed department or entity that is owned by two 
or more providers engaged in a joint venture.
    In proposed paragraph (f), we proposed to state that facilities or 
organizations operated under management contracts would be considered 
provider-based only if specific requirements are met related to: Staff 
employment, administrative functions, day-to-day control of operations, 
and holding of the management contract by the provider itself rather 
than by a parent organization.
    In proposed paragraph (g), we proposed to specify nine obligations 
of hospital outpatient departments and hospital-based entities. We 
explained that these obligations ensure that facilities seeking 
recognition as hospital outpatient departments or hospital-based 
entities are in fact what they represent themselves to be, and are not 
simply the private offices of individual physicians or of physicians in 
group practices.
    We also proposed to preclude any facility or organization that 
furnishes all services under arrangements from qualifying as provider-
based. We believe the provision of services under arrangement was 
intended to be allowed only to a limited extent, in situations where 
cost-effectiveness or clinical considerations, or both, necessitate the 
provision of services by someone other than the provider's own staff. 
The ``under arrangement'' provision in section 1861(w)(1) of the Act 
and Sec. 409.3 is not intended to allow a facility merely to act as a 
billing agent for another.
    Proposed paragraph (h) states that, if we learn of a provider that 
has inappropriately treated a facility or organization as provider-
based, before obtaining our determination of provider-based status, we 
would reconsider all payments to that main provider for those periods 
subject to reopening, and we would investigate to determine whether the 
designation was appropriate.
    In proposed paragraph (i), we would apply the principles in 
paragraph (h) to situations involving inappropriate billing for 
services furnished in a physician's office or other facility or 
organization as if they had been furnished in a hospital outpatient or 
other department of a provider or in a provider-based entity.
    We also proposed to add a new paragraph (j) that would allow us to 
review past determinations. If we find that a designation was in error, 
and the facility or organization in question does not meet the 
requirements of this section, we will notify the main provider that the 
provider-based status will cease as of the first day of the next cost 
report period following notification of the redetermination.
    In addition, we proposed to add to Sec. 413.24(d) new paragraphs 
(6)(i) and (6)(ii) to clarify that main providers, in completing their 
Medicare cost reports, may not allocate overhead costs to the provider-
based or other cost centers that incur similar costs directly through 
management contracts or other arrangements. These changes are needed to 
prevent misallocation of management costs, which would result in 
excessive payment to those types of providers paid on a reasonable cost 
basis.
    To provide an administrative appeals process for entities that have 
been denied provider-based status, we proposed to revise the 
regulations on provider appeals at Sec. 498.3. As revised, these rules 
would specify that a provider seeking a determination that a facility 
or an organization is a department of the provider or a provider-based 
entity under proposed Sec. 413.65 would be included in the definition 
of ``prospective provider'' for purposes of part 498, and would be 
afforded the same appeal rights as a prospective provider, such as a 
hospital or SNF, that we have found not to qualify for participation as 
a provider.

C. Comments and Responses

    In response to our proposals, we received approximately 120 letters 
of comment, most of which raised a number of issues. Included among the 
commenters were hospitals and hospital and other provider associations, 
physicians, attorneys, and other individuals. Here we respond to 
comments submitted on the proposed rule.

General Comments

    Many comments were not directed to a specific provision or 
criterion, but concerned the implementation of the regulations or the 
application of provider-based criteria to specific types of facilities. 
These are summarized below.

Effective Date

    Comment: A commenter requested clarification as to when the parts 
of the final rule setting forth criteria for provider-based status 
would be effective, and a number of commenters requested an extended 
grace period or a delay in effective date of the final rules, with some 
commenters requesting delays as long as 12 to 18 months. Various 
reasons were cited, including the pressures on providers to prepare 
their systems and staff for the outpatient PPS, the need to bring 
operations into compliance with the provider-based criteria, and the 
anticipated workloads of HCFA regional offices that may

[[Page 18506]]

receive a large number of requests for provider-based determinations. 
Commenters argued that it is unrealistic to expect that a hospital 
would engage in a full-blown analysis of its provider-based 
arrangements and modify each arrangement until it knows against which 
exact criteria it is measuring those arrangements. Any changes in 
status will require hospitals to implement billing and other 
operational changes. Thus, commenters argued that it is not reasonable 
to expect hospitals to complete such steps within a 30-day period.
    Response: We agree, and are providing a delay in the effective date 
until October 10, 2000. Moreover, as stated in our response to comments 
on proposed Sec. 413.65(j) below, any redetermination of provider-based 
status that finds the facility or organization not to be provider-based 
will not take effect for at least 6 months after the date the provider 
is notified of the redetermination.

Application to Specific Facilities

    Comment: One commenter stated that under the Balanced Budget Act of 
1997 (the BBA 1997) long-term hospitals established on or before 
September 30, 1995 are entitled to retain their long-term hospital 
classification notwithstanding their location in the same building or 
campus of another hospital. In the commenter's view, these hospitals 
should not now have this classification revoked by this proposed 
regulation.
    Response: The provision referred to by the commenter, section 
4417(a) of the BBA 1997, is codified in section 1886(d)(1)(B) of the 
Act and is implemented under regulations at Sec. 412.22(f). That 
provision authorizes certain hospitals to continue being excluded from 
the Medicare hospital inpatient prospective payment system (PPS) based 
on their exclusion status and configuration on or before September 30, 
1995, even though they would not otherwise qualify for this exclusion. 
The criteria for provider-based status do not conflict with or even 
directly relate to the section 4417(a) provision, and we have therefore 
not made any change in the regulations based on this comment.
    Comment: The commenter believes that rural health clinics (RHCs) 
should be exempted from provider-based designation requirements if they 
meet the intent of the enabling regulation. The commenter requested 
that an RHC be granted provider-based status if it meets one of the 
following criteria: Is the sole source of primary care for the 
community; has traditionally served the community with an open door 
policy; or treats a disproportionate share of the community's Medicare 
and Medicaid population.
    Response: We share the commenter's concern, but believe the 
criteria suggested are overly inclusive and could lead to a 
proliferation of RHCs in areas where there are no true shortages of 
care. While we do not believe a blanket exemption from the criteria is 
warranted, we have developed a special provision for RHCs affiliated 
with small rural hospitals, as described below in our responses to 
comments on Sec. 415.65(d)(7), Location in immediate vicinity.
    Comment: A commenter stated that there may be instances where the 
Medicare regulations related to provider-based definitions conflict 
with the Medicaid provider-based regulations, and asked whether 
Medicaid will be required to comply with the new Medicare provider-
based regulations.
    Response: Because hospitals under Medicaid are required to meet the 
same standards as Medicare facilities, these final rules would affect 
the Medicaid definition of these facilities as well as the Medicare 
definitions.
    Comment: Commenters stated that the reasons cited for establishing 
provider-based requirements that are found in the preamble do not apply 
to clinical laboratories and thus these requirements should not apply. 
The commenters asked that we explicitly state in the final regulations 
that the provider-based requirements are not applicable to clinical 
laboratories. They believe the regulations have little bearing where, 
as with clinical laboratory services, reimbursement is under a fee 
schedule amount, and neither the Medicare program nor the beneficiary 
will pay anyone differently as a result of the treatment of the 
laboratory in the manner proposed.
    Response: As explained more fully in the preamble to the proposed 
rule, our objective in issuing specific criteria for provider-based 
status is to ensure that higher levels of Medicare payment and 
increases in beneficiary liability for deductibles or coinsurance 
(which can all be associated with provider-based status) are limited to 
situations where the facility or organization is clearly and 
unequivocally an integral and subordinate part of a provider. Under 
this principle, we agree with the commenter's view that it would not be 
either necessary or appropriate to make provider-based determinations 
with respect to facilities or organizations if by law their status 
(that is, provider-based or free-standing) would not affect either 
Medicare payment levels or beneficiary liability. However, we believe 
that it is not necessary to specify in the regulations that specific 
facility types are excluded, since these facilities or organizations 
are unlikely to seek a provider-based determination. We will be careful 
to clarify this policy in program operating instructions.
    Comment: A commenter stated that the proposed provider-based 
requirements seem to preclude the possibility of a Comprehensive 
Outpatient Rehabilitation Facility (CORF) meeting these new 
requirements. The commenter believes that in the past, CORFs have been 
permitted to be either provider-based or free-standing and asked 
whether the final rules will give CORFs the option of being either 
free-standing or provider-based.
    Response: As explained more fully in the preamble to the proposed 
rule, our objective in issuing specific criteria for provider-based 
status is to ensure that higher levels of Medicare payment and 
increases in beneficiary liability for deductibles or coinsurance 
(which can all be associated with provider-based status) are limited to 
situations where the facility or organization is clearly and 
unequivocally an integral and subordinate part of a provider. We are 
aware that, under the cost-based payment system that applied to CORFs 
prior to January 1, 1999, approximately 17 percent of participating 
CORFs claimed provider-based status. However, effective January 1, 
1999, in accordance with the BBA 1997, payment for all CORF services is 
made no longer on the basis of cost reimbursement but on the basis of 
the physician fee schedule. Beneficiary liability is also determined 
under the fee schedule, regardless of the organizational structure or 
affiliations of the CORF. The switch to fee schedule payment from a 
cost-based system eliminates or removes any payment incentives to be a 
provider-based rather than a free-standing CORF. Thus, as in the case 
of the preceding comment, we agree with the commenter's view that it 
would not be either necessary or appropriate to make provider-based 
determinations with respect to facilities or organizations if by law 
their status (that is, provider-based or free-standing) would not 
affect either Medicare payment levels or beneficiary liability. We also 
note that existing regulations at Sec. 413.174 specify rules for 
determining whether ESRD facilities are independent or hospital-based, 
and we have revised Sec. 413.65(a) to state that determinations with 
respect to ESRD facilities will continue to be made under Sec. 413.174,

[[Page 18507]]

not Sec. 413.65. However, we believe that it is not necessary to 
specify in the regulations that most specific facility types are 
excluded, since these facilities or organizations are unlikely to seek 
a provider-based determination. We will be careful to clarify this 
policy in program operating instructions.

Application to Specific Facilities--Indian Health Service (IHS)

    Comment: Several commenters requested an exception or exemption 
from the rules for IHS and tribal facilities. One commenter was 
concerned that the implementation of these proposed regulations will 
have the effect of denying Medicare participation as provider-based 
entities to a number of IHS facilities that are currently operated by 
Indian tribes under the auspices of Public Law 93-638. They will also 
cause a disruption of the coordinated health care delivery system(s) 
that exist between IHS and numerous tribes, and jeopardize statutorily 
authorized contracting and compacting relationships between the IHS and 
these tribes due to the conflict between these proposed regulations and 
the statutory opportunities for self-determination by the Indian 
tribes. The IHS strongly recommended that these proposed regulations 
not apply to IHS and tribal health systems as written. Recommendations 
were also made to deem satellite facilities within a discrete Indian 
reservation as meeting the definition of a provider-based entity as 
well as satellite facilities within a historical service unit. Finally, 
the IHS recommended that the current system be ``grandfathered'' to 
meet the definition of provider-based entity.
    Response: We share many of these concerns and have provided special 
treatment for IHS and tribal facilities as described below.
    Comment: A commenter was concerned that the proposed regulations 
would severely restrict a number of IHS satellite clinics from 
receiving reimbursement for the provision of Medicare Part B services. 
The commenter believes that a number of the requirements that must be 
met before an entity can be designated as provider-based for Medicare 
payment purposes are unrealistic for IHS satellite clinics, which are 
often the only Medicare providers on remote tribal lands. The commenter 
recommended that HCFA provide for an exemption for IHS satellite 
facilities that are generally located on a main hospital campus or 
within a short distance of a hospital. Also, the commenter recommended 
that the final rule clarify that IHS and tribal outpatient departments 
or satellite clinics are eligible to receive designation as a 
department of a provider or a provider-based entity and are eligible 
for Part B reimbursement.
    Response: We share many of these concerns and have provided special 
treatment for IHS and tribal facilities as described below.
    Comment: Many tribes have acquired operations of outpatient 
facilities and are in the process of acquiring the affiliated 
hospitals. The commenter stated that this trend, coupled with the 
complexities of the Indian Self-Determination Act (Pub. L. 93-638), the 
Indian Health Care Improvement Act (Pub. L. 94-437), and a moratorium 
on tribal compacting and contracting, requires special consideration by 
HCFA. The commenter requested that facilities be recognized as 
provider-based if--
    (1) The outpatient facility is owned and operated by the tribe that 
owns the majority of the tribal shares utilized in funding the main 
hospital;
    (2) The tribe has previously compacted programs that were 
historically administered by the hospital and are now administered 
through a committee or board comprised of medical staff of both 
facilities;
    (3) The outpatient facility is in the same State as the hospital;
    (4) There is coordination and integration of services, to the 
extent practicable, between the outpatient facility seeking provider-
based status and the main provider.
    Response: We recognize that the provision of health services to 
members of Federally recognized Tribes is based on a special and 
legally recognized relationship between Indian tribes and the United 
States Government. To address this relationship, the IHS has developed 
an integrated system to provide care that has its foundation in IHS 
hospitals. Because of these special circumstances, not present in the 
case of private, non-Federal facilities and organizations that serve 
patients generally, we agree that it would not be appropriate to apply 
the provider-based criteria to IHS facilities or organizations or to 
most tribal facilities or organizations. Therefore, we have revised the 
final rule to state that facilities and organizations operated by the 
IHS or Tribes will be considered to be departments of hospitals 
operated by the Indian Health Service or Tribes if, on or before April 
7, 2000, they furnished only services that were billed as if they had 
been furnished by a department of a hospital operated by the Indian 
Health Service or a Tribe and they are: (1) owned and operated by the 
IHS; (2) owned by the Tribe but leased from the Tribe by the IHS under 
the Indian Self-Determination Act in accordance with applicable 
regulations and policies of the Indian Health Service in consultation 
with Tribes: or (3) owned by the IHS but leased and operated by the 
Tribe under the Indian Self-Determination Act in accordance with 
applicable regulations and policies of the Indian Health Service in 
consultation with Tribes. Facilities or organizations that are neither 
leased nor owned by the IHS would not be eligible for this special 
treatment, even if operated on Tribal land by members of the Tribe. 
These facilities would, of course, be eligible to participate in 
Medicare as FQHCs if applicable requirements in our regulations at 42 
CFR part 405, subpart X are met. We did not adopt the conditions 
recommended by one commenter because we believe they may not apply to 
all Tribes.

Application to Specific Facilities--Federally Qualified Health Centers 
(FQHCs)

    Comment: A commenter stated that despite specific acknowledgment of 
the eligibility of FQHCs to qualify as provider-based entities, certain 
proposed ownership, governance, and supervision criteria in connection 
with the determination of provider-based status would effectively 
prohibit entities from maintaining concurrent provider-based and FQHC 
designations. The commenter believe the criteria should be modified, or 
some other special provision created, to allow FQHCs to be departments 
of a provider.
    Response: We understand the commenter's concerns and have provided 
special treatment for FQHCs as described below.
    Comment: The commenter, a hospital that is affiliated with a number 
of off-site community health centers, believes the criteria in the 
proposed rule would deny provider-based status to community controlled, 
urban tax-exempt health centers operated under the license of a ``main 
provider.'' Several of the commenter's health centers are FQHCs that 
must fulfill certain criteria to maintain this status. In the 
commenter's view, it is not feasible to require the ``main provider'' 
to own and control these health centers or to require that the health 
centers and the ``main provider'' strictly meet all of the requirements 
set forth in the proposed rule. The commenter asked that the final rule 
be revised to take into account these historical relationships and 
``grandfather'' the provider-based status of health centers that have 
been on the license of a disproportionate share hospital for at least 
10 years. The recommended ``grandfathering''

[[Page 18508]]

provisions also could, in the commenter's view, require common Joint 
Commission on Accreditation of Healthcare Organizations (JCAHO) 
accreditation, integration of clinical care committees, main provider 
approval of clinical guidelines and protocols, and financial oversight 
and review by the main provider.
    Response: We share many of these concerns and have provided special 
treatment for FQHCs as described below.
    Comment: A commenter requested that we provide a transition period 
of at least five years for health centers that have been treated as 
provider-based entities for a significant period of time (for example, 
10 years or more), so that the centers will have adequate time to 
achieve compliance with the provider-based criteria. In the commenter's 
view, an extended time period for compliance would permit continuity of 
care to the populations served by the health centers while granting the 
affected health centers an opportunity to find alternative funding 
streams.
    Response: We recognize that FQHC qualification criteria effectively 
require these facilities to be governed by community-based boards 
independent of hospitals and other providers, while our provider-based 
criteria require facilities seeking provider-based status to be 
operated under the ownership and control of the main provider, and to 
be under the direct supervision of that provider. This does not 
preclude an FQHC from participating in Medicare as a free-standing 
entity; on the contrary, this participation is entirely appropriate. 
However, it does preclude the facility from qualifying as a department 
of a hospital or other provider under our criteria.
    Despite the difference between HRSA and HCFA requirements, we are 
aware that some FQHCs may have been treated by hospitals as departments 
for purposes of Medicare and Medicaid billing, and we are concerned 
that an abrupt change in status for them could force some or all to 
close, leading to shortages of care in some areas. Therefore, we plan 
to establish special provisions for FQHCs and FQHC ``look-alikes'' 
(facilities that are structured like FQHCs and meet all requirements 
for grant funding, but have not actually received these grants). 
Specifically, we have revised the regulations to state that if a 
facility has since April 7, 1995 furnished only services that were 
billed as if they had been furnished by a department of a provider and 
either (1) received a grant before 1995 under section 330 of the Public 
Health Service Act or, before 1995, received funding from such a grant 
under a contract with the recipient of such a grant and meets the 
requirements to receive a grant under section 330 of the Public Health 
Service Act; or (2) based on the recommendation of the PHS, was 
determined by HCFA before 1995 to meet the requirements for receiving 
such a grant, the facility will continue to be treated, for purposes of 
this section, as a department of the provider without regard to whether 
it complies with the criteria for provider-based status in Sec. 413.65. 
We note that both types of facilities would be obligated, for as long 
as they are treated as a department of a provider, to comply with the 
applicable requirements for departments of providers as stated in 
Sec. 413.65(g).

Application of Standards

    Comment: One commenter believes that the proposed rule did not make 
clear how it would apply to existing entities, because some language in 
the rule could be read to require that existing entities would not 
receive provider-based status until we have issued a determination 
letter. Another commenter requested that we clarify whether we expect 
to review all clinics prospectively or just new clinics. The commenter 
stated that requirements that only new clinics seek designation does 
not preclude us from auditing currently designated clinics. Another 
commenter asked if there will be a set time frame during which current 
providers with provider-based departments or entities under Program 
Memorandum A-96-7 must contact us and receive an official designation 
in order to continue billing as they currently do. More specifically, 
the commenter asked whether, if there is such a time frame, compliance 
with the criteria in the Program Memorandum would constitute a good 
faith effort as referred to in Sec. 413.65(i)(2). Additional guidance 
was also requested as to what providers should do now to demonstrate 
that they have made a good faith effort.
    Response: We plan to review all new requests for provider-based 
status. At present, we have no plans to systematically review all 
providers to determine whether they may be claiming provider-based 
status for some facilities or organizations inappropriately. However, 
we will review the status of specific facilities or organizations in 
response to complaints or any other credible information that indicates 
that provider-based status requirements are not being met. If the 
regional office determines that this is the case, it will take action 
in accordance with the rules in new Sec. 413.65(h) and (i). In response 
to the comment about possible retroactive application of the new 
regulations, we note that they will apply only on or after their 
effective date of October 10, 2000. We will not apply the provider-
based criteria in the new regulations to periods prior to that date; on 
the contrary, decisions for such periods will be reviewed only under 
the criteria in effect at the time, as stated in Program Memoranda and 
the Provider Reimbursement Manual and State Operations Manual.
    Comment: Two commenters pointed out the proposed rules do not state 
whether the required approval status is retroactive to when the 
provider applied or to when we granted approval. These commenters 
believe it should be retroactive to the date of the provider's 
application for the determination.
    Response: We plan to make provider-based status applicable as of 
the earliest date on which a request for provider-based status has been 
made and all requirements for provider-based status are shown to have 
been met, not on the date of our determination. Thus, if a provider 
requests provider-based status for a facility on May 1 and demonstrates 
that applicable criteria were met on that date, but the regional office 
did not make a formal determination until June 1, the determination 
would be effective on May 1.
    Comment: The commenter stated that we should not have published 
important provider-based policies in a Federal Register document that 
some providers, such as skilled nursing facilities and home health 
agencies, may not have read. The commenter recommended that we re-issue 
these proposed rules separately from the proposed hospital outpatient 
prospective payment rules.
    Response: We do not agree that the proposed rules were published in 
an obscure location. On the contrary, the number of written comments 
received, many of them from providers other than hospitals, indicates 
that our proposals were widely known among providers that could be 
affected. Therefore, we do not intend to republish the proposed rules.
    Comment: A commenter expressed concern that these provider-based 
provisions are unnecessarily restrictive and will unreasonably limit 
practice arrangements. The commenter went on to state that in the 
current health care environment, physicians and hospitals need 
flexibility to adapt to local market conditions and participate in a 
variety of practice arrangements to provide cost effective, high 
quality care. An unnecessary strict definition of

[[Page 18509]]

``provider-based entity'' could have a chilling effect on the evolution 
of new care delivery structures that would expand access to care, 
especially in rural areas.
    Response: We share the commenter's concern with preserving Medicare 
beneficiaries' access to care, but do not agree that the provider-based 
rules will limit access. We note that the rules do not prohibit 
hospitals from purchasing physician practices or taking other actions 
to enhance access to care in remote rural areas; they only set minimum 
standards for the type of affiliations that will be recognized for 
provider-based designation.
    For example, an institutional provider such as a hospital or SNF 
may elect to use part of its institutional complex to house physician 
offices or other facilities that provide services complementing those 
of the provider. Those facilities'costs will have to be included in the 
trial balance of the institutional complex, in order to allow costs to 
be allocated accurately to all parts of the complex, and permit the 
costs of the provider to be determined. However, inclusion of such 
facilities' costs on the institutional complex trial balance does not 
make the facilities provider-based. On the contrary such facilities 
would have to meet the criteria in Sec. 413.65 to qualify for provider-
based status.
    Comment: Different views were expressed on how much
    discretion regional offices should have in applying the provider-
based criteria. One commenter asked that we make the rules as clear and 
concise as possible. The commenter argued that rules allowing for great 
latitude in interpretation could be dangerous for the provider 
community. On the other hand, another commenter stated that we should 
allow Medicare regional offices greater latitude for determining when 
sufficient integration exists for a facility to qualify as provider-
based, and should avoid adopting regulations that ``micro-manage'' a 
hospital's operations. Another commenter suggested that rather than 
requiring that all criteria must be met to achieve provider-based 
status, we change the test to substantially all. There may be 
circumstances where criteria are not fully met, but an overall 
assessment supports a provider-based determination. This same commenter 
recommended that a ``pending'' status be incorporated into the 
evaluation process, whereby hospitals not meeting the criteria for 
provider-based status would be afforded an opportunity to make the 
modifications necessary. Another commenter asked that instead of 
meeting all criteria, we permit the regional offices to evaluate a 
facility's status with respect to the main provider with input from 
local government and the fiscal intermediary. Another commenter also 
suggested that the standards only be enforced to the extent that they 
are applicable and relevant, consistent with state laws, and relate to 
practices that are subject to the control of the particular provider.
    Response: We have tried to balance the need to apply standards that 
can be adapted to fit particular circumstances, and agree that the 
standards should not be overly prescriptive, but rely on regional 
judgment to ensure appropriate decision making. Because provider-based 
status is a matter of extreme importance to many facilities, published 
standards provide a basis for advance assessment and planning of 
particular organizational and financial arrangements. Therefore, we 
have decided that a facility or organization will be found to be 
provider-based only when it is in compliance with all standards set 
forth in these final rules.
    With respect to the comment regarding situations in which all but a 
few criteria for provider-based status are met, we note that nothing 
prohibits the main provider from re-applying for approval of provider-
based status for a facility or organization after having made the 
changes necessary to come into compliance. Regional offices would in 
such cases only need to verify compliance with whatever criteria had 
not been previously met, unless the amount of time that elapses between 
requests, or other factors, make a full re-evaluation necessary. 
Because facilities have this flexibility under the rules as proposed, 
we did not make any changes based on this comment.
    Comment: One commenter believes that we had not fully addressed the 
impact of these rules on service delivery. The commenter suggested that 
changes would affect deemed status, survey and certification 
requirements, state licensure requirements, physician referral 
requirements, and a host of related issues. Another commenter stated 
that the new requirement regarding administration and supervision found 
in Sec. 413.65(d)(3) could impact more than our estimated 105 
providers. The commenter believes that if providers are required to 
convert management firm employees to hospital employees and then revert 
back when outpatient PPS becomes effective, this could impact 5,000 
inpatient PPS hospitals.
    Response: We again reviewed our requirements, but do not believe 
they will have the far-reaching effects envisioned by these commenters. 
In particular, to the extent a facility or organization that claims to 
be a department of a provider must be accredited, surveyed, or licensed 
as a part of that provider, or must adapt to the physician referral 
requirements of the main provider, that result does not flow from the 
existence of criteria for provider-based status, but instead is a 
direct result of the provider's decision to claim the facility or 
entity as a department. We also do not think it is reasonable to assume 
that any significant number of hospitals will restructure themselves 
repeatedly because of the final rules set forth below. As noted 
earlier, both the proposed and final rules closely parallel policies 
that have been stated explicitly on program instructions since 1996, 
and we are providing a 6-month delay in effective date for the final 
rule. Thus, hospitals and other providers have had ample time to assess 
the impact of any changes and to make necessary adjustments in an 
orderly way.
    Comment: A commenter requested clarification as to how the proposed 
rules would apply to two hospitals seeking consolidation into a single 
provider. The commenter also asked whether two small PPS hospitals 
located approximately 15 to 25 miles apart in separate towns within a 
metropolitan statistical area (MSA) who wish to consolidate would be 
prohibited from doing so because of patient population or licensure 
requirements. Furthermore, if these two hospitals are already certified 
as a single provider, would the proposed rules require them to separate 
and create separate providers? Another commenter requested that the 
final regulatory text state that the provider-based requirements do not 
apply to any facility where there are inpatient beds since such a 
facility would be viewed as a ``main provider.'' The provider-based 
requirements should apply only to facilities or organizations other 
than main providers.
    Response: Although the Program Memorandum and proposed rules were 
issued in response to situations primarily involving outpatient 
facilities, we believe the policies set forth in these documents are 
equally applicable to inpatient facilities, and should be applied in 
the many cases in which a determination about inpatient facilities must 
be made. The rules would not prohibit two previously separate hospitals 
from merging to become a single provider. However, for either facility 
to be considered provider-based with respect to the main provider, the 
facility would have to meet the criteria

[[Page 18510]]

in this final rule. To clarify the scope of application of these 
regulations, we have added a definition of ``remote location of a 
hospital'' and a reference to hospital satellite facilities to 
Sec. 413.65(a) Definitions, and have clarified the wording of several 
later sections by including references to remote locations and 
satellites. We have defined a ``remote location of a hospital'' as a 
facility or an organization that is either created by, or acquired by, 
a hospital that is a main provider for the purpose of furnishing 
inpatient hospital services under the name, ownership, and financial 
and administrative control of the main provider, in accordance with the 
provisions of this section. A remote location of a hospital may not be 
licensed to provide inpatient hospital services in its own right, and 
Medicare conditions of participation do not apply to a department as an 
independent entity. The term ``remote location of a hospital'' does not 
include a satellite facility as defined in Sec. 412.22(h)(1) and 
Sec. 412.25(e)(1). Hospitals may acquire remote locations by various 
means, but often do so by mergers or acquisitions, in which a single 
hospital purchases other, previously separate hospitals, and operates 
them as remote locations that are not separately organized as 
departments, but instead furnish the same types of services as the 
original hospital. For example, a long-term care or other specialty 
hospital might acquire one or more other hospitals, terminate their 
separate participation in Medicare, but continue to use them as sites 
of the same type of care as the original hospital. Satellite facilities 
are currently defined in our regulations at Sec. 412.22(h)(1) (for 
hospitals) and Sec. 412.25(e)(1) (for units). In general, a satellite 
facility is a part of a hospital (or of a hospital unit) that provides 
services in a building also used by another hospital, or in one or more 
buildings on the same campus as buildings also used by another 
hospital. Satellite status always involves co-location with another 
hospital, while remote locations are not co-located with other 
hospitals' facilities.
    Comment: A commenter requested clarification that the provider-
based requirements apply only to providers who are paid under the 
reasonable cost methodology. The preamble language in section VI 
implies that these requirements would also apply to providers under the 
outpatient PPS. The commenter believe that if this were the case, the 
requirements found in Secs. 413.24(d)(6) and 413.65 would be 
appropriately placed in Subchapter E (for example, Part 482, Conditions 
of Participation for Hospitals).
    Response: The rules set forth below are not limited in their scope 
to providers paid on a reasonable cost basis but, except where 
specifically stated in the text of the rules, apply to all providers 
and facilities seeking Medicare payment. While many of the problems 
associated with inappropriate accordance of provider-based status 
relate to cost reimbursement, the different payment systems used for 
various providers may produce some unintended incentives for one type 
of facility to gain an unfair payment advantage by misrepresenting 
itself. The specific requirements cited do not, like the Medicare 
conditions of participation, implement section 1861(e) of the Act, nor 
do they primarily concern patient health and safety. Therefore, we did 
not adopt the suggestion that the section be relocated to part 482.
    Comment: A commenter would support a provision that prohibits 
hospitals from acquiring free-standing physician practices and 
converting them to hospital-based entities.
    Response: We understand the commenter's concern, but do not have 
authority under the Medicare law to prohibit this practice. We do 
believe that the rules set forth below will keep hospitals from 
misrepresenting physicians' practices as hospital outpatient 
departments.

Section 413.24(d)(6)  Adequate cost data and cost finding: Management 
contracts

    Comment: The proposed cost reporting requirements state that if an 
overhead administrative cost center does not perform services for the 
off-site clinic or department, no costs should be allocated to that 
function. The commenter pointed out that this contradicts generally 
established Medicare cost reporting principles that have always 
required that the administrative costs be allocated to allowed and 
nonallowed cost centers.
    Response: Our position, as expressed in the Provider Reimbursement 
Manual, Part II, Chapter 36 for hospitals, is to allow the provider to 
bypass the allocation of overhead through the cost report to avoid 
inappropriate allocations. An example of this would be lab services 
under arrangement, where there is obviously no administrative activity 
by the main provider. Our electronic cost report systems are set up to 
``skip'' that particular cost center and to re-allocate the costs to 
the remaining cost centers. Likewise, where administrative costs such 
as billing are performed by the subordinate provider, no billing cost 
from the main provider should be allocated to that cost center from the 
main provider.
    Comment: Several commenters suggested clarification of ``like'' 
costs by adding a definition or providing examples. Also, a commenter 
stated that since the main concern is costs, this provision should be 
applied when management costs exceed the hospital's operating costs of 
the department by 10 percent on a comparable basis. Another commenter 
stated that: (1) Management services benefit only the specific 
department to which they are expensed, and provide no direct services 
to other hospital departments; (2) A department under the management 
contract receives necessary services from other hospital overhead 
departments; (3) such overhead departments do not represent duplicate 
services provided under the management contract. Since management 
agreements can be drastically diverse, the commenter believes this 
clarification would assist in avoiding any confusion, as well as allow 
for consistency with generally accepted cost finding principles. 
Another commenter stated that most entities that contract to manage an 
area of a hospital manage just that area. Therefore, if they offer 
assistance with a particular function, it is only for that area and not 
for the whole hospital. The commenter believes the same principles of 
reimbursement should be applied whether the hospital provides the 
service directly or contracts for the service to be provided.
    Response: Examples of similar costs when management contracts 
provide services also available through the main provider are the 
following: billing services, computer services, accounting services, 
and, possibly, general administrative staff. When the same services are 
included in the administrative and general costs of the main provider, 
and allocated down to subordinate cost centers or providers incurring 
and reporting these same costs in the trial balance, the result is a 
duplication of costs to the subordinate cost center or provider. As 
long as the main provider has the ability to identify these ``like'' 
service costs, these costs should be re-allocated to the remaining 
reimbursable and non-reimbursable cost centers in proportion to each 
cost center's total costs as prescribed in the Provider Reimbursement 
Manual, Part II, Chapter 36. However, if the main provider is not able 
to identify the costs of these same services to permit the exclusion of 
allocation to the subordinate providers or cost centers,

[[Page 18511]]

the cost of the management contract of the subordinate provider or cost 
center must be reclassified to the main provider's administrative and 
general cost center, and allocated down to all reimbursable and non-
reimbursable cost centers in proportion to each cost center's total 
cost.
    Comment: With regard to the language in paragraph (d)(6)(ii), 
Medicare principles of reimbursement require that, when two entities 
are related, and one contracts from the other, reimbursement for these 
services is at cost due to the ``related party principle.'' The 
commenter stated that the cost of a service is both direct and 
indirect; Medicare reimbursement has a longstanding methodology 
concerning nonrevenue producing costs and their allocation on a 
provider's cost report. A separate work paper should not be required. 
The appropriate methodology for stepping down administrative costs 
should be based on the cost of the entity utilizing the service. The 
cost of the free-standing entity must be placed on the main provider's 
cost report to step down cost appropriately. Additional work papers 
would allow room for error and would delay any necessary adjustments.
    Response: The intent of Sec. 413.24(d)(6)(ii) was to require the 
main provider to report costs of related party entities that would not 
be reported through their accounting system on the main provider's 
books and records, for example, trial balance. Consequently, when there 
is a sharing of administrative services, for example, managerial staff, 
the related entity escapes any administrative overhead allocation when 
that same related entity is not reported on the main provider's trial 
balance of the cost report. While the commenter is correct regarding 
the proper reporting of related transactions at cost of the related 
entity, this regulation section goes further to require the main 
provider to develop the total cost of the related entity, utilizing and 
maintaining workpapers to justify the amount to be reported, and to 
report those costs by the main provider on the cost report trial 
balance.

Section 413.65(a) Definitions (retitled in this final rule as Section 
413.65(a) Scope and definitions)

    Comment: Two commenters requested that a definition be provided for 
``a provider's campus.'' A definition would be important since the 
proposed regulation specifies additional requirements for off-campus 
locations.
    Response: We agree that location on or off a hospital's campus is 
important. To provide a clear standard, we have revised the final rule 
to define ``campus'' as ``the physical area immediately adjacent to the 
provider's main buildings, other areas and structures that are not 
strictly contiguous to the main buildings but are located within 250 
yards of the main buildings, and any other areas determined on an 
individual case basis, by our regional office, to be part of the 
provider's campus.'' This definition would encompass not only 
institutions that are located in self-contained, well-defined settings, 
but other locations, such as in central city areas, where there may be 
a group of buildings that function as a campus but are not strictly 
contiguous and may even be crossed by public streets. This would also 
allow the regional offices to determine, on a case-by-case basis, what 
comprises a hospital's campus. We believe allowing regional office 
discretion to make these determinations will allow us to take a 
flexible and realistic approach to the many physical configurations 
that hospitals and other providers can adopt.
    Comment: The commenter expressed concern regarding the definition 
of provider-based facilities as many hospital-owned outpatient services 
are often provided with leased employees with ambulatory care 
experience. It is not clear that such an arrangement would satisfy the 
intent of the regulation.
    Response: The regulations do not explicitly prohibit the use of 
leased employees, and each situation will be evaluated relative to the 
criteria in the regulations set forth below.
    Comment: One commenter stated that the difference between 
``department of a provider'' and ``provider-based entity'' is not clear 
from the definitions given of those terms. The commenter requested that 
we clarify in the regulations text whether a provider-based entity must 
be certified in its own right, and what type of certification this 
encompasses. The commenter also requested clarification in the 
regulations text concerning whether the term ``provider'' in the 
definition is intended to mean only entities that satisfy the Medicare 
definition of ``provider'' contained in Sec. 400.202.
    Response: We have clarified Sec. 413.65(a) to state that a 
``department of a provider'' is a facility or organization that could 
not by itself be qualified to participate in Medicare as a provider 
under Sec. 489.2, while a ``provider-based entity'' could be so 
qualified. For example, a skilled nursing facility (SNF) could be a 
``provider-based entity,'' whereas an entity that furnishes ambulatory 
surgical services could not be a provider-based entity, and could 
participate in Medicare (for example, receive Medicare payment for 
services furnished to beneficiaries), only as a department of a 
provider, as a physician office, or as an ambulatory surgical center 
approved by Medicare under part 416, if at all. We have further revised 
the final rule to clarify that a department of a provider furnishes 
services of the same type as the main provider (for example, a 
department of a hospital furnishes hospital services), while a 
provider-based entity furnishes services of a different type from those 
of the main provider (for example, a hospital-based RHC furnishes RHC 
services, not hospital services).
    Comment: A commenter believes the proposed rule should be revised 
for medically underserved populations and health manpower shortage 
areas to allow the referral of beneficiaries back to their community 
for treatment of community-based therapy providers. Therapy services 
provided under such a referral would be included under the provider-
based designation.
    Response: We do not oppose use of such referrals where they are 
medically appropriate, but believe that referral arrangements should 
not be equated to provider-based status.
    Comment: A commenter questioned the requirement that services be 
furnished ``under the name'' of the main provider entity. The commenter 
argued that the requirement is inconsistent with the commenter's view 
that health care in the late 1990s is, and in many markets must be, 
``marketed'' in a highly competitive environment. The commenter's view 
is that having provider-based status turn on the names used will 
inevitably invite micro-management of the way the main provider's name 
is used by the department or other hospital-based entity.
    Response: We disagree with any suggestion that health care is 
merely a generic commodity that can be repackaged under another name 
for marketing purposes. On the contrary, we believe that operating 
under the name of the main provider, and holding oneself forward to 
patients under that name, is an important indicator of status as an 
integral and subordinate part of that provider. Therefore, we did not 
make any changes in the regulation based on this comment.

Section 413.65(b)  Responsibility for obtaining provider-based 
determinations 

    Comment: A commenter stated that the proposed rule does not state 
clearly enough whether our approval is required in order to permit 
billing each

[[Page 18512]]

time a provider sets up a new service, regardless of whether the 
service is acquired, managed, new, located on the main campus, or off 
the main campus. Some commenters stated that if approval is required in 
all instances, it will cause a significant paperwork backlog and will 
be quite costly to administer.
    Response: Section 413.65(b) states explicitly that a determination 
by us that a facility or organization is provider-based is required 
before the main provider may treat the facility or organization as 
provider-based for billing or cost reporting purposes. We recognize 
that this may generate some administrative cost, but believe the cost 
will be much less than the amounts that would be spent improperly if 
payment were made to a free-standing facility as if it were provider-
based.
    Comment: A commenter urged that the new determination process be 
applied to all current as well as new hospital-based services.
    Response: We have no plans at present to review all hospitals and 
other providers with respect to provider-based criteria, but will look 
into any situations that come to our attention in which it appears that 
a facility does not meet the requirements of the new regulations but is 
being treated as provider-based. If the facility or organization does 
not qualify as provider-based, action will be taken as described later 
in this preamble and in Sec. 413.65(i).
    Comment: A commenter stated that there should be some mechanism in 
place for a long-term hospital (LTH) to seek an advance determination 
or advisory ruling that a proposed LTH satellite will be granted 
provider-based status. Because establishing an LTH requires a huge 
expenditure of time and human resources, an LTH main provider needs to 
know in advance whether or not its proposed satellite will receive a 
favorable provider-based determination. It is suggested that we 
institute a system by which advance rulings or determinations are 
available before the satellite is established.
    Response: We understand the commenter's concern, but do not have 
the staff or facilities to provide advance approvals of restructuring 
proposals. We suggest that providers review the new criteria carefully 
and avoid forms of organization that are not clearly in compliance with 
them.
    Comment: Two commenters suggested that we provide guidance on the 
application process providers must complete in order to receive a 
provider-based determination. In addition, time limits for approval of 
these determinations should be established. Furthermore, existing 
provider-based entities should not be required to change their billing 
and accounting procedures. A commenter also asked for clarification as 
to whether the intermediary and regional office is to be the contact, 
and who will make the actual determination of provider-based status.
    Response: We are developing an application process and intend to 
have it in place and ready for use before the effective date of the 
regulation. We expect that determinations of provider-based status will 
be made by our regional offices. Involvement by other entities, such as 
fiscal intermediaries or State survey agencies, will be for 
information-gathering purposes and under the direction of the regional 
office.
    Comment: A commenter suggested that if a determination goes against 
the provider, the provider should be given the option to come into 
compliance with the requirements or file an appeal.
    Response: As noted earlier, the regulations do not prohibit a 
provider that meets most but not all criteria from taking action to 
fully meet the criteria, thus qualifying a facility or organization for 
provider-based status. In the case of a provider that believes that the 
determination of the regional office is incorrect, an appeals process 
is provided under part 498.
    Comment: A commenter stated that the requirement in paragraph 
(b)(3) establishes an adverse presumption against provider status for 
``off-campus'' physician practice sites, and that the focus on 
``campus'' boundaries will prove elusive, and serve no real policy 
purpose.
    Response: As explained later, we believe location in the immediate 
vicinity is an important indicator of provider-based status, and that 
location can be a good basis for identifying facilities for further 
scrutiny.

Section 413.65(c)  Reporting

    Comment: Several commenters pointed out that the regulatory 
language does not reflect the preamble language regarding off-campus 
entities and the five percent increase in a provider's costs.
    Response: We have revised the final rule to correct this oversight.
    Comment: One commenter asked whether this language applies only to 
entities that are applying for provider-based status, or also applies 
to entities that have already achieved provider-based status.
    Response: The requirement applies to both types of providers, but 
providers that have entities with provider-based status are required to 
report only newly created or acquired facilities or organizations.
    Comment: Two commenters stated that the five percent and off-campus 
criteria with regard to provider-based status do not take into account 
the characteristics of rural and frontier areas, and could lead to 
lower payments to some facilities, thus reducing the flow of Federal 
money into rural areas and possibly creating a shortage of care. In 
addition, considering the small budget of RHCs and other rural 
facilities, 5 percent is an inappropriately low and unreasonable growth 
limit.
    Response: We understand the commenter's concern but do not agree 
that a 5 percent threshold for reporting is too low. Therefore, we made 
no change based on this comment.
    Comment: A commenter asked whether this reporting requirement also 
applies to all newly developed services (that is, department on the 
campus of the hospital).
    Response: The requirement applies to all newly developed on-campus 
services that could increase the costs of the provider by 5 percent or 
more.
    Comment: A commenter requested clarification that a main provider 
that ``creates'' as well as ``acquires'' a facility or organization is 
responsible for reporting to us. The commenter also suggested specific 
items to be included in the reporting and approval process. These 
include specific data elements to be reported by the main provider, 
specifying our component with primary responsibility; specifying our 
approval process; adding a preliminary conditional approval process; 
adding a specific time period for our approval; and adding requirements 
for the effective date that the costs of the provider-based entity can 
be included on the main provider's cost report.
    Response: We have revised the regulation to clarify that it applies 
to facilities or organizations created by the main provider, as well as 
those ongoing operations acquired by purchase or other means. We have 
not included the procedural detail requested by the commenter in 
regulations, but will consider including it in program instructions.
    Comment: A commenter stated that the use of the phrase ``any 
material change'' in paragraph (c)(2) of this section is too vague and 
open to interpretation. It is suggested that the section be revised to 
clearly designate changes of ownership and new management agreements as 
the only two material changes that require reporting by provider-based 
entities.

[[Page 18513]]

    Response: We do not agree that the range of reportable events 
should be limited in this way. On the contrary, we intend to require 
reporting of any change that could have a significant (``material'') 
effect on compliance with the provider-based criteria.
    Comment: A commenter asked if the reporting requirements are 
coordinated with the notification of change of ownership requirements 
at Sec. 489.18(b), where notice is to be given in advance, and whether 
there should be a cross reference or clarification with respect to the 
change in ownership regulation and this proposed regulation.
    Response: We believe this suggestion has merit, and will consider 
revising our program instructions to specify that a report under 
Sec. 489.18(b) should be reviewed for its applicability to provider-
based determinations.

Section 413.65(d)  Requirements

    Comment: A commenter suggested that we clarify whether all 
requirements, or only a majority of the requirements, must be met to 
obtain provider-based status.
    Response: We have revised the first sentence of paragraph (d) to 
state that all of the stated requirements must be met by a facility or 
organization that wishes to be classified as provider-based.

Section 413.65(d)(1)  Licensure

    Comment: Many commenters objected to the requirement that provider-
based facilities share a common license with the main provider unless 
the State requires separate licensure for the subordinate facility. One 
commenter listed several reasons for this concern. First, in the 
commenter's opinion, licensure determinations may be made based on 
factors that are different from those that would be important for 
provider-based determinations. Another reason cited by the commenter is 
that State licensure laws may vary from State to State. Some State 
hospital licensure definitions are building specific, and do not 
include off-site outpatient facilities, thus giving what the commenter 
argues is undue weight to physical location in evaluating provider-
based status. Finally, the commenter believes that requiring common 
licensure will create a situation where some States may have a large 
number of provider-based entities and others will have few or none, 
thus leading to inconsistent application of our rules. One commenter 
recommended that the same licensure requirement be waived for States 
with idiosyncratic licensure requirements. An alternative would be 
accreditation with the provider as a deemed status for meeting a common 
license requirement. The commenter suggested that the proposed language 
could be reworded to clarify that offsite clinics would not have to be 
licensed or operated under the same license as the provider in those 
States that do not license them.
    Response: We recognize that licensure may not be an appropriate 
indicator of provider-based status in all States, and have therefore 
revised the regulations to require common licensure only in States with 
laws that permit common licensure of the provider and the prospective 
provider-based department under a single license. This means that in 
States that do not allow licensure of certain types of facilities, such 
as those providing ambulatory care or those located off the provider's 
main campus, the licensure criterion would not be applied. We do not 
agree that JCAHO or other accreditation should be accepted in lieu of 
licensure, since such accreditation may not necessarily reflect an on-
site evaluation of the prospective provider-based department. In 
recognition of the fact that some hospitals are not licensed by the 
State because they are Indian Health Service (Federal) hospitals or are 
located on Tribal lands, we also will not apply the licensure 
requirement to departments of those hospitals.
    Comment: Under paragraph (d)(1) as proposed, clinics in another 
State from the main provider could not be under the hospital's license. 
Several commenters argued that this requirement would arbitrarily 
affect rural and urban health care delivery, where the main provider is 
close to a State line. A commenter recommended that close proximity be 
used instead, where a hospital-based clinic is in another State from 
the main provider. For urban hospitals in large metropolitan 
statistical areas that cross State boundaries, the commenter believes 
that the market area of the main provider should be the primary 
determinant of the potential for integration with the main provider.
    Response: Under the regulations as revised based on the comments 
summarized above, common licensure would not be required of facilities 
located across State lines if the law of the State in which the main 
provider is located does not allow such licensing. However, see the 
discussion, later in this preamble, of Sec. 413.65(d)(7)(ii).
    Comment: A commenter pointed out that the proposed rule appears to 
limit the licensure requirement to ``departments'' of the main 
provider. The commenter asked whether this requirement only applied to 
``provider-based entities.'' The commenter also suggested that where a 
State has two licensure schemes for the same type of facility, we 
should not prefer one licensure scheme over the other for purposes of 
determining the provider-based status of the facility.
    Response: The commenter is correct in noting that the common 
licensure requirement in the proposed rule would have applied only to 
provider-based departments. We did not propose to apply a common 
licensure requirement to provider-based entities such as SNFs and HHAs, 
because they are providers of services in their own right, and 
typically would be separately licensed without regard to their 
affiliation with the provider. We disagree with the commenter's view 
that licensure should not be viewed as an indicator of integration. On 
the contrary, our view is that if a facility could be licensed as part 
of a main provider but chooses not to be, the facility cannot 
reasonably be seen as an integral and subordinate part of that 
provider.
    Comment: With regard to the proposed requirement that states that 
our determination regarding provider-based status will be based on a 
State health facilities' review commission, one commenter argued that 
relying on the commission's criteria for purposes of making provider-
based determinations is arbitrary and inappropriate. The commenter 
believes imposing this criterion could disadvantage providers and 
discourage expansion to off-site locations, thus indirectly leading to 
shortages of care. Another commenter requested that there be a delay in 
implementation during which time changes can be made to the 
commission's definition of what rates it can regulate.
    Response: We continue to believe it would be inappropriate for a 
facility to claim to be separate from the provider for State rate-
setting purposes while also claiming to be an integral and subordinate 
part of the provider for Medicare purposes. To allow this practice 
would authorize providers to misrepresent their structures and 
affiliations in whatever way will yield the highest payment. Thus, we 
did not make changes to reflect the comment.

Section 413.65(d)(2) Operation under the ownership and control of the 
main provider

    Comment: Regarding Sec. 413.65(d)(2), the commenter suggested that 
the regulations provide a separate set of criteria that would allow a 
provider that is operated within one legal entity to be provider-based 
to a provider that is operated within another legal entity, as long as 
the two entities are under common control. Another commenter

[[Page 18514]]

stated that this ownership and control requirement is unnecessarily 
rigid, since a hospital-based clinic, which was strictly an 
administrative division of the hospital, might qualify while another 
similar clinic, wholly owned by the hospital with slightly different 
governing bodies and documents, would not be eligible.
    Response: We do not agree that common control of two separate 
entities by the same parent organization should be sufficient to meet a 
requirement for ownership and control by the main provider. While this 
arrangement may be an appropriate way to manage two separate entities, 
it does not establish provider-based status for either. With respect to 
the second comment, we agree that the form of administration of an 
entity can determine whether or not the entity is found to be provider-
based. We believe this would be an appropriate result, since it would 
help ensure that only facilities that are organized as provider-based 
entities or departments of a provider are given this status.
    Comment: One commenter believes it is unrealistic to require a 
potential provider-based facility or organization to be owned by the 
main provider and share bylaws and an identical governing body. The 
commenter stated that in the present business climate an entity can 
operate as a provider-based entity without meeting these criteria. It 
is recommended that we replace the proposed 100 percent ownership 
standard with a majority standard, require only overlapping governing 
bodies, and eliminate the requirement for organization under the same 
organizational documents. Another commenter believes that the key 
consideration should be whether the provider is in control of the day-
to-day operations of that portion of the facility in which the provider 
seeks provider-based status, and not necessarily whether the building 
is 100 percent owned by the provider. The commenter believes we should 
rephrase this provision to require that the operations of that portion 
of the facility or organization in which the provider is seeking 
provider-based status be controlled by the provider.
    Response: In response to the first comment, we recognize that many 
organizations enter into business relationships that involve 
overlapping of ownership, governance, and applicability of bylaws. 
However, this degree of collaboration does not mean that one facility 
is an integral and subordinate part of another. Therefore, we made no 
change based on this comment. Regarding the second comment, we wish to 
clarify that it is ownership of the business enterprise, not of the 
buildings or other physical assets of the enterprise, that is required 
under paragraph (b)(1). We have therefore revised the regulation text 
to refer to ownership of the business enterprise.
    Comment: A commenter stated that the requirements contained in 
paragraph (d)(2) would preclude entities that are jointly owned through 
legitimate joint ventures or those separately organized subordinate 
facilities from qualifying for provider-based status. Additionally, to 
require the level of integration suggested by our proposed rule would 
prevent providers from establishing efficient systems of delegation and 
management, solely to qualify for provider-based status.
    Response: We agree that this criterion would have the stated 
effect. As explained further in our discussion of comments on proposed 
Sec. 413.65(e), facilities operated jointly by two or more providers 
cannot appropriately be considered integral and subordinate parts of 
either provider. With respect to the second comment, we do not oppose 
systems of operation that stress separate, decentralized operation 
where this leads to greater efficiency. However, we believe such 
facilities or organizations should be recognized as the separate 
enterprises that they are, not considered integral and subordinate 
parts of another institution.
    Comment: A commenter suggested that the requirement under paragraph 
(d)(2) be modified for medically underserved populations and health 
manpower shortage areas.
    Response: We are also concerned that our criteria not limit access 
to care for any vulnerable populations and have, to avoid this 
potential problem, created special provisions for FQHCs and IHS and 
tribal facilities. As described later in this preamble, we have also 
created an exception to the location requirements in paragraph (d)(7), 
which is designed to help avoid restricting access to primary care 
furnished by RHCs in remote, underserved areas. In view of these 
provisions, we do not believe it is necessary to also modify our 
requirement relating to ownership of the facility or organization.
    Comment: A commenter stated that the proposed requirements in 
paragraph (d)(2) are inherently inconsistent with section 330 of the 
Public Health Service Act statutory and regulatory requirements and the 
Bureau of Primary Health Care expectations necessary to obtain and 
maintain section 330 funding (and FQHC status). The commenter believes 
HCFA should not require FQHCs to be 100 percent owned by the main 
provider or share a common governing body and common bylaws with the 
main provider. The commenter also suggested that we accept appropriate 
reporting relationships and satisfaction of other criteria (for 
example, licensure, quality assurance, integration of certain 
administrative and clinical functions, such as billing, purchasing, 
retention of medical records, quality assurance and utilization review 
procedures; and public awareness of the relationship between the health 
center and the main provider) as a sufficient basis for provider-based 
status.
    Response: As described earlier, we have provided a special 
transition period for FQHCs. We believe this period will be adequate to 
avoid the problems envisioned in this comment.

Section 413.65(d)(3) Administration and supervision

    Comment: A commenter recommended that the daily reporting 
relationship stated in Sec. 413.65(d)(3) should be replaced with the 
standard of having the reporting relationships have the same intensity 
as on-site departments. The commenter stated that in practice at the 
hospital, there may be very little day-to-day contact between medical 
directors of various hospital services. Also, the commenter believes it 
is unlikely that departmental directors report directly to the chief 
executive officer, but rather to a chief operating officer or other 
designee. Finally, the commenter argued that under the common 
governance requirement, while all hospital employees are theoretically 
accountable to the governing body, the accountability may be directed 
through the CEO, and multiple executives may not have an independent 
reporting with the board. Another commenter also believes that the 
standards for the provider-based entity should mirror those of the main 
facility; personnel reporting structure needs to be respected within 
the regulations. Still another commenter found ``intensity'' to be a 
subjective standard and asked how it will be measured.
    Response: We agree that reporting need not be daily in all cases, 
and have revised the final rule to state that the reporting 
relationship between the facility or organization seeking provider-
based status and the main provider must have the same frequency, 
intensity, and level of accountability that exists in the relationship 
between the main provider and one of its departments. We agree with the 
commenter that the intensity of supervision will have to be assessed on 
a case-by-case basis, but do not believe

[[Page 18515]]

this will lead to imprecise or poorly reasoned decisions.
    Comment: Several commenters believe that this requirement limits 
the flexibility of the entity to operate efficiently and effectively in 
the current environment, since hospitals frequently turn to many 
specialized management companies to operate more efficiently and 
effectively than with hospital resources. Another commenter stated that 
whether the administrative department utilizes employees at one 
location and contracts at another location should be irrelevant as long 
as the function is integrated with the main provider, follows the 
policies and procedures of the main provider, and is accountable to the 
governing body of the main provider as is any other department. Still 
another disagreed, and believes that it may be appropriate to require 
that the main provider manage such contracts.
    Response: We do not agree that the provision unreasonably limits 
hospital flexibility. Paragraph (3)(iii)(B) explicitly allows different 
management contracts to be used for the facility or organization and 
the main provider, as long as the provider manages the contracts. Thus, 
we did not make any changes in the proposal based on these comments.
    Comment: A commenter asked whether the administrative functions 
listed in paragraph (d)(3)(iii) are the only services that must be 
integrated between the main provider and the subordinate facility.
    Response: The commenter was correct in understanding that the 
functions listed are the only administrative functions that must be 
integrated. There are also requirements for integration of certain 
financial functions, as described below.
    Comment: One commenter posed several questions concerning this 
proposed requirement. First, in a certain situation, the facility fee 
is billed to the intermediary by the hospital billing department using 
the provider number, while the professional fee is billed to the Part B 
carrier by the faculty practice billing organization under its 
physician group number. The commenter asked if the different provider 
number and tax identification impact on the provider-based status, and 
if there is a more appropriate way to obtain billing numbers for 
hospital-based clinics. Also, the commenter asked if clinic space can 
be shared by two clinics, when one is provider-based and one is free-
standing, without impacting the provider-based status of the first 
clinic.
    Response: In the circumstances described, the use of separate 
billing and tax identification numbers for provider and physician 
services would not adversely affect a facility's request for provider-
based status, since such billings are required under Medicare to be 
separate in the case of services in hospitals. The question regarding 
sharing of space, however, can be answered only in the context of a 
specific case, and we expect that such decisions will be made by our 
regional offices.
    Comment: With respect to the oversight of contracts under paragraph 
(3)(B)(iii)(B), several commenters stated that it is common for 
hospitals to subcontract out the billing for different departments, 
especially the hospital outpatient department, due to the complexity 
and number of claims. These commenters stated that while it may be 
appropriate to require the main provider to manage such contracts, 
departments other than the billing department should be permitted to 
perform this management function. One commenter suggested revising the 
criterion on billing under the integration of administrative functions 
to state, ``common billing or the contract for billing services is held 
by the provider where it is based.''
    Response: We agree that departments other than the main provider's 
billing department may appropriately manage billing contracts, and have 
revised the criterion to state that the contract for a provider-based 
facility or organization must be managed by the main provider.

Section 413.65(d)(4) Clinical services

    Comment: A commenter asked for clarification of paragraph (4)(iv) 
of this section, specifically concerning whether this language would 
require a Medicare certified HHA's improvement activities to be 
overseen by hospital medical staff, rather than the advisory committee 
as is now being done. The commenter believes that having the hospital 
medical staff overseeing the quality assurance activities of a HHA may 
not be appropriate or cost effective and may even slow the process of 
performance changes.
    Response: The commenter is correct in understanding that compliance 
with this criterion would require oversight of a hospital-based HHA's 
quality improvement activities by the hospital's medical staff. We do 
not agree with the commenter that the outcome would be to substitute 
the judgment of the hospital for the HHA's own committee or that it 
would be inappropriate. The hospital conditions of participation 
contain a number of separate requirements that must be read together to 
make complete sense of this provision. Conditions spelled out at 
Sec. 482.12 (Governing body), Sec. 482.21 (Quality assurance), and 
Sec. 482.22 (Medical staff) establish a chain of accountability in a 
hospital for the quality of care it provides. The requirements are 
clearly applicable to any activity (for example, provider-based entity) 
that is an integral part of the hospital. Thus, a quality improvement 
activity of the HHA is likely to be firmly grounded in the hospital's 
operating and governance fabric even when the group is ``established'' 
by the HHA, and staffed by employees and physicians who work primarily 
in home health. We would expect the linkages to be formal (that is, 
known to the governing bodies and medical staffs of both providers), 
and the quality assurance mechanisms interrelated to the extent that 
shared patients are the subject of the effort.
    Comment: Regarding paragraph (d)(4)(v) of this provision, some 
commenters requested clarification of what is meant by a ``unified 
retrieval system,'' or for guidance as to what types of cross 
referencing are acceptable. Another commenter asked for an explanation 
of the practical expectations regarding the maintenance of medical 
records. Finally, a commenter expressed support for the requirement for 
a unified retrieval system (or cross references), saying the latter 
system would be used in States that mandate a unified system.
    Response: We would like to clarify that what is intended is that a 
system be maintained under which both the potential provider-based 
entity or department of a provider and the main provider have access to 
the beneficiary's record, so that practitioners in either location can 
obtain relevant medical information about care in the other setting. We 
did not, however, make any changes in the requirement based on these 
comments.
    Comment: A commenter believes that functions of operations should 
not be regulated to dissuade cost efficiency, and that laundry and 
housekeeping would be examples where shared services may not be the 
most effective manner of operation.
    Response: We agree that in some cases it may be less expensive for 
a facility to obtain services independently, but continue to believe 
such separateness is an indicator that the facility is not an integral 
and subordinate part of a provider.
    Comment: With regard to paragraph (d)(4)(vi) requiring integration 
of services of the main and provider-based entity, the commenter 
expressed concern about the potential impact of

[[Page 18516]]

this section on a patient's freedom of choice. The commenter believes 
that the entity's efforts to meet this standard would limit a patient's 
freedom of choice. The commenter suggested that we clarify our position 
so that providers acting in good faith will not be sanctioned for 
attempting to comply with this requirement.
    Response: Paragraph (d)(4)(vi) requires only that patients have 
access to the services of the main provider and that they be referred 
to it where the referral is appropriate. We wish to clarify that these 
criteria are not intended to restrict patient freedom of choice or the 
practitioner's freedom to refer patients to other locations, where 
doing so will result in better care for the patient.

Section 413.65(d)(5)  Financial integration

    Comment: A commenter believes that Sec. 413.65(d)(5), which 
requires full integration of financial operations, is too rigid. An 
alternative approach is suggested that would allow managers of 
provider-based entities to retain some control over both the resources 
and information required to administer these units.
    Response: Section 413.65(d)(5) requires that there be financial 
integration of the potential provider-based facility or organization 
and the main provider, but does not preclude normal management control 
of resources. Thus, we made no change in the regulation based on this 
comment.
    Comment: A commenter stated that the criteria for common resource 
usage of building, equipment, and service personnel is not even 
relevant for multi-campus systems or even buildings that are across the 
street from each other, much less off-site hospital outpatient 
departments.
    Response: Although the provider-based program memoranda required 
that there be significant common resource usage of buildings, 
equipment, and service personnel on a daily basis, this requirement 
does not appear in the proposed rule. Thus, we made no change in the 
regulation based on this comment.
    Comment: One commenter stated that the requirement for financial 
integration seems unnecessary in light of the requirement for 100 
percent ownership by the main provider. The commenter stated that some 
providers may wish to segregate the operations of certain departments 
in their financial systems, and expressed the view that as long as the 
costs of a department can be adequately identified on the cost report, 
the practice should be acceptable.
    Response: We do not believe that these two requirements are 
duplicative. On the contrary, in some cases a provider may own 100 
percent of another facility or organization, but not be financially 
integrated with it, either because the other facility or organization 
is engaged in a different, non-health care activity, or because it is 
organized and operated separately from the main provider. In these 
circumstances, we believe the criteria on financial integration apply 
appropriately to deny provider-based status to separate facilities or 
organizations.

Section 413.65(d)(6)  Public awareness

    Comment: Section 413.65(d)(6) requires that provider-based entities 
be identified as part of the main provider organization. The commenter 
did not understand the importance of this criterion, particularly when 
the provider-based organization is licensed and Medicare certified 
separately from the main provider.
    Response: The proposed rule would not apply this criterion to 
provider-based entities (which may participate separately as 
providers), but only to provider-based departments. In the latter case, 
we think it is not unreasonable for such a department to be expected to 
identify itself with the provider of which it claims to be a part.

Section 413.65(d)(7)  Location in immediate vicinity

    Comment: A commenter stated that if off-site RHCs cannot be 
considered provider-based, it will be much harder to deliver care in 
rural areas. The commenter asked that RHCs be allowed to continue as 
provider-based RHCs even though they are off campus.
    Response: We continue to believe close physical proximity is an 
important indicator of provider-based status. We note, however, that 
paragraph (d)(7) does allow off-campus facilities to be treated as 
provider-based if they meet the criterion relating to service to the 
same patient population.
    Comment: Many commenters believe that more specific tests of 
service to the same patient population are needed. One commenter 
suggested that an appropriate criterion would be that the proposed 
provider-based facility or organization be located within the same 
geographic area that accounts for a high percentage of patients in the 
main provider. The commenter believes this test is consistent with 
Program Memorandum No. 96-7 and with the qualification requirements for 
sole community hospitals. Other commenters suggested that the main 
provider's geographical service area be considered the area from which 
the main provider drew 80 percent of its Medicare inpatients for the 
previous three years.
    Response: We agree that more precise criteria are needed. 
Therefore, we have revised the regulations to provide that a 
prospective provider-based facility or organization will be considered 
to serve the same patient population as the main provider if, during 
the 12-month period immediately preceding the first day of the month in 
which the application for provider-based status is filed with us, at 
least 75 percent of the patients served by the facility or organization 
seeking provider-based status reside in the same zip code areas as at 
least 75 percent of the patients served by the main provider. As an 
alternative, we would consider a facility or organization to serve the 
same patient population if, during the same 12-month period described 
above, at least 75 percent of the patients served by the prospective 
provider-based facility or organization who required the type of care 
furnished by the main provider received that care from the main 
provider. We require this ``same patient population'' test to be met 
for the 12-month period used to support an initial determination of 
provider-based status, and it must continue to be met for each 
subsequent 12-month period to justify a continuation of provider-based 
status. Application of population/geographic standards to newly 
established facilities or organizations is discussed below.
    Comment: Commenters suggested we show some flexibility with regard 
to the definition of patient population for teaching hospitals. The 
commenter stated that it will not always be the case that the patient 
populations for the teaching program will be the same as the overall 
mix or patient population for the main provider.
    Response: We recognize that patient populations will not be 
identical in all cases, and thus have adopted a patient population 
criterion under which there may be a divergence of up to 25 percent 
between the main provider and the facility or organization seeking 
provider-based status. We believe this provides a reasonable allowance 
for differences in patient population. Moreover, we note that under 
section 1886 of the Act, Medicare provides much flexibility for 
teaching hospitals in other ways, for example, under section 
1886(h)(4)(E), permitting the counting of residents for purposes of 
payment to teaching hospitals for the time the residents spend in 
nonhospital settings.

[[Page 18517]]

    Comment: Two commenters suggested that the criterion on service to 
the same patient population be dropped. One commenter believes the 
criterion is overly vague, could limit access to care as facilities 
seek to control their service patterns, and, in general, represents a 
geographically based approach that is out of keeping with modern 
technology and communications. Another commenter stated that the 
criterion is unclear, and providers could find it burdensome to 
assemble the data to show compliance. Other commenters shared the 
second commenter's concern, but instead of recommending elimination of 
the criterion, they suggested that a more administrable solution would 
be to use regional or state standards to define ``same geographic 
area,'' such as, health systems area, a specified mileage amount, or 
our wage area.
    Response: As described above, we have developed a more precisely 
stated test of service to the same patient population. We believe that 
test will be clear and understandable, not impose unrealistic burdens 
on providers, and allow provider-based designations that parallel 
service patterns.
    Comment: With respect to paragraph (d)(7)(i), a commenter asserted 
that many currently operating facilities that are treated as provider-
based by us provide types of service that are the same as those of the 
main provider, but serve patient populations from different geographic 
areas. The commenter believes these entities provide care under the 
direction of, and utilize substantial services from, the main provider. 
An example would be the geographically separate campuses of a single 
parent hospital that are located at various sites throughout a region. 
The commenter suggested that such campuses be presumed to be provider-
based if they provide substantially the same services as the main 
provider, do not exceed the size of the main provider, and comply with 
all other provider-based requirements. Another commenter stated that 
the ``same patient population'' requirement should not apply to multi-
campus long term care hospital locations. These locations are 
fundamentally different from other provider-based entities that the 
regulation addresses, since a long-term care hospital main provider and 
its remote campus furnish the same services, and offer the same 
programs of care, but operate in slightly different geographic areas. 
The commenter suggested that so long as all of the strict financial and 
administrative integration requirements of the proposed provider-based 
regulation are satisfied, the ``same patient population'' requirements 
should not apply to long-term care hospitals. The result of this 
criterion would be that satellites will not be established in many 
underserved areas where long term services are needed. Another 
commenter believes a specialty facility, such as a long-term care 
hospital, should be exempt from the geographic proximity requirement if 
it can demonstrate that it will improve the quality of patient care, 
and offer services that are not otherwise provided in that area.
    Response: We recognize that there may be some cases in which a 
hospital and another facility seeking provider-based status as a remote 
location of that hospital may meet most or all other criteria in 
Sec. 413.65, yet not qualify because the two facilities serve different 
patient populations. However, we do not agree that this result should 
lead us to abandon the ``same patient population'' test. On the 
contrary, we continue to believe that criterion is a valid indicator of 
provider-based status. Thus, we did not revise the regulation based on 
this comment. In this context, we note that there is no Medicare rule 
that would prohibit a hospital from setting up another hospital in 
another area. We do not agree with the commenter's assumption that 
because the program memorandum and proposed rule were issued in 
response to situations primarily involving outpatient facilities, they 
can apply only to such facilities. On the contrary, we believe the 
policies set forth in these documents are equally applicable to 
inpatient facilities, and should be applied in the many cases in which 
a determination about inpatient facilities must be made. In particular, 
the rules apply to remote locations of long-term care and other 
hospitals that are main providers, as well as to satellite facilities 
of hospitals and hospital units that are excluded from the hospital 
inpatient prospective payment system. Remote locations and satellite 
facilities are discussed more fully earlier in this preamble, and 
``satellite facilities'' are specifically described in our regulations 
in Secs. 412.22(h) and 412.25(e). (As explained in that document, we 
are concerned that establishment of satellites by hospitals and units 
excluded from the inpatient PPS could lead to payment abuses, such as 
circumvention of certain payment caps mandated by section 4414 of the 
Balanced Budget Act of 1997, and we have therefore established special 
payment rules for those facilities. Facilities seeking to qualify as 
``satellites'' under the inpatient payment criteria in Secs. 412.22(h) 
and 412.25(e) would first need to comply with the provider-based 
requirements before being eligible for satellite status.) We have 
revised the final rule to clarify its application to remote locations 
of hospitals and satellite facilities.
    Comment: The commenter believes that flexibility in the definition 
of ``located in the immediate vicinity'' needs to be met with 
additional considerations when viewing rural and underserved areas; for 
example, it should not be our intention to eliminate the provider-based 
designation of a rural health clinic (RHC), when the purpose of the RHC 
is to be an outreach to geographically isolated areas.
    Response: We share the commenter's concern and have developed a 
special provision for RHCs, as described below.
    Comment: A commenter believes that the requirement that provider-
based entities serve the same population as the main provider could 
cause significant problems for RHCs. The unique situations addressed by 
hospital-based RHCs attempting to satisfy the health care needs of 
medically underserved areas should be considered as exceptions to the 
proposed rule.
    Response: We continue to believe close physical proximity is an 
important indicator of provider-based status; however, we recognize 
that small rural hospitals and their RHCs may not be able to 
demonstrate that a substantial number of clinic patients receive 
services from the main provider. Small rural hospitals typically 
provide limited inpatient care compared to their urban counterparts, 
which may cause the RHC patients to seek inpatient service from other 
providers. In light of this, we believe small rural hospitals (less 
than 50 beds) that own and operate RHCs should not be expected to 
demonstrate that they serve the same patient population as the main 
provider. Therefore, we are revising the regulation to allow off-campus 
RHCs affiliated with small rural hospitals (less than 50 beds) to 
retain their provider-based status without satisfying that requirement.
    Comment: Several commenters opposed the inclusion of paragraph 
(d)(7)(ii), since they view a State border as an arbitrary boundary 
inhibiting a hospital's ability to serve patients, which seems 
counterproductive. They also argued that a regulation that fails to 
recognize the operation of health care systems that function across 
State lines is unrealistic. Another commenter suggested that we rely on 
the proposal concerning serving the same patient population. It was 
also stated that in one case a provider can be located in a city

[[Page 18518]]

split by the State border with its related facility located one mile 
away, but in another state, while in another case, the provider and its 
subordinate facility can be a mile apart and in the same State. Another 
commenter believes that, since Medicare beneficiaries often cross 
borders for health care services, disallowing hospitals in these areas 
from establishing provider-based entities eliminates choices and 
prohibits the development of new services. The commenter recommended 
that we revise or eliminate this criterion. Another commenter suggested 
that LTHs and their satellites not be subject to this requirement if 
the main provider and its satellite are located in two contiguous 
States. Alternatively, the commenter suggested that we consider using 
the wage index areas as guidelines for the areas to be served by 
provider-based entities even if that area crosses State lines.
    Response: After reviewing these comments, we have decided to revise 
the regulations to allow providers in one State to have provider-based 
facilities in an adjacent State, if doing so is not inconsistent with 
the law of either State, and other criteria are met, including those 
related to service to the same patient population.
    Comment: With regard to paragraph (d)(7)(i), while the proposed 
rule permits a provider to show that a ``high percentage'' of patients 
of the main provider and the facility come from the same geographic 
region, new facilities would not have any historical data upon which to 
base this assertion, and therefore would fail to be able to demonstrate 
the criteria prior to operation. Another commenter believes the 
requirement may pose an impediment to new facilities being located in 
underserved or outlying areas. Thus, the commenters believe the same 
patient population requirement should not apply to new facilities, 
including new long-term care hospital satellites.
    Response: We agree that it would be appropriate to establish a 
criterion that could be met by new facilities or organizations, and 
therefore have revised the final rule to include a special provision 
for new facilities or organizations. Under this revision, a new 
facility or organization, (one that has not been in operation for all 
of the 12-month period immediately preceding the first day of the month 
in which the application for provider-based status is filed with us), 
may be considered to meet the criterion on service to the same patient 
population, if it is located in a zip code area included among those 
that (during the 12-month period described above) accounted for at 
least 75 percent of the patients served by the main provider. We note 
that this provision would not be limited to long-term care hospitals' 
satellites or their remote locations, but would be available to all new 
facilities or organizations.

Section 413.65(e) Provider-based status not applicable to joint 
ventures

    Comment: Several commenters expressed concern that this criterion 
would prohibit the use of joint ventures for entities that want to 
participate as provider-based entities, and argued that such a 
prohibition would unnecessarily restrict hospital flexibility. One 
believes this provision should be eliminated. Another commenter 
suggested modification of paragraph (d)(2) of the rule to establish 
majority ownership as the standard rather than 100 percent ownership. 
Still other commenters suggested that provider-based status for 
facilities or organizations run as joint ventures should be permitted, 
as long as the hospital at which the facility is located has the 
equipment or service under its control.
    Response: We reviewed these comments carefully, but did not make 
any changes in the regulations based on them. When a facility or 
organization is run as a joint venture of two or more providers, it is 
by definition under their joint control, and therefore cannot be an 
integral and subordinate part of any individual provider. We have no 
interest in discouraging such ventures, but continue to believe they do 
not qualify as provider-based.

Section 413.65(f) Management contracts

    Comment: Several commenters expressed the view that the criterion 
under which the staff of the facility or organization must be employed 
by the provider or another organization other than a management company 
is too restrictive, and should be deleted. One commenter argued that, 
if the written contract maintains the responsibility and control for 
services in the hands of the main provider, the employer of the staff 
working at the site is not relevant. Another believes the criterion 
will discourage economic efficiencies. If a provider is able to 
demonstrate integration and subordination of the off-site facility 
based upon other provider-based criteria, the fact that a hospital 
chooses to provide certain services either directly through its own 
employees or indirectly through an independent contractor/management 
arrangements is irrelevant. Another commenter argued that the proposed 
criterion is inconsistent with: the provision of the Medicare statute 
that expressly permits coverage of ``services under arrangement''; with 
the hospital conditions of participation that recognize that 
contractors may be used to furnish patient care services; and with the 
Provider Reimbursement Manual, which recognizes that providers commonly 
contract for management services and the costs of the contract services 
may be allowed under Medicare principles of reimbursement. Still 
another commenter believes the proposed criterion would negatively 
impact the therapy profession, and could impact the health and safety 
of Medicare beneficiaries.
    Response: We do not believe the criterion is overly restrictive, 
nor do we agree that employment of the staff of a facility or 
organization is irrelevant to the question of whether that facility or 
organization is an integral and subordinate part of a provider. On the 
contrary, employment of the staff of such a facility or organization 
will normally give the provider significant control over it, thus 
promoting integration. Conversely, if a facility or organization is 
staffed by personnel who are employed by another entity that has only a 
contractual relationship with the provider, the facility or 
organization may well be an integral and subordinate part of the 
management company, not of the provider.
    We also do not agree that the criterion is inconsistent with 
section 1861(w)(1) of the Act, which permits providers to make 
arrangements for the provision of specific health services, nor do we 
believe adopting this criterion will undercut the ability of providers 
to have selective services provided under arrangements. In this regard, 
we point out that existing Medicare policy, stated in section 207 of 
the Medicare Hospital Manual (HCFA Publication 10), emphasizes the need 
for the hospital to exercise professional responsibility for the 
arranged-for services, not merely to serve as a billing mechanism for 
the other party. This is consistent with our view that section 
1861(w)(1) was intended to allow specific health care services to be 
furnished under arrangements, but was never meant to be a vehicle by 
which a provider could nominally operate a facility or organization, 
but, in fact, contract out its operation to another entity. Finally, we 
note that while there are various sections of the hospital conditions 
of participation and the Provider Reimbursement Manual that recognize 
the possibility that specialized health care services or management 
services may be provided under contract, this does not indicate that 
providers may

[[Page 18519]]

contract out entire departments or services while claiming them as 
provider-based. To clarify the scope of the requirement on contracted 
services, we have revised it to state that management staff of the 
facility or organization (rather than health care or support staff) 
need not be employed directly by the provider. We have also revised the 
rule to clarify that if staff of the facility or organization (other 
than management staff) are employed by an organization other than the 
management company or the provider, it must be the same organization 
that also employs the staff of the main provider.

Section 413.65(g) Obligations of hospital outpatient departments and 
hospital-based entities

Section 413.65(g)(1)
    Because of the direct relationship between the proposed changes in 
this section and those in Sec. 489.24(b), comments on both proposals 
are discussed later, under Sec. 489.24(b), ``Special responsibilities 
of Medicare hospitals in emergency cases.''
    Comment: A commenter requested clarification as to the application 
of the anti-dumping requirement in the home health setting.
    Response: Section 413.65(g)(1) states that the EMTALA requirements 
apply to hospital outpatient departments. EMTALA requirements would not 
apply to off-campus provider-based entities that are not hospital 
departments, such as home health agencies.
Section 413.65(g)(2)
    Comment: While one commenter agreed with the requirement under 
Sec. 413.65(g)(2) for billing of physician services with the 
appropriate site-of-service indicator, another commenter also believes 
there should be clarification that correct billing is the 
responsibility of the entity performing the billing function. Both 
commenters suggested that the hospital notify physicians who do their 
own billing that they must use the correct indicator; they agree that 
it should not be the responsibility of the hospital.
    Response: We agree that physicians (or those to whom they assign 
their billing privileges) are responsible for appropriate billing, but 
note that physicians who practice in hospitals, including off-site 
hospital departments, do so under privileges granted by the hospital. 
Thus, we believe the hospital has a role in ensuring proper billing.
Section 413.65(g)(5)
    Comment: Presently, provider-based clinics bill Medicare for the 
facility charge on a UB-92 form, and the physician fee is billed 
separately on a HCFA-1500 form, while other payers may accept a single 
bill for both charges. A commenter believes it is inappropriate to 
mandate that two bills be submitted for all patients, as long as 
charges for similar services are uniform regardless of payer.
    Response: As explained further below, we have revised the final 
rule to eliminate the part of this criterion relating to billing of 
services to non-Medicare patients. We believe this responds to this 
commenter's concern.
    Comment: Many commenters stated that Medicare should treat a 
facility that claims a facility fee as being provider-based even when 
other payers do not do so, reasoning that as long as the hospital 
claims that the patient is an outpatient for Medicare purposes, the 
practices of other payers, with respect to similar patients, are not 
significant, and should be ignored. Another commenter believes this 
requirement should be eliminated, because, in the commenter's view, it 
has no bearing on the outpatient services delivered to Medicare 
beneficiaries, and therefore does not affect Medicare reimbursement. To 
illustrate, a large commercial insurer does not have the capability to 
accept certain types of outpatient claims from hospitals; therefore, it 
requires claims for those services to be billed on a physician claim 
form, so hospitals will receive the proper reimbursement. If this 
criteria is retained as proposed, many hospital-based departments would 
not meet our criteria due to the nuances of other payers' policies, 
that are often contractual issues with providers. Still another 
commenter believes that we should reexamine the proposal made in 
paragraph (g)(5), and at a minimum, clarify what it means by its 
proposal mandating uniform ``treatment of all patients, for billing 
purposes, as hospital outpatients.'' If we are proposing to mandate 
that all outpatients be billed on the same basis, this would 
effectively extend Medicare direct billing or rebundling rules to all 
payers. In addition, this proposed requirement would not only be 
contrary to past policy and practice, but would affect departments that 
have differentiated billing practices. Another commenter stated that 
payers typically determine payments based upon how they define a 
particular service or their individual market power; Medicare 
certification of outpatient departments should not be influenced by how 
unrelated third parties pay for services to the patients they cover at 
these sites. Moreover, this criterion would be very difficult to 
implement, because hospitals can have hundreds of contracts with 
insurance companies and the providers that subcontract for part of the 
risk for plans.
    Response: After review of the comments on this section, we have 
decided to revise it to restrict the requirement for uniform billing to 
Medicare patients only, thus allowing hospitals to bill other payers in 
whatever manner is appropriate under those payers' rules. As revised, 
Sec. 413.65(g)(6) states that hospital outpatient departments (other 
than RHCs) must treat all Medicare patients, for billing purposes, as 
hospital outpatients. The department must not treat some Medicare 
patients as hospital outpatients and others as physician office 
patients.
    Comment: A commenter stated that there appears to be some confusion 
as to whether this requirement applies to ``departments'' or all 
facilities and organizations seeking provider-based status. Also, the 
commenter asked if there is a provision of the proposed rule that 
mandates that a facility fee be charged to patients of facilities and 
organizations receiving provider-based status.
    Response: As noted earlier, the proposed rule would not apply this 
criterion to provider-based entities (which may participate separately 
as providers) but only to provider-based departments. Regarding the 
second issue, we have, as described in response to the preceding 
comment, revised the final rule to eliminate the criterion regarding 
billing of payers other than Medicare.
Section 413.65(g)(7)
    Comment: A commenter stated that requiring written notice for each 
patient (presumably signed by the patient), would be an overly 
burdensome requirement, and requested that the requirement allow for a 
clear, prominently displayed sign in lieu of individual notice. Another 
commenter believes that the proposed requirement would apply a standard 
to hospital outpatient departments that is not applied to any other 
site of service.
    Response: First, we emphasize that notice is required only for 
Medicare beneficiaries, not for all patients. We recognize that 
providing notice will generate some burden for the provider, but 
believe that the protection it affords to patients warrants the 
requirement. We considered allowing the notice requirement to be 
satisfied through the posting of signs, as recommended by one 
commenter, but concluded that use of individual written notices would 
more effectively ensure that each

[[Page 18520]]

beneficiary receives the necessary information. In response to the 
comment concerning settings other than hospital outpatient departments, 
we note that in other settings, a patient is unlikely to be misled as 
to what type of facility is the site of treatment, so provision of 
notice is not required. To avoid confusion as to when the requirement 
applies, we have revised the final rule to state that notice is 
required only if the hospital outpatient department or provider-based 
entity is not located on the campus of the hospital that is the main 
provider. We have revised this final rule to specify that the notice 
must be in writing, must be one the beneficiary can read and 
understand, and must be given to the beneficiary's authorized 
representative if the beneficiary is unconscious, under great duress, 
or for any other reason unable to read a written notice and understand 
and act on his or her own rights.
Section 413.65(g)(9) (redesignated in this final rule as Section 
413.65(h), Furnishing all services under arrangement)
    Comment: A commenter observed that Sec. 413.65(g)(9) does not 
preclude an outpatient facility from obtaining a certain type of 
service from an off-site supplier. If this is correct, if the service 
is provided on-site in the hospital's outpatient facility, it is not 
clear how the proposed regulations are intended to be applied. It would 
appear that if the facility is looked at as a whole, all services are 
not provided ``under arrangements''; therefore, paragraph (g)(9) of 
this section would not preclude the facility from being recognized as 
provider-based. However, in this case, the commenter stated that both 
licensure and ownership requirements would be difficult to satisfy. In 
most cases, that portion of the facility that is operated ``under 
arrangements'' with the hospital will not be on the hospital's license, 
nor will that portion necessarily be owned by the hospital. Thus, the 
commenter urged that the ``under arrangements'' portion of an 
outpatient facility be excluded from the licensure and ownership 
analyses.
    Response: We agree that where a facility offers a variety of 
services, provision of a single type of service under arrangement would 
not prevent the facility from meeting this criterion. The criterion 
could not, of course, be met by a facility that furnished only a 
specific type of service (such as physical therapy), and provided that 
service only under arrangement. In the case envisioned by the second 
commenter, the facility would be out of compliance with licensure and 
ownership requirements, as well as the requirement involving services 
under arrangement, and we would agree that it could not be provider-
based.
    Comment: A commenter asked for clarification of ``under 
arrangements'', in reference to our other regulations that contain 
these terms. Also, the commenter requested clarification on the types 
of services to which this standard applies, that is, direct patient 
care as opposed to facility related services.
    Response: The term ``arrangements'' is defined in section 
1861(w)(1) of the Act and the Medicare regulations Sec. 409.3, in that 
``arrangements'' refers to arrangements that provide that Medicare 
payment made to the provider that arranged for the services discharges 
the liability of the beneficiary or any other person to pay for the 
services. We wish to emphasize that the provision will apply to patient 
care services, not housekeeping, security, billing, or other services 
that are not patient care services but are needed to support their 
provision.

Section 413.65(h)  Inappropriate treatment of a facility or 
organization as provider-based (redesignated in this final rule as 
paragraph (i))

    Comment: This section establishes sanctions that may be used to 
address a main provider that has treated an entity as provider-based 
without our review and approval. A commenter believes that the 
investigation phase should precede the review of payments to the main 
provider. A commenter was also concerned that the individuals involved 
in these reviews and investigations are properly trained to make the 
required determinations.
    Response: We believe review of payments will encompass two 
activities--investigation to determine whether applicable provider-
based requirements were met, and a calculation of the amount of 
overpayment if they were not. Thus, investigation necessarily precedes 
recovery, but is a part of the overall effort, which is to reconsider 
payment amounts. To respond more effectively to concerns about how the 
review and recovery activities will occur, and to clarify the specific 
actions we will take in cases of inappropriate billing, we have 
reorganized paragraph (i) to deal separately with the processes of 
determination and review, recovery of overpayments, and the good faith 
effort exception. With respect to determination and review, we state 
that if we learn that a provider has treated a facility or organization 
as provider-based and the provider had not obtained a determination of 
provider-based status under this section, we will review current 
payments and, if necessary, take action in accordance with the rules on 
inappropriate billing in paragraph (j), investigate and determine 
whether the requirements for provider-based status in paragraph (d) of 
Sec. 413.65 (or, for periods prior to October 10, 2000, the 
requirements in applicable program instructions) were met, and review 
all previous payments to that provider for all cost reporting periods 
subject to re-opening in accordance with Sec. 405.1885 and 
Sec. 405.1889 of this chapter. With respect to recovery of overpayments 
and the good faith exception, we have clarified that we will recover 
only the difference between the amount of payments that actually were 
made and the amount of payments that we estimate should have been made 
in the absence of a determination of provider-based status, and that 
recovery will not be made for any period prior to the effective date of 
these final rules if during all of that period the management of the 
entity made a good faith effort to operate it as a provider-based 
facility or organization, as described in paragraph (h)(3) of 
Sec. 413.65. In response to the comment about the competence of 
individuals involved in these activities, we wish to emphasize that we 
will ensure that staff involved in these activities have the necessary 
expertise.
    Comment: A commenter believes that it would be unfair to apply the 
proposed regulations retroactively, that is, to periods before the 
effective date of the final rule. Even though paragraphs (h) and (i) 
provide for a good faith exception, it is still unfair to provide that 
the conditions for this exception will apply prior to the effective 
date of the final regulation. The commenter requested that these 
sections be revised to provide that the period of recovery will not 
extend to any period prior to the effective date of the final 
regulations. Another commenter also believes that any payment changes 
be prospective (unless the hospital did not make a good faith effort to 
operate the site as provider-based).
    Response: We agree that it would be inappropriate to apply the 
rules in paragraph (h) to any period prior to their effective date, and 
have revised the final rule to clarify that for such periods, we will 
make determinations based on the program memoranda or other 
instructions in effect at the time. However, the criteria in paragraph 
(i) that form the basis for a good faith exception were in effect prior 
to the issuance of these regulations. Regarding

[[Page 18521]]

the last comment, we cannot agree to ignore possible overpayments 
resulting from noncompliance with published criteria in effect at that 
time.
    Comment: A commenter believes that the term ``good faith effort'' 
should be defined to provide more direction and opportunity to comply. 
Also, entities making ``good faith efforts'' should be given an 
opportunity to correct those factors or criteria that render it out of 
compliance with the provider-based requirements.
    Response: The conditions under which a provider will be found to 
have made a good faith effort were clarified in Sec. 413.65(i)(2), and 
have been restated in the final rule.

Section 413.65(i)  Inappropriate billing (redesignated in this final 
rule as paragraph (j))

    Comment: A commenter believes that suspending all payments for 
outpatient services to facilities that have billed inappropriately as 
provider-based entities until the provider can demonstrate that 
payments are proper is too onerous. Instead, the commenter suggested 
that we consider suspending the reimbursement differential between a 
provider-based entity and a nonprovider-based entity until a 
determination is made or the facility has had a reasonable opportunity 
to comply.
    Response: We understand the commenter's concern and have revised 
the final rule to authorize partial suspension of payment (that is, a 
reduction in payment) to the extent needed to prevent creation of an 
overpayment to the provider. This rule will allow payment to continue 
at a reduced rate, thus avoiding creation of financial hardship for the 
provider. To describe more clearly how we will deal with instances of 
inappropriate billing, we have reorganized paragraph (j) of Sec. 413.65 
to spell out more clearly the actions we will take, and the extent to 
which payment will be adjusted. Specifically, we state that if we find 
that a facility or organization is being treated as provider-based 
without having obtained a determination of provider-based status under 
this section, we will notify the provider, adjust future payments, 
review previous payments, determine whether the facility or 
organization qualifies for provider-based status under this paragraph, 
and continue payments only under specific conditions. The notice to the 
provider will explain that payments for past cost reporting periods may 
be reviewed and recovered, that future payments for services in or of 
the facility or organization will be adjusted, and that a determination 
of provider-based status will be made.
    We further state that we will not stop all payment in such cases, 
but instead, will adjust future payments to approximate as closely as 
possible the amounts that would be paid in the absence of a provider-
based determination, if all other requirements for billing were met. We 
also explain that we will review previous payments and, if necessary, 
take action in accordance with the rules on inappropriate treatment of 
a facility or organization described above. The regulation states that 
we will determine whether the facility or organization qualifies for 
provider-based status under the criteria in this section. If we 
determine that the facility or organization qualifies for provider-
based status, future payment for services at or by the facility or 
organization will be adjusted to reflect that determination. Even if 
the facility or organization does not qualify for provider-based 
status, however, we will continue paying, at an appropriately adjusted 
level, for a limited time period in order to avoid disruption of 
services to program beneficiaries at that site and to allow an orderly 
transition to freestanding status.
    The notice of denial of provider-based status sent to the provider 
will ask the provider to notify us in writing, within 30 days of the 
date the notice is issued, as to whether the facility or organization 
(or, where applicable, the practitioners who staff the facility or 
organization) will be seeking to enroll and meet other requirements to 
bill for services in a free-standing facility. If the provider 
indicates that the facility, organization, or practitioners will not be 
seeking to enroll, or if we do not receive a response within 30 days of 
the date the notice was issued, all payment will end as of the 30th day 
after the date of notice. If the provider indicates that the facility 
or organization, or its practitioners, will be seeking to enroll and 
meet other requirements for billing for services in a free-standing 
facility, payment for services of the facility or organization will 
continue, at the adjusted amounts described in paragraph (j)(2) of this 
section for as long as is required for all billing requirements to be 
met (but not longer than 6 months) if--
     The facility or organization, or its practitioners, submit 
a complete enrollment application and provide all other required 
information within 90 days after the date of notice, and
     The facility or organization, or its practitioners, 
furnish all other information we need to process the enrollment 
application and verify that other billing requirements are met.
    If the necessary applications or information are not provided, we 
will terminate all payment to the provider, facility, or organization 
as of the date we issue notice that necessary applications or 
information have not been submitted. We have clarified the final rule 
to state that these reductions will occur where inappropriate billing 
is or has been taking place.
    Comment: A commenter believes that there are already existing 
mechanisms for overpayment and recoupment that may be used in the 
situations described in this section. At the very least, administrative 
actions of this type should be subject to time frames in order to 
protect providers from the impact of extended investigations.
    Response: We plan to conduct any recovery efforts in accordance 
with applicable law and regulations on overpayment recovery. However, 
investigations may be complex and require examination of many records, 
and we do not agree that they should be limited by additional, self-
imposed restrictions.
    Comment: A commenter stated that a facility or organization that 
requests a provider-based determination prior to the effective date of 
the final rule, and meets the good faith requirements, should not be 
subject to recovery of overpayment for periods either before or after 
the effective date of the final rule. This will prevent disruptions to 
existing arrangements that meet the good faith exception during the 
time that the request is being processed.
    Response: If we were to adopt this proposal, we would be 
guaranteeing an overpayment to providers who, for a specific time 
period, knowingly billed for services as those of provider-based 
entities, even though they met only a few of the provider-based 
criteria. Thus, we did not adopt this comment.
    Comment: A commenter requested that the requirement found at 
paragraph (i)(2)(iii) be clarified to state that management is only 
responsible for professional services billed by the hospital.
    Response: As explained earlier, we believe hospitals' privileging 
mechanisms give them adequate leverage to prevent inappropriate billing 
by practitioners using their facilities. Therefore, we did not adopt 
this comment.
    Comment: As to the good faith criteria found in paragraph (i)(2), a 
commenter questioned why requirements related to public awareness were 
chosen for inclusion. An organization can represent itself to the 
public in any number of inaccurate ways in order to mislead our 
officials and others. The

[[Page 18522]]

commenter believes that we should focus our attention on more tangible 
expressions of good faith efforts to operate a provider based entity.
    Response: We believe inclusion of this requirement is needed to 
help ensure that beneficiaries are protected from unexpected deductible 
and coinsurance liability. While we agree with the commenter that some 
providers may misrepresent the status of off-site facilities, we 
believe such providers cannot reasonably be said to have acted in good 
faith, and should not receive favorable treatment with respect to past 
overpayments.

Section 413.65(j)  Correction of errors (redesignated in this final 
rule as paragraph (k))

    Comment: A commenter disagreed with the language in this subsection 
that would allow us to review and rescind, if appropriate, any past 
determinations. The commenter believes that this subsection should be 
removed and any previous determinations should be grandfathered in 
under the new regulations. Other commenters recommended that we 
grandfather facilities or organizations that had previously been 
determined by the regional office to be provider-based, or that have 
not received such a determination but have been billing as provider-
based without a determination for a period of at least ten years, so 
that those facilities or organizations could retain provider-based 
status even though they do not meet the criteria in the regulations.
    Response: We do not agree that it would be appropriate to 
grandfather existing facilities or organizations, since this would in 
effect create an ongoing double standard, under which some facilities 
or organizations are held to higher standards than others. Moreover, 
the fact that improper billing may have continued undetected for a long 
period is not a reason to continue to permit such billing. As explained 
in the response to the following comment, however, any adverse 
determination regarding provider-based status of facilities or 
organizations which we previously determined were provider-based will 
not be effective until the start of the cost reporting period after the 
period in which the provider is notified of the redetermination, or for 
at least 6 months, whichever date is later.
    Comment: A commenter believes that our proposal that we may review 
past provider-based determinations inserts needless uncertainty into 
the process for making provider-based designations. The commenter is 
concerned that providers may file before the final rule is published in 
order to avoid a crush of applications and subsequent disruption in 
payment, if they do not have a determination within 30 days of the rule 
becoming final. The commenter stated that providers need to be able to 
receive prompt determinations on which they can rely.
    Response: We understand the concern about avoiding the need to 
process a large number of applications in a short time, and agree that 
it would not be appropriate to make abrupt changes in provider-based 
status. To avoid a possible crush of applications within a 30-day 
period, as envisioned by the commenter, we are providing the delayed 
effective date described earlier in this document. In addition, under 
Sec. 413.65(j) of these regulations, when a facility or organization 
that previously was determined to be provider-based is found to no 
longer qualify for provider-based status, treatment of the facility or 
organization as provider-based will not cease until the first day of 
the first cost reporting period following notification of the 
redetermination, but not less than 6 months after the date the provider 
is notified of the redetermination. If there has been no prior 
determination of provider-based status, and a facility or organization 
is later found not to meet the criteria, that determination may be 
effective up to 6 months after the date the provider is notified of the 
determination, if within 30 days of the determination, the provider 
indicates that the facility or organization, or its practitioners, will 
enroll separately and, within 90 days, the facility or organization, or 
its practitioners, take other necessary action to enroll.

Section 489.24(b)  Special responsibilities of Medicare hospitals in 
emergency cases

    Comment: One commenter disagreed strongly with the proposed 
revisions to the regulation defining ``comes to the emergency 
department,'' and in particular expressed the view that patients 
arriving on the campus, sidewalk, driveway, or parking lot of hospital 
facilities should not be considered to have come to the emergency 
department. The commenter stated the view that an obligation under 
section 1867 of the Act (sometimes referred to as the Emergency Medical 
Treatment and Active Labor Act (EMTALA), after the original title of 
the legislation adding section 1867) and our regulations at 
Secs. 489.20(l), (m), (q), and (r), and Sec. 489.24 should be triggered 
only by a presentation to the emergency department, and that only in 
exceptional situations should EMTALA apply to someone not technically 
in the emergency department. The commenter recommended that the 
regulations be revised to state that in these cases, the hospital may 
rely on a variety of transport options, consistent with the 
individual's condition and established policies that are applied in a 
nondiscriminatory manner. The commenter also recommended that the 
statute be interpreted as requiring only that hospitals with emergency 
departments have policies and procedures to assure that a person who 
presents to the hospital requesting emergency services is provided a 
medical screening examination and, if needed, stabilization or an 
appropriate transfer.
    Another commenter raised several arguments against the proposed 
change. The commenter stated that there is a legal and ethical conflict 
in requiring hospital personnel to leave an area of patient care and 
furnish assistance to another patient in a remote area of the hospital. 
The commenter also believes that ED personnel are not well-trained or 
practiced in immobilization or scene safety, and patients and staff may 
be put at risk if staff are asked to go into the field and render aid 
to a victim who needs the expert care and experience for which field 
emergency medical services (EMS) personnel are trained. Finally, the 
commenter expressed concern about possible increases in the liability 
insurance cost to hospitals as a result of the proposed change.
    Response: We do not agree that the proposed language 
inappropriately extends the scope of hospitals' EMTALA 
responsibilities. On the contrary, existing regulations at Sec. 489.24 
make it clear that EMTALA applies to hospitals that offer services for 
emergency medical conditions, and we believe it would defeat the 
purpose of EMTALA if we were to allow hospitals to rely on narrow, 
legalistic definitions of ``comes to the emergency department'' or of 
``emergency department'' to escape their EMTALA obligations. We would 
also note, as discussed further below, that there is no requirement 
that all areas of the hospital be equipped to provide emergency care or 
that treatment always be provided outside the emergency area or 
department. Similarly, there is no prohibition of appropriate transfers 
to other facilities where such a transfer is conducted in accordance 
with Sec. 489.24. On the contrary, the intent of the revised regulation 
is to ensure that patients who come to the hospital and request 
examination or treatment for what may be an emergency medical condition 
are not denied EMTALA protection simply because they enter the

[[Page 18523]]

wrong part of the hospital or fail to make their way to the emergency 
room.
    Comment: Two commenters recommended clarification of the 
applicability of section 1867 of the Act regarding transfer 
requirements to scheduled patients at an ``off-campus'' hospital site, 
to ensure that the movement of scheduled patients unexpectedly 
requiring a higher level of care to another site of the same hospital 
is not construed as a ``transfer'' under the emergency access law, and 
that only those patients taken from one hospital's off-campus facility 
to another hospital's emergency department or inpatient unit be 
considered ``transfers'' that must be in accordance with the 
requirements of section 1867.
    Response: We agree that movement of a patient from one part of a 
hospital to another, including movement from a remote location to a 
main hospital campus, does not constitute a ``transfer'' for EMTALA 
purposes, nor does it require compliance with the appropriate transfer 
requirements in Sec. 489.24(d). The final regulations at 
Sec. 489.24(i)(3)(i) clarify this policy.
    Comment: A commenter expressed the view that the proposed revision 
to Sec. 489.24 does not recognize the role that EMS personnel play in 
emergency situations and the true medical benefit provided by EMS 
personnel to patients in emergency situations. The commenter 
recommended that language be included in the regulation to authorize 
hospitals' use of EMS in responding to emergency situations on hospital 
grounds.
    Response: We agree that EMS personnel can play a valuable role in 
transporting patients to appropriate sources of emergency care. A 
hospital may not, however, meet its EMTALA obligations merely by 
summoning EMS personnel. EMS may be used appropriately in conjunction 
with an appropriate hospital response to treat and move an individual 
who is already on hospital property. We therefore did not make any 
change to these regulations to authorize exclusive use of EMS to 
respond to emergency situations on hospital property.
    Comment: A number of commenters stated that the anti-dumping rules 
implemented under section 1867 of the Act (EMTALA requirements) and our 
regulations at Secs. 489.20(l), (m), (q), and (r), and Sec. 489.24 
should apply to the hospital's main campus and to all emergency 
departments. However, they argued that it is not reasonable to apply 
these rules to outpatient departments located off-campus that would not 
be set up to provide emergency services. In the commenters' view, it 
should suffice that patients in an emergency situation be directed to 
the hospital's emergency room. Another commenter stated that EMTALA 
obligations should be limited to those hospital entities that hold 
themselves out as providing emergency services, and should not be 
enforceable anywhere outside the emergency department or anywhere on 
hospital property, including an outpatient department or provider-based 
entity. Another commenter stated that the enforcement of this 
requirement would lead to the elimination of service-specific 
outpatient departments located off a main campus, and asked that we 
reconsider our policy. One commenter expressed concern that patients 
identifying a facility as a hospital-based department could mistakenly 
assume it is equipped to handle emergency cases. Another commenter 
believes that hospitals should be required to have policies and 
procedures in place to assure that all parts of the hospital are 
prepared to deal with getting an individual the appropriate medical 
screening.
    Response: Existing regulations at Sec. 489.24(b) define ``hospital 
with an emergency department'' to include all hospitals that offer 
services for emergency medical conditions, not just those that have 
organized emergency rooms or departments. To the extent a hospital 
acquires or creates an off-campus location, identifies it to us and to 
the public as a part of that hospital, and claims payment for services 
at that location as hospital services, we believe it is not 
unreasonable to expect that hospital also to assume the obligations, 
including compliance with EMTALA requirements, which flow from hospital 
status. This principle does not mean, of course, that a hospital must 
have a fully equipped and staffed emergency department at each 
location. It also does not mean that every appearance by an individual 
at an off-campus hospital department that does not offer services for 
emergency medical conditions will necessarily trigger an EMTALA 
obligation on the part of the hospital. Individuals come to these 
departments for many medical purposes which may not involve potential 
emergency medical conditions. Under these circumstances, the hospital 
would not have an EMTALA obligation with respect to that individual. 
This principle does mean, however, that if an individual comes to an 
off-campus department of a hospital and a request is made for 
examination or treatment for a potential emergency medical condition, 
the hospital incurs an obligation to provide, within its capability, an 
appropriate medical screening examination and necessary stabilizing 
treatment. In some cases, the patient may need to be taken back to the 
main hospital campus for a full screening and/or stabilizing treatment. 
Under these circumstances, the hospital is responsible for moving the 
patient or arranging his or her safe transport, but this movement would 
not be considered a ``transfer'' under Sec. 489.24(b), since the 
patient is merely going from one part of the hospital to another. If it 
is necessary to transfer the patient to another medical facility, the 
hospital must provide an appropriate transfer in accordance with 
Sec. 489.24(d).
    After review of the comments on this issue, we have decided to 
revise the regulations to state more clearly the extent of a hospital's 
EMTALA obligations with respect to patients who come to a hospital 
department located off the hospital's main campus. Provider-based 
entities, such as SNFs or HHAs, located off the hospital campus would 
not, of course, be subject to EMTALA since a patient coming to such an 
entity would not have come to the hospital. We will require that each 
off-campus hospital department, during its regular hours of operation, 
have in effect procedures for: (1) assessing the possibility that an 
emergency medical condition exists, and providing such screening (as 
defined in Sec. 489.24(a) and (b)) and necessary stabilization (as 
defined in Sec. 489.24(c)) at the off-campus site); (2) transporting 
the patient to the hospital's emergency room or department for 
screening and necessary stabilization meeting the requirements of 
Sec. 489.24; or (3) providing an appropriate transfer to another 
facility in accordance with the requirements in Sec. 489.24(c). To meet 
these requirements, the hospital will need to develop procedures that 
permit staff of the off-campus department to contact emergency 
physicians or other qualified emergency practitioners at the main 
hospital campus, to obtain advice and direction regarding the handling 
of any potential emergencies, and to obtain prompt medical transport, 
by hospital-owned or other ambulance or other appropriate vehicle, 
either to the main hospital campus or, where an appropriate transfer is 
being provided, to another medical facility.
    Specifically, we are adding new paragraph (i) to Sec. 489.24 to 
describe a hospital's obligations. The paragraph states that, if an 
individual comes to a facility or organization that is located off the 
main hospital campus as defined in Sec. 413.65(b), but has been 
determined under Sec. 413.65 of this chapter to be a department of the 
hospital, and a

[[Page 18524]]

request is made on the individual's behalf for examination or treatment 
of a potential emergency medical condition as otherwise described in 
paragraph (a) of Sec. 489.24, the hospital is obligated to provide the 
individual with an appropriate medical screening examination and any 
necessary stabilizing treatment.
    The capability of the hospital includes that of the hospital as a 
whole, not just the capability of the off-campus facility or 
organization. Except for cases described in paragraph (i)(3)(iii) 
(those in which the main hospital campus does not have the specialized 
capability or facilities needed to treat the individual, or the 
individual's condition is deteriorating so rapidly that transport to 
the main campus would significantly jeopardize the life or health of 
the individual), the obligation of a hospital under this section must 
be discharged within the hospital as a whole. However, the hospital is 
not required to locate additional personnel or staff to off-site 
locations to be on standby for possible emergencies.
    In Sec. 489.24(i)(2), Protocols for off-campus departments, we 
further state that the hospital must establish protocols for the 
handling of potential emergency cases at off-campus departments. These 
protocols must include provision for direct contact between personnel 
at the off-campus department and emergency personnel at the main 
hospital campus, and may provide for dispatch of practitioners, when 
appropriate, from the main hospital campus to the off-campus department 
to provide screening or stabilization services. The intent of these 
requirements is to ensure timely exchange of information between the 
two sites, and to allow the hospital the flexibility to bring emergency 
personnel to the patient, rather than the opposite, where doing so is 
the best medical approach to meeting the patient's needs.
    Under the final rule, if the off-campus department is an urgent 
care center, primary care center, or other facility that is routinely 
staffed by physicians, RNs, or LPNs, these personnel must be trained, 
and given appropriate protocols, for the handling of emergency cases. 
At least one individual on duty at the off-campus department during its 
regular hours of operation must be designated as a qualified medical 
person as described in paragraph (d). The qualified medical person must 
initiate screening of individuals who come to the off-campus department 
with a potential emergency medical condition, and may be able to 
complete the screening and provide any necessary stabilizing treatment 
at the off-campus department, or to arrange an appropriate transfer.
    The final rule further states that if the off-campus department is 
a physical therapy, radiology, or other facility not routinely staffed 
with physicians, RNs, or LPNs, the department's personnel must be given 
protocols that direct them to contact emergency personnel at the main 
hospital campus for direction. Under this direction, and in accordance 
with protocols established in advance by the hospital, the personnel at 
the off-campus department must describe patient appearance and reported 
symptoms and, if appropriate, arrange transportation of the individual 
to the main hospital campus (if the main hospital campus has the 
capability required by the individual, and movement to the main campus 
would not significantly jeopardize the individual's life or health), or 
assist in an appropriate transfer. Movement of the individual to the 
main campus of the hospital is not considered a transfer under this 
section, since the individual is simply being moved from one department 
of a hospital to another department or facility of the same hospital.
    Finally, specific rules apply if the individual's condition 
warrants movement to a facility other than the main hospital campus, 
either because the main hospital campus does not have the specialized 
capability or facilities required by the individual, or because the 
individual's condition is deteriorating so quickly that taking the time 
required to move the individual to the main hospital campus could place 
the life or health of the individual in significant jeopardy. Under 
these circumstances, personnel at the off-campus department must, in 
accordance with protocols established in advance by the hospital, 
assist in arranging an appropriate transfer of the individual to a 
medical facility other than the main hospital. The hospital must have 
protocols to ensure that the movement is an appropriate transfer in 
accordance with paragraph (d)(2) of this section. The protocol must 
include procedures and agreements established in advance with other 
hospitals or medical facilities in the area of the off-campus 
department to facilitate these anticipated transfers. We note that the 
interpretive guidelines for enforcement of EMTALA requirements will be 
revised to conform to these new rules.

Section 498.3  Scope and applicability

    Comment: A commenter asked for clarification as to whether appeal 
rights would be available in the event of revocation by us of provider-
based status.
    Response: We have revised Sec. 489.3(b)(2) to specify that a 
determination that a facility or organization no longer qualifies for 
provider-based status is an initial determination, thus providing an 
administrative appeals mechanism for these decisions.

D. Requirements for Payment

    We proposed to revise Sec. 410.27, Outpatient Hospital Services and 
Supplies Incident to a Physician Service: Conditions, to require that 
services furnished at a location other than an RHC or an FQHC that we 
designate as having provider-based status under Sec. 413.65 must be 
under the direct supervision of a physician as defined in 
Sec. 410.32(b)(3)(ii).
    Comment: Several commenters requested clarification of what we mean 
by ``direct supervision.'' One commenter asked that we further define 
the nature and extent of the supervision needed to comply with our 
proposal. One commenter asked whether the supervision requirement would 
be met if a physician is in the hospital or whether the physician must 
be in the department while the procedure is being performed. The same 
commenter asked whether the physician billing for the incident to 
services must be of the same specialty as the procedure being 
performed. A large trade association stated that we appear to be 
replacing our current policy in section 3112.4(A) of the Intermediary 
Manual, which states that we assume the physician supervision 
requirement to be met when incident to services are furnished on 
hospital premises, with a policy requiring direct physician supervision 
at all times, in all outpatient departments, regardless of whether or 
not they are located on the hospital campus. The commenter recommended 
that if we retain a direct supervision requirement, it should be 
limited to outpatient departments located off-site of the main 
provider. One commenter stated that facilities and organizations 
accorded provider-based status that are located on the main provider's 
campus should be subject to the same physician supervision requirements 
that apply to ``incident to'' services provided elsewhere on the 
campus.
    Response: We regret that our proposal to define ``direct 
supervision'' by referring to the definition of ``direct supervision of 
a physician'' given at Sec. 410.32(b)(3)(ii) may have been confusing to 
some commenters. Section 410.32(b)(3)(ii) defines ``direct 
supervision'' within (a physician) office

[[Page 18525]]

setting as meaning that the physician must be present in the office 
suite and immediately available to furnish assistance and direction 
throughout the performance of the procedure. The definition at 
Sec. 410.32(b)(3)(ii) goes on to state that ``direct supervision'' does 
not mean that the physician must be present in the room when the 
procedure is performed.
    Our intention in the proposed rule was to define ``direct 
supervision'' of hospital outpatient services incident to physician 
services when they are furnished at a department of a hospital to mean 
that a physician must be present on the premises of the entity accorded 
status as a department of the hospital and, therefore, immediately 
available to furnish assistance and direction for as long as patients 
are being treated at the site. By ``direct supervision'' we do not mean 
that the physician must physically be in the room where a procedure or 
service is furnished. Nor does the supervising physician necessarily 
have to be of the same specialty as the procedure or service that is 
being performed. We emphasize that our proposed amendment of 
Sec. 410.27 to require direct supervision of hospital services 
furnished incident to a physician service to outpatients applies to 
services furnished at an entity that is located off the campus of a 
hospital that we designate as having provider-based status as a 
department of a hospital in accordance with the provisions of 
Sec. 413.65. Our proposed amendment of Sec. 410.27 to require direct 
supervision of hospital services furnished incident to a physician 
service to outpatients does not apply to services furnished in a 
department of a hospital that is located on the campus of that 
hospital. For hospital services furnished incident to a physician 
service to outpatients in a department of a hospital that is located on 
the campus of the hospital, we assume the direct supervision 
requirement to be met as we explain in section 3112.4(A) of the 
Intermediary Manual. The requirement at Sec. 410.27 does not affect the 
definition of physician supervision in section 3112.4(A) of the 
Intermediary Manual. In response to these comments, we have revised our 
definition of ``direct supervision by a physician'' in the final 
regulation.
    Comment: A major trade association asserted that requiring a 
physician to be on-site at a provider-based entity throughout the 
performance of all ``incident to'' services would be burdensome and 
costly for hospitals where there are a limited number of physicians 
available to provide coverage, particularly in rural settings. Another 
commenter believes that entities with provider-based status should not 
be subject to physician supervision requirements that are more 
stringent than those applicable to free-standing facilities. A third 
commenter believes that this requirement is unnecessary because the 
requirements for integration with the hospital and other requirements 
for provider-based status include adequate checks and balances to 
ensure quality care. The commenter recommended that this proposal be 
omitted from the final rule with the potential for a separate, better 
defined, proposal at a later date.
    Response: We disagree with commenters who believe the proposed 
supervision requirement is not necessary or that it would be burdensome 
to the hospital. First, the supervision requirement is separate from 
and independent of the provider-based requirements, and hospitals and 
physicians already have to meet a direct supervision of ``incident to'' 
services requirement that is unrelated to provider-based issues. That 
is, we require that hospital services and supplies furnished to 
outpatients that are incident to physician services be furnished on a 
physician's order by hospital personnel and under a physician's 
supervision (Intermediary Manual, section 3112.4(A)). We assume the 
physician supervision requirement is met on hospital premises because 
staff physicians would always be nearby within the hospital. The effect 
of the regulations in this final rule is to extend this assumption to a 
department of a provider that is located on the campus of a hospital. 
However, the regulation does not extend the assumption of supervision 
to a department of a hospital that is located off the campus of the 
hospital. We would not extend this assumption to a provider-based 
entity, regardless of its location, because the ``incident to'' 
requirement in Sec. 410.27(a)(1)(iii) applies only to hospitals. Also, 
as we state above, satisfying the requirements to be designated 
provider-based is unrelated to our requirement that hospital services 
furnished incident to a physician service to outpatients at an entity 
that has provider-based status be under the direct supervision of a 
physician. Finally, this supervision requirement is entirely consistent 
with the direct supervision requirements currently set forth in the 
Medicare Carriers Manual, Part 3, section 2050.1(B).
    Comment: One commenter suggested that partial hospitalization 
services furnished by a hospital to its outpatients be exempt from the 
outpatient department ``incident to'' requirements, or that other 
requirements be drafted that would, in the commenter's opinion, be more 
appropriate to the nature of this care.
    Response: Section 1861(s)(2)(B) restricts coverage of partial 
hospitalization services furnished by a hospital to its outpatients to 
services that meet ``incident to'' requirements. We do not have the 
discretion to ignore this statutory restriction.
    Comment: One commenter asked that we provide an exception to the 
direct supervision requirement in the case of physical therapy 
services. The commenter questioned why therapists who furnish the same 
services in a provider-based entity that they would furnish in an 
independent practice should be subject to direct physician supervision 
in one setting and not the other.
    Response: The provision on coverage for outpatient physical therapy 
and occupational therapy services does not require that they be 
``incident to'' physician services (see section 1861(s)(2)(D) of the 
Act). Therefore, there is no need to exempt them from the supervision 
requirement for outpatient hospital services incident to a physician 
service that is furnished at a provider-based entity. We therefore made 
no change in the final regulation based on this comment.
    Comment: One commenter suggested that we modify our proposed 
regulation to waive the direct supervision requirement in entities with 
provider-based status for certain procedures for which we already waive 
the direct supervision requirement when the procedures are performed on 
homebound patients, as set forth in section 2051 of the Medicare 
Carriers Manual. The commenter believes that general supervision is 
sufficient for these waived services, for example, the physician need 
not be present, but the services must be performed under a physician's 
overall supervision and control, and ordered by a physician.
    Response: Under section 2050.2 of the Medicare Carriers Manual, 
subject to certain requirements, we waive the direct supervision 
requirement when the following services are furnished to homebound 
patients: injections; venipuncture; EKGs; therapeutic exercises; 
insertion and sterile irrigation of a catheter; changing of catheters 
and collection of catheterized specimen for urinalysis and culture; 
dressing changes, for example, the most common chronic conditions that 
may need dressing changes are decubitus care and gangrene; replacement 
and/or insertion of nasogastric tubes; removal of fecal

[[Page 18526]]

impaction, including enemas; sputum collection for gram stain and 
culture, and possible acid-fast and/or fungal stain and culture; 
paraffin bath therapy for hands and/or feet in rheumatoid arthritis or 
osteoarthritis; and, teaching and training the patient for the care of 
colostomy and ileostomy, the care of permanent tracheostomy, testing 
urine and care of the feet (diabetic patients only), and blood pressure 
monitoring. While we believe the commenter's suggestion has merit, we 
do not believe it would be appropriate to adopt it before we have had 
time to analyze the issue further. Therefore, we did not revise the 
final rule based on this comment.
    In our proposed rule, we proposed to require that the same 
supervision levels established for diagnostic x-ray and other 
diagnostic tests in accordance with Sec. 410.32(b)(3) be required when 
these tests are furnished at an entity that has been accorded provider-
based status by us.
    Comment: A large industry federation generally favored our 
requiring that diagnostic tests be furnished at provider-based entities 
under levels of physician supervision that we specify, consistent with 
the definitions of general, direct, and personal supervision 
established at Sec. 410.32(b)(3). The commenter suggested that we 
modify the definition of general supervision to make it clear that the 
training of nonphysician personnel and the maintenance of necessary 
equipment and supplies are the responsibility of the hospital, not the 
physicians.
    Response: We agree and we will modify our regulation accordingly.
    Comment: Numerous commenters, including radiology and imaging 
specialty groups, neurologists, vascular technologists, and 
sonographers, questioned the level of supervision required for various 
specific diagnostic tests and services.
    Response: Our model for this proposed requirement was the 
requirement for physician supervision for diagnostic tests payable 
under the Medicare physician fee schedule that was issued in the 
October 31, 1997 physician fee schedule final rule (for CY 1998) (62 FR 
59048). There have been issues raised about the appropriate level of 
supervision for some specific diagnostic services, similar to the 
comments we received about our proposed regulation. We have not yet 
resolved these issues, and this final rule is not the place to convey 
decisions about appropriate supervision levels for specific diagnostic 
tests and services by individual HCPCS code. In January 1998, we sent a 
memorandum to all Associate Regional Administrators advising them to 
instruct carriers to follow their existing policies on physician 
supervision of diagnostic tests until we provide further instruction. 
We intend to instruct hospitals and intermediaries to use the October 
31, 1997 physician supervision requirements as a guide, pending 
issuance of updated requirements. In the meantime, fiscal 
intermediaries, in consultation with their medical directors, will 
define appropriate supervision levels for services not listed in the 
October 31, 1997 final rule when those services are furnished at an 
entity with provider-based status in order to determine whether claims 
for these services are reasonable and necessary.

V. Summary of and Response to MedPAC Recommendations

    The following are additional recommendations contained in the 
report on Medicare payment policy that the Medicare Payment Advisory 
Commission submitted to the Congress in March 1999. (MedPAC, Report to 
the Congress: Medicare Payment Policy, March 1999.) We respond to 
recommendations that are specifically related to a particular component 
of the hospital outpatient PPS in the appropriate section of this 
preamble.
    MedPAC Recommendation: MedPAC recommends that the Secretary 
evaluate payment amounts under the hospital outpatient PPS and the 
ambulatory surgical center (ASC) PPS along with the practice expense 
payments under the Medicare physician fee schedule for services 
furnished in physicians' offices to ensure that the differing payments 
made under the three payment systems do not create unwarranted 
financial incentives regarding site of care.
    Response: We agree that the three payment systems should avoid 
creating unnecessary financial incentives to deliver care in particular 
settings. We will consider this matter further and evaluate differences 
in payments.
    MedPAC Recommendation: MedPAC recommends that the Secretary study 
means of adjusting base prospective payment rates across ambulatory 
settings for patient characteristics such as age, frailty, 
comorbidities and coexisting conditions, and other measurable traits. 
Under this approach, payment would be less dependent on the type of 
facility and more dependent on the relative costliness of furnishing 
specific services to individual patients. MedPAC notes that no viable 
patient-level adjuster currently exists that could be used in this 
fashion.
    As an interim measure, MedPAC recommends, with reservations, that 
HCFA evaluate facility-level adjustments in order to preserve access to 
care for particularly vulnerable segments of the Medicare population.
    Response: The underlying premise in this recommendation, as MedPAC 
states, is that HCFA should move toward development of a more unified 
and rational payment system for ambulatory care. Many powerful 
arguments favor such a system, but the challenges of creating and 
implementing it are substantial. We will give further consideration to 
the recommendation to study possible adjustments that could be used in 
various settings.
    We agree that we should evaluate the need for facility-level 
adjustments. We believe the best course is to evaluate the need for 
these adjustments during the next several years as we gain actual 
experience with the operation of the hospital outpatient PPS and are 
able to observe the effects on particular provider groups. In 
consideration of the transitional protections provided by the BBRA 
1999, we have not adopted facility-level adjustments, other than an 
adjustment for local labor costs, at this time.
    MedPAC Recommendation: MedPAC recommends that the Secretary seek 
legislation to develop and implement a single update mechanism that 
would link conversion factor updates to volume growth across all 
ambulatory care settings. These settings include hospital outpatient 
departments, physicians' offices, and ASCs, as well as other specific 
settings mentioned.
    Response: We believe that this proposal requires further study to 
determine its feasibility and possible impact. Therefore, we are not 
prepared to seek legislation at this time.
    MedPAC Recommendation: MedPAC recommends that we not use patient 
diagnosis to calculate relative weights or make payments for medical 
visits, ``given the current state of the available data and the lack of 
definitive rules for reporting patients' diagnoses under the proposed 
system.''
    Response: As discussed in section III.C.3, we have dropped 
diagnosis from our characterization of medical visit APCs. We hope to 
develop procedure codes for medical visits that are more descriptive of 
hospital outpatient resource use, rather than physician services. Once 
we revise procedure coding to better reflect hospital services, we will 
assess whether accurate diagnosis coding further improves recognition 
of resources.
    MedPAC Recommendation: MedPAC recommends that the Secretary closely

[[Page 18527]]

monitor the use of hospital outpatient services to ensure that 
beneficiary access to care is not compromised.
    Response: We plan to evaluate the operation of the new PPS to 
address a variety of issues, including beneficiary access to care. We 
note that the provisions of the BBRA 1999 should mitigate substantially 
any payment reductions and hence the possibility of reduced access.
    MedPAC Recommendation: MedPAC recommends that the Secretary 
consider making payment adjustments in addition to the proposed 
adjustment for local area wages under the new system. These adjustments 
should be tied to patient characteristics. The facility-level 
adjustments that are made until the time that a patient-level adjuster 
is available should reflect the population of Medicare patients treated 
by facilities identified to receive the adjustments.
    MedPAC points out that HCFA, in setting Medicare payment rates for 
hospital inpatient services, adjusts payments based on the costs or 
provider characteristics of hospitals (for example, sole community 
hospitals). Rather than continuing this practice in the outpatient 
setting, MedPAC recommends that HCFA move toward making adjustments 
based on patient characteristics and the relative costliness of 
resources required in furnishing care to differing patients. Any 
differences in the payment of the same ambulatory care service should 
be based on patient characteristics, rather than on the setting. MedPAC 
recommends that HCFA evaluate any relationships between immutable 
patient characteristics and the cost of furnishing care.
    Response: Other than those adjustments specified in sections 201 
and 202 of the BBRA 1999, we have made no additional adjustments in 
this final rule. We will consider the possibility of adjustments in the 
future once we have actual experience with operation of the hospital 
outpatient PPS and can examine its effects. The extent to which 
adjustments at the level of patient characteristics will be feasible is 
unclear and would require further study.

VI. Provisions of the Final Rule

    The provisions of this final rule reflect the provisions of the 
September 8, 1998 proposed rule, except as noted elsewhere in this 
preamble. Following is a synopsis of the major changes we have made, 
either in response to comments or in order to implement provisions of 
the BBRA 1999 that apply to the hospital outpatient prospective payment 
system.
    For our proposal to adjust the CY 2002 update of the conversion 
factor by the percentage that actual CY 2000 payments exceed the 
estimated CY 2000 expenditure target, we are delaying implementation of 
the volume control mechanism for 2 years.
    For our proposal to package costs that are directly related and 
integral to performing a procedure or furnishing a service on an 
outpatient basis, we are making the following changes:
     We are creating separate APC groups to pay for blood, 
blood products, and anti-hemophilic factors, for splints and casts, and 
for certain very costly drugs that are not included in the transitional 
pass-through payment provision.
     We are paying separately, at cost, for the acquisition of 
corneal tissue.
     As required by section 201(e) of the BBRA 1999, we are not 
paying for certain implantable items under the DMEPOS fee schedule, but 
are including them as covered outpatient services. We are packaging the 
costs of these items into the APC payment rate for the procedures or 
services with which they are associated. These include implantable 
items used in connection with diagnostic tests, implantable DME, and 
implantable prosthetic devices.
    For our proposal to base payment for medical visits to clinics and 
emergency departments on diagnosis codes as well as HCPCS codes, we are 
not using diagnosis codes at this time.
    For our proposal to classify a new technology procedure or service 
within the APC group that it most closely resembles in terms of 
clinical characteristics and resource utilization, pending collection 
of additional pricing data, we are creating separate APC groups to 
which we can temporarily classify new technology services while we 
gather additional data and gain pricing experience. We are also 
creating a process under which interested parties may submit requests 
for consideration of services that may be eligible for payment as new 
technology.
    For our proposal to pay for drugs, pharmaceuticals, and biologicals 
(except for cancer therapy drugs and certain infrequently used but very 
expensive drugs) as part of the APC payment for the service or 
procedure with which they are used, we are establishing transitional 
pass-through payments, as directed by section 201(b) of the BBRA 1999. 
Under this provision, an additional payment will be made for current 
orphan drugs, current cancer therapy drugs, biologicals, and 
brachytherapy, and current radiopharmaceutical drugs and biological 
products.
    For our proposal to classify a new or innovative medical device, 
drug or biological (for which we were not making payment as of December 
31, 1996) within the APC group that it most closely resembles in terms 
of clinical characteristics and resource utilization, pending 
collection of additional pricing data, we are establishing transitional 
pass-through payments. Under this provision, as directed by section 
201(b) of the BBRA 1999, an additional payment will be made for new or 
innovative devices, drugs, and biologicals whose cost is not 
insignificant in relation to the APC payment for the group of services 
with which they are used.
    For our proposal not to establish an outlier adjustment, as 
directed by section 201(a) of the BBRA 1999, we will make an outlier 
payment when calculated bill costs exceed 2.5 times the PPS payment for 
a service.
    For our proposal to determine comparability of resources and 
clinical characteristics among the codes within an APC group based on 
our claims data and the analyses and judgment of our medical advisors, 
supported by comments from medical specialty societies and trade 
associations, as provided in section 201(g) of the BBRA 1999, we are 
limiting the variation so that the highest median cost of an item or 
service in an APC group is no more than two times the lowest median 
cost of an item or service within that group. We will also consult with 
an expert outside advisory panel regarding the clinical integrity of 
the APC groups and weights as part of our update of the PPS.
    For our proposal to periodically review and update payment weights, 
APC groups, and other elements of the hospital outpatient PPS, as 
required by section 201(h) of the BBRA 1999, we will annually review 
the groups, relative payment weights, and the wage and other 
adjustments that are a part of the PPS.
    For our proposal to implement the hospital outpatient PPS fully and 
in its entirety for all hospitals beginning as early as possible in CY 
2000, with no phase-in period, as required by section 202(a) of the 
BBRA 1999, we are establishing transitional corridors for services 
furnished before January 1, 2004 to limit losses facilities might 
otherwise face.
    For our proposal not to make any adjustments for any specific 
classes of hospitals, we are holding small rural hospitals harmless 
through CY 2003 in accordance with the requirements set by section 
202(a)(3) of the BBRA 1999,

[[Page 18528]]

which added section 1833(t)(7)(D)(i) to the Act. Also, we are holding 
cancer centers permanently harmless in accordance with the requirements 
set by section 202(a)(3) of the BBRA 1999.
    For our proposal on beneficiary coinsurance payment amounts, we are 
limiting the coinsurance amount for a procedure to be no more than the 
hospital inpatient deductible, as specified in section 204(a)(3) of the 
BBRA 1999.
    The following is a synopsis of the principal changes that we are 
making in the provider-based requirements:
    For our proposal to require main providers and provider-based 
entities to share a common license, we will require common licensure 
only where State law permits it. Where State law prohibits it or is 
silent, we will not apply the licensure requirement. We will also 
exempt IHS facilities and facilities located on Tribal lands from this 
requirement.
    For our proposal requiring a main provider and a provider-based 
entity to serve a common service area indicated largely by overlapping 
patient populations, we have redefined ``common service area'' to mean 
a 75 percent threshold of patients who reside in a zip code area that 
is common to the main provider and the provider-based entity.
    For our proposal to require provider-based entities to be in the 
same State as the main provider, we will allow providers in one State 
to have provider-based facilities in an adjacent State, if doing so is 
consistent both with the law of the affected States and with other 
criteria, including those related to a common service area.
    For our proposal to require that a provider-based outpatient 
department bill all payers as an outpatient department, we have 
rescinded this requirement.
    For our proposal to require FQHCs that have been billing Medicare 
as hospital outpatient departments to comply with the provider-based 
requirements, we are grandfathering both FQHCs and FQHC ``look-alikes'' 
(facilities that are organized as FQHCs but do not receive grants) so 
that these facilities will be considered departments of providers 
without having to meet Sec. 413.65 requirements.
    For our proposal to apply the provider-based requirements to Indian 
Health Service (including tribally operated) entities, we are creating 
a permanent exception for those entities that were billing as 
departments of IHS or Tribal hospitals on or before October 10, 2000.
    For our proposal to consider provider-based entities to be part of 
the hospital for Emergency Medical Treatment and Active Labor Act 
(EMTALA) (``anti-dumping'' purposes), we are maintaining the principle 
that off-site hospital facilities are subject to EMTALA. We have 
clarified the obligations of hospitals with respect to these locations 
to ensure they are consistent with staffing patterns and resources.
    For our proposal to apply provider-based criteria to inpatient 
facilities such as multi-campus hospitals created by mergers and 
satellites of PPS-excluded hospitals that are created by hospitals 
leasing space in other hospitals, we have clarified the applicability 
of provider-based criteria to remote locations of hospitals and 
hospital satellite facilities.

VII. Collection of Information Requirements

    Under the Paperwork Reduction Act (PRA) of 1995, we are required to 
provide 30-day notice in the Federal Register and solicit public 
comment before a collection of information requirement is submitted to 
the Office of Management and Budget (OMB) for review and approval. In 
order to fairly evaluate whether an information collection should be 
approved by OMB, section 3506(c)(2)(A) of the PRA requires that we 
solicit comment on the following issues:
     The need for the information collection and its usefulness 
in carrying out the proper functions of our agency.
     The accuracy of our estimate of the information collection 
burden.
     The quality, utility, and clarity of the information to be 
collected.
     Recommendations to minimize the information collection 
burden on the affected public, including automated collection 
techniques.
    We are soliciting public comment on each of these issues for the 
provisions summarized below that contain information collection 
requirements:

Section 413.24  Adequate cost data and cost finding

    Section 413.24(d)(6)(ii) states that a provider must develop 
detailed work papers showing the exact cost of the services (including 
overhead) provided to or by the free-standing entity and show those 
carved out costs as nonreimbursable cost centers in the provider's 
trial balance. While these information collection requirements are 
subject to the PRA, the burden associated with these requirements is 
captured under Secs. 413.65(c)(1) and (c)(2) below.

Section 413.65  Requirements for a determination that a facility or an 
organization is a department of a provider or a provider-based entity

    Section 413.65(b)(2) states that a provider or a facility or 
organization must contact HCFA and the facility or organization must be 
determined by HCFA to be provider-based before the main provider begins 
billing for services of the facility or organization as if they were 
furnished by a department of the provider-based entity, or before it 
includes costs of those services on its cost report. While these 
information collection requirements are subject to the PRA, the burden 
associated with these requirements is captured under Secs. 413.65(c)(1) 
and (c)(2) below.
    Sections 413.65(c)(1) and (c)(2) state that a main provider that 
acquires a facility or organization for which it wishes to claim 
provider-based status, including any physician offices that a hospital 
wishes to operate as a hospital outpatient department or clinic, must 
report its acquisition of the facility or organization to HCFA and must 
furnish all information needed for a determination as to whether the 
facility or organization meets the requirements in paragraph (d) of 
this section for provider-based status, if the facility or organization 
is located off the campus of the provider or would increase the 
provider's total costs by at least 5 percent. Furthermore, a main 
provider that has had one or more entities considered provider-based 
also must report to HCFA any material change in the relationship 
between it and any provider-based facility or organization, such as a 
change in ownership of the facility or organization or entry into a new 
or different management contract that could affect the provider-based 
status of the facility or organization.
    The burden associated with this requirement is the time for the 
main provider to report its acquisition to HCFA, furnish all 
information needed for a determination, report to HCFA any material 
change in the relationship between it and any provider-based facility 
or organization, such as a change in ownership of the facility or 
organization or entry into a new or different management contract that 
could affect the provider-based status of the facility or organization. 
It is estimated that 105 main providers will take 10 hours for a total 
of 1,050 hours.
    Section 413.65(d)(4)(v) states that medical records for patients 
treated in a facility or organization must be integrated and maintained 
into a unified retrieval system (or cross reference) of the main 
provider. The burden

[[Page 18529]]

associated with this requirement is the time required for the main 
provider to maintain medical records in a unified retrieval system. 
While this requirement is subject to the PRA, we believe this 
requirement is a usual and customary business activity and the burden 
associated with this requirement is exempt from the PRA, as stipulated 
under 5 CFR 1320.3(b)(2) and (b)(3).
    Section 413.65(d)(7)(i) requires that for a facility or 
organization and the main provider that is not located on the same 
campus, the facility or organization must demonstrate a high level of 
integration with the main provider by showing that it meets all of the 
other provider-based criteria, and demonstrates that it serves the same 
patient population as the main provider, by submitting records showing 
that, during the 12-month period immediately preceding the first day of 
the month in which the application for provider-based status is filed 
with HCFA, and for each subsequent 12-month period meet the 
requirements of paragraphs (d)(7)(i)(A), (B), or (C) of this section. 
While the information collection requirements listed below are subject 
to the PRA, the burden associated with these requirements is captured 
under Secs. 413.65(c)(1) and (c)(2).
    Section 413.65(g)(7) states that when a Medicare beneficiary is 
treated in a hospital outpatient department or hospital-based entity, 
the hospital has a duty to notify the beneficiary, prior to the 
delivery of services, of the beneficiary's potential financial 
liability (that is, a coinsurance liability for a facility visit as 
well as for the physician service).
    The burden associated with this requirement is the time for the 
provider to disseminate information to each beneficiary of the 
beneficiary's potential financial liability (that is, a coinsurance 
liability for a facility visit as well as for the physician service). 
It is estimated that 750 providers will make on average 667 disclosures 
on an annual basis, at 3 minutes per disclosure, for a total annual 
burden of 25,013 hours.
    Section 413.65(j)(5) requires that upon notice of denial of 
provider-based status sent to the provider by HCFA, the notice will ask 
the provider to notify HCFA in writing, within 30 days of the date the 
notice is issued, of whether the facility or organization (or, where 
applicable, the practitioners who staff the facility or organization) 
will be seeking to enroll and meet other requirements to bill for 
services in a free-standing facility. This requirement is exempt from 
the PRA as stipulated under 5 CFR 1320.4(a)(2).
    Further, if the provider indicates that the facility or 
organization, or its practitioners, will be seeking to meet enrollment 
and other requirements for billing for services in a free-standing 
facility, the facility or organization must submit a complete 
enrollment application and provide all other required information 
within 90 days after the date of notice; and the facility or 
organization, or its practitioners, furnish all other information 
needed by HCFA to process the enrollment application and verify that 
other billing requirements are met. The requirements and burden 
associated with the provider enrollment process are currently approved 
under OMB control number 0938-0685, with a current expiration date of 
September 30, 2001.

Section 424.24  Requirements for Medical and Other Health Services 
Furnished by Providers Under Medicare Part B

    Section 424.24(e)(3)(i) requires that when a partial 
hospitalization service occurs the physician recertification must be 
signed by a physician who is treating the patient and has knowledge of 
the patient's response to treatment. While this signature requirement 
is subject to the PRA, the overall requirements associated with 
physician recertification, as currently referenced in HCFA regulation 
number HCFA-1006, published in the Federal Register on June 5, 1998, 
have not yet been approved by OMB under the PRA. Therefore, we continue 
to solicit comment on all of the requirements and associated burden 
referenced in Sec. 424.24.

Section 419.42  Hospital Election To Reduce Copayment

    Sections 419.42(b) and (c) state that a hospital must notify its 
fiscal intermediary of its election to reduce copayments no later than 
June 1, 2000 prior to the date the PPS is implemented or for subsequent 
calendar years, beginning with elections for calendar year 2001, no 
later than December 1 of the preceding calendar year. The hospital's 
election must be properly documented. It must specifically identify the 
ambulatory payment classification to which it applies and the 
coinsurance amounts (within the limits identified within this 
regulation) that the hospital has elected for each group.
    The burden associated with these requirements is the time it takes 
a hospital to compile, review, and analyze data for both revenues and 
coinsurance; prepare and present the data to the hospital board; make a 
business decision as to whether the hospital would elect to reduce 
coinsurance; and then notify its fiscal intermediary of its election. A 
hospital would notify its fiscal intermediary of its election to reduce 
coinsurance only if there were other providers, in close proximity, 
that would attract a majority of the hospital's business if they did 
not reduce their coinsurance. Since hospitals do not want to lose money 
by absorbing coinsurance, we anticipate that this requirement will 
affect 750 hospitals and take them 10 hours each for a total of 7,500 
hours.
    Section 419.42(e) states that the hospital may advertise and 
otherwise disseminate information concerning the reduced level(s) of 
coinsurance that it has elected. All advertisements and information 
furnished to Medicare beneficiaries must specify that the coinsurance 
reductions advertised apply only to the specified services of that 
hospital and that these coinsurance reductions are available only for 
hospitals that choose to reduce coinsurance for hospital outpatient 
services and are not applicable in any other ambulatory settings or 
physician offices.
    The burden associated with this requirement is the time for the 
hospital to disseminate information concerning its coinsurance 
election. It is estimated that 750 hospitals will each take 10 hours 
annually to disseminate this information via newsletters and 
information sessions at senior citizen centers for a total of 7,500 
hours.
    We have submitted a copy of this final rule to OMB for its review 
of the information collection requirements. These requirements are not 
effective until they have been approved by OMB. A notice will be 
published in the Federal Register when approval is obtained.
    If you comment on any of these information collection and record 
keeping requirements, please mail copies directly to the following:

Health Care Financing Administration, Office of Information Services, 
Information Technology Investment Management Group, Division of HCFA 
Enterprise Standards, Room C2-26-17, 7500 Security Boulevard, 
Baltimore, MD 21244-1850, Attn: John Burke HCFA-1005-FC/R-240,

    and

Office of Information and Regulatory Affairs, Office of Management and 
Budget, Room 10235, New Executive Office Building, Washington, DC 
20503, Attn.: Allison Herron Eydt, HCFA-1005-FC.

[[Page 18530]]

VIII. 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. Comments on the 
provision of this final rule that implement provisions of the BBRA 1999 
will be considered if we receive them by the date and time specified in 
the DATES section of this preamble. We will not consider comments 
concerning provisions that remain unchanged from the September 8, 1998 
proposed rule or that were changed based on public comments.

IX. Regulatory Impact Analysis

A. Introduction

    Section 804(2) of title 5, United States Code (as added by section 
251 of Pub. L. 104-121), specifies that a ``major rule'' is any rule 
that the Office of Management and Budget finds is likely to result in--
     An annual effect on the economy of $100 million or more;
     A major increase in costs or prices for consumers, 
individual industries, Federal, State, or local government agencies, or 
geographic regions; or
     Significant adverse effects on competition, employment, 
investment productivity, innovation, or on the ability of United States 
based enterprises to compete with foreign-based enterprises in domestic 
and export markets.
    We estimate, based on a simulation model, that the effect on 
hospitals participating in the Medicare program associated with this 
final rule would be to increase Medicare payments by $600 million in 
calendar year 2000. This figure includes beneficiary copayments. We 
estimate that the additional expenditures to hospitals from the Part B 
Trust Fund associated with this final rule will be $490 million in 
fiscal year 2000. Therefore, this rule is a major rule as defined in 
Title 5, United States Code, section 804(2).
    We have examined the impacts of this final rule as required by 
Executive Order 12866, the Unfunded Mandates Reform Act of 1995, and 
the Regulatory Flexibility Act (RFA) (Public Law 96-354). Executive 
Order 12866 directs agencies to assess all costs and benefits of 
available regulatory alternatives and, when regulation is necessary, to 
select regulatory approaches that maximize net benefits (including 
potential economic, environmental, public health and safety effects, 
distributive impacts, and equity). A regulatory impact analysis (RIA) 
must be prepared for major rules with economically significant effects 
($100 million or more annually). Because the projected spending 
resulting from this final rule is expected to exceed $100 million, it 
is considered a major rule for purposes of the RFA.
    The Unfunded Mandates Reform Act of 1995 also requires (in section 
202) that agencies prepare an assessment of anticipated costs and 
benefits for any rule that may result in an expenditure in any 1 year 
by State, local, or tribal governments, in the aggregate, or by the 
private sector, of $100 million. This final rule does not mandate any 
requirements for State, local, or tribal governments.
    We generally prepare a regulatory flexibility analysis that is 
consistent with the RFA (5 U.S.C. 601 through 612), unless we certify 
that a final rule will not have a significant economic impact on a 
substantial number of small entities. For purposes of the RFA, we 
consider all hospitals to be small entities.
    Also, section 1102(b) of the Social Security Act requires us to 
prepare a regulatory impact analysis for any final rule that may have a 
significant impact on the operations of a substantial number of small 
rural hospitals. Such an analysis must conform to the provisions of 
section 604 of the RFA. With the exception of hospitals located in 
certain New England counties, for purposes of section 1102(b) of the 
Act, we define a small rural hospital as a hospital with fewer than 100 
beds that is located outside of a Metropolitan Statistical Area (MSA) 
or New England County Metropolitan Area (NECMA). Section 601(g) of the 
Social Security Amendments of 1983 (Pub. L. 98-21) designated hospitals 
in certain New England counties as belonging to the adjacent NECMA. 
Thus, for purposes of the proposed prospective payment system, we 
classify these hospitals as urban hospitals.

B. Estimated Impact on the Medicare Program

    Our Office of the Actuary projects that the additional benefit 
expenditures from the Part B Trust Fund resulting from implementation 
of the hospital outpatient PPS for hospital outpatient services 
furnished on or after July 1, 2000, and the hospital outpatient 
provisions enacted by the BBRA 1999, are as follows:

------------------------------------------------------------------------
                                               Impact  (In millions of
                Fiscal year                           dollars)
------------------------------------------------------------------------
2000......................................  490
2001......................................  3,030
2002......................................  3,520
2003......................................  4,230
2004......................................  4,670
------------------------------------------------------------------------

C. Objectives

    The primary objective of the hospital outpatient prospective 
payment system is to simplify the payment system and encourage hospital 
efficiency in providing outpatient services, while at the same time 
ensuring that payments are sufficient to compensate hospitals 
adequately for their legitimate costs. Another important goal of the 
new system is to reduce beneficiaries' share of outpatient payment to 
hospitals by freezing coinsurance amounts at an absolute level until 
they equal 20 percent of the total payment amounts.
    We believe that implementation of the final PPS will ultimately 
further each of these goals while maintaining the financial viability 
of the hospital industry and ensuring access to high quality health 
care for Medicare beneficiaries. We expect that the provisions of this 
final rule with comment period will ensure that the outcomes of the PPS 
are reasonable and equitable while avoiding or minimizing unintended 
adverse consequences.

D. Limitations of Our Analysis

    The following quantitative analysis presents the projected effects 
of our policy changes resulting from comments, as well as statutory 
changes enacted by the BBRA 1999, on various hospital groups. We use 
the best data available. In addition, we do not make adjustments for 
future changes in such variables as volume and intensity. For this 
final rule with comment period, we are soliciting comments and 
information about the anticipated effects of the changes on hospitals 
resulting from implementation of the hospital outpatient provisions of 
the BBRA 1999, and our methodology for estimating them.

E. Hospitals Included In and Excluded From the Prospective Payment 
System

    The outpatient prospective payment system encompasses nearly all 
hospitals that participate in the Medicare program. However, Maryland 
hospitals that are paid under a cost containment waiver in accordance 
with section 1814(b)(3) of the Act are excluded from the PPS. Critical 
access hospitals (CAHs) are also excluded and are paid at cost under 
section 1834(g) of the Act.

[[Page 18531]]

F. Quantitative Analysis of the Impact of Policy Changes on Payment 
Under the Hospital Outpatient PPS: Basis and Methodology of Estimates

    We have analyzed the impact on hospital payment under the 
outpatient PPS. Our analysis compares the payment impact of PPS 
compared to current law. The definition and calculation of current law 
used in the impact analysis is the same used in estimating the 
conversion factor. That is, current law reflects pre-PPS payment 
methodologies in effect on January 1, 2000, and prior to July 1, 2000, 
which include the elimination of the formula-driven overpayment and 
application of the capital and operating cost reductions. A detailed 
explanation of the current law calculation can be found in section 
III.E.2.a.
    The data used in developing the quantitative analyses presented 
below are taken from the CY 1996 cost and charge data and the most 
current provider-specific file that is used for payment purposes. Our 
analysis has several qualifications. First, we draw upon various 
sources for the data used to categorize hospitals in Table 2, below. In 
some cases, there is a degree of variation in the data from the 
different sources. We have attempted to construct these variables with 
the best available source overall. For individual hospitals, however, 
some miscategorizations are possible.
    Using CY 1996 cost and charge data, we simulated payments using the 
pre-PPS and PPS payment methodologies. Although we used only single-
procedure/visit bills to determine APC relative payment weights, we 
used both single and multiple-procedure bills in the conversion factor 
and service mix calculations, regressions, and impact analyses. Both 
pre-PPS and PPS payment estimates include operating and capital costs, 
adjusted to the calendar year 1996 cost reporting period. We excluded 
Kaiser, New York Health and Hospital Corporation, and all-inclusive 
providers because reported charges on their cost reports are not actual 
charges. Cost-to-charge ratios for these hospitals are not comparable 
to all other hospitals. The excluded Maryland hospitals were not 
included in the calculation of the conversion factor and the 
simulations; however, we did include the 10 cancer hospitals that will 
be paid under the PPS.
    We also trimmed outlier hospitals from the impact analysis because 
inclusion of hospitals with extremely high and low unit costs would not 
allow us to assess the impacts among the various classes of hospitals 
accurately. First, we identified all of the outlier hospitals by using 
an edit of 3 standard deviations from the mean of the logged unit 
costs. Trimming the data in this manner ensures that only the hospitals 
with aberrantly high and low costs are eliminated from the impact 
analysis. In doing this, we removed 97 hospitals of which 41 hospitals 
had extremely low unit costs and 56 hospitals had extremely high unit 
costs. We conducted a thorough analysis of these hospitals to ensure 
that we did not remove any particular type of hospital (for example, 
teaching hospitals) that would further harm the integrity of the data. 
We speculate that many of these hospitals are not coding accurately, 
and we will continue to perform further analysis in this area following 
implementation of the PPS.
    After we removed the 58 excluded Maryland hospitals, the all-
inclusive rate hospitals, the statistical outlier hospitals, and 
hospitals for which we could not identify payment variables, we used 
the remaining 5,362 hospitals as the basis for our analysis. Table 2, 
Annual Impact of Outpatient Prospective Payment System in CY2000-
CY2001, below, demonstrates the results of our analysis. The table 
categorizes hospitals by various geographic and special payment 
consideration groups to illustrate the varying impacts on different 
types of hospitals. The first column represents the number of hospitals 
in each category. The second column shows the hospitals' Medicare 
outpatient payments under the current (non-PPS) payment system as a 
percentage of the hospitals' total Medicare payment. The third and 
fourth columns show the impact of the PPS excluding the transitional 
corridor payments enacted by the BBRA 1999. Column three shows the 
percentage change in total Medicare outpatient payments comparing pre-
PPS payments with payments under the PPS. The fourth column shows the 
change in total (outpatient and inpatient) Medicare payments resulting 
from implementation of the PPS for outpatient services. The fifth and 
sixth columns show the impact of the PPS including the transitional 
corridor payments enacted by the BBRA 1999. Column five shows the 
percentage change in Medicare outpatient payments comparing pre-PPS 
payments with payments under the PPS. Column six shows the change in 
total (outpatient and inpatient) Medicare payments resulting from 
implementation of the PPS for outpatient services.
    The first row of Table 2 shows the overall impact on the 5,362 
hospitals included in the analysis. We included as much data as 
possible to the extent that we were able to capture all the provider 
information necessary to determine payment. Our estimates include the 
same set of services for both pre-PPS and PPS payments so that we could 
determine the impact of the PPS as accurately as possible. Because 
payment under the hospital outpatient PPS can only be determined if 
bills are accurately coded, the data upon which the impacts were 
developed do not reflect all CY 1996 hospital outpatient services, but 
only those that were coded using valid HCPCS codes.
    The second row of Table 2 shows the overall impact of the PPS on 
the 4,828 hospitals that remain when we exclude psychiatric, long-term 
care, children's, and rehabilitation hospitals.
    The next four rows of the table contain hospitals categorized 
according to their geographic location (all urban, which is subdivided 
into large urban and other urban, and rural). We include 2,665 
hospitals located in urban areas (MSAs or NECMAs) in our analysis. 
Among these, 1,505 hospitals are located in large urban areas 
(populations over 1 million), and 1,160 hospitals are located in other 
urban areas (populations of 1 million or less). In addition, we include 
2,160 hospitals located in rural areas in our analysis. The next two 
groupings are by bed-size categories, shown separately for urban and 
rural hospitals. The next category groups urban and rural hospitals by 
volume of outpatient services. We then show the distribution of urban 
and rural hospitals by regional census divisions.
    The next three categories group hospitals according to whether or 
not they have residency programs (teaching hospitals that receive an 
indirect medical education (IME) adjustment), receive disproportionate 
share hospital (DSH) payments, or some combination of these two 
adjustments. In our analysis we show the impact of the PPS on the 3,738 
nonteaching hospitals, the 821 teaching hospitals with fewer than 100 
residents, and the 269 teaching hospitals with 100 or more residents.
    In the DSH categories, hospitals are grouped according to their DSH 
payment status. The next category groups hospitals considered urban 
after geographic reclassification, in terms of whether they receive the 
IME adjustment, the DSH adjustment, both, or neither. The next five 
rows examine the impacts of the changes on rural hospitals by special 
payment groups (rural referral centers (RRCs), sole community 
hospitals/essential access community hospitals (SCHs/EACHs), Medicare 
dependent hospitals (MDHs), and hospitals that are both SCHs and

[[Page 18532]]

RRCs), as well as rural hospitals not receiving a special payment 
designation. The RRCs (164), SCH/EACHs (634), MDHs (358), and SCH and 
RRCs (56) shown here were not reclassified for purposes of the 
standardized amount.
    The next grouping is based on type of ownership. These data are 
taken primarily from the FY 1996 Medicare cost report files, if 
available; otherwise, earlier cost report data are used.
    The final two groups are specialty hospitals. The first set 
includes eye and ear hospitals, trauma hospitals (hospitals having a 
level one trauma center), and cancer hospitals, which are TEFRA 
hospitals. The last group lists all other TEFRA hospitals, 
specifically, rehabilitation, psychiatric, long-term care, and 
children's hospitals.

G. Estimated Impact of the New APC System (Includes Table 2, Annual 
Impact of Hospital Outpatient Prospective Payment System in CY2000-
CY2001)

    Column 3 compares our estimate of PPS payments without application 
of the BBRA 1999 transitional corridors, but incorporating policy 
changes and all other BBRA 1999 provisions contained in this final 
rule, to our estimate of payments under the current system. The percent 
differences shown in columns 3 and 4 between current and PPS payment 
(without the BBRA 1999 transitional corridors) reflect the impact of 
the BBRA 1999 outlier and pass-through payment adjustments and 
nonbudget-neutral hold-harmless provisions for cancer hospitals, as 
well as distributional differences attributable to variation in cost 
and charge structures among hospitals.
    The percent changes in columns 5 and 6 are the result of comparing 
our estimate of PPS payments with application of the BBRA 1999 
transitional corridors, as well as the statutory and policy changes 
contained in this final rule, to our estimate of payments under the 
pre-PPS system. Percent differences between the pre-PPS and the PPS 
payment (with the BBRA 1999 transition) reflect the combined impact of 
the transitional corridor adjustments, outlier and pass-through payment 
adjustments and the hold-harmless provision for cancer hospitals, in 
addition to distributional differences attributable to variation in 
cost and charge structures among hospitals.
    Basing the conversion factor on pre-PPS program and pre-PPS 
beneficiary payments and on budget-neutral outlier and pass-through 
adjustments results in no net change in payments to hospitals overall 
relative to pre-PPS payments. (As noted above, in section III.E.2 of 
this preamble, pursuant to section 201(l) of the BBRA 1999, we set the 
conversion factor by estimating pre-PPS rather than PPS copayments.) 
However, the BBRA hold-harmless provision for cancer hospitals results 
in a 0.2 percent increase in payments to hospitals overall because this 
provision is not budget neutral. Including the BBRA 1999 transitional 
corridor adjustments further increases payment to hospitals overall. We 
estimate that in calendar year 2000, payment will increase by an annual 
rate of 4.6 percent under the PPS compared to the pre-PPS payments.
    Without the BBRA 1999 transitional corridor payments, the impact on 
short-term acute care hospitals is negative for a substantial number of 
hospital classifications. That is, for certain groups of hospitals, 
payments under the PPS without the transitional corridor payments would 
be several percentage points below pre-PPS payments. For nearly all of 
these hospital groups, the BBRA 1999 transitional corridor payments 
mitigate this negative impact. In addition, hospital groups that 
experience net gains without the BBRA 1999 transitional corridor 
payments experience even greater gains with them. The reason is that 
even though the average impact for hospitals in these groups is 
positive, some individual hospitals experience net losses in payments 
and, thus, benefit from the transitional corridor payments. The 
hospital groups that gain without the transitional corridor payments 
receive even greater increases in payments with the transitional 
corridor payments. The following discussion highlights some of the 
changes in payments among hospital classifications.
    Comparing the pre-PPS and PPS payment estimates, payment to low-
volume hospitals would decrease substantially without the BBRA 1999 
transitional corridor payments (12.2 percent annually for rural and 7.7 
percent annually for urban hospitals with fewer than 5,000 units of 
service). These hospitals experience a net gain with the BBRA 1999 
transitional corridor payments (2.5 percent annually and 0.2 percent 
annually for low-volume rural and urban hospitals, respectively), 
although these payment increases are relatively small compared to the 
4.6 percent annual increase for hospitals overall. We believe several 
factors contribute to this outcome, including undercoding, lack of 
economies of scale, and the reliance on the median instead of the 
geometric mean in the calculation of APC weights. The majority of these 
hospitals (about 75 percent) are rural. For these small hospitals, some 
of the higher standardized unit costs could be attributed to economies 
of scale. These low-volume rural hospitals also receive a greater 
percentage of their Medicare income (18.5 percent) from outpatient 
services than the national average (9.9 percent).
    Major teaching hospitals, whose payments would decrease annually by 
3.7 percentage points without the BBRA 1999 transitional corridor 
payments, gain 2.6 percent annually with the BBRA 1999 transitional 
corridor payments relative to pre-PPS payments. Major teaching 
hospitals receive less of their total Medicare income (9.1 percent) 
from outpatient services than the national average. This results in a 
0.2 percent annual gain in their total Medicare payments. Minor 
teaching and nonteaching hospitals would experience marginal gains in 
outpatient payment without the BBRA 1999 transitional corridor 
payments. Payment to both hospital groups increases by 5.0 percent 
annually relative to the pre-PPS payment system.
    Without the BBRA 1999 transitional corridor payments, hospitals 
with a high percentage of low-income patients (disproportionate share 
patient percentage greater than or equal to 0.35) would have a 2.5 
percent annual decrease in payment relative to pre-PPS payments. But 
payments to these hospitals increase annually by 3.5 percent relative 
to pre-PPS payments with the BBRA 1999 transitional corridor payments. 
These hospitals have lower than average volume, and, like major 
teaching hospitals, receive a smaller than average percentage of their 
Medicare income from outpatient services. Thus, their total Medicare 
payments increase marginally, by 0.3 percent, with the BBRA 1999 
transitional corridor payments.
    Without the BBRA 1999 adjustments, payment to rural hospitals would 
decrease 1.8 percent annually and payment to large urban hospitals 
would decrease 0.3 percent annually, while payment to other urban 
hospitals would increase 1.8 percent annually relative to pre-PPS 
payments. These hospitals all experience net gains in PPS payment with 
the BBRA 1999 transitional corridor payments, at an annual rate of 4.4 
percent, 4.3 percent, and 5.1 percent, respectively. Even though rural 
hospitals receive a greater percentage of their Medicare income (14.7 
percent) from outpatient services compared to the national average, 
their total Medicare payments increase by only a fraction, 0.6 percent.
    Negative impacts for urban hospitals in the Mid-Atlantic and the 
West North Central regions are also reversed under

[[Page 18533]]

the BBRA 1999 transitional corridor payments, changing from -3.4 
percent to 2.4 percent on an annual basis, and from -3.5 percent to 2.5 
percent on an annual basis, respectively. Similarly, rural hospitals in 
nearly all census regions experience net increases in payment relative 
to pre-PPS payments with the BBRA 1999 transitional corridor payments.
    The impact on TEFRA hospitals is shown separately at the end of the 
table. The TEFRA hospitals were not included in determining the impact 
on any of the other categories discussed above (for example, geographic 
location, bed size, volume, etc.). These hospitals demonstrated a very 
low service mix, but an average unit cost that approximates the 
national average. We believe that undercoding or billing an all-
inclusive rate could account for their low-volume, low-service mix, and 
average cost per unit. We expect that once these hospitals begin to 
code services accurately under the PPS, payments will more closely 
approximate pre-PPS payments.
    If the effect of the BBRA 1999 transition payments were removed, 
differences between pre-PPS payments and PPS payments among hospitals 
would still exist. These distributional differences are the result of 
many factors. First, cost variations among hospitals result in 
differences between pre-PPS payments and PPS payments, and charge 
structure variations result in differences between pre-PPS payments and 
PPS beneficiary copayment amounts. Hospitals whose costs are low 
relative to payment would gain under the PPS even without the BBRA 1999 
transitional corridor payments. Because the transitional corridor 
payments are not budget neutral, these hospitals continue to gain 
relative to pre-PPS payments.
    Redistributions may also occur as a result of current payment 
methods. Total Medicare outpatient payments are less than reported 
total costs because (in addition to the 5.8 and 10 percent reductions 
for operating and capital costs) the blended payment methods applicable 
to many surgical and diagnostic services often result in payments that 
are less than reported costs. Other services such as medical visits, 
chemotherapy services, and non-ASC approved surgeries are paid based on 
hospital costs. The new system redistributes the current total Medicare 
payments, based in part on cost-based payments and in part on blended 
payment amounts, across all services. Hospitals, in the aggregate, will 
receive proportionately less for services that are currently paid based 
on costs, and more for services that had been paid under blended 
payment methods.

            Table 2. Annual Impact Of Hospital Outpatient Prospective Payment System In CY2000-CY2001
----------------------------------------------------------------------------------------------------------------
                                                                   Excluding BBRA            Including BBRA
                                                              transitional corridors 1   transitional corridors
                                                             ---------------------------------------------------
                                     Number of    Outpatient    Percent      Percent      Percent      Percent
                                     hospitals     percent     change in    change in    change in    change in
                                                                Medicare      total       Medicare      total
                                                               outpatient    Medicare    outpatient    Medicare
                                                               payments 3    payments    payments 3    payments
                                            (1)          (2)          (3)          (4)          (5)          (6)
----------------------------------------------------------------------------------------------------------------
 
ALL HOSPITALS.....................        5,362          9.9          0.2          0.0          4.6          0.5
NON-TEFRA HOSPITALS...............        4,828           10          0.1          0.0          4.6          0.5
URBAN HOSPS 2.....................        2,665          9.3          0.6          0.1          4.6          0.4
LARGE URBAN 2 (GT 1 MILL.)........        1,505          9.1         -0.3          0.0          4.3          0.4
OTHER URBAN 2 (LE 1 MILL.)........        1,160          9.7          1.8          0.2          5.1          0.5
RURAL HOSPS.......................        2,160         14.7         -1.8         -0.3          4.4          0.6
BEDS (URBAN): 2
    0--99 BEDS....................          672         14.9          0.6          0.1          4.6          0.7
    100-199 BEDS..................          924         10.5          1.3          0.1          5.2          0.5
    200-299 BEDS..................          533          9.2          0.8          0.1          4.4          0.4
    300-499 BEDS..................          399          8.5          1.8          0.2          5.2          0.4
    500 + BEDS....................          137          8.4         -2.9         -0.2          2.8          0.2
BEDS (RURAL):
    0--49 BEDS....................        1,170         19.5         -8.5         -1.7          3.3          0.6
    50-99 BEDS....................          615         15.5         -2.7         -0.4          4.4          0.7
    100-149 BEDS..................          223         13.3         -0.2          0.0          3.8          0.5
    150-199 BEDS..................           81           13          2.5          0.3          5.5          0.7
    200 + BEDS....................           71         11.6          2.7          0.3          6.1          0.7
VOLUME (URBAN):
    LT 5,000......................          349           12         -7.7         -0.9          0.2          0.0
    5,000-10,999..................          504          9.8          0.0          0.0          4.2          0.4
    11,000-20,999.................          596          9.1          0.1          0.0          4.4          0.4
    21,000-42,999.................          773          8.8          1.3          0.1          4.9          0.4
    GT 42,999.....................          443          9.7          0.4          0.0          4.6          0.4
VOLUME (RURAL):
    LT 5,000......................        1,049         18.5        -12.2         -2.3          2.5          0.5
    5,000-10,999..................          595         15.2         -5.2         -0.8          2.9          0.4
    11,000-20,999.................          322         13.8          0.1          0.0          4.7          0.6
    21,000-42,999.................          173         13.6          2.4          0.3          5.7          0.8
    GT 42,999.....................           21         13.2          3.0          0.4          6.8          0.9
REGION (URBAN): 3
    NEW ENGLAND...................          146         10.7          3.8          0.4          6.7          0.7
    MIDDLE ATLANTIC...............          393          8.4         -3.4         -0.3          2.4          0.2
    SOUTH ATLANTIC................          401          8.6          0.3          0.0          4.2          0.4
    EAST NORTH CENT...............          465         10.7          1.0          0.1          4.5          0.5

[[Page 18534]]

 
    EAST SOUTH CENT...............          161          7.9          1.8          0.1          4.6          0.4
    WEST NORTH CENT...............          183          9.5          0.9          0.1          4.9          0.5
    WEST SOUTH CENT...............          335          9.7         -2.7         -0.3          2.5          0.2
    MOUNTAIN......................          123         10.2          3.1          0.3          6.1          0.6
    PACIFIC.......................          423          9.4          5.6          0.5          8.6          0.8
    PUERTO RICO...................           35          6.6         10.8          0.7         13.2          0.9
REGION (RURAL):
    NEW ENGLAND...................           53         17.2         -3.2         -0.6          3.3          0.6
    MIDDLE ATLANTIC...............           80         13.6          7.1          1.0         10.1          1.4
    SOUTH ATLANTIC................          285         11.8         -1.8         -0.2          3.6          0.4
    EAST NORTH CENT...............          282         15.7         -1.2         -0.2          4.3          0.7
    EAST SOUTH CENT...............          260         11.1          0.1          0.0          4.9          0.5
    WEST NORTH CENT...............          508         19.8         -5.2         -1.0          3.0          0.6
    WEST SOUTH CENT...............          337         14.2         -5.7         -0.8          3.0          0.4
    MOUNTAIN......................          213         16.9         -3.4         -0.6          4.7          0.8
    PACIFIC.......................          140         15.9          0.7          0.1          6.3          1.0
    PUERTO RICO...................            2          6.6         32.1          2.1         32.1          2.1
TEACHING STATUS:
    NON-TEACHING..................        3,738         11.3          0.5          0.1          5.0          0.6
    MINOR.........................          821          9.1          1.6          0.1          5.0          0.5
    MAJOR.........................          269          9.1         -3.7         -0.3          2.6          0.2
DSH PATIENT PERCENT:
    0.............................          101         10.9         -5.8         -0.6          0.7          0.1
    GT 0--0.10....................        1,139         10.5          0.8          0.1          4.6          0.5
    0.10-0.16.....................          986           11          2.0          0.2          5.6          0.6
    0.16-0.23.....................          880         10.1          0.8          0.1          4.9          0.5
    0.23-0.35.....................          855          9.5         -1.5         -0.1          3.7          0.4
    GE 0.35.......................          867          9.2         -2.5         -0.2          3.5          0.3
URBAN IME/DSH: 2
    IME & DSH.....................          994            9         -0.4          0.0          4.1          0.4
    IME/NO DSH....................           17          9.2         -3.6         -0.3          1.1          0.1
    NO IME/DSH....................        1,611          9.9          1.9          0.2          5.4          0.5
    NO IME/NO DSH.................           43         14.7         -8.2         -1.2         -0.3          0.0
RURAL HOSP. TYPES:
    NO SPECIAL STATUS.............          864           15         -2.2         -0.3          4.4          0.7
    RRC...........................          164         12.3          5.0          0.6          7.3          0.9
    SCH/EACH......................          634         16.5         -7.7         -1.3          2.2          0.4
    MDH...........................          358         18.3         -5.4         -1.0          3.5          0.6
    SCH AND RRC...................           56         13.9         -1.4         -0.2          3.1          0.4
TYPE OF OWNERSHIP:
    VOLUNTARY.....................        2,816          9.9          0.6          0.1          4.7          0.5
    PROPRIETARY...................          752          8.3         -0.1          0.0          4.7          0.4
    GOVERNMENT....................        1,260         12.2         -2.3         -0.3          3.6          0.4
SPECIALTY HOSPITALS:
    EYE AND EAR...................           10         31.1         20.1          6.3         20.2          6.3
    TRAUMA........................          159          9.1         -1.2         -0.1          4.0          0.4
    CANCER........................           10           22          0.8          0.2          0.8          0.2
TEFRA HOSPITALS (NOT INCLUDED ON
 OTHER LINES):
    REHAB.........................          147          3.7         -9.4         -0.3          1.7          0.1
    PSYCH.........................          281            9         21.3          1.9         27.9          2.5
    LTC...........................           65          3.7        -15.3         -0.6         -1.7         -0.1
    CHILDREN......................           41         16.5        -11.9         -2.0         -3.2        -0.5
----------------------------------------------------------------------------------------------------------------
Notes:
1 Includes all BBRA provisions except the transitional corridor provisions that expire 01/01/04.
2 Does not include impact of reclassifications as allowed under section 401 of the BBRA 1999.
3 Estimate of change compared to pre-PPS payments, which reflect the payment methodologies in effect as of
  January 1, 2000, and prior to July 1, 2000.


[[Page 18535]]

X. Federalism

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

XI. Waiver of Proposed Rulemaking

    We ordinarily publish a notice of proposed rulemaking in the 
Federal Register and invite public comment on the 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 a 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. We find that the 
circumstances surrounding this rule make it impracticable to pursue a 
process of notice-and-comment rulemaking before the provisions of this 
rule take effect.
    The BBRA 1999 was enacted on November 29, 1999. This final rule 
incorporates the following hospital outpatient PPS provisions in the 
BBRA 1999: outlier adjustment for high cost cases; transitional pass-
through payment adjustments for additional costs (over the payments for 
APCs otherwise made) for new medical devices, drugs, and biologicals; 
definition of APCs so that the variation of costs of items within an 
APC is subject to certain limits; establishment of ``transitional 
corridors'' for the first 3\1/2\ years of the new system that limit 
losses hospitals might otherwise face; payment for implantable devices 
under the hospital outpatient PPS, rather than under the Durable 
Medical Equipment Fee Schedule; limitation of the copayment on an 
outpatient procedure to the amount of the inpatient hospital 
deductible; requirement to review annually the APC groups, relative 
weights, and wage and other adjustments; and calculation of the 
conversion factor in a budget-neutral manner, eliminating the 5.7 
percent reduction indicated in the proposed rule.
    As discussed earlier in this rule, July 1, 2000 is the earliest 
date on which we can feasibly implement the PPS. The provisions of the 
BBRA 1999, enacted on November 29, 1999, made numerous refinements to 
the PPS. With respect to the BBRA 1999 provisions, it would have been 
impracticable to complete notice and comment procedures by July 1, 
2000. Given the limited timeframe, given the nature and scope of the 
BBRA 1999 refinements, and given the time required to complete notice 
and comment rulemaking (to develop proposed policies, draft the 
proposed rule, provide a 60-day public comment period, consider public 
comments, develop final policies, draft a final rule), it would not 
have been possible to issue this document as a proposed rule and issue 
a final rule by July 1.
    In addition, it would not be feasible to implement the hospital 
outpatient PPS without the BBRA 1999 provisions, not only because of 
the nature of the BBRA 1999 provisions, but also because section 201(m) 
of the BBRA 1999 states: ``Except as provided in this section, the 
amendments made by this section shall be effective as if included in 
the enactment of BBA.'' Therefore, if we undertook prior notice and 
comment procedures with respect to the BBRA 1999 provisions, then 
(because such procedures could not be completed by July 1, 2000) the 
PPS would not be implemented by July 1, 2000.
    Accordingly, we find good cause to waive the procedures for prior 
notice and comment with respect to the provisions of this document that 
implement the BBRA 1999 refinements to hospital outpatient PPS. We are 
providing a 60-day period for public comment with respect to the 
provisions of this final rule with comment period that implement the 
BBRA refinements. We are not accepting comments with respect to the 
other aspects of this document (for which the public has already had an 
extensive opportunity to comment).

List of Subjects

42 CFR Part 409

    Health facilities, Medicare.

42 CFR Part 410

    Health facilities, Health professions, Kidney diseases, 
Laboratories, Medicare, Rural areas, X-rays.

42 CFR Part 411

    Kidney diseases, Medicare, Reporting and recordkeeping 
requirements.

42 CFR Part 412

    Administrative practice and procedure, Health facilities, Medicare, 
Puerto Rico, Reporting and recordkeeping requirements.

42 CFR Part 413

    Health facilities, Kidney diseases, Medicare, Puerto Rico, 
Reporting and recordkeeping requirements.

42 CFR Part 419

    Health facilities, Hospitals, Medicare.

42 CFR Part 424

    Emergency medical services, Health facilities, Health professions, 
Medicare.

42 CFR Part 489

    Health facilities, Medicare, Reporting and recordkeeping 
requirements.

42 CFR Part 498

    Administrative practice and procedure, Health facilities, Health 
professions, Medicare, Reporting and recordkeeping requirements.

42 CFR Part 1003

    Administrative practice and procedure, Archives and records, Grant 
program--social programs, Maternal and Child Health, Medicaid, 
Medicare, Penalties.
    For the reasons set forth in the preamble, 42 CFR chapter IV is 
amended as follows:

PART 409--HOSPITAL INSURANCE BENEFITS

    A. Part 409 is amended as set forth below:
    1. The authority citation for part 409 continues to read as 
follows:

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

Subpart B--Inpatient Hospital Services and Inpatient Critical 
Access Hospital Services

    2. In Sec. 409.10, paragraph (b) is revised to read as follows:


Sec. 409.10  Included services.

* * * * *
    (b) Inpatient hospital services does not include the following 
types of services:
    (1) Posthospital SNF care, as described in Sec. 409.20, furnished 
by a hospital or a critical access hospital that has a swing-bed 
approval.
    (2) Nursing facility services, described in Sec. 440.155 of this 
chapter, that may be furnished as a Medicaid service under title XIX of 
the Act in a swing-bed hospital that has an approval to furnish nursing 
facility services.
    (3) Physician services that meet the requirements of 
Sec. 415.102(a) of this chapter for payment on a fee schedule basis.
    (4) Physician assistant services, as defined in section 
1861(s)(2)(K)(i) of the Act.
    (5) Nurse practitioner and clinical nurse specialist services, as 
defined in section 1861(s)(2)(K)(ii) of the Act.

[[Page 18536]]

    (6) Certified nurse mid-wife services, as defined in section 
1861(gg) of the Act.
    (7) Qualified psychologist services, as defined in section 1861(ii) 
of the Act.
    (8) Services of an anesthetist, as defined in Sec. 410.69 of this 
chapter.

PART 410--SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS

    B. Part 410 is amended as set forth below:
    1. The authority citation for part 410 continues to read as 
follows:

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

Subpart A--General Provisions

    2. In Sec. 410.2, the introductory text is republished, the 
definition of ``Community mental health center (CMHC)'' is revised, and 
the definitions of ``Encounter'' and ``Outpatient'' are added in 
alphabetical order to read as follows:


Sec. 410.2  Definitions.

    As used in this part--
    Community mental health center (CMHC) means an entity that--
    (1) Provides outpatient services, including specialized outpatient 
services for children, the elderly, individuals who are chronically 
mentally ill, and residents of its mental health service area who have 
been discharged from inpatient treatment at a mental health facility;
    (2) Provides 24-hour-a-day emergency care services;
    (3) Provides day treatment or other partial hospitalization 
services, or psychosocial rehabilitation services;
    (4) Provides screening for patients being considered for admission 
to State mental health facilities to determine the appropriateness of 
this admission; and
    (5) Meets applicable licensing or certification requirements for 
CMHCs in the State in which it is located.
    Encounter means a direct personal contact between a patient and a 
physician, or other person who is authorized by State licensure law 
and, if applicable, by hospital or CAH staff bylaws, to order or 
furnish hospital services for diagnosis or treatment of the patient.
* * * * *
    Outpatient means a person who has not been admitted as an inpatient 
but who is registered on the hospital or CAH records as an outpatient 
and receives services (rather than supplies alone) directly from the 
hospital or CAH.
* * * * *

Subpart B--Medical and Other Health Services

    3. In Sec. 410.27:
    A. The section heading is revised;
    B. The introductory text to paragraph (a) is revised;
    C. The introductory text to paragraph (a)(1) is republished;
    D. The word ``and'' at the end of paragraph (a)(1)(i) is removed; 
and
    E. New paragraphs (a)(1)(iii), (e), and (f) are added to read as 
follows:


Sec. 410.27  Outpatient hospital services and supplies incident to a 
physician service: Conditions.

    (a) Medicare Part B pays for hospital services and supplies 
furnished incident to a physician service to outpatients, including 
drugs and biologicals that cannot be self-administered, if--
    (1) They are furnished--
* * * * *
    (iii) In the hospital or at a location (other than an RHC or an 
FQHC) that HCFA designates as a department of a provider under 
Sec. 413.65 of this chapter; and
* * * * *
    (e) Services furnished by an entity other than the hospital are 
subject to the limitations specified in Sec. 410.42(a).
    (f) Services furnished at a location (other than an RHC or an FQHC) 
that HCFA designates as a department of a provider under Sec. 413.65 of 
this chapter must be under the direct supervision of a physician. 
``Direct supervision'' means the physician must be present and on the 
premises of the location and immediately available to furnish 
assistance and direction throughout the performance of the procedure. 
It does not mean that the physician must be present in the room when 
the procedure is performed.

    4. In Sec. 410.28, paragraph (a)(4) is removed, paragraph (c) is 
redesignated as paragraph (d), and new paragraphs (c) and (e) are added 
to read as follows:


Sec. 410.28  Hospital or CAH diagnostic services furnished to 
outpatients: Conditions.

* * * * *
    (c) Diagnostic services furnished by an entity other than the 
hospital or CAH are subject to the limitations specified in 
Sec. 410.42(a).
* * * * *
    (e) Medicare Part B makes payment under section 1833(t) of the Act 
for diagnostic services furnished at a facility (other than an RHC or 
an FQHC) that HCFA designates as having provider-based status only when 
the diagnostic services are furnished under the appropriate level of 
physician supervision specified by HCFA in accordance with the 
definitions in Sec. 410.32(b)(3)(i), (b)(3)(ii), and (b)(3)(iii). Under 
general supervision at a facility accorded provider-based status, the 
training of the nonphysician personnel who actually perform the 
diagnostic procedure and the maintenance of the necessary equipment and 
supplies are the continuing responsibility of the facility.

    5. A new Sec. 410.42 is added to read as follows:


Sec. 410.42  Limitations on coverage of certain services furnished to 
hospital outpatients.

    (a) General rule. Except as provided in paragraph (b) of this 
section, Medicare Part B does not pay for any item or service that is 
furnished to a hospital outpatient (as defined in Sec. 410.2) during an 
encounter (as defined in Sec. 410.2) by an entity other than the 
hospital unless the hospital has an arrangement (as defined in 
Sec. 409.3 of this chapter) with that entity to furnish that particular 
service to its patients. As used in this paragraph, the term 
``hospital'' includes a CAH.
    (b) Exception. The limitations stated in paragraph (a) of this 
section do not apply to the following services:
    (1) Physician services that meet the requirements of 
Sec. 415.102(a) of this chapter for payment on a fee schedule basis.
    (2) Physician assistant services, as defined in section 
1861(s)(2)(K)(i) of the Act.
    (3) Nurse practitioner and clinical nurse specialist services, as 
defined in section 1861(s)(2)(K)(ii) of the Act.
    (4) Certified nurse mid-wife services, as defined in section 
1861(gg) of the Act.
    (5) Qualified psychologist services, as defined in section 1861(ii) 
of the Act.
    (6) Services of an anesthetist, as defined in Sec. 410.69.
    (7) Services furnished to SNF residents as defined in 
Sec. 411.15(p) of this chapter.
    6. In Sec. 410.43, paragraph (b) is revised to read as follows:


Sec. 410.43  Partial hospitalization services: Conditions and 
exclusions.

* * * * *
    (b) The following services are separately covered and not paid as 
partial hospitalization services:
    (1) Physician services that meet the requirements of 
Sec. 415.102(a) of this chapter for payment on a fee schedule basis.

[[Page 18537]]

    (2) Physician assistant services, as defined in section 
1861(s)(2)(K)(i) of the Act.
    (3) Nurse practitioner and clinical nurse specialist services, as 
defined in section 1861(s)(2)(K)(ii) of the Act.
    (4) Qualified psychologist services, as defined in section 1861(ii) 
of the Act.
    (5) Services furnished to SNF residents as defined in 
Sec. 411.15(p) of this chapter.

PART 411--EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE 
PAYMENT

    C. Part 411 is amended as set forth below:
    1. The authority citation for part 411 continues to read as 
follows:

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

Subpart A--General Exclusions and Exclusion of Particular Services

    2. In Sec. 411.15:
    A. The introductory text is republished;
    B. The section heading to paragraph (m) is revised;
    C. Paragraph (m)(1) is revised;
    D. Paragraph (m)(2) is redesignated as paragraph (m)(3);
    E. The introductory text to newly redesignated paragraph (m)(3) is 
republished;
    F. Newly redesignated paragraphs (m)(3)(iii), (m)(3)(iv), and 
(m)(3)(v) are redesignated as paragraphs (m)(3)(iv), (m)(3)(v), and 
(m)(3)(vi), respectively; and
    G. New paragraphs (m)(2) and (m)(3)(iii) are added to read as 
follows:


Sec. 411.15  Particular services excluded from coverage.

    The following services are excluded from coverage:
* * * * *
    (m) Services to hospital patients--(1) Basic rule. Except as 
provided in paragraph (m)(3) of this section, any service furnished to 
an inpatient of a hospital or to a hospital outpatient (as defined in 
Sec. 410.2 of this chapter) during an encounter (as defined in 
Sec. 410.2 of this chapter) by an entity other than the hospital unless 
the hospital has an arrangement (as defined in Sec. 409.3 of this 
chapter) with that entity to furnish that particular service to the 
hospital's patients. As used in this paragraph (m)(1), the term 
``hospital'' includes a CAH.
    (2) Scope of exclusion. Services subject to exclusion from coverage 
under the provisions of this paragraph (m) include, but are not limited 
to, clinical laboratory services; pacemakers and other prostheses and 
prosthetic devices (other than dental) that replace all or part of an 
internal body organ (for example, intraocular lenses); artificial 
limbs, knees, and hips; equipment and supplies covered under the 
prosthetic device benefits; and services incident to a physician 
service.
    (3) Exceptions. The following services are not excluded from 
coverage:
* * * * *
    (iii) Nurse practitioner and clinical nurse specialist services, as 
defined in section 1861(s)(2)(K)(ii) of the Act.
* * * * *

PART 412--PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL 
SERVICES

    D. Part 412 is amended as set forth below:
    1. The authority citation for part 412 continues to read as 
follows:

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

Subpart C--Conditions for Payment Under the Prospective Payment 
Systems for Inpatient Operating Costs and Inpatient Capital-Related 
Costs

    2. In Sec. 412.50, paragraphs (a) and (b) are revised to read as 
follows:


Sec. 412.50  Furnishing of inpatient hospital services directly or 
under arrangements.

    (a) The applicable payments made under the prospective payment 
systems, as described in subparts H and M of this part, are payment in 
full for all inpatient hospital services, as defined in Sec. 409.10 of 
this chapter. Inpatient hospital services do not include the following 
types of services:
    (1) Physician services that meet the requirements of 
Sec. 415.102(a) of this chapter for payment on a fee schedule basis.
    (2) Physician assistant services, as defined in section 
1861(s)(2)(K)(i) of the Act.
    (3) Nurse practitioner and clinical nurse specialist services, as 
defined in section 1861(s)(2)(K)(ii) of the Act.
    (4) Certified nurse mid-wife services, as defined in section 
1861(gg) of the Act.
    (5) Qualified psychologist services, as defined in section 1861(ii) 
of the Act.
    (6) Services of an anesthetist, as defined in Sec. 410.69 of this 
chapter.
    (b) HCFA does not pay any provider or supplier other than the 
hospital for services furnished to a beneficiary who is an inpatient, 
except for the services described in paragraphs (a)(1) through (a)(6) 
of this section.
* * * * *

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

    E. Part 413 is amended as set forth below:
     1. The authority citation for part 413 continues to read as 
follows:

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

Subpart A--Introduction and General Rules


Sec. 413.1  [Amended]

    2. In Sec. 413.1, paragraph (a)(2)(viii) is removed.

Subpart B--Accounting Records and Reports

    3. In Sec. 413.24, the heading to paragraph (d) is republished, and 
a new paragraph (d)(6) is added to read as follows:


Sec. 413.24  Adequate cost data and cost finding.

* * * * *
    (d) Cost finding methods. * * *
    (6) Management contracts. (i) If the main provider purchases 
services for a department of the provider or a provider-based entity 
through a management contract or otherwise directly assigns costs to 
the department or entity, the like costs of the main provider must be 
carved out to ensure that they are not allocated to the department of 
the provider or provider-based entity. However, if the like costs of 
the main provider cannot be separately identified, the costs of the 
services purchased through a management contract must be included in 
the main provider's administrative and general costs and allocated 
among the provider's overall statistics.
    (ii) Costs of free-standing entities may not be shown in the 
provider's trial balance for purposes of stepping down overhead costs 
to these entities. The provider must develop detailed work papers 
showing the exact cost of the services (including overhead) provided to 
or by the free-standing entity and show those carved out costs as

[[Page 18538]]

nonreimbursable cost centers in the provider's trial balance.
* * * * *

Subpart E--Payments to Providers

    4. A new Sec. 413.65 is added to read as follows:


Sec. 413.65  Requirements for a determination that a facility or an 
organization has provider-based status.

    (a) Scope and definitions. (1) Scope. This section applies to all 
facilities or organizations for which provider-based status is sought, 
including remote locations of hospitals, as defined in paragraph (a)(2) 
of this section and satellite facilities as defined in 
Sec. 412.22(h)(1) and Sec. 412.25(e)(1) of this chapter, other than 
ESRD facilities. Determinations for ESRD facilities are made under 
Sec. 413.174 of this chapter.
    (2) Definitions. In this subpart E, unless the context indicates 
otherwise--
    Campus means the physical area immediately adjacent to the 
provider's main buildings, other areas and structures that are not 
strictly contiguous to the main buildings but are located within 250 
yards of the main buildings, and any other areas determined on an 
individual case basis, by the HCFA regional office, to be part of the 
provider's campus.
    Department of a provider means a facility or organization or a 
physician office that is either created by, or acquired by, a main 
provider for the purpose of furnishing health care services of the same 
type as those furnished by the main provider under the name, ownership, 
and financial and administrative control of the main provider, in 
accordance with the provisions of this section. A department of a 
provider may not be licensed to provide health care services in its own 
right, may not by itself be qualified to participate in Medicare as a 
provider under Sec. 489.2 of this chapter, and Medicare conditions of 
participation do not apply to a department as an independent entity. 
For purposes of this part, the term ``department of a provider'' does 
not include an RHC or, except as specified in paragraph (m)(1) of this 
section, an FQHC.
    Free-standing facility means an entity that furnishes health care 
services to Medicare beneficiaries and that is not integrated with any 
other entity as a main provider, a department of a provider, remote 
location of a hospital, satellite facility, or a provider-based entity.
    Main provider means a provider that either creates, or acquires 
ownership of, another entity to deliver additional health care services 
under its name, ownership, and financial and administrative control.
    Provider-based entity means a provider of health care services, or 
an RHC or an FQHC as defined in Sec. 405.2401(b) of this chapter, that 
is either created by, or acquired by, a main provider for the purpose 
of furnishing health care services of a different type from those of 
the main provider under the name, ownership, and administrative and 
financial control of the main provider, in accordance with the 
provisions of this section.
    Provider-based status means the relationship between a main 
provider and a provider-based entity or a department of a provider, 
remote location of a hospital, or satellite facility, that complies 
with the provisions of this section.
    Remote location of a hospital means a facility or an organization 
that is either created by, or acquired by, a hospital that is a main 
provider for the purpose of furnishing inpatient hospital services 
under the name, ownership, and financial and administrative control of 
the main provider, in accordance with the provisions of this section. A 
remote location of a hospital may not be licensed to provide inpatient 
hospital services in its own right, and Medicare conditions of 
participation do not apply to a remote location of a hospital as an 
independent entity. For purposes of this part, the term ``remote 
location of a hospital'' does not include a satellite facility as 
defined in Sec. 412.22(h)(1) and Sec. 412.25(e)(1) of this chapter.
    (b) Responsibility for obtaining provider-based determinations. (1) 
A facility or organization is not entitled to be treated as provider-
based simply because it or the main provider believe it is provider-
based.
    (2) A main provider or a facility or organization must contact HCFA 
and the facility or organization must be determined by HCFA to be 
provider-based before the main provider bills for services of the 
facility or organization as if the facility or organization were 
provider-based, or before it includes costs of those services on its 
cost report.
    (3) A facility that is not located on the campus of a hospital and 
is used as a site of physician services of the kind ordinarily 
furnished in physician offices will be presumed to be a free-standing 
facility, unless it is determined by HCFA to have provider-based 
status.
    (c) Reporting. (1) A main provider that creates or acquires a 
facility or organization for which it wishes to claim provider-based 
status, including any physician offices that a hospital wishes to 
operate as a hospital outpatient department or clinic, must report its 
acquisition of the facility or organization to HCFA if the facility or 
organization is located off the campus of the provider, or inclusion of 
the costs of the facility or organization in the provider's cost report 
would increase the total costs on the provider's cost report by at 
least 5 percent, and must furnish all information needed for a 
determination as to whether the facility or organization meets the 
requirements in paragraph (d) of this section for provider-based 
status.
    (2) A main provider that has had one or more facilities or 
organizations considered provider-based also must report to HCFA any 
material change in the relationship between it and any provider-based 
facility or organization, such as a change in ownership of the facility 
or organization or entry into a new or different management contract 
that could affect the provider-based status of the facility or 
organization.
    (d) Requirements. An entity must meet all of the following 
requirements to be determined by HCFA to have provider-based status.
    (1) Licensure. The department of the provider, remote location of a 
hospital, or satellite facility and the main provider are operated 
under the same license, except in areas where the State requires a 
separate license for the department of the provider, remote location of 
a hospital, or satellite facility, or in States where State law does 
not permit licensure of the provider and the prospective department of 
the provider, remote location of a hospital, or satellite facility 
under a single license. If a State health facilities' cost review 
commission or other agency that has authority to regulate the rates 
charged by hospitals or other providers in a State finds that a 
particular facility or organization is not part of a provider, HCFA 
will determine that the facility or organization does not have 
provider-based status.
    (2) Operation under the ownership and control of the main provider. 
The facility or organization seeking provider-based status is operated 
under the ownership and control of the main provider, as evidenced by 
the following:
    (i) The business enterprise that constitutes the facility or 
organization is 100 percent owned by the provider.
    (ii) The main provider and the facility or organization seeking 
status as a department of the provider, remote location of a hospital, 
or satellite facility have the same governing body.
    (iii) The facility or organization is operated under the same 
organizational documents as the main provider. For

[[Page 18539]]

example, the facility or organization seeking provider-based status 
must be subject to common bylaws and operating decisions of the 
governing body of the provider where it is based.
    (iv) The main provider has final responsibility for administrative 
decisions, final approval for contracts with outside parties, final 
approval for personnel actions, final responsibility for personnel 
policies (such as fringe benefits/code of conduct), and final approval 
for medical staff appointments in the facility or organization.
    (3) Administration and supervision. The reporting relationship 
between the facility or organization seeking provider-based status and 
the main provider must have the same frequency, intensity, and level of 
accountability that exists in the relationship between the main 
provider and one of its departments, as evidenced by compliance with 
all of the following requirements:
    (i) The facility or organization is under the direct supervision of 
the main provider.
    (ii) The facility or organization is operated under the same 
monitoring and oversight by the provider as any other department of the 
provider, and is operated just as any other department of the provider 
with regard to supervision and accountability. The facility or 
organization director or individual responsible for daily operations at 
the entity--
    (A) Maintains a reporting relationship with a manager at the main 
provider that has the same frequency, intensity, and level of 
accountability that exists in the relationship between the main 
provider and its departments; and
    (B) Is accountable to the governing body of the main provider, in 
the same manner as any department head of the provider.
    (iii) The following administrative functions of the facility or 
organization are integrated with those of the provider where the 
facility or organization is based: billing services, records, human 
resources, payroll, employee benefit package, salary structure, and 
purchasing services. Either the same employees or group of employees 
handle these administrative functions for the facility or organization 
and the main provider, or the administrative functions for both the 
facility or organization and the entity are--
    (A) Contracted out under the same contract agreement; or
    (B) Handled under different contract agreements, with the contract 
of the facility or organization being managed by the main provider.
    (4) Clinical services. The clinical services of the facility or 
organization seeking provider-based status and the main provider are 
integrated as evidenced by the following:
    (i) Professional staff of the facility or organization have 
clinical privileges at the main provider.
    (ii) The main provider maintains the same monitoring and oversight 
of the facility or organization as it does for any other department of 
the provider.
    (iii) The medical director of the facility or organization seeking 
provider-based status maintains a reporting relationship with the Chief 
Medical Officer or other similar official of the main provider that has 
the same frequency, intensity, and level of accountability that exists 
in the relationship between the medical director of a department of the 
main provider and the Chief Medical Officer or other similar official 
of the main provider, and is under the same type of supervision and 
accountability as any other director, medical or otherwise, of the main 
provider.
    (iv) Medical staff committees or other professional committees at 
the main provider are responsible for medical activities in the 
facility or organization including quality assurance, utilization 
review, and the coordination and integration of services, to the extent 
practicable, between the facility or organization seeking provider-
based status and the main provider.
    (v) Medical records for patients treated in the facility or 
organization are integrated into a unified retrieval system (or cross 
reference) of the main provider.
    (vi) Inpatient and outpatient services of the facility or 
organization and the main provider are integrated, and patients treated 
at the facility or organization who require further care have full 
access to all services of the main provider and are referred where 
appropriate to the corresponding inpatient or outpatient department or 
service of the main provider.
    (5) Financial integration. The financial operations of the facility 
or organization are fully integrated within the financial system of the 
main provider, as evidenced by shared income and expenses between the 
main provider and the facility or organization. The costs of the 
facility or organization are reported in a cost center of the provider, 
and the financial status of the facility or organization is 
incorporated and readily identified in the main provider's trial 
balance.
    (6) Public awareness. The facility or organization seeking status 
as a department of a provider, remote location of a hospital, or 
satellite facility is held out to the public and other payers as part 
of the main provider. When patients enter the provider-based facility 
or organization, they are aware that they are entering the main 
provider and are billed accordingly.
    (7) Location in immediate vicinity. The facility or organization 
and the main provider are located on the same campus, except where the 
following requirements are met:
    (i) The facility or organization demonstrates a high level of 
integration with the main provider by showing that it meets all of the 
other provider-based criteria, and demonstrates that it serves the same 
patient population as the main provider, by submitting records showing 
that, during the 12-month period immediately preceding the first day of 
the month in which the application for provider-based status is filed 
with HCFA, and for each subsequent 12-month period--
    (A) At least 75 percent of the patients served by the facility or 
organization reside in the same zip code areas as at least 75 percent 
of the patients served by the main provider;
    (B) At least 75 percent of the patients served by the facility or 
organization who required the type of care furnished by the main 
provider received that care from that provider (for example, at least 
75 percent of the patients of an RHC seeking provider-based status 
received inpatient hospital services from the hospital that is the main 
provider); or
    (C) If the facility or organization is unable to meet the criteria 
in paragraph (d)(7)(i)(A) or (d)(7)(i)(B) of this section because it 
was not in operation during all of the 12-month period described in the 
previous sentence, the facility or organization is located in a zip 
code area included among those that, during all of the 12-month period 
described in the previous sentence, accounted for at least 75 percent 
of the patients served by the main provider.
    (ii) A facility or organization is not considered to be in the 
``immediate vicinity'' of the main provider unless the facility or 
organization and the main provider are located in the same State or, 
where consistent with the laws of both States, adjacent States.
    (iii) A rural health clinic that is otherwise qualified as a 
provider-based entity of a hospital that is located in a rural area, as 
defined in Sec. 412.62(f)(1)(iii) of this chapter, and has fewer than 
50 beds, as determined under Sec. 412.105(b) of this chapter, is not 
subject to the criterion in this paragraph (d)(7).
    (e) Provider-based status not applicable to joint ventures. A 
facility or

[[Page 18540]]

organization cannot be considered provider-based if the entity is owned 
by two or more providers engaged in a joint venture. For example, where 
a hospital has jointly purchased or jointly created free-standing 
facilities under joint venture arrangements, neither party to the joint 
venture arrangement can claim the free-standing facility as a provider-
based entity.
    (f) Management contracts. Facilities and organizations that 
otherwise meet the requirements of paragraph (d) of this section, but 
are operated under management contracts, must also meet all of the 
following criteria:
    (1) The staff of the facility or organization, other than 
management staff, are employed by the provider or by another 
organization, other than the management company, which also employs the 
staff of the main provider.
    (2) The administrative functions of the facility or organization 
are integrated with those of the main provider, as determined under 
criteria in paragraph (d)(3)(iii) of this section.
    (3) The main provider has significant control over the operations 
of the facility or organization as determined under criteria in 
paragraph (b)(3)(ii) of this section.
    (4) The management contract is held by the main provider itself, 
not by a parent organization that has control over both the main 
provider and the facility or organization.
    (g) Obligations of hospital outpatient departments and hospital-
based entities. (1) Hospital outpatient departments located either on 
or off the campus of the hospital that is the main provider must comply 
with the anti-dumping rules in Secs. 489.20(l), (m), (q), and (r) and 
Sec. 489.24 of this chapter. If any individual comes to any hospital-
based entity (including an RHC) located on the main hospital campus, 
and a request is made on the individual's behalf for examination or 
treatment of a medical condition, as described in Sec. 489.24 of this 
chapter, the hospital must comply with the anti-dumping rules in 
Sec. 489.24 of this chapter.
    (2) Physician services furnished in hospital outpatient departments 
or hospital-based entities (other than RHCs) must be billed with the 
correct site-of-service indicator, so that applicable site-of-service 
reductions to physician and practitioner payment amounts can be 
applied.
    (3) Hospital outpatient departments must comply with all the terms 
of the hospital's provider agreement.
    (4) Physicians who work in hospital outpatient departments or 
hospital-based entities are obligated to comply with the non-
discrimination provisions in Sec. 489.10(b) of this chapter.
    (5) Hospital outpatient departments (other than RHCs) must treat 
all Medicare patients, for billing purposes, as hospital outpatients. 
The department must not treat some Medicare patients as hospital 
outpatients and others as physician office patients.
    (6) In the case of a patient admitted to the hospital as an 
inpatient after receiving treatment in the hospital outpatient 
department or hospital-based entity, payments for services in the 
hospital outpatient department or hospital-based entity are subject to 
the payment window provisions applicable to PPS hospitals and to 
hospitals and units excluded from PPS set forth at Sec. 412.2(c)(5) of 
this chapter and at Sec. 413.40(c)(2), respectively.
    (7) When a Medicare beneficiary is treated in a hospital outpatient 
department or hospital-based entity (other than an RHC) that is not 
located on the main provider's campus, the hospital has a duty to 
provide written notice to the beneficiary, prior to the delivery of 
services, of the amount of the beneficiary's potential financial 
liability (that is, of the fact that the beneficiary will incur a 
coinsurance liability for an outpatient visit to the hospital as well 
as for the physician service, and of the amount of that liability). The 
notice must be one that the beneficiary can read and understand. If the 
beneficiary is unconscious, under great duress, or for any other reason 
unable to read a written notice and understand and act on his or her 
own rights, the notice must be provided, prior to the delivery of 
services, to the beneficiary's authorized representative.
    (8) Hospital outpatient departments must meet applicable hospital 
health and safety rules for Medicare-participating hospitals in part 
482 of this chapter.
    (h) Furnishing all services under arrangement. A facility or 
organization may not qualify for provider-based status if all patient 
care services furnished at the facility are furnished under 
arrangement.
    (i) Inappropriate treatment of a facility or organization as 
provider-based. (1) Determination and review. If HCFA learns that a 
provider has treated a facility or organization as provider-based and 
the provider had not obtained a determination of provider-based status 
under this section, HCFA will--
    (i) Review current payments and, if necessary, take action in 
accordance with the rules on inappropriate billing in paragraph (j) of 
this section;
    (ii) Investigate and determine whether the requirements in 
paragraph (d) of this section (or, for periods prior to October 10, 
2000, the requirements in applicable program instructions) were met; 
and
    (iii) Review all previous payments to that provider for all cost 
reporting periods subject to re-opening in accordance with 
Sec. 405.1885 and Sec. 405.1889 of this chapter.
    (2) Recovery of overpayments. If HCFA finds that payments for 
services at the facility or organization have been made as if the 
facility or organization were provider-based, even though HCFA had not 
previously determined that the facility or organization qualified for 
provider-based status, HCFA will recover the difference between the 
amount of payments that actually were made and the amount of payments 
that HCFA estimates should have been made in the absence of a 
determination of provider-based status, except that recovery will not 
be made for any period prior to October 10, 2000 if during all of that 
period the management of the entity made a good faith effort to operate 
it as a provider-based facility or organization, as described in 
paragraph (h)(3) of this section.
    (3) Exception for good faith effort. HCFA determines that the 
management of a facility or organization has made a good faith effort 
to operate it as a provider-based entity if--
    (i) The requirements regarding licensure and public awareness in 
paragraphs (d)(1) and (d)(6) of this section are met;
    (ii) All facility services were billed as if they had been 
furnished by a department of a provider, remote location of a hospital, 
satellite facility, or a provider-based entity of the main provider; 
and
    (iii) All professional services of physicians and other 
practitioners were billed with the correct site-of-service indicator, 
as described in paragraph (g)(2) of this section.
    (j) Inappropriate billing. If HCFA finds that a facility or 
organization is being treated as provider-based without having obtained 
a determination of provider-based status under this section, HCFA will 
notify the provider, adjust future payments, review previous payments, 
determine whether the facility or organization qualifies for provider-
based status under this paragraph, and continue payments only under 
specific conditions, as described in paragraphs (j)(1), (j)(2), (j)(3), 
and (j)(4) of this section.
    (1) Notice to provider. If HCFA finds that inappropriate billing 
has occurred or is occurring since no provider-based

[[Page 18541]]

determination has been made by HCFA, HCFA will issue written notice to 
the provider that payments for past cost reporting periods may be 
reviewed and recovered as described in paragraph (i) of this section, 
that future payments for services in or of the facility or organization 
will be adjusted as described in paragraph (j)(2) of this section, and 
that a determination of provider-based status will be made.
    (2) Adjustment of payments. If HCFA finds that inappropriate 
billing has occurred or is occurring since no provider-based 
determination has been made by HCFA, HCFA will adjust future payments 
to the provider, the facility or organization, or both, to approximate 
as closely as possible the amounts that would be paid, in the absence 
of a provider-based determination, if all other requirements for 
billing were met.
    (3) Review of previous payments. If HCFA finds that inappropriate 
billing has occurred or is occurring since no provider-based 
determination has been made by HCFA, HCFA will review previous payments 
and, if necessary, take action in accordance with the rules on 
inappropriate treatment of a facility or organization as provider-based 
in paragraph (h) of this section.
    (4) Determination regarding provider-based status. If HCFA finds 
that inappropriate billing has occurred or is occurring since no 
provider-based determination has been made by HCFA, HCFA will determine 
whether the facility or organization qualifies for provider-based 
status under the criteria in this section. If HCFA determines that the 
facility or organization qualifies for provider-based status, future 
payment for services at or by the facility or organization will be 
adjusted to reflect that determination. If HCFA determines that the 
facility or organization does not qualify for provider-based status, 
future payment for services at or by the facility or organization will 
be made only in accordance with the rules in paragraph (i)(5) of this 
section.
    (5) Continuation of payment. The notice of denial of provider-based 
status sent to the provider will ask the provider to notify HCFA in 
writing, within 30 days of the date the notice is issued, of whether 
the facility or organization (or, where applicable, the practitioners 
who staff the facility or organization) will be seeking to enroll and 
meet other requirements to bill for services in a free-standing 
facility. If the provider indicates that the facility, organization, or 
practitioners will not be seeking to enroll, or if HCFA does not 
receive a response within 30 days of the date the notice was issued, 
all payment under this paragraph (i)(5) will end as of the 30th day 
after the date of notice. If the provider indicates that the facility 
or organization, or its practitioners, will be seeking to meet 
enrollment and other requirements for billing for services in a free-
standing facility, payment for services of the facility or organization 
will continue, at the adjusted amounts described in paragraph (j)(2) of 
this section for as long as is required for all billing requirements to 
be met (but not longer than 6 months) if the facility or organization, 
or its practitioners, submit a complete enrollment application and 
provide all other required information within 90 days after the date of 
notice; and the facility or organization, or its practitioners, furnish 
all other information needed by HCFA to process the enrollment 
application and verify that other billing requirements are met. If the 
necessary applications or information are not provided, HCFA will 
terminate all payment to the provider, facility, or organization as of 
the date HCFA issues notice that necessary applications or information 
have not been submitted.
    (k) Correction of errors. HCFA may review a past determination of 
provider-based status for a facility or organization or may review the 
status of a facility or organization (that is, whether the facility or 
organization is provider-based) if no determination regarding provider-
based status has previously been made, if HCFA believes that status may 
be inappropriate, based on the provisions of this section. If HCFA 
determines that a previous determination was in error, and the entity 
should not be considered provider-based, HCFA notifies the main 
provider. Treatment of the facility or organization as provider-based 
ceases with the first day of the next cost report period following 
notification of the redetermination, but not less than 6 months after 
the date of notification.
    (l) Status of Indian Health Service and Tribal facilities and 
organizations. Facilities and organizations operated by the Indian 
Health Service or Tribes will be considered to be departments of 
hospitals operated by the Indian Health Service or Tribes if, on or 
before April 7, 2000, they furnished only services that were billed as 
if they had been furnished by a department of a hospital operated by 
the Indian Health Service or a Tribe and they are:
    (1) Owned and operated by the Indian Health Service;
    (2) Owned by the Tribe but leased from the Tribe by the IHS under 
the Indian Self-Determination Act (Pub. L. 93-638) in accordance with 
applicable regulations and policies of the Indian Health Service in 
consultation with Tribes: or
    (3) Owned by the Indian Health Service but leased and operated by 
the Tribe under the Indian Self-Determination Act (Pub. L. 93-638) in 
accordance with applicable regulations and policies of the Indian 
Health Service in consultation with Tribes.
    (m) FQHCs and ``look-alikes''. A facility that has, since April 7, 
1995, furnished only services that were billed as if they had been 
furnished by a department of a provider will continue to be treated, 
for purposes of this section, as a department of the provider without 
regard to whether it complies with the criteria for provider-based 
status in this section, if the facility--
    (1) Received a grant before 1995 under section 330 of the Public 
Health Service Act, or is receiving funding from such a grant under a 
contract with the recipient of such a grant and meets the requirements 
to receive a grant under section 330 of the Public Health Service Act; 
or
    (2) Based on the recommendation of the Public Health Service, was 
determined by HCFA before 1995 to meet the requirements for receiving 
such a grant.
    (n) Effective date of provider-based status. Provider-based status 
for a facility or organization is effective on the earliest date on 
which a request for provider-based status has been made, and all 
requirements of this part have been met.

Subpart F--Specific Categories of Costs

    5. In Sec. 413.118, the heading to paragraph (d) is republished, 
and a new paragraph (d)(5) is added to read as follows:


Sec. 413.118  Payment for facility services related to covered ASC 
surgical procedures performed in hospitals on an outpatient basis.

* * * * *
    (d) Blended payment amount. * * *
    (5) For portions of cost reporting periods beginning on or after 
October 1, 1997, for purposes of calculating the blended payment amount 
under paragraph (d)(4) of this section, the ASC payment amount is the 
sum of the standard overhead amounts reduced by deductibles and 
coinsurance as defined in section 1866(a)(2)(ii) of the Act.
* * * * *
    6. In Sec. 413.122:
    A. The heading to paragraph (b) is republished
    B. A new paragraph (b)(5) is added
    C. The heading to paragraph (c) is republished; and

[[Page 18542]]

    D. A new paragraph (c)(4) is added to read as follows:


Sec. 413.122  Payment for hospital outpatient radiology services and 
other diagnostic procedures.

* * * * *
    (b) Payment for hospital outpatient radiology services. * * *
    (5) For hospital outpatient radiology services furnished on or 
after October 1, 1997, the blended payment amount is equal to the sum 
of--
    (i) 42 percent of the hospital-specific amount; and
    (ii) 58 percent of the fee schedule amount calculated as 62 percent 
of the sum of the fee schedule amounts payable for the same services 
when furnished by participating physicians in their offices in the same 
locality, less deductible and coinsurance as defined in section 
1866(a)(2)(A)(ii) of the Act.
    (c) Payment for other diagnostic procedures. * * *
    (4) For other diagnostic services furnished on or after October 1, 
1997, the blended payment amount is equal to the sum of--
    (i) 50 percent of the hospital-specific amount; and
    (ii) 50 percent of the fee schedule amount calculated as 42 percent 
of the sum of the fee schedule amounts payable for the same services 
when furnished by participating physicians in their offices in the same 
locality less deductible and coinsurance as defined in section 
1866(a)(2)(A)(ii) of the Act.

    7. In Sec. 413.124, paragraph (a) is revised to read as follows:


Sec. 413.124  Reduction to hospital outpatient operating costs.

    (a) Except for sole community hospitals, as defined in Sec. 412.92 
of this chapter, and critical access hospitals, the reasonable costs of 
outpatient hospital services (other than capital-related costs of these 
services) are reduced by 5.8 percent for services furnished during 
portions of cost reporting periods occurring on or after October 1, 
1990 and until the first date that the prospective payment system under 
part 419 of this chapter is implemented.
* * * * *

Subpart G--Capital-Related Costs

    8. In Sec. 413.130, the heading to paragraph (j) and the 
introductory text to paragraph (j)(1) are republished, and paragraph 
(j)(1)(ii) is revised to read as follows:


Sec. 413.130  Introduction to capital-related costs.

* * * * *
    (j) Reduction to capital-related costs. (1) Except for sole 
community hospitals and critical access hospitals, the amount of 
capital-related costs of all hospital outpatient services is reduced 
by--
* * * * *
    (ii) 10 percent for portions of cost reporting periods occurring on 
or after October 1, 1991 and until the first date that the prospective 
payment system under part 419 of this chapter is implemented.
* * * * *

    F. A new part 419, consisting of Secs. 419.1, 419.2, 419.20, 
419.21, 419.22, 419.30, 419.31, 419.32, 419.40, 419.41, 419.42, 419.43, 
419.44, 419.50, 419.60, and 419.70, is added to read as follows:

PART 419--PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT 
DEPARTMENT SERVICES

Subpart A--General Provisions

Sec.
419.1   Basis and scope.
419.2   Basis of payment.

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

419.20   Hospitals subject to the hospital outpatient prospective 
payment system.
419.21   Hospital outpatient services subject to the outpatient 
prospective payment system.
419.22   Hospital outpatient services excluded from payment under 
the hospital outpatient prospective payment system.

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

419.30   Base expenditure target for calendar year 1999.
419.31   Ambulatory payment classification (APC) system and payment 
weights.
419.32   Calculation of prospective payment rates for hospital 
outpatient services.

Subpart D--Payments to Hospitals

419.40   Payment concepts.
419.41   Calculation of national beneficiary copayment amounts and 
national Medicare program payment amounts.
419.42   Hospital election to reduce copayment.
419.43   Adjustments to national program payment and beneficiary 
copayment amounts.
419.44   Payment reductions for surgical procedures.

Subpart E--Updates

419.50   Annual updates.

Subpart F--Limitations on Review

419.60   Limitations on administrative and judicial review.

Subpart G--Transitional Corridors

419.70   Transitional adjustment to limit decline in payment.

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

PART 419--PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT 
DEPARTMENT SERVICES

Subpart A--General Provisions


Sec. 419.1  Basis and scope.

    (a) Basis. This part implements section 1833(t) of the Act by 
establishing a prospective payment system for services furnished on or 
after July 1, 2000 by hospital outpatient departments to Medicare 
beneficiaries who are registered on hospital records as outpatients.
    (b) Scope. This subpart describes the basis of payment for 
outpatient hospital services under the prospective payment system. 
Subpart B sets forth the categories of hospitals and services that are 
subject to the outpatient hospital prospective payment system and those 
categories of hospitals and services that are excluded from the 
outpatient hospital prospective payment system. Subpart C sets forth 
the basic methodology by which prospective payment rates for hospital 
outpatient services are determined. Subpart D describes Medicare 
payment amounts, beneficiary copayment amounts, and methods of payment 
to hospitals under the hospital outpatient prospective payment system. 
Subpart E describes how the hospital outpatient prospective payment 
system may be updated. Subpart F describes limitations on 
administrative and judicial review. Subpart G describes the 
transitional payment adjustments that are made before 2004 to limit 
declines in payment for outpatient services.


Sec. 419.2  Basis of payment.

    (a) Unit of payment. Under the hospital outpatient prospective 
payment system, predetermined amounts are paid for designated services 
furnished to Medicare beneficiaries. These services are identified by 
codes established under the Health Care Financing Administration Common 
Procedure Coding System (HCPCS). The prospective payment rate for each 
service or procedure for which payment is allowed under the hospital 
outpatient prospective payment system is

[[Page 18543]]

determined according to the methodology described in subpart C of this 
part. The manner in which the Medicare payment amount and the 
beneficiary copayment amount for each service or procedure are 
determined is described in subpart D of this part.
    (b) Determination of hospital outpatient prospective payment rates: 
Included costs. The prospective payment system establishes a national 
payment rate, standardized for geographic wage differences, that 
includes operating and capital-related costs that are directly related 
and integral to performing a procedure or furnishing a service on an 
outpatient basis. In general, these costs include, but are not limited 
to--
    (1) Use of an operating suite, procedure room, or treatment room;
    (2) Use of recovery room;
    (3) Use of an observation bed;
    (4) Anesthesia, certain drugs, biologicals, and other 
pharmaceuticals; medical and surgical supplies and equipment; surgical 
dressings; and devices used for external reduction of fractures and 
dislocations;
    (5) Supplies and equipment for administering and monitoring 
anesthesia or sedation;
    (6) Intraocular lenses (IOLs);
    (7) Incidental services such as venipuncture;
    (8) Capital-related costs;
    (9) Implantable items used in connection with diagnostic X-ray 
tests, diagnostic laboratory tests, and other diagnostic tests;
    (10) Durable medical equipment that is implantable;
    (11) Implantable prosthetic devices (other than dental) which 
replace all or part of an internal body organ (including colostomy bags 
and supplies directly related to colostomy care), including replacement 
of these devices; and
    (12) Costs incurred to procure donor tissue other than corneal 
tissue.
    (c) Determination of hospital outpatient prospective payment rates: 
Excluded costs. The following costs are excluded from the hospital 
outpatient prospective payment rates:
    (1) Medical education costs for approved nursing and allied health 
education programs.
    (2) Corneal tissue acquisition costs incurred by hospitals that are 
paid for on a reasonable cost basis.
    (3) Costs for services listed in Sec. 419.22.

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


Sec. 419.20  Hospitals subject to the hospital outpatient prospective 
payment system.

    (a) Applicability. The hospital outpatient prospective payment 
system is applicable to any hospital participating in the Medicare 
program, except those specified in paragraph (b) of this section, for 
services furnished on or after July 1, 2000.
    (b) Hospitals excluded from the outpatient prospective payment 
system. (1) Those services furnished by Maryland hospitals that are 
paid under a cost containment waiver in accordance with section 
1814(b)(3) of the Act are excluded from the hospital outpatient 
prospective payment system.
    (2) Critical access hospitals (CAHs) are excluded from the hospital 
outpatient prospective payment system.


Sec. 419.21  Hospital outpatient services subject to the outpatient 
prospective payment system.

    Except for services described in Sec. 419.22, effective for 
services furnished on or after July 1, 2000, payment is made under the 
hospital outpatient prospective payment system for the following:
    (a) Medicare Part B services furnished to hospital outpatients 
designated by the Secretary under this part.
    (b) Services designated by the Secretary that are covered under 
Medicare Part B when furnished to hospital inpatients who are either 
not entitled to benefits under Part A or who have exhausted their Part 
A benefits but are entitled to benefits under Part B of the program.
    (c) Partial hospitalization services furnished by community mental 
health centers (CMHCs).
    (d) The following medical and other health services furnished by a 
comprehensive outpatient rehabilitation facility (CORF) when they are 
provided outside the patient's plan (of care); or by a home health 
agency (HHA) to patients who are not under an HHA plan or treatment; or 
by a hospice program furnishing services to patients outside the 
hospice benefit:
    (1) Antigens.
    (2) Splints and casts.
    (3) Pneumococcal vaccine, influenza vaccine, and hepatitis B 
vaccine.


Sec. 419.22  Hospital outpatient services excluded from payment under 
the hospital outpatient prospective payment system.

    The following services are not paid for under the hospital 
outpatient prospective payment system:
    (a) Physician services that meet the requirements of 
Sec. 415.102(a) of this chapter for payment on a fee schedule basis.
    (b) Nurse practitioner and clinical nurse specialist services, as 
defined in section 1861(s)(2)(K)(ii) of the Act.
    (c) Physician assistant services, as defined in section 
1861(s)(2)(K)(i) of the Act.
    (d) Certified nurse-midwife services, as defined in section 
1861(gg) of the Act.
    (e) Services of qualified psychologists, as defined in section 
1861(ii) of the Act.
    (f) Services of an anesthetist as defined in Sec. 410.69 of this 
chapter.
    (g) Clinical social worker services as defined in section 
1861(hh)(2) of the Act.
    (h) Outpatient therapy services described in section 1833(a)(8) of 
the Act.
    (i) Ambulance services, as described in section 1861(v)(1)(U) of 
the Act, or, if applicable, the fee schedule established under section 
1834(l).
    (j) Except as provided in Sec. 419.22(b)(11), prosthetic devices, 
prosthetics, prosthetic supplies, and orthotic devices.
    (k) Except as provided in Sec. 419.2(b)(10), durable medical 
equipment supplied by the hospital for the patient to take home.
    (l) Clinical diagnostic laboratory services.
    (m) Services for patients with ESRD that are paid under the ESRD 
composite rate and drugs and supplies furnished during dialysis but not 
included in the composite rate.
    (n) Services and procedures that the Secretary designates as 
requiring inpatient care.
    (o) Hospital outpatient services furnished to SNF residents (as 
defined in Sec. 411.15(p) of this chapter) as part of the patient's 
resident assessment or comprehensive care plan (and thus included under 
the SNF PPS) that are furnished by the hospital ``under arrangements'' 
but billable only by the SNF, regardless of whether or not the patient 
is in a Part A SNF stay.
    (p) Services that are not covered by Medicare by statute.
    (q) Services that are not reasonable or necessary for the diagnosis 
or treatment of an illness or disease.

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


Sec. 419.30  Base expenditure target for calendar year 1999.

    (a) HCFA estimates the aggregate amount that would be payable for

[[Page 18544]]

hospital outpatient services in calendar year 1999 by summing--
    (1) The total amounts that would be payable from the Trust Fund for 
covered hospital outpatient services without regard to the outpatient 
prospective payment system described in this part; and
    (2) The total amounts of coinsurance that would be payable by 
beneficiaries to hospitals for covered hospital outpatient services 
without regard to the outpatient prospective payment system described 
in this part.
    (b) The estimated aggregate amount under paragraph (a) of this 
section is determined as though the deductible required under section 
1833(b) of the Act did not apply.


Sec. 419.31  Ambulatory payment classification (APC) system and payment 
weights.

    (a) APC groups. (1) HCFA classifies outpatient services and 
procedures that are comparable clinically and in terms of resource use 
into APC groups. Except as specified in paragraph (a)(2) of this 
section, items and services within a group are not comparable with 
respect to the use of resources if the highest median cost for an item 
or service within the group is more than 2 times greater than the 
lowest median cost for an item or service within the group.
    (2) HCFA may make exceptions to the requirements set forth in 
paragraph (a)(1) in unusual cases, such as low volume items and 
services, but may not make such an exception in the case of a drug or 
biological that has been designated as an orphan drug under section 526 
of the Federal Food, Drug and Cosmetic Act.
    (3) The payment rate determined for an APC group in accordance with 
Sec. 419.32, and the copayment amount and program payment amount 
determined for an APC group in accordance with subpart D of this part, 
apply to every HCPCS code classified within an APC group.
    (b) APC weighting factors. (1) Using hospital outpatient claims 
data from calendar year 1996 and data from the most recent available 
hospital cost reports, HCFA determines the median costs for the 
services and procedures within each APC group.
    (2) HCFA assigns to each APC group an appropriate weighting factor 
to reflect the relative median costs for the services within the APC 
group compared to the median costs for the services in all APC groups.
    (c) Standardizing amounts. (1) HCFA determines the portion of costs 
determined in paragraph (b)(1) of this section that is labor-related. 
This is known as the ``labor-related portion'' of hospital outpatient 
costs.
    (2) HCFA standardizes the median costs determined in paragraph 
(b)(1) of this section by adjusting for variations in hospital labor 
costs across geographic areas.


Sec. 419.32  Calculation of prospective payment rates for hospital 
outpatient services.

    (a) Conversion factor for 1999. HCFA calculates a conversion factor 
in such a manner that payment for hospital outpatient services 
furnished in 1999 would have equaled the base expenditure target 
calculated in Sec. 419.30, taking into account APC group weights and 
estimated service frequencies and reduced by the amounts that would be 
payable in 1999 as outlier payments under Sec. 419.43(d) and 
transitional pass-through payments under Sec. 419.43(e).
    (b) Conversion factor for calendar year 2000 and subsequent years. 
(1) Subject to paragraph (b)(2) of this section, the conversion factor 
for a calendar year is equal to the conversion factor calculated for 
the previous year adjusted as follows:
    (i) For calendar years 2000, 2001, and 2002, by the hospital 
inpatient market basket percentage increase applicable under section 
1886(b)(3)(B)(iii) of the Act reduced by one percentage point.
    (ii) For calendar years 2003 and subsequent years, by the hospital 
inpatient market basket percentage increase applicable under section 
1886(b)(3)(B)(iii) of the Act.
    (2) Beginning in calendar year 2000, HCFA may substitute for the 
hospital inpatient market basket percentage in paragraph (b) of this 
section a market basket percentage increase that is determined and 
applied to hospital outpatient services in the same manner that the 
hospital inpatient market basket percentage increase is determined and 
applied to inpatient hospital services.
    (c) Payment rates. The payment rate for services and procedures for 
which payment is made under the hospital outpatient prospective payment 
system is the product of the conversion factor calculated under 
paragraph (a) or paragraph (b) of this section and the relative weight 
determined under Sec. 419.31(b).
    (d) Budget neutrality. HCFA adjusts the conversion factor as needed 
to ensure that updates and adjustments under Sec. 419.50(a) are budget 
neutral.

Subpart D--Payments to Hospitals


Sec. 419.40  Payment concepts.

    (a) In addition to the payment rate described in Sec. 419.32, for 
each APC group there is a predetermined beneficiary coinsurance amount 
as described in Sec. 419.41(a). The Medicare program payment amount for 
each APC group is calculated by applying the program payment percentage 
as described in Sec. 419.41(b).
    (b) For purposes of this section--
    (1) Coinsurance percentage is calculated as the difference between 
the program payment percentage and 100 percent. The coinsurance 
percentage in any year is thus defined for each APC group as the 
greater of the following: the ratio of the APC group unadjusted 
copayment amount to the annual APC group payment rate, or 20 percent.
    (2) Program payment percentage is calculated as the lower of the 
following: the ratio of the APC group payment rate minus the APC group 
unadjusted coinsurance amount, to the APC group payment rate, or 80 
percent.
    (3) Unadjusted coinsurance amount is calculated as 20 percent of 
the wage-adjusted national median of charges for services within an APC 
group furnished during 1996, updated to 1999 using an actuarial 
projection of charge increases for hospital outpatient department 
services during the period 1996 to 1999.
    (c) Limitation of coinsurance amount to inpatient hospital 
deductible amount. The coinsurance amount for a procedure performed in 
a year cannot exceed the amount of the inpatient hospital deductible 
established under section 1813(b) of the Act for that year.


Sec. 419.41  Calculation of national beneficiary coinsurance amounts 
and national Medicare program payment amounts.

    (a) To calculate the unadjusted coinsurance amount for each APC 
group, HCFA--
    (1) Standardizes 1996 hospital charges for the services within each 
APC group to offset variations in hospital labor costs across 
geographic areas;
    (2) Identifies the median of the wage-neutralized 1996 charges for 
each APC group; and
    (3) Determines the value equal to 20 percent of the wage-
neutralized 1996 median charge for each APC group and multiplies that 
value by an actuarial projection of increases in charges for hospital 
outpatient department services during the period 1996 to 1999. The 
result is the unadjusted beneficiary coinsurance amount for the APC 
group.
    (b) HCFA calculates annually the program payment percentage for 
every APC group on the basis of each group's unadjusted coinsurance 
amount and its payment rate after the payment rate is adjusted in 
accordance with Sec. 419.32.
    (c) To determine payment amounts due for a service paid under the 
hospital

[[Page 18545]]

outpatient prospective payment system, HCFA makes the following 
calculations:
    (1) Makes the wage index adjustment in accordance with Sec. 419.43.
    (2) Subtracts the amount of the applicable Part B deductible 
provided under Sec. 410.160 of this chapter.
    (3) Multiplies the remainder by the program payment percentage for 
the group to determine the preliminary Medicare program payment amount.
    (4) Subtracts the program payment amount from the amount determined 
in paragraph (c)(2) of this section to determine the coinsurance 
amount.
    (i) The coinsurance amount for an APC cannot exceed the amount of 
the inpatient hospital deductible established under section 1813(b) of 
the Act for that year.
    (ii) The coinsurance amount is computed as if the adjustments under 
Sec. 419.43(d) and (e) (and any adjustment made under Sec. 419.43(f) in 
relation to these adjustments) had not been paid.
    (5) Adds the amount by which the coinsurance amount would have 
exceeded the inpatient hospital deductible for that year to the 
preliminary Medicare program payment amount determined in paragraph 
(c)(3) of this section to determine the final Medicare program payment 
amount.


Sec. 419.42  Hospital election to reduce coinsurance.

    (a) A hospital may elect to reduce coinsurance for any or all APC 
groups on a calendar year basis. A hospital may not elect to reduce 
copayment for some, but not all, services within the same group.
    (b) A hospital must notify its fiscal intermediary of its election 
to reduce coinsurance no later than--
    (1) June 1, 2000, for coinsurance elections for the period July 1, 
2000 through December 31, 2000; or
    (2) December 1 preceding the beginning of each subsequent calendar 
year.
    (c) The hospital's election must be properly documented. It must 
specifically identify the APCs to which it applies and the coinsurance 
amount (within the limits identified below) that the hospital has 
selected for each group.
    (d) The election of reduced coinsurance remains in effect unchanged 
during the year for which the election was made.
    (e) In electing reduced coinsurance, a hospital may elect a level 
that is less than that year's wage-adjusted coinsurance amount for the 
group but not less than 20 percent of the APC payment rate as 
determined in Sec. 419.32.
    (f) The hospital may advertise and otherwise disseminate 
information concerning the reduced level of coinsurance that it has 
elected. All advertisements and information furnished to Medicare 
beneficiaries must specify that the coinsurance reductions advertised 
apply only to the specified services of that hospital and that 
coinsurance reductions are available only for hospitals that choose to 
reduce coinsurance for hospital outpatient services and are not allowed 
in any other ambulatory settings or physician offices.


Sec. 419.43  Adjustments to national program payment and beneficiary 
coinsurance amounts.

    (a) General rule. HCFA determines national prospective payment 
rates for hospital outpatient department services and determines a wage 
adjustment factor to adjust the portion of the APC payment and national 
beneficiary coinsurance amount attributable to labor-related costs for 
relative differences in labor and labor-related costs across geographic 
regions in a budget neutral manner.
    (b) Labor-related portion of payment and copayment rates for 
hospital outpatient services. HCFA determines the portion of hospital 
outpatient costs attributable to labor and labor-related costs (known 
as the ``labor-related portion'' of hospital outpatient costs) in 
accordance with Sec. 419.31(c)(1).
    (c) Wage index factor. HCFA uses the hospital inpatient prospective 
payment system wage index established in accordance with part 412 of 
this chapter to make the adjustment referred to in paragraph (a) of 
this section.
    (d) Outlier adjustment--(1) General rule. Subject to paragraph 
(d)(4) of this section, HCFA provides for an additional payment for 
each hospital outpatient service (or group of services) for which a 
hospital's charges, adjusted to cost, exceed the following:
    (i) A fixed multiple of the sum of--
    (A) The applicable Medicare hospital outpatient payment amount 
determined under Sec. 419.32(c), as adjusted under Sec. 419.43 (other 
than for adjustments under this paragraph (d) or paragraph (e) of this 
section); and
    (B) Any transitional pass-through payment under paragraph (e) of 
this section.
    (ii) At the option of HCFA, a fixed dollar amount.
    (2) Amount of adjustment. The amount of the additional payment 
under paragraph (d)(1) of this section is determined by HCFA and 
approximates the marginal cost of care beyond the applicable cutoff 
point under paragraph (d)(1) of this section.
    (3) Limit on aggregate outlier adjustments--(i) In general. The 
total of the additional payments made under this paragraph (d) for 
covered hospital outpatient department services furnished in a year (as 
estimated by HCFA before the beginning of the year) may not exceed the 
applicable percentage specified in paragraph (d)(3)(ii) of this section 
of the total program payments (sum of both the Medicare and beneficiary 
payments to the hospital) estimated to be made under this part for all 
hospital outpatient services furnished in that year. If this paragraph 
is first applied to less than a full year, the limit applies only to 
the portion of the year.
    (ii) Applicable percentage. For purposes of paragraph (d)(3)(i) of 
this section, the term ``applicable percentage'' means a percentage 
specified by HCFA up to (but not to exceed)--
    (A) For a year (or portion of a year) before 2004, 2.5 percent; and
    (B) For 2004 and thereafter, 3.0 percent.
    (4) Transitional authority. In applying paragraph (d)(1) of this 
section for hospital outpatient services furnished before January 1, 
2002, HCFA may--
    (i) Apply paragraph (d)(1) of this section to a bill for these 
services related to an outpatient encounter (rather than for a specific 
service or group of services) using hospital outpatient payment amounts 
and transitional pass-through payments covered under the bill; and
    (ii) Use an appropriate cost-to-charge ratio for the hospital or 
CMHC (as determined by HCFA), rather than for specific departments 
within the hospital.
    (e) Transitional pass-through for additional costs of innovative 
medical devices, drugs, and biologicals--(1) General rule. HCFA 
provides for an additional payment under this paragraph for any of the 
following that are provided as part of a hospital outpatient service 
(or group of services):
    (i) Current orphan drugs. A drug or biological that is used for a 
rare disease or condition with respect to which the drug or biological 
has been designated as an orphan drug under section 526 of the Federal 
Food, Drug and Cosmetic Act if payment for the drug or biological as an 
outpatient hospital service under this part was being made on the first 
date that the system under this part is implemented.
    (ii) Current cancer therapy drugs and biologicals and 
brachytherapy. A drug or biological that is used in cancer therapy, 
including, but not limited to, a chemotherapeutic agent, an antiemetic,

[[Page 18546]]

a hematopoietic growth factor, a colony stimulating factor, a 
biological response modifier, a bisphosphonate, and a device of 
brachytherapy, if payment for the drug, biological, or device as an 
outpatient hospital service under this part was being made on the first 
date that the system under this part is implemented.
    (iii) Current radiopharmaceutical drugs and biological products. A 
radiopharmaceutical drug or biological product used in diagnostic, 
monitoring, and therapeutic nuclear medicine procedures if payment for 
the drug or biological as an outpatient hospital service under this 
part was being made on the first date that the system under this part 
is implemented.
    (iv) New medical devices, drugs, and biologicals. A medical device, 
drug, or biological not described in paragraph (e)(1)(i), (e)(1)(ii), 
or (e)(1)(iii) of this section if--
    (A) Payment for the device, drug, or biological as an outpatient 
hospital service under this part was not being made as of December 31, 
1996; and
    (B) The cost of the device, drug, or biological is not 
insignificant (as defined in paragraph (e)(1)(iv)(C) of this section) 
in relation to the hospital outpatient fee schedule amount (as 
calculated under Sec. 419.32(c)) payable for the service (or group of 
services) involved.
    (C) The cost of the device, drug, or biological is considered not 
insignificant if it meets all of the following thresholds:
    (1) Its expected reasonable cost exceeds 25 percent of the 
applicable fee schedule amount for the associated service.
    (2) The expected reasonable cost of the new drug, biological, or 
device must exceed the current portion of the fee schedule amount 
determined to be associated with the drug, biological, or device by 25 
percent.
    (3) The difference between the expected reasonable cost of the item 
and the portion of the hospital outpatient fee schedule amount 
determined to be associated with the item exceeds 10 percent of the 
applicable hospital outpatient fee schedule amount.
    (2) Limited period of payment. The payment under this paragraph (e) 
with respect to a medical device, drug, or biological applies during a 
period of at least 2 years, but not more than 3 years, that begins--
    (i) On the first date this section is implemented in the case of a 
drug, biological, or device described in paragraphs (e)(2)(i), 
(e)(2)(ii), or (e)(2)(iii) of this section and in the case of a device, 
drug, or biological described in paragraph (e)(1)(iv) of this section 
and for which payment under this part is made as an outpatient hospital 
service before the first date; or
    (ii) In the case of a device, drug, or biological described in 
paragraph (e)(1)(iv) of this section not described in paragraph 
(e)(2)(i) of this section, on the first date on which payment is made 
under this part for the device, drug, or biological as an outpatient 
hospital service.
    (3) Amount of additional payment. Subject to paragraph (e)(4)(iii) 
of this section, the amount of the payment under this paragraph is--
    (i) In the case of a drug or biological, the amount by which the 
amount determined under section 1842(o) of the Act for the drug or 
biological exceeds the portion of the otherwise applicable Medicare 
hospital outpatient fee schedule amount that HCFA determines is 
associated with the drug or biological; or
    (ii) In the case of a medical device, the amount by which the 
hospital's charges for the device, adjusted to cost, exceeds the 
portion of the otherwise applicable Medicare hospital outpatient fee 
schedule amount that HCFA determines is associated with the device.
    (4) Limit on aggregate annual adjustment--(i) General rule. The 
total of the additional payments made under this paragraph for hospital 
outpatient services furnished in a year, as estimated by HCFA before 
the beginning of the year, may not exceed the applicable percentage 
specified in paragraph (e)(4)(ii) of this section of the total program 
payments estimated to be made under this section for all hospital 
outpatient services furnished in that year. If this paragraph is first 
applied to less than a full year, the limit applies only to the portion 
of the year.
    (ii) Applicable percentage. For purposes of paragraph (e)(4)(i) of 
this section, the term ``applicable percentage'' means--
    (A) For a year (or portion of a year) before 2004, 2.5 percent; and
    (B) For 2004 and thereafter, a percentage specified by HCFA up to 
(but not to exceed) 2.0 percent.
    (iii) Uniform prospective reduction if aggregate limit projected to 
be exceeded. If HCFA estimates before the beginning of a year that the 
amount of the additional payments under this paragraph (e) for the year 
(or portion thereof) as determined under paragraph (e)(4)(i) of this 
section without regard to this paragraph (e)(4)(iii) would exceed the 
limit established under this paragraph (e)(4)(iii), HCFA reduces pro 
rata the amount of each of the additional payments under this paragraph 
for that year (or portion thereof) in order to ensure that the 
aggregate additional payments under this paragraph (as so estimated) do 
not exceed the limit.
    (f) Budget neutrality. Outlier adjustments under paragraph (d) of 
this section and transitional pass-through payments under paragraph (e) 
of this section are established in a budget-neutral manner.


Sec. 419.44  Payment reductions for surgical procedures.

    (a) Multiple surgical procedures. When more than one surgical 
procedure for which payment is made under the hospital outpatient 
prospective payment system is performed during a single surgical 
encounter, the Medicare program payment amount and the beneficiary 
copayment amount are based on--
    (1) The full amounts for the procedure with the highest APC payment 
rate; and
    (2) One-half of the full program and the beneficiary payment 
amounts for all other covered procedures.
    (b) Terminated procedures. When a surgical procedure is terminated 
prior to completion due to extenuating circumstances or circumstances 
that threaten the well-being of the patient, the Medicare program 
payment amount and the beneficiary copayment amount are based on--
    (1) The full amounts if the procedure is discontinued after the 
induction of anesthesia or after the procedure is started; or
    (2) One-half of the full program and the beneficiary coinsurance 
amounts if the procedure is discontinued after the patient is prepared 
for surgery and taken to the room where the procedure is to be 
performed but before anesthesia is induced.

Subpart E--Updates


Sec. 419.50  Annual review.

    (a) General rule. Not less often than annually, HCFA reviews and 
updates groups, relative payment weights, and the wage and other 
adjustments to take into account changes in medical practice, changes 
in technology, the addition of new services, new cost data, and other 
relevant information and factors.
    (b) Consultation requirement. HCFA will consult with an expert 
outside advisory panel composed of an appropriate selection of 
representatives of providers to review (and advise HCFA concerning) the 
clinical integrity of the groups and weights. The panel may use data 
collected or developed by entities and organizations (other than the 
Department of Health and Human Services) in conducting the review.

[[Page 18547]]

    (c) Effective dates. HCFA conducts the first annual review under 
paragraph (a) of this section in 2001 for payments made in 2002.

Subpart F--Limitations on Review


Sec. 419.60  Limitations on administrative and judicial review.

    There can be no administrative or judicial review under sections 
1869 and 1878 of the Act or otherwise of the following:
    (a) The development of the APC system, including--
    (1) Establishment of the groups and relative payment weights;
    (2) Wage adjustment factors;
    (3) Other adjustments; and
    (4) Methods for controlling unnecessary increases in volume.
    (b) The calculation of base amounts described in section 1833(t)(3) 
of the Act.
    (c) Periodic adjustments described in section 1833(t)(9) of the 
Act.
    (d) The establishment of a separate conversion factor for hospitals 
described in section 1886(d)(1)(B)(v) of the Act.
    (e) The determination of the fixed multiple, or a fixed dollar 
cutoff amount, the marginal cost of care, or applicable percentage 
under Sec. 419.43(d) or the determination of insignificance of cost, 
the duration of the additional payments (consistent with 
Sec. 419.43(e)), the portion of the Medicare hospital outpatient fee 
schedule amount associated with particular devices, drugs, or 
biologicals, and the application of any pro rata reduction under 
Sec. 419.43(e).

Subpart G--Transitional Corridors


Sec. 419.70  Transitional adjustment to limit decline in payment.

    (a) Before 2002. Except as provided in paragraph (d) of this 
section, for covered hospital outpatient services furnished before 
January 1, 2002, for which the prospective payment system amount (as 
defined in paragraph (e) of this section) is--
    (1) At least 90 percent, but less than 100 percent, of the pre-BBA 
amount (as defined in paragraph (f) of this section), the amount of 
payment under this part is increased by 80 percent of the amount of 
this difference;
    (2) At least 80 percent, but less than 90 percent, of the pre-BBA 
amount, the amount of payment under this part is increased by the 
amount by which the product of 0.71 and the pre-BBA amount exceeds the 
product of 0.70 and the prospective payment system amount;
    (3) At least 70 percent, but less than 80 percent, of the pre-BBA 
amount, the amount of payment under this part is increased by the 
amount by which the product of 0.63 and the pre-BBA amount, exceeds the 
product of 0.60 and the PPS amount; or
    (4) Less than 70 percent of the pre-BBA amount, the amount of 
payment under this part shall be increased by 21 percent of the pre-BBA 
amount.
    (b) For 2002. Except as provided in paragraph (d) of this section, 
for covered hospital outpatient services furnished during 2002, for 
which the prospective payment system amount is--
    (1) At least 90 percent, but less than 100 percent, of the pre-BBA 
amount, the amount of payment under this part is increased by 70 
percent of the amount of this difference;
    (2) At least 80 percent, but less than 90 percent, of the pre-BBA 
amount, the amount of payment under this part is increased by the 
amount by which the product of 0.61 and the pre-BBA amount exceeds the 
product of 0.60 and the prospective payment system amount; or
    (3) Less than 80 percent of the pre-BBA amount, the amount of 
payment under this part is increased by 13 percent of the pre-BBA 
amount.
    (c) For 2003. Except as provided in paragraph (d) of this section, 
for covered hospital outpatient services furnished during 2003, for 
which the prospective payment system amount is--
    (1) At least 90 percent, but less than 100 percent, of the pre-BBA 
amount, the amount of payment under this part is increased by 60 
percent of the amount of this difference; or
    (2) Less than 90 percent of the pre-BBA amount, the amount of 
payment under this part is increased by 6 percent of the pre-BBA 
amount.
    (d) Hold harmless provisions--(1) Temporary treatment for small 
rural hospitals. For covered hospital outpatient services furnished in 
a calendar year before January 1, 2004 for which the prospective 
payment system amount is less than the pre-BBA amount, the amount of 
payment under this part is increased by the amount of that difference 
if the hospital--
    (i) Is located in a rural area as defined in Sec. 412.63(b) of this 
chapter or is treated as being located in a rural area under section 
1886(d)(8)(E) of the Act; and
    (ii) Has 100 or fewer beds as defined in Sec. 412.105(b) of this 
chapter.
    (2) Permanent treatment for cancer hospitals. In the case of a 
hospital described in Sec. 412.23(f) of this chapter for which the 
prospective payment system amount is less than the pre-BBA amount for 
covered hospital outpatient services, the amount of payment under this 
part is increased by the amount of this difference.
    (e) Prospective payment system amount defined. In this paragraph, 
the term ``prospective payment system amount'' means, with respect to 
covered hospital outpatient services, the amount payable under this 
part for these services (determined without regard to this paragraph or 
any reduction in coinsurance elected under Sec. 419.42), including 
amounts payable as copayment under Sec. 419.41, coinsurance under 
section 1866(a)(2)(A)(ii) of the Act, and the deductible under section 
1833(b) of the Act.
    (f) Pre-BBA amount defined--(1) General rule. In this paragraph, 
the ``pre-BBA amount'' means, with respect to covered hospital 
outpatient services furnished by a hospital or a community mental 
health center (CMHC) in a year, an amount equal to the product of the 
reasonable cost of the provider for these services for the portions of 
the provider's cost reporting period (or periods) occurring in the year 
and the base provider outpatient payment-to-cost ratio for the provider 
(as defined in paragraph (f)(2) of this section).
    (2) Base payment-to-cost-ratio defined. For purposes of this 
paragraph, HCFA shall determine these ratios as if the amendments to 
sections 1833(i)(3)(B)(i)(II) and 1833(n)(1)(B)(i) of the Act made by 
section 4521 of the BBA, to require that the full amount beneficiaries 
paid as coinsurance under section 1862(a)(2)(A) of the Act are taken 
into account in determining Medicare Part B Trust Fund payment to the 
hospital, were in effect in 1996. The ``base payment-to-cost ratio'' 
for a hospital or CMHC means the ratio of--
    (i) The provider's payment under this part for covered outpatient 
services furnished during the cost reporting period ending in 1996, 
including any payment for these services through cost-sharing described 
in paragraph (e) of this section; and
    (ii) The reasonable cost of these services for this period, without 
applying the cost reductions under section 1861(v)(1)(S) of the Act.
    (g) Interim payments. HCFA makes payments under this paragraph to 
hospitals and CMHCs on an interim basis, subject to retrospective 
adjustments based on settled cost reports.
    (h) No effect on coinsurance. No payment made under this section 
affects the unadjusted coinsurance amount or the coinsurance amount 
described in Sec. 419.41.
    (i) Application without regard to budget neutrality. The additional 
payments made under this paragraph--

[[Page 18548]]

    (1) Are not considered an adjustment under Sec. 419.43(f); and
    (2) Are not implemented in a budget neutral manner.

PART 424--CONDITIONS FOR MEDICARE PAYMENT

    G. Part 424 is amended as set forth below:
    1. The authority citation for part 424 continues to read as 
follows:

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

    2. In Sec. 424.24, the heading to paragraph (e) is republished, and 
a new paragraph (e)(3) is added to read as follows:


Sec. 424.24  Requirements for medical and other health services 
furnished by providers under Medicare Part B.

* * * * *
    (e) Partial hospitalization services: Content of certification and 
plan of treatment requirements--
* * * * *
    (3) Recertification requirements.
    (i) Signature. The physician recertification must be signed by a 
physician who is treating the patient and has knowledge of the 
patient's response to treatment.
    (ii) Timing. The first recertification is required as of the 18th 
day of partial hospitalization services. Subsequent recertifications 
are required at intervals established by the provider, but no less 
frequently than every 30 days.
    (iii) Content. The recertification must specify that the patient 
would otherwise require inpatient psychiatric care in the absence of 
continued stay in the partial hospitalization program and describe the 
following:
    (A) The patient's response to the therapeutic interventions 
provided by the partial hospitalization program.
    (B) The patient's psychiatric symptoms that continue to place the 
patient at risk of hospitalization.
    (C) Treatment goals for coordination of services to facilitate 
discharge from the partial hospitalization program.
* * * * *

PART 489--PROVIDER AGREEMENTS AND SUPPLIER APPROVAL

    H. Part 489 is amended as set forth below:
    1. The authority citation to part 489 continues to read as follows:

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

Subpart B--Essentials of Provider Agreements

    2. In Sec. 489.20, the introductory text to the section is 
republished; the introductory text to paragraph (d) is revised; 
paragraphs (d)(3), (d)(4), and (d)(5) are redesignated as paragraphs 
(d)(4), (d)(5), and (d)(6), respectively; and a new paragraph (d)(3) is 
added to read as follows:


Sec. 489.20  Basic commitments.

    The provider agrees to the following:
* * * * *
    (d) In the case of a hospital or a CAH that furnishes services to 
Medicare beneficiaries, either to furnish directly or to make 
arrangements (as defined in Sec. 409.3 of this chapter) for all 
Medicare-covered services to inpatients and outpatients of a hospital 
or a CAH except the following:
* * * * *
    (3) Nurse practitioner and clinical nurse specialist services, as 
defined in section 1861(s)(2)(K)(ii) of the Act.
* * * * *

    3. In Sec. 489.24, the definition for ``Comes to the emergency 
department'' in paragraph (b) is revised, and a new paragraph (i) is 
added to read as follows:


Sec. 489.24  Special responsibilities of Medicare hospitals in 
emergency cases.

* * * * *
    (b) * * *
    Comes to the emergency department means, with respect to an 
individual requesting examination or treatment, that the individual is 
on the hospital property. For purposes of this section, ``property'' 
means the entire main hospital campus as defined in Sec. 413.65(b) of 
this chapter, including the parking lot, sidewalk, and driveway, as 
well as any facility or organization that is located off the main 
hospital campus but has been determined under Sec. 413.65 of this 
chapter to be a department of the hospital. The responsibilities of 
hospitals with respect to these off-campus facilities or organizations 
are described in paragraph (i) of this section. Property also includes 
ambulances owned and operated by the hospital even if the ambulance is 
not on hospital grounds. An individual in a nonhospital-owned ambulance 
on hospital property is considered to have come to the hospital's 
emergency department. An individual in a nonhospital-owned ambulance 
off hospital property is not considered to have come to the hospital's 
emergency department even if a member of the ambulance staff contacts 
the hospital by telephone or telemetry communications and informs the 
hospital that they want to transport the individual to the hospital for 
examination and treatment. In these situations, the hospital may deny 
access if it is in ``diversionary status,'' that is, it does not have 
the staff or facilities to accept any additional emergency patients. 
If, however, the ambulance staff disregards the hospital's instructions 
and transports the individual on to hospital property, the individual 
is considered to have come to the emergency department.
* * * * *
    (i) Off-campus departments. If an individual comes to a facility or 
organization that is located off the main hospital campus but has been 
determined under Sec. 416.35 of this chapter to be a department of the 
hospital and a request is made on the individual's behalf for 
examination or treatment of a potential emergency medical condition as 
otherwise described in paragraph (a) of this section, the hospital is 
obligated in accordance with the rules in this paragraph to provide the 
individual with an appropriate medical screening examination and any 
necessary stabilizing treatment or an appropriate transfer.
    (1) Capability of the hospital. The capability of the hospital 
includes that of the hospital as a whole, not just the capability of 
the off-campus department. Except for cases described in paragraph 
(i)(3)(ii) of this section, the obligation of a hospital under this 
section must be discharged within the hospital as a whole. However, the 
hospital is not required to locate additional personnel or staff to 
off-campus departments to be on standby for possible emergencies.
    (2) Protocols for off-campus departments. The hospital must 
establish protocols for the handling of individuals with potential 
emergency conditions at off-campus departments. These protocols must 
provide for direct contact between personnel at the off-campus 
department and emergency personnel at the main hospital campus and may 
provide for dispatch of practitioners, when appropriate, from the main 
hospital campus to the off-campus department to provide screening or 
stabilization services.
    (i) If the off-campus department is an urgent care center, primary 
care center, or other facility that is routinely staffed by physicians, 
RNs, or LPNs, these department personnel must be trained, and given 
appropriate protocols, for the handling of emergency cases. At least 
one individual on duty at the off-campus department during its regular 
hours of operation must be designated

[[Page 18549]]

as a qualified medical person as described in paragraph (d) of this 
section. The qualified medical person must initiate screening of 
individuals who come to the off-campus department with a potential 
emergency medical condition, and may be able to complete the screening 
and provide any necessary stabilizing treatment at the off-campus 
department, or to arrange an appropriate transfer.
    (ii) If the off-campus department is a physical therapy, radiology, 
or other facility not routinely staffed with physicians, RNs, or LPNs, 
the department's personnel must be given protocols that direct them to 
contact emergency personnel at the main hospital campus for direction. 
Under this direction, and in accordance with protocols established in 
advance by the hospital, the personnel at the off-campus department 
must describe patient appearance and report symptoms and, if 
appropriate, either arrange transportation of the individual to the 
main hospital campus in accordance with paragraph (i)(3)(i) of this 
section or assist in an appropriate transfer as described in paragraphs 
(i)(3)(ii) and (d)(2) of this section.
    (3) Movement or appropriate transfer from off-campus departments--
(i) If the main hospital campus has the capability required by the 
individual and movement of the individual to the main campus would not 
significantly jeopardize the life or health of the individual, the 
personnel at the off-campus department must assist in arranging this 
movement. Movement of the individual to the main campus of the hospital 
is not considered a transfer under this section, since the individual 
is simply being moved from one department of a hospital to another 
department or facility of the same hospital.
    (ii) If transfer of an individual with a potential emergency 
condition to a medical facility other than the main hospital campus is 
warranted, either because the main hospital campus does not have the 
specialized capability or facilities required by the individual, or 
because the individual's condition is deteriorating so rapidly that 
taking the time needed to move the individual to the main hospital 
campus would significantly jeopardize the life or health of the 
individual, personnel at the off-campus department must, in accordance 
with protocols established in advance by the hospital, assist in 
arranging an appropriate transfer of the individual to a medical 
facility other than the main hospital. The protocols must include 
procedures and agreements established in advance with other hospitals 
or medical facilities in the area of the off-campus department to 
facilitate these appropriate transfers. Such a transfer would require--
    (A) That there be either a request by or on behalf of the 
individual as described in paragraph (d)(1)(ii)(A) of this section or a 
certification by a physician or a qualified medical person as described 
in paragraph (d)(1)(ii)(B) or (d)(1)(ii)(C) of this section; and
    (B) That the transfer comply with the requirements described in 
paragraph (d)(2) of this section.
    (iii) If the individual is being appropriately transferred to 
another medical facility from the off-campus department, the 
requirement for the provision of medical treatment in paragraph 
(d)(2)(i) of this section would be met by provision of medical 
treatment within the capability of the transferring off-campus 
department.

PART 498--APPEALS PROCEDURES FOR DETERMINATIONS THAT AFFECT 
PARTICIPATION IN THE MEDICARE PROGRAM AND FOR DETERMINATIONS THAT 
AFFECT THE PARTICIPATION OF ICFs/MR AND CERTAIN NFs IN THE MEDICAID 
PROGRAM

    I. Part 498 is amended as set forth below:
    1. The authority citation for part 498 continues to read as 
follows:

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

    2. In Sec. 498.2, the introductory text is republished, and the 
definition of ``Provider'' is revised to read as follows:


Sec. 498.2  Definitions.

    As used in this part--
* * * * *
    Provider means a hospital, critical access hospital (CAH), skilled 
nursing facility (SNF), comprehensive outpatient rehabilitation 
facility (CORF), home health agency (HHA), or hospice, that has in 
effect an agreement to participate in Medicare, that has in effect an 
agreement to participate in Medicaid, or a clinic, rehabilitation 
agency, or public health agency that has a similar agreement but only 
to furnish outpatient physical therapy or outpatient speech pathology 
services, and prospective provider means any of the listed entities 
that seeks to participate in Medicare as a provider or to have any 
facility or organization determined to be a department of the provider 
or provider-based entity under Sec. 413.65 of this chapter.
* * * * *

    3. In Sec. 498.3, the introductory text to paragraph (b) is 
republished; paragraphs (b)(2) through (b)(15) are redesignated as 
paragraphs (b)(3) through (b)(16), respectively; and a new paragraph 
(b)(2) is added to read as follows:


Sec. 498.3  Scope and applicability.

* * * * *
    (b) Initial determinations by HCFA. HCFA makes initial 
determinations with respect to the following matters:
* * * * *
    (2) Whether a prospective department of a provider, remote location 
of a hospital, satellite facility, or provider-based entity qualifies 
for provider-based status under Sec. 413.65 of this chapter, or whether 
such a facility or entity currently treated as a department of a 
provider, remote location of a hospital, satellite facility, or a 
provider-based entity no longer qualifies for that status under 
Sec. 413.65 of this chapter.
* * * * *

PART 1003--CIVIL MONEY PENALTIES, ASSESSMENTS AND EXCLUSIONS

    J. Part 1003 is amended as set forth below:
    1. The authority citation for part 1003 is revised to read as 
follows:

    Authority: 42 U.S.C. 1302, 1320-7, 1320a-7a, 1320a-7e, 1320b-10, 
1395u(j), 1395u(k), 1395cc(g), 1395dd(d)(1), 1395mm, 1395nn(g), 
1395ss(d), 1396(m), 11131(c), and 11137(b)(2).

    2. Section 1003.100 is amended by revising paragraph (a), by 
republishing the introductory text to paragraphs (b) and (b)(1), by 
revising paragraphs (b)(1)(xi) and (b)(1)(xii), and by adding paragraph 
(b)(1)(xiii) to read as follows:


Sec. 1003.100  Basis and purpose.

    (a) Basis. This part implements sections 1128(c), 1128A, 1128E, 
1140, 1866(g), 1876(i), 1877(g), 1882(d) and 1903(m)(5) of the Social 
Security Act, and sections 421(c) and 427(b)(2) of Pub. L. 99-660 (42 
U.S.C. 1320a-7, 1320a-7a, 1320a-7e, 1320a-7c, 1320b-10, 1395cc(g), 
1395mm, 1395ss(d), 1396(m), 11131(c), and 11137(b)(2)).
    (b) Purpose. This part--
    (1) Provides for the imposition of civil money penalties and, as 
applicable, assessments against persons who--
* * * * *
    (xi) Are physicians or entities that enter into an arrangement or 
scheme that they know or should know has as a principal purpose the 
assuring of referrals by the physician to a particular entity that, if 
made directly, would violate the provisions of Sec. 411.353 of this 
title;

[[Page 18550]]

    (xii) Violate the Federal health care programs' anti-kickback 
statute as set forth in section 1128B of the Act; or
    (xiii) Knowingly and willfully present, or cause to be presented, a 
bill or request for payment for nonphysician services furnished to 
hospital patients (unless the services are furnished by the hospital, 
either directly or under an arrangement) in violation of sections 
1862(a)(14) and 1866(a)(1)(H) of the Act.
* * * * *

    3. Section 1003.102 is amended by republishing the introductory 
text to paragraph (b), by adding and reserving paragraphs (b)(12) 
through (b)(14), and by adding a new paragraph (b)(15) to read as 
follows:


Sec. 1003.102  Basis for civil money penalties and assessments.

* * * * *
    (b) The OIG may impose a penalty, and where authorized, an 
assessment against any person (including an insurance company in the 
case of paragraphs (b)(5) and (b)(6) of this section) whom it 
determines in accordance with this part--
* * * * *
    (15) Has knowingly and willfully presented, or caused to be 
presented, a bill or request for payment for items and services 
furnished to a hospital patient for which payment may be made under the 
Medicare or another Federal health care program, if that bill or 
request is inconsistent with an arrangement under section 1866(a)(1)(H) 
of the Act, or violates the requirements for such an arrangement.
* * * * *

    4. Section 1003.103 is amended by revising paragraph (a), by adding 
and reserving paragraphs (i) and (j), and by adding a new paragraph (k) 
to read as follows:


Sec. 1003.103  Amount of penalty.

    (a) Except as provided in paragraphs (b) and (d) through (k) of 
this section, the OIG may impose a penalty of not more than $10,000 for 
each item or service that is subject to a determination under 
Sec. 1003.102.
* * * * *
    (k) For violations of section 1862(a)(14) of the Act and 
Sec. 1003.102(b)(15), the OIG may impose a penalty of not more than 
$2,000 for each bill or request for payment for items and services 
furnished to a hospital patient.

    5. Section 1003.105 is amended by republishing the introductory 
text to paragraph (a)(1) and by revising paragraph (a)(1)(i) to read as 
follows:


Sec. 1003.105  Exclusion from participation in Medicare, Medicaid and 
other Federal health care programs.

    (a)(1) Except as set forth in paragraph (b) of this section, in 
lieu of or in addition to any penalty or assessment, the OIG may 
exclude from participation in Medicare, Medicaid and other Federal 
health care programs the following persons for a period of time 
determined under Sec. 1003.107--
    (i) Any person who is subject to a penalty or assessment under 
Sec. 1003.102(a), (b)(1) through (b)(4), or (b)(15).
* * * * *

(Catalog of Federal Domestic Assistance 93.774, Medicare--
Supplementary Medical Insurance Program)

    Dated: March 3, 2000.
Nancy-Ann Min DeParle,
Administrator, Health Care Financing Administration.
    Dated: March 28, 2000.
June G. Brown,
Inspector General, Department of Health and Human Services.
    Approved: March 29, 2000.
Donna E. Shalala,
Secretary.

    Note: The following addenda will not appear in the Code of 
Federal Regulations.


    Note to Addenda A, B, C, E and F: Addenda A, B, and C have a 
number of errors in the following columns: APC, status indicator, 
payment rate, and national unadjusted coinsurance and minimum 
unadjusted coinsurance. We identified these errors too late in 
preparing this rule for publication to correct them. Some of the 
errors are related to the status codes assigned to the HCPCS codes 
and APCs.
    Some errors affect addenda B, C, and E. Several of these errors 
involve procedures incorrectly identified as inpatient procedures, 
and one inpatient procedure incorrectly identified as an outpatient 
procedure. Certain PET scan codes and other codes are shown in 
incorrect APCs. Screening sigmoidoscopy and colonoscopy APCs have 
the wrong HCPCS codes and incorrect payment rates and coinsurance 
amounts. Certain dental codes were inadvertently identified as 
errors, so their correct APC assignments, payment rate and 
coinsurance amounts were not shown in the addenda. Two breath tests 
are subject to the clinical diagnostic lab fee schedule. We have 
listed below the corrections that have payment implications.
    Addendum F does not include status indicators G and H which 
identify items that are eligible for pass-through payments. (See 
section III.B.3 of the preamble for a complete description of all 
status indications used in conjunction with this final rule.)
    We also note that the word ``proposed'' should not appear on any 
Addenda contained in this final rule such as on Addendum A or C.
    The fiscal intermediaries will receive the necessary changes to 
process outpatient PPS claims correctly. We will post the corrected 
Addendum B on our Website and publish a correction document in the 
Federal Register.
    Our Website address is http://www.hcfa.gov/medicare/hopsmain.htm.


                                                   List Accompanying Note To Addenda A, B, C, E and F
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                             National         Minimum
  CPT/        HOPD Status Indicator                Description                  APC          Relative        Proposed       Unadjusted      Unadjusted
 HCPCS                                                                                        Weight       Payment Rate     Coinsurance     Coinsurance
--------------------------------------------------------------------------------------------------------------------------------------------------------
  20979  E                               US bone stimulation............
  31375  C                               Partial removal of larynx......
  35481  T                               Atherectomy, open..............            0081           19.36         $938.71         $434.25         $187.74
  61795  S                               Brain surgery using computer...            0302            8.21         $398.08         $216.55          $79.62
  61886  T                               Implant neurostim arrays.......            0222           25.48       $1,235.45         $780.07         $247.09
  75945  S                               Intravascular us...............            0267            2.72         $131.88          $80.06          $26.38
  75946  S                               Intravascular us add-on........            0267            2.72         $131.88          $80.06          $26.38
  78267  A                               Breath test attain/anal, c-14..
  78268  A                               Breath test analysis, c-14.....
  92978  S                               Intravasc us, heart add-on.....            0267            2.72         $131.88          $80.06          $26.38
  92979  S                               Intravasc us, heart add-on.....            0267            2.72         $131.88          $80.06          $26.38
  96570  T                               Photodynamic Tx, 30 min........            0973            5.16         $250.19  ..............          $50.04
  96571  T                               Photodynamic Tx, addl 15 min...            0973            5.16         $250.19  ..............          $50.04
  D0277  S                               Vert bitewings-sev to eight....            0330            1.51          $73.22          $14.64          $14.64
  D0472  S                               Gross exam, prep & report......            0330            1.51          $73.22          $14.64          $14.64

[[Page 18551]]

 
  D0473  S                               Micro exam, prep & report......            0330            1.51          $73.22          $14.64          $14.64
  D0474  S                               Micro w exam of surg margins...            0330            1.51          $73.22          $14.64          $14.64
  D0480  S                               Cytopath smear prep & report...            0330            1.51          $73.22          $14.64          $14.64
  D4268  S                               Surgical revision procedure....            0330            1.51          $73.22          $14.64          $14.64
  G0104  S                               CA screen; flexible                        0159            2.83         $137.22  ..............          $34.31
                                          sigmoidscope.
  G0105  S                               Colorectal screen; high risk               0158            7.98         $386.93  ..............          $96.73
                                          ind.
  G0122  S                               Colon ca scrn; barium enema....            0157            1.79          $86.79  ..............          $17.36
  G0125  S                               Lung Image (PET)...............            0981           46.40       $2,249.80  ..............         $449.96
  G0126  S                               Lung Image (PET) staging.......            0981           46.40       $2,249.80  ..............         $449.96
  G0163  S                               PET for rec of colorectal                  0981           46.40       $2,249.80  ..............         $449.96
                                          cancer.
  G0164  S                               PET for lymphoma staging.......            0981           46.40       $2,249.80  ..............         $449.96
  G0165  S                               PET, rec of melanoma/met cancer            0981           46.40       $2,249.80  ..............         $449.96
  G0168  T                               Wound closure by adhesive......            0970            0.52          $25.21  ..............           $5.04
  G0169  T                               Removal tissue; no anesthesia..            0013            0.91          $44.12          $17.66           $8.82
  G0170  T                               Skin biograft..................            0025            3.74         $181.34          $70.66          $36.27
  G0171  T                               Skin biograft add-on...........            0025            3.74         $181.34          $70.66          $36.27
--------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------
\1\ Not subject to national coinsurance. Minimum unadjusted coinsurance 
is 25% of the payment rate. The Payment rate is the lower of the HOPD 
payment rate or the Ambulatory Surgical Center payment.

  

\2\ Not subject to national coinsurance.

\3\ Eligible for pass-through payments. See Preamble for payment rate 
determination. See Addendum K for complete list of pass-through codes.

 

 

[[Page 18551]]



  Addendum A.--List of Hospital Outpatient Ambulatory Payment Classes With Status Indicators, Relative Weights,
                                     Payment Rates, and Coinsurance Amounts
----------------------------------------------------------------------------------------------------------------
                                                                                     National         Minimum
  APC        Group Title      Status  Indicator      Relative      Payment  Rate    Unadjusted      Unadjusted
                                                      Weight                        Coinsurance     Coinsurance
----------------------------------------------------------------------------------------------------------------
   0001  Photochemotherapy.  S                              0.47          $22.79           $8.49           $4.56
   0002  Fine needle Biopsy/ T                              0.62          $30.06          $17.66           $6.01
          Aspiration.
   0003  Bone Marrow Biopsy/ T                              0.98          $47.52          $27.99           $9.50
          Aspiration.
   0004  Level I Needle      T                              1.84          $89.22          $32.57          $17.84
          Biopsy/Aspiration
          Except Bone
          Marrow.
   0005  Level II Needle     T                              5.41         $262.32         $119.75          $52.46
          Biopsy/Aspiration
          Except Bone
          Marrow.
   0006  Level I Incision &  T                              2.00          $96.97          $33.95          $19.39
          Drainage.
   0007  Level II Incision   T                              3.68         $178.43          $72.03          $35.69
          & Drainage.
   0008  Level III Incision  T                              6.15         $298.20         $113.67          $59.64
          & Drainage.
   0009  Nail Procedures...  T                              0.74          $35.88           $9.63           $7.18
   0010  Level I             T                              0.55          $26.67           $9.86           $5.33
          Destruction of
          Lesion.
   0011  Level II            T                              2.72         $131.88          $50.01          $26.38
          Destruction of
          Lesion.
   0012  Level I             T                              0.53          $25.70           $9.18           $5.14
          Debridement &
          Destruction.
   0013  Level II            T                              0.91          $44.12          $17.66           $8.82
          Debridement &
          Destruction.
   0014  Level III           T                              1.50          $72.73          $24.55          $14.55
          Debridement &
          Destruction.
   0015  Level IV            T                              1.77          $85.82          $31.20          $17.16
          Debridement &
          Destruction.
   0016  Level V             T                              3.53         $171.16          $74.67          $34.23
          Debridement &
          Destruction.
   0017  Level VI            T                             12.45         $603.66         $289.16         $120.73
          Debridement &
          Destruction.
   0018  Biopsy Skin,        T                              0.94          $45.58          $17.66           $9.12
          Subcutaneous
          Tissue or Mucous
          Membrane.
   0019  Level I Excision/   T                              4.00         $193.95          $78.91          $38.79
          Biopsy.
   0020  Level II Excision/  T                              6.51         $315.65         $130.53          $63.13
          Biopsy.
   0021  Level III Excision/ T                             10.49         $508.63         $236.51         $101.73
          Biopsy.
   0022  Level IV Excision/  T                             12.49         $605.60         $292.94         $121.12
          Biopsy.
   0023  Exploration         T                              1.98          $96.00          $40.37          $19.20
          Penetrating Wound.
   0024  Level I Skin        T                              2.43         $117.82          $44.50          $23.56
          Repair.
   0025  Level II Skin       T                              3.74         $181.34          $70.66          $36.27
          Repair.
   0026  Level III Skin      T                             12.11         $587.18         $277.92         $117.44
          Repair.
   0027  Level IV Skin       T                             15.80         $766.10         $383.10         $153.22
          Repair.
   0029  Incision/Excision   T                             12.85         $623.06         $303.50         $124.61
          Breast.
   0030  Breast              T                             20.19         $978.95         $523.95         $195.79
          Reconstruction/
          Mastectomy.
   0031  Hyperbaric Oxygen.  S                              3.00         $145.46         $140.85          $29.09
   0032  Placement           T                              5.40         $261.83         $119.52          $52.37
          Transvenous
          Catheters/
          Arterial Cutdown.
   0033  Partial             P                              4.17         $202.19          $48.17          $40.44
          Hospitalization.
   0040  Arthrocentesis &    T                              2.11         $102.31          $40.60          $20.46
          Ligament/Tendon
          Injection.
   0041  Arthroscopy.......  T                             24.57       $1,191.33         $592.08         $238.27
   0042  Arthroscopically-   T                             29.22       $1,416.79         $804.74         $283.36
          Aided Procedures.
   0043  Closed Treatment    T                              1.64          $79.52          $25.46          $15.90
          Fracture Finger/
          Toe/Trunk.
   0044  Closed Treatment    T                              2.17         $105.22          $38.08          $21.04
          Fracture/
          Dislocation
          Except Finger/Toe/
          Trunk.
   0045  Bone/Joint          T                             11.02         $534.33         $277.12         $106.87
          Manipulation
          Under Anesthesia.
   0046  Open/Percutaneous   T                             22.29       $1,080.78         $535.76         $216.16
          Treatment
          Fracture or
          Dislocation.
   0047  Arthroplasty        T                             22.09       $1,071.08         $537.03         $214.22
          without
          Prosthesis.
   0048  Arthroplasty with   T                             29.06       $1,409.03         $725.94         $281.81
          Prosthesis.
   0049  Level I             T                             15.04         $729.25         $356.95         $145.85
          Musculoskeletal
          Procedures Except
          Hand and Foot.
   0050  Level II            T                             21.13       $1,024.53         $513.86         $204.91
          Musculoskeletal
          Procedures Except
          Hand and Foot.
   0051  Level III           T                             27.76       $1,346.00         $675.24         $269.20
          Musculoskeletal
          Procedures Except
          Hand and Foot.
   0052  Level IV            T                             36.16       $1,753.29         $930.91         $350.66
          Musculoskeletal
          Procedures Except
          Hand and Foot.
   0053  Level I Hand        T                             11.32         $548.87         $253.49         $109.77
          Musculoskeletal
          Procedures.
   0054  Level II Hand       T                             19.66         $953.26         $472.33         $190.65
          Musculoskeletal
          Procedures.
   0055  Level I Foot        T                             15.47         $750.10         $355.34         $150.02
          Musculoskeletal
          Procedures.
   0056  Level II Foot       T                             17.30         $838.83         $405.81         $167.77
          Musculoskeletal
          Procedures.

[[Page 18552]]

 
   0057  Bunion Procedures.  T                             21.00       $1,018.23         $496.65         $203.65
   0058  Level I Strapping   S                              1.09          $52.85          $19.27          $10.57
          and Cast
          Application.
   0059  Level II Strapping  S                              1.74          $84.37          $29.59          $16.87
          and Cast
          Application.
   0060  Manipulation        S                              0.77          $37.34           $7.80           $7.47
          Therapy.
   0070  Thoracentesis/      T                              3.64         $176.49          $79.60          $35.30
          Lavage Procedures.
   0071  Level I Endoscopy   T                              0.55          $26.67          $14.22           $5.33
          Upper Airway.
   0072  Level II Endoscopy  T                              1.26          $61.09          $41.52          $12.22
          Upper Airway.
   0073  Level III           T                              4.11         $199.28          $91.07          $39.86
          Endoscopy Upper
          Airway.
   0074  Level IV Endoscopy  T                             13.61         $659.91         $347.54         $131.98
          Upper Airway.
   0075  Level V Endoscopy   T                             18.55         $899.44         $467.29         $179.89
          Upper Airway.
   0076  Endoscopy Lower     T                              8.06         $390.81         $197.05          $78.16
          Airway.
   0077  Level I Pulmonary   S                              0.43          $20.85          $12.62           $4.17
          Treatment.
   0078  Level II Pulmonary  S                              1.34          $64.97          $29.13          $12.99
          Treatment.
   0079  Ventilation         S                              3.18         $154.19         $107.70          $30.84
          Initiation and
          Management.
   0080  Diagnostic Cardiac  T                             25.77       $1,249.51         $713.89         $249.90
          Catheterization.
   0081  Non-Coronary        T                             19.36         $938.71         $434.25         $187.74
          Angioplasty or
          Atherectomy.
   0082  Coronary            T                             40.34       $1,955.97         $859.56         $391.19
          Atherectomy.
   0083  Coronary            T                             45.79       $2,220.22       $1,322.95         $444.04
          Angiosplasty.
   0084  Level I             S                             10.70         $518.81         $177.79         $103.76
          Electrophysiologi
          c Evaluation.
   0085  Level II            S                             27.06       $1,312.06         $654.48         $262.41
          Electrophysiologi
          c Evaluation.
   0086  Ablate Heart        S                             47.62       $2,308.95       $1,265.37         $461.79
          Dysrhythm Focus.
   0087  Cardiac             S                              9.53         $462.08         $214.72          $92.42
          Electrophysiologi
          c Recording/
          Mapping.
   0088  Thrombectomy......  T                             26.49       $1,284.42         $678.68         $256.88
   0089  Level I             T                              6.49         $314.68         $130.07          $62.94
          Implantation/
          Removal/Revision
          of Pacemaker,
          AICD or Vascular
          Device.
   0090  Level II            T                             20.96       $1,016.29         $573.04         $203.26
          Implantation/
          Removal/Revision
          of Pacemaker,
          AICD or Vascular
          Device.
   0091  Level I Vascular    T                             14.79         $717.12         $348.23         $143.42
          Ligation.
   0092  Level II Vascular   T                             20.21         $979.92         $505.37         $195.98
          Ligation.
   0093  Vascular Repair/    T                             17.95         $870.34         $422.33         $174.07
          Fistula
          Construction.
   0094  Resuscitation and   S                              4.51         $218.68         $105.29          $43.74
          Cardioversion.
   0095  Cardiac             S                              0.64          $31.03          $16.98           $6.21
          Rehabilitation.
   0096  Non-Invasive        S                              2.06          $99.88          $61.48          $19.98
          Vascular Studies.
   0097  Cardiovascular      S                              1.62          $78.55          $62.40          $15.71
          Stress Test.
   0098  Injection of        T                              1.19          $57.70          $20.88          $11.54
          Sclerosing
          Solution.
   0099  Continuous Cardiac  S                              0.38          $18.43          $14.68           $3.69
          Monitoring.
   0100  Continuous ECG....  S                              1.70          $82.43          $71.57          $16.49
   0101  Tilt Table          S                              4.47         $216.74         $128.84          $43.35
          Evaluation.
   0102  Electronic          S                              0.45          $21.82          $12.62           $4.36
          Analysis of
          Pacemakers/other
          Devices.
   0109  Bone Marrow         S                              4.13         $200.25          $40.05          $40.05
          Harvesting and
          Bone Marrow/Stem
          Cell Transplant.
   0110  Transfusion.......  S                              5.83         $282.68         $122.73          $56.54
   0111  Blood Product       S                             14.17         $687.06         $300.74         $137.41
          Exchange.
   0112  Extracorporeal      S                             39.60       $1,920.09         $663.65         $384.02
          Photopheresis.
   0113  Excision Lymphatic  T                             13.89         $673.49         $326.55         $134.70
          System.
   0114  Thyroid/            T                             19.56         $948.41         $493.78         $189.68
          Lymphadenectomy
          Procedures.
   0116  Chemotherapy        S                              2.34         $113.46          $22.69          $22.69
          Administration by
          Other Technique
          Except Infusion.
   0117  Chemotherapy        S                              1.84          $89.22          $71.80          $17.84
          Administration by
          Infusion Only.
   0118  Chemotherapy        S                              2.90         $140.61          $72.03          $28.12
          Administration by
          Both Infusion and
          Other Technique.
   0120  Infusion Therapy    S                              1.66          $80.49          $42.67          $16.10
          Except
          Chemotherapy.
   0121  Level I Tube        T                              2.36         $114.43          $52.53          $22.89
          changes and
          Repositioning.
   0122  Level II Tube       T                              5.04         $244.37         $114.93          $48.88
          changes and
          Repositioning.
   0123  Level III Tube      T                             13.89         $673.49         $350.75         $134.70
          changes and
          Repositioning.
   0130  Level I             T                             25.36       $1,229.63         $659.53         $245.93
          Laparoscopy.
   0131  Level II            T                             41.81       $2,027.24       $1,089.88         $405.45
          Laparoscopy.
   0132  Level III           T                             48.91       $2,371.50       $1,239.22         $474.30
          Laparoscopy.
   0140  Esophageal          T                              4.74         $229.83         $107.24          $45.97
          Dilation without
          Endoscopy.
   0141  Upper GI            T                              7.15         $346.68         $184.67          $69.34
          Procedures.
   0142  Small Intestine     T                              7.45         $361.23         $162.42          $72.25
          Endoscopy.
   0143  Lower GI Endoscopy  T                              7.98         $386.93         $199.12          $77.39
   0144  Diagnostic          T                              2.23         $108.13          $49.32          $21.63
          Anoscopy.
   0145  Therapeutic         T                              7.46         $361.71         $179.39          $72.34
          Anoscopy.
   0146  Level I             T                              2.83         $137.22          $65.15          $27.44
          Sigmoidoscopy.
   0147  Level II            T                              6.26         $303.53         $149.11          $60.71
          Sigmoidoscopy.
   0148  Level I Anal/       T                              2.34         $113.46          $43.59          $22.69
          Rectal Procedure.
   0149  Level II Anal/      T                             12.86         $623.54         $293.06         $124.71
          Rectal Procedure.
   0150  Level III Anal/     T                             17.68         $857.25         $437.12         $171.45
          Rectal Procedure.
   0151  Endoscopic          T                             10.53         $510.57         $245.46         $102.11
          Retrograde
          Cholangio-
          Pancreatography
          (ERCP).
   0152  Percutaneous        T                              8.22         $398.56         $207.38          $79.71
          Biliary
          Endoscopic
          Procedures.
   0153  Peritoneal and      T                             19.62         $951.32         $496.31         $190.26
          Abdominal
          Procedures.
   0154  Hernia/Hydrocele    T                             22.43       $1,087.57         $556.98         $217.51
          Procedures.
 2 0157  Colorectal Cancer   S                              1.79          $86.79  ..............          $17.36
          Screening: Barium
          Enema.
 1 0158  Colorectal Cancer   S                              7.98         $386.93  ..............          $96.73
          Screening:
          Colonoscopy.
 1 0159  Colorectal Cancer   S                              7.98         $137.22  ..............          $34.31
          Screening:
          Flexible
          Sigmoidoscopy.

[[Page 18553]]

 
   0160  Level I             T                              5.43         $263.28         $110.11          $52.66
          Cystourethroscopy
          and other
          Genitourinary
          Procedures.
   0161  Level II            T                             10.94         $530.45         $249.36         $106.09
          Cystourethroscopy
          and other
          Genitourinary
          Procedures.
   0162  Level III           T                             17.49         $848.04         $427.49         $169.61
          Cystourethroscopy
          and other
          Genitourinary
          Procedures.
   0163  Level IV            T                             28.98       $1,405.16         $792.58         $281.03
          Cystourethroscopy
          and other
          Genitourinary
          Procedures.
   0164  Level I Urinary     T                              2.17         $105.23          $33.03          $21.05
          and Anal
          Procedures.
   0165  Level II Urinary    T                              3.89         $188.61          $91.76          $37.72
          and Anal
          Procedures.
   0166  Level I Urethral    T                             10.17         $493.11         $218.73          $98.62
          Procedures.
   0167  Level II Urethral   T                             21.06       $1,021.14         $555.84         $204.23
          Procedures.
   0168  Level III Urethral  T                             24.94       $1,209.27         $536.11         $241.85
          Procedures.
   0169  Lithotripsy.......  T                             46.72       $2,265.32       $1,384.20         $453.06
   0170  Dialysis for Other  S                              6.68         $323.89          $72.26          $64.78
          Than ESRD
          Patients.
   0180  Circumcision......  T                             13.62         $660.39         $304.87         $132.08
   0181  Penile Procedures.  T                             32.37       $1,569.53         $906.36         $313.91
   0182  Insertion of        T                             52.11       $2,526.66       $1,525.05         $505.33
          Penile Prosthesis.
   0183  Testes/Epididymis   T                             18.26         $885.37         $448.94         $177.07
          Procedures.
   0184  Prostate Biopsy...  T                              4.94         $239.53         $122.96          $47.91
   0190  Surgical            T                             17.85         $865.49         $443.89         $173.10
          Hysteroscopy.
   0191  Level I Female      T                              1.19          $57.70          $17.43          $11.54
          Reproductive
          Procedures.
   0192  Level II Female     T                              2.38         $115.40          $35.33          $23.08
          Reproductive
          Procedures.
   0193  Level III Female    T                              8.93         $432.99         $171.13          $86.60
          Reproductive
          Procedures.
   0194  Level IV Female     T                             16.21         $785.98         $395.94         $157.20
          Reproductive
          Procedures.
   0195  Level V Female      T                             18.68         $905.74         $483.80         $181.15
          Reproductive
          Procedures.
   0196  Dilatation &        T                             14.47         $701.61         $357.98         $140.32
          Curettage.
   0197  Infertility         T                              2.40         $116.37          $49.55          $23.27
          Procedures.
   0198  Pregnancy and       T                              1.34          $64.97          $33.03          $12.99
          Neonatal Care
          Procedures.
   0199  Vaginal Delivery..  T                             11.20         $543.06         $157.83         $108.61
   0200  Therapeutic         T                             13.89         $673.49         $373.23         $134.70
          Abortion.
   0201  Spontaneous         T                             13.00         $630.33         $329.65         $126.07
          Abortion.
   0210  Spinal Tap........  T                              3.00         $145.46          $62.40          $29.09
   0211  Level I Nervous     T                              3.32         $160.98          $74.78          $32.20
          System Injections.
   0212  Level II Nervous    T                              3.64         $176.49          $88.78          $35.30
          System Injections.
   0213  Extended EEG        S                             11.15         $540.63         $290.42         $108.13
          Studies and Sleep
          Studies.
   0214  Electroencephalogr  S                              2.32         $112.49          $58.50          $22.50
          am.
   0215  Level I Nerve and   S                              1.15          $55.76          $30.05          $11.15
          Muscle Tests.
   0216  Level II Nerve and  S                              2.87         $139.16          $64.69          $27.83
          Muscle Tests.
   0217  Level III Nerve     S                              5.87         $284.62         $156.68          $56.92
          and Muscle Tests.
   0220  Level I Nerve       T                             13.96         $676.88         $326.21         $135.38
          Procedures.
   0221  Level II Nerve      T                             18.36         $890.22         $463.62         $178.04
          Procedures.
   0222  Implantation of     T                             25.48       $1,235.45         $780.07         $247.09
          Neurological
          Device.
   0223  Level I Revision/   T                              6.34         $307.41         $153.24          $61.48
          Removal
          Neurological
          Device.
   0224  Level II Revision/  T                             15.94         $772.88         $374.61         $154.58
          Removal
          Neurological
          Device.
   0225  Implantation of     T                              3.43         $166.31          $64.46          $33.26
          Neurostimulator
          Electrodes.
   0230  Level I Eye Tests.  S                              0.98          $47.52          $22.48           $9.50
   0231  Level II Eye Tests  S                              2.64         $128.01          $59.87          $25.60
   0232  Level I Anterior    T                              6.04         $292.86         $134.66          $58.57
          Segment Eye.
   0233  Level II Anterior   T                             13.79         $668.64         $331.60         $133.73
          Segment Eye.
   0234  Level III Anterior  T                             20.64       $1,000.77         $502.16         $200.15
          Segment Eye
          Procedures.
   0235  Level I Posterior   T                              2.94         $142.55          $78.91          $28.51
          Segment Eye
          Procedures.
   0236  Level II Posterior  T                              6.70         $324.86         $147.96          $64.97
          Segment Eye
          Procedures.
   0237  Level III           T                             33.96       $1,646.62         $852.68         $329.32
          Posterior Segment
          Eye Procedures.
   0238  Level I Repair and  T                              2.80         $135.76          $58.96          $27.15
          Plastic Eye
          Procedures.
   0239  Level II Repair     T                              6.26         $303.53         $123.42          $60.71
          and Plastic Eye
          Procedures.
   0240  Level III Repair    T                             13.47         $653.12         $315.31         $130.62
          and Plastic Eye
          Procedures.
   0241  Level IV Repair     T                             16.60         $804.89         $384.47         $160.98
          and Plastic Eye
          Procedures.
   0242  Level V Repair and  T                             23.70       $1,149.14         $597.36         $229.83
          Plastic Eye
          Procedures.
   0243  Strabismus/Muscle   T                             17.99         $872.28         $431.39         $174.46
          Procedures.
   0244  Corneal Transplant  T                             32.88       $1,594.26         $851.42         $318.85
   0245  Cataract            T                             26.55       $1,287.33         $623.85         $257.47
          Procedures
          without IOL
          Insert.
   0246  Cataract            T                             26.55       $1,287.33         $623.85         $257.47
          Procedures with
          IOL Insert.
   0247  Laser Eye           T                              4.89         $237.10         $112.86          $47.42
          Procedures Except
          Retinal.
   0248  Laser Retinal       T                              4.19         $203.16          $94.05          $40.63
          Procedures.
   0250  Nasal               T                              2.21         $107.16          $38.54          $21.43
          Cauterization/
          Packing.
   0251  Level I ENT         T                              1.68          $81.46          $27.99          $16.29
          Procedures.
   0252  Level II ENT        T                              5.18         $251.16         $114.24          $50.23
          Procedures.
   0253  Level III ENT       T                             12.02         $582.81         $284.00         $116.56
          Procedures.
   0254  Level IV ENT        T                             12.45         $603.66         $272.41         $120.73
          Procedures.
   0256  Level V ENT         T                             25.40       $1,231.57         $623.05         $246.31
          Procedures.
   0257  Implantation of     T                            115.31       $5,591.04       $3,498.58       $1,118.21
          Cochlear Device.
   0258  Tonsil and Adenoid  T                             18.62         $902.83         $462.81         $180.57
          Procedures.
   0260  Level I Plain Film  X                              0.79          $38.30          $22.02           $7.66
          Except Teeth.
   0261  Level II Plain      X                              1.38          $66.91          $38.77          $13.38
          Film Except Teeth
          Including Bone
          Density
          Measurement.
   0262  Plain Film of       X                              0.40          $19.39          $10.90           $3.88
          Teeth.

[[Page 18554]]

 
   0263  Level I             X                              1.68          $81.46          $45.88          $16.29
          Miscellaneous
          Radiology
          Procedures.
   0264  Level II            X                              3.83         $185.71         $108.97          $37.14
          Miscellaneous
          Radiology
          Procedures.
   0265  Level I Diagnostic  S                              1.17          $56.73          $38.08          $11.35
          Ultrasound Except
          Vascular.
   0266  Level II            S                              1.79          $86.79          $57.35          $17.36
          Diagnostic
          Ultrasound Except
          Vascular.
   0267  Vascular            S                              2.72         $131.88          $80.06          $26.38
          Ultrasound.
   0268  Guidance Under      X                              2.23         $108.13          $69.51          $21.63
          Ultrasound.
   0269  Echocardiogram      S                              4.40         $213.34         $114.01          $42.67
          Except
          Transesophageal.
   0270  Transesophageal     S                              5.55         $269.10         $150.26          $53.82
          Echocardiogram.
   0271  Mammography.......  S                              0.70          $33.94          $19.50           $6.79
   0272  Level I             X                              1.40          $67.88          $39.00          $13.58
          Fluoroscopy.
   0273  Level II            X                              2.49         $120.73          $61.02          $24.15
          Fluoroscopy.
   0274  Myelography.......  S                              4.83         $234.19         $128.12          $46.84
   0275  Arthrography......  S                              2.74         $132.85          $72.26          $26.57
   0276  Level I Digestive   S                              1.79          $86.79          $49.78          $17.36
          Radiology.
   0277  Level II Digestive  S                              2.47         $119.76          $69.28          $23.95
          Radiology.
   0278  Diagnostic          S                              2.85         $138.19          $81.67          $27.64
          Urography.
   0279  Level I Diagnostic  S                              6.30         $305.47         $174.57          $61.09
          Angiography and
          Venography Except
          Extremity.
   0280  Level II            S                             14.98         $726.34         $380.12         $145.27
          Diagnostic
          Angiography and
          Venography Except
          Extremity.
   0281  Venography of       S                              4.40         $213.34         $115.16          $42.67
          Extremity.
   0282  Level I             S                              2.38         $115.40          $94.51          $23.08
          Computerized
          Axial Tomography.
   0283  Level II            S                              4.89         $237.10         $179.39          $47.42
          Computerized
          Axial Tomography.
   0284  Magnetic Resonance  S                              8.02         $388.87         $257.39          $77.77
          Imaging.
   0285  Positron Emission   S                             15.06         $730.22         $415.21         $146.04
          Tomography (PET).
   0286  Myocardial Scans..  S                              7.28         $352.99         $200.04          $70.60
   0290  Standard Non-       S                              1.94          $94.06          $55.51          $18.81
          Imaging Nuclear
          Medicine.
   0291  Level I Diagnostic  S                              3.15         $152.73          $93.14          $30.55
          Nuclear Medicine
          Excluding
          Myocardial Scans.
   0292  Level II            S                              4.36         $211.40         $126.63          $42.28
          Diagnostic
          Nuclear Medicine
          Excluding
          Myocardial Scans.
   0294  Level I             S                              5.13         $248.74         $144.06          $49.75
          Therapeutic
          Nuclear Medicine.
   0295  Level II            S                             19.85         $962.47         $609.17         $192.49
          Therapeutic
          Nuclear Medicine.
   0296  Level I             S                              3.57         $173.10         $100.25          $34.62
          Therapeutic
          Radiologic
          Procedures.
   0297  Level II            S                              6.13         $297.23         $172.51          $59.45
          Therapeutic
          Radiologic
          Procedures.
   0300  Level I Radiation   S                              1.98          $96.00          $47.72          $19.20
          Therapy.
   0301  Level II Radiation  S                              2.21         $107.16          $52.53          $21.43
          Therapy.
   0302  Level III           S                              8.21         $398.08         $216.55          $79.62
          Radiation Therapy.
   0303  Treatment Device    X                              2.83         $137.22          $69.28          $27.44
          Construction.
   0304  Level I             X                              1.49          $72.25          $41.52          $14.45
          Therapeutic
          Radiation
          Treatment
          Preparation.
   0305  Level II            X                              4.06         $196.86          $97.50          $39.37
          Therapeutic
          Radiation
          Treatment
          Preparation.
   0310  Level III           X                             13.98         $677.85         $339.05         $135.57
          Therapeutic
          Radiation
          Treatment
          Preparation.
   0311  Radiation Physics   X                              1.32          $64.00          $31.66          $12.80
          Services.
   0312  Radioelement        S                              4.09         $198.31         $109.65          $39.66
          Applications.
   0313  Brachytherapy.....  S                              7.89         $382.56         $164.02          $76.51
   0314  Hyperthermic        S                              5.88         $285.10         $150.95          $57.02
          Therapies.
   0320  Electroconvulsive   S                              3.68         $178.43          $80.06          $35.69
          Therapy.
   0321  Biofeedback and     S                              1.26          $61.09          $29.25          $12.22
          Other Training.
   0322  Brief Individual    S                              1.32          $64.00          $14.22          $12.80
          Psychotherapy.
   0323  Extended            S                              1.85          $89.70          $22.48          $17.94
          Individual
          Psychotherapy.
   0324  Family              S                              1.87          $90.67          $20.19          $18.13
          Psychotherapy.
   0325  Group               S                              1.55          $75.16          $19.96          $15.03
          Psychotherapy.
   0330  Dental Procedures.  S                              1.51          $73.22          $14.64          $14.64
   0340  Minor Ancillary     X                              1.04          $50.43          $12.85          $10.09
          Procedures.
   0341  Immunology Tests..  X                              0.13           $6.30           $3.67           $1.26
   0342  Level I Pathology.  X                              0.26          $12.61           $8.03           $2.52
   0343  Level II Pathology  X                              0.45          $21.82          $12.16           $4.36
   0344  Level III           X                              0.79          $38.30          $23.63           $7.66
          Pathology.
 2 0354  Administration of   X                              0.13           $6.19  ..............  ..............
          Influenza Vaccine.
   0355  Level I             X                              0.19           $9.21           $5.05           $1.84
          Immunizations.
   0356  Level II            X                              0.36          $17.46           $4.82           $3.49
          Immunizations.
   0357  Level III           X                              1.85          $89.70          $38.31          $17.94
          Immunizations.
   0358  Level IV            X                              6.98         $338.44         $126.74          $67.69
          Immunizations.
   0359  Injections........  X                              0.96          $46.55           $9.31           $9.31
   0360  Level I Alimentary  X                              1.38          $66.91          $34.75          $13.38
          Tests.
   0361  Level II            X                              3.53         $171.16          $88.09          $34.23
          Alimentary Tests.
   0362  Fitting of Vision   X                              0.51          $24.73           $9.63           $4.95
          Aids.
   0363  Otorhinolaryngolog  X                              2.83         $137.22          $53.22          $27.44
          ic Function Tests.
   0364  Level I Audiometry  X                              0.68          $32.97          $13.31           $6.59
   0365  Level II            X                              1.47          $71.28          $22.48          $14.26
          Audiometry.
   0366  Electrocardiogram   X                              0.38          $18.43          $15.60           $3.69
          (ECG).
   0367  Level I Pulmonary   X                              0.83          $40.24          $20.65           $8.05
          Test.
   0368  Level II Pulmonary  X                              1.66          $80.49          $42.44          $16.10
          Tests.
   0369  Level III           X                              2.34         $113.46          $58.50          $22.69
          Pulmonary Tests.
   0370  Allergy Tests.....  X                              0.57          $27.64          $11.81           $5.53
   0371  Allergy Injections  X                              0.32          $15.52           $3.67           $3.10
   0372  Therapeutic         X                              0.43          $20.85          $10.09           $4.17
          Phlebotomy.

[[Page 18555]]

 
   0373  Neuropsychological  X                              3.21         $155.64          $44.96          $31.13
          Testing.
   0374  Monitoring          X                              1.17          $56.73          $13.08          $11.35
          Psychiatric Drugs.
   0600  Low Level Clinic    V                              0.98          $47.52           $9.50           $9.50
          Visits.
   0601  Mid Level Clinic    V                              1.00          $48.49           $9.70           $9.70
          Visits.
   0602  High Level Clinic   V                              1.66          $80.49          $16.29          $16.10
          Visits.
   0603  Interdisciplinary   V                              1.66          $80.49          $16.29          $16.10
          Team Conference.
   0610  Low Level           V                              1.34          $64.97          $20.65          $12.99
          Emergency Visits.
   0611  Mid Level           V                              2.11         $102.31          $36.47          $20.46
          Emergency Visits.
   0612  High Level          V                              3.19         $154.67          $54.14          $30.93
          Emergency Visits.
   0620  Critical Care.....  S                              8.60         $416.99         $152.78          $83.40
 3 0701  Strontium.........  X                    ..............  ..............  ..............          $84.76
 3 0702  Samariam..........  X                    ..............  ..............  ..............         $139.06
 3 0704  Satumomab           X                    ..............  ..............  ..............          $63.13
          Pendetide.
 3 0705  Tc99 Tetrofosmin..  X                    ..............  ..............  ..............          $71.08
 3 0725  Leucovorin Calcium  X                    ..............  ..............  ..............           $1.07
 3 0726  Dexrazoxane         X                    ..............  ..............  ..............          $18.81
          Hydrochloride.
 3 0727  Injection,          X                    ..............  ..............  ..............           $9.31
          Etidronate
          Disodium.
 3 0728  Filgrastim (G-CSF)  X                    ..............  ..............  ..............          $25.21
 3 0730  Pamidronate         X                    ..............  ..............  ..............          $30.93
          Disodium.
 3 0731  Sargramostim (GM-   X                    ..............  ..............  ..............          $16.97
          CSF).
 3 0732  Mesna.............  X                    ..............  ..............  ..............           $2.42
 3 0733  Epoetin Alpha.....  X                    ..............  ..............  ..............           $1.75
 3 0750  Dolasetron          X                    ..............  ..............  ..............           $1.94
          Mesylate 10 mg.
 3 0754  Metoclopramide HCL  X                    ..............  ..............  ..............            $.19
 3 0755  Thiethylperazine    X                    ..............  ..............  ..............            $.68
          Maleate.
 3 0761  Oral Substitute     X                    ..............  ..............  ..............            $.10
          for IV Antiemtic.
 3 0762  Dronabinol........  X                    ..............  ..............  ..............            $.48
 3 0763  Dolasetron          X                    ..............  ..............  ..............           $8.53
          Mesylate 100 mg
          Oral.
 3 0764  Granisetron HCL,    X                    ..............  ..............  ..............           $2.33
          100 mcg.
 3 0765  Granisetron HCL,    X                    ..............  ..............  ..............           $3.20
          1mg Oral.
 3 0768  Ondansetron         X                    ..............  ..............  ..............            $.87
          Hydrochloride per
          1 mg Injection.
 3 0769  Ondansetron         X                    ..............  ..............  ..............           $2.62
          Hydrochloride 8
          mg oral.
 3 0800  Leuprolide Acetate  X                    ..............  ..............  ..............          $68.56
          per 3.75 mg.
 3 0801  Cyclophosphamide..  X                    ..............  ..............  ..............            $.19
 3 0802  Etoposide.........  X                    ..............  ..............  ..............           $3.10
 3 0803  Melphalan.........  X                    ..............  ..............  ..............            $.19
 3 0807  Aldesleukin single  X                    ..............  ..............  ..............          $65.07
          use vial.
 3 0809  BCG (Intravesical)  X                    ..............  ..............  ..............          $19.78
          one vial.
 3 0810  Goserelin Acetate   X                    ..............  ..............  ..............          $59.74
          Implant, per 3.6
          mg.
 3 0811  Carboplatin 50 mg.  X                    ..............  ..............  ..............          $13.96
 3 0812  Carmustine 100 mg.  X                    ..............  ..............  ..............          $10.57
 3 0813  Cisplatin 10 mg...  X                    ..............  ..............  ..............           $4.56
 3 0814  Asparaginase,       X                    ..............  ..............  ..............           $8.34
          10,000 units.
 3 0815  Cyclophosphamide    X                    ..............  ..............  ..............            $.48
          100 mg.
 3 0816  Cyclophosphamide,   X                    ..............  ..............  ..............           $1.16
          Lyophilized 100
          mg.
 3 0817  Cytrabine 100 mg..  X                    ..............  ..............  ..............            $.68
 3 0818  Dactinomycin 0.5    X                    ..............  ..............  ..............           $1.75
          mg.
 3 0819  Dacarbazine 100 mg  X                    ..............  ..............  ..............           $1.26
 3 0820  Daunorubicin HCI    X                    ..............  ..............  ..............          $11.64
          10 mg.
 3 0821  Daunorubicin        X                    ..............  ..............  ..............           $7.76
          Citrate,
          Liposomal
          Formulation, 10
          mg.
 3 0822  Diethylstibestrol   X                    ..............  ..............  ..............           $2.13
          Diphosphate 250
          mg.
 3 0823  Docetaxel 20 mg...  X                    ..............  ..............  ..............          $34.72
 3 0824  Etoposide 10 mg...  X                    ..............  ..............  ..............            $.58
 3 0826  Methotrexate Oral   X                    ..............  ..............  ..............            $.29
          2.5 mg.
 3 0827  Floxuridine 500 mg  X                    ..............  ..............  ..............          $18.81
 3 0828  Gemcitabine HCL     X                    ..............  ..............  ..............           $9.31
          200 mg.
 3 0830  Irinotecan 20 mg..  X                    ..............  ..............  ..............          $14.16
 3 0831  Ifosfamide per 1    X                    ..............  ..............  ..............          $13.58
          gram.
 3 0832  Idarubicin          X                    ..............  ..............  ..............          $46.45
          Hydrochloride 5
          mg.
 3 0833  Interferon Alfacon- X                    ..............  ..............  ..............            $.19
          1, Recombinant, 1
          mcg.
 3 0834  Interferon, Alfa-   X                    ..............  ..............  ..............           $3.20
          2A, Recombinant 3
          million units.
 3 0836  Interferon, Alfa-   X                    ..............  ..............  ..............           $1.36
          2B, Recombinant,
          1 million units.
 3 0838  Interferon, Gamma   X                    ..............  ..............  ..............          $22.79
          1-B, 3 million
          units.
 3 0839  Mechlorethamine     X                    ..............  ..............  ..............           $1.65
          HCI 10 mg.
 3 0840  Melphalan HCI 50    X                    ..............  ..............  ..............          $44.71
          mg.
 3 0841  Methotrexate        X                    ..............  ..............  ..............            $.10
          Sodium 5 mg.
 3 0842  Fludarabine         X                    ..............  ..............  ..............          $30.84
          Phosphate 50 mg.
 3 0843  Pegaspargase per    X                    ..............  ..............  ..............         $178.72
          single dose vial.
 3 0844  Pentostatin 10 mg.  X                    ..............  ..............  ..............         $133.73
 3 0847  Doxorubicin HCL 10  X                    ..............  ..............  ..............           $2.81
          mg.
 3 0849  Rituximab, 100 mg.  X                    ..............  ..............  ..............          $51.40
 3 0850  Streptozocin 1 gm.  X                    ..............  ..............  ..............          $14.64
 3 0851  Thiotepa 15 mg....  X                    ..............  ..............  ..............           $9.50

[[Page 18556]]

 
 3 0852  Topotecan 4 mg....  X                    ..............  ..............  ..............          $73.22
 3 0853  Vinblastine         X                    ..............  ..............  ..............            $.39
          Sulfate 1 mg.
 3 0854  Vincristine         X                    ..............  ..............  ..............           $2.23
          Sulfate 1 mg.
 3 0855  Vinorelbine         X                    ..............  ..............  ..............           $9.60
          Tartrate per 10
          mg.
 3 0856  Porfimer Sodium 75  X                    ..............  ..............  ..............          $34.62
          mg.
 3 0857  Bleomycin Sulfate   X                    ..............  ..............  ..............          $48.29
          15 units.
 3 0858  Cladribine, 1mg...  X                    ..............  ..............  ..............           $8.24
 3 0859  Fluorouracil......  X                    ..............  ..............  ..............            $.19
 3 0860  Plicamycin 2.5 mg.  X                    ..............  ..............  ..............           $1.36
 3 0861   Leuprolide         X                    ..............  ..............  ..............          $19.39
          Acetate 1 mg.
 3 0862  Mitomycin, 5mg....  X                    ..............  ..............  ..............          $19.88
 3 0863  Paclitaxel, 30mg..  X                    ..............  ..............  ..............          $30.16
 3 0864  Mitoxantrone HCl,   X                    ..............  ..............  ..............          $25.80
          per 5mg.
 3 0865  Interferon alfa-    X                    ..............  ..............  ..............           $1.07
          N3, 250,000 IU.
 3 0884  Rho (D) Immune      X                    ..............  ..............  ..............           $3.78
          Globulin, Human
          one dose pack.
 2 0886  Azathioprine, 50    X                              0.02            $.97  ..............            $.19
          mg oral.
 2 0887  Azathioprine,       X                              1.40          $67.88  ..............          $13.58
          Parenteral 100
          mg, 20 ml each
          injection.
 2 0888  Cyclosporine, Oral  X                              0.08           $3.88  ..............            $.78
          100 mg.
 2 0889  Cyclosporine,       X                              0.36          $17.46  ..............           $3.49
          Parenteral.
 2 0890  Lymphocyte Immune   X                              3.79         $183.77  ..............          $36.75
          Globulin 50 mg/
          ml, 5 ml each.
 2 0891  Tacrolimus per 1    X                              3.15         $152.73  ..............          $30.55
          mg oral.
 3 0892  Daclizumab,         X                    ..............  ..............  ..............          $54.11
          Parenteral, 25 mg.
 3 0900  Injection,          X                    ..............  ..............  ..............           $5.14
          Alglucerase per
          10 units.
 3 0901  Alpha I,            X                    ..............  ..............  ..............          $15.22
          Proteinase
          Inhibitor, Human
          per 10mg.
 3 0902  Botulinum Toxin,    X                    ..............  ..............  ..............          $56.05
          Type A per unit.
 3 0903  CMV Immune          X                    ..............  ..............  ..............          $54.11
          Globulin.
 3 0905  Immune Globulin     X                    ..............  ..............  ..............           $6.40
          per 500 mg.
 3 0906  RSV Immune          X                    ..............  ..............  ..............          $85.53
          Globulin.
 2 0907  Ganciclovir Sodium  X                              0.51          $24.73  ..............           $4.95
          500 mg injection.
 2 0908  Tetanus Immune      X                              0.90          $43.64  ..............           $8.73
          Globulin, Human,
          up to 250 units.
 3 0909  Interferon Beta--   X                    ..............  ..............  ..............          $28.70
          1a 33 mcg.
 3 0910  Interferon Beta--   X                    ..............  ..............  ..............           $8.44
          1b 0.25 mg.
 2 0911  Streptokinase per   X                              1.64          $79.69  ..............          $15.94
          250,000 iu.
 3 0913  Ganciclovir 4.5     X                    ..............  ..............  ..............         $701.51
          mg, Implant.
 2 0914  Reteplase, 37.6 mg  X                             38.20       $1,852.21  ..............         $370.44
          (Two Single Use
          Vials).
 2 0915  Alteplase           X                              5.85         $283.70  ..............          $56.74
          recombinant, 10mg.
 3 0916  Imiglucerase per    X                    ..............  ..............  ..............            $.58
          unit.
 2 0917  Dipyridamole, 10mg  X                              0.36          $17.46  ..............           $3.49
          Adenosine 6MG.
 3 0918  Brachytherapy       S                    ..............  ..............  ..............           $9.99
          Seeds, Any type,
          Each.
 3 0925  Factor VIII         X                    ..............  ..............  ..............            $.19
          (Antihemophilic
          Factor, Human)
          per iu.
 3 0926  Factor VIII         X                    ..............  ..............  ..............            $.19
          (Antihemophilic
          Factor, Porcine)
          per iu.
 3 0927  Factor VIII         X                    ..............  ..............  ..............            $.19
          (Antihemophilic
          Factor,
          Recombinant) per
          iu.
 3 0928  Factor IX, Complex  X                    ..............  ..............  ..............            $.08
 3 0929  Other Hemophilia    X                    ..............  ..............  ..............            $.27
          Clotting Factors
          per iu.
 3 0930  Antithrombin III    X                    ..............  ..............  ..............            $.19
          (Human) per iu.
 3 0931  Factor IX           X                    ..............  ..............  ..............            $.04
          (Antihemophilic
          Factor, Purified,
          Non-Recombinant).
 3 0932  Factor IX           X                    ..............  ..............  ..............            $.10
          (Antihemophilic
          Factor,
          Recombinant).
 2 0949  Plasma, Pooled      S                              3.49         $169.22  ..............          $33.84
          Multiple Donor,
          Solvent/Detergent
          Treated, Frozen.
 2 0950  Blood (Whole) For   S                              2.08         $101.02  ..............          $20.20
          Transfusion.
 2 0952  Cryoprecipitate...  S                              0.70          $33.92  ..............           $6.78
 2 0953  Fibrinogen Unit...  S                              0.48          $23.27  ..............           $4.65
 2 0954  Leukocyte Poor      S                              2.83         $137.21  ..............          $27.44
          Blood.
 2 0955  Plasma, Fresh       S                              2.26         $109.35  ..............          $21.87
          Frozen.
 2 0956  Plasma Protein      S                              1.26          $61.09  ..............          $12.22
          Fraction.
 2 0957  Platelet            S                              0.98          $47.46  ..............           $9.49
          Concentrate.
 2 0958  Platelet Rich       S                              1.16          $56.25  ..............          $11.25
          Plasma.
 2 0959  Red Blood Cells...  S                              2.04          $99.04  ..............          $19.81
 2 0960  Washed Red Blood    S                              3.81         $184.53  ..............          $36.91
          Cells.
 2 0961  Infusion, Albumin   X                              2.77         $134.31  ..............          $26.86
          (Human) 5%, 500
          ml.
 2 0962  Infusion, Albumin   X                              1.38          $66.91  ..............          $13.38
          (Human) 25%, 50
          ml.
 2 0970  New Technology--    T                              0.52          $25.21  ..............           $5.04
          Level I ($0-$50).
 2 0971  New Technology--    S                              1.55          $75.16  ..............          $15.03
          Level II ($50-
          $100).
 2 0972  New Technology--    T                              3.09         $149.83  ..............          $29.97
          Level III ($100-
          $200).
 2 0973  New Technology--    T                              5.16         $250.19  ..............          $50.04
          Level IV ($200-
          $300).
 2 0974  New Technology--    T                              8.25         $400.02  ..............          $80.00
          Level V ($300-
          $500).
 2 0975  New Technology--    T                             12.90         $625.48  ..............         $125.10
          Level VI ($500-
          $750).
 2 0976  New Technology--    T                             18.05         $875.19  ..............         $175.04
          Level VII ($750-
          $1000).
 2 0977  New Technology--    T                             23.20       $1,124.90  ..............         $224.98
          Level VIII ($1000-
          $1250).
 2 0978  New Technology--    T                             28.36       $1,375.09  ..............         $275.02
          Level IX ($1250-
          $1500).
 2 0979  New Technology--    T                             33.51       $1,624.80  ..............         $324.96
          Level X ($1500-
          $1750).
 2 0980  New Technology--    S                             38.67       $1,875.00  ..............         $375.00
          Level XI ($1750-
          $2000).
 2 0981  New Technology--    T                             46.40       $2,249.80  ..............         $449.96
          Level XII ($2000-
          $2500).
 2 0982  New Technology--    T                             61.87       $2,999.90  ..............         $599.98
          Level XIII ($2500-
          $3500).

[[Page 18557]]

 
 2 0983  New Technology--    T                             87.65       $4,249.89  ..............         $849.98
          Level XIV ($3500-
          $5000).
 2 0984  New Technology--    T                            113.43       $5,499.89  ..............       $1,099.98
          Level XV ($5000-
          $6000).
 3 7000  Amifostine, 500 mg  X                    ..............  ..............  ..............          $41.99
 3 7001  Amphotericin B      X                    ..............  ..............  ..............          $12.12
          lipid complex, 50
          mg, Inj.
 3 7002  Clonidine, HCl, 1   X                    ..............  ..............  ..............           $4.17
          MG.
 3 7003  Epoprostenol, 0.5   X                    ..............  ..............  ..............           $2.23
          MG, inj.
 3 7004  Immune globulin     X                    ..............  ..............  ..............          $45.48
          intravenous human
          5g, inj.
 3 7005  Gonadorelin hcI,    X                    ..............  ..............  ..............           $9.12
          100 mcg.
 2 7007  Milrinone           X                              0.47          $22.79  ..............           $4.56
          lacetate, per 5
          ml, inj.
 3 7010  Morphine sulfate    X                    ..............  ..............  ..............            $.68
          concentrate
          (preservative
          free) per 10 mg.
 3 7011  Oprelevekin, inj,   X                    ..............  ..............  ..............          $30.35
          5 mg.
 3 7012  Pentamidine         X                    ..............  ..............  ..............           $8.73
          isethionate, 300
          mg.
 3 7014  Fentanyl citrate,   X                    ..............  ..............  ..............            $.19
          inj, up to 2 ml.
 3 7015  Busulfan, oral 2    X                    ..............  ..............  ..............            $.19
          mg.
 3 7019  Aprotinin, 10,000   X                    ..............  ..............  ..............           $2.42
          kiu.
 3 7021  Baclofen,           X                    ..............  ..............  ..............            $.10
          intrathecal, 50
          mcg.
 3 7022  Elliotts B          X                    ..............  ..............  ..............          $19.20
          Solution, per ml.
 3 7023  Treatment for       X                    ..............  ..............  ..............           $4.46
          bladder calculi,
          I.e. Renacidin
          per 500 ml.
 3 7024  Corticorelin ovine  X                    ..............  ..............  ..............          $45.77
          triflutate, 0.1
          mg.
 3 7025  Digoxin immune FAB  X                    ..............  ..............  ..............          $14.06
          (Ovine), 10 mg.
 3 7026  Ethanolamine        X                    ..............  ..............  ..............           $2.13
          oleate, 1000 ml.
 3 7027  Fomepizole, 1.5 G.  X                    ..............  ..............  ..............         $141.29
 3 7028  Fosphenytoin, 50    X                    ..............  ..............  ..............            $.78
          mg.
 3 7029  Glatiramer          X                    ..............  ..............  ..............           $3.59
          acetate, 25 mg.
 3 7030  Hemin, 1 mg.......  X                    ..............  ..............  ..............            $.10
 3 7031  Octreotide          X                    ..............  ..............  ..............           $5.43
          Acetate, 500 mcg.
 3 7032  Sermorelin          X                    ..............  ..............  ..............          $53.34
          acetate, 0.5 mg.
 3 7033  Somatrem, 5 mg....  X                    ..............  ..............  ..............          $28.03
 3 7034  Somatropin, 1 mg..  X                    ..............  ..............  ..............           $5.04
 3 7035  Teniposide, 50 mg.  X                    ..............  ..............  ..............          $20.85
 2 7036  Urokinase, inj,     X                              0.73          $35.40  ..............           $7.08
          IV, 250,000 I.U..
 3 7037  Urofollitropin, 75  X                    ..............  ..............  ..............           $8.24
          I.U..
 3 7038  Muromonab-CD3, 5    X                    ..............  ..............  ..............          $89.60
          mg.
 3 7039  Pegademase bovine   X                    ..............  ..............  ..............           $1.16
          inj 25 I.U..
 3 7040  Pentastarch 10%     X                    ..............  ..............  ..............           $2.04
          inj, 100 ml.
 2 7041  Tirofiban HCL, 0.5  X                              0.02            $.97  ..............            $.19
          mg.
 3 7042  Capecitabine, oral  X                    ..............  ..............  ..............            $.19
          150 mg.
 3 7043  Infliximab, 10 MG.  X                    ..............  ..............  ..............           $6.89
 3 7045  Trimetrexate        X                    ..............  ..............  ..............           $8.15
          Glucoronate.
 3 7046  Doxorubicin Hcl     X                    ..............  ..............  ..............          $39.18
          Liposome.
----------------------------------------------------------------------------------------------------------------

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

Copyright American Dental Association. All rights reserved.

\1\ Not subject to national coinsurance. Minimum unadjusted coinsurance 
is 25% of the payment rate. The payment rate is the lower of the HOPD 
payment rate or the Ambulatory Surgical Center payment.

  

\2\ Not subject to national coinsurance.

\3\ Eligible for pass-through payments. See Preamble for payment rate 
determination. See Addendum K for complete list of pass-through codes.

                         Addendum B.--Hospital Outpatient Department (HOPD) Payment Status by HCPCS Code and Related Information
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                             National         Minimum
  CPT/       HOPD  Status  Indicator               Description                  APC          Relative      Payment  Rate    Unadjusted      Unadjusted
 HCPCS                                                                                        Weight                        Coinsurance     Coinsurance
--------------------------------------------------------------------------------------------------------------------------------------------------------
  00100  N                               Anesth, salivary gland.........  ..............  ..............  ..............  ..............  ..............
  00102  N                               Anesth, repair of cleft lip....  ..............  ..............  ..............  ..............  ..............
  00103  N                               Anesth, blepharoplasty.........  ..............  ..............  ..............  ..............  ..............
  00104  N                               Anesth, electroshock...........  ..............  ..............  ..............  ..............  ..............
  00120  N                               Anesth, ear surgery............  ..............  ..............  ..............  ..............  ..............
  00124  N                               Anesth, ear exam...............  ..............  ..............  ..............  ..............  ..............
  00126  N                               Anesth, tympanotomy............  ..............  ..............  ..............  ..............  ..............
  00140  N                               Anesth, procedures on eye......  ..............  ..............  ..............  ..............  ..............
  00142  N                               Anesth, lens surgery...........  ..............  ..............  ..............  ..............  ..............
  00144  N                               Anesth, corneal transplant.....  ..............  ..............  ..............  ..............  ..............
  00145  N                               Anesth, vitrectomy.............  ..............  ..............  ..............  ..............  ..............
  00147  N                               Anesth, iridectomy.............  ..............  ..............  ..............  ..............  ..............
  00148  N                               Anesth, eye exam...............  ..............  ..............  ..............  ..............  ..............
  00160  N                               Anesth, nose/sinus surgery.....  ..............  ..............  ..............  ..............  ..............
  00162  N                               Anesth, nose/sinus surgery.....  ..............  ..............  ..............  ..............  ..............
  00164  N                               Anesth, biopsy of nose.........  ..............  ..............  ..............  ..............  ..............
  00170  N                               Anesth, procedure on mouth.....  ..............  ..............  ..............  ..............  ..............
  00172  N                               Anesth, cleft palate repair....  ..............  ..............  ..............  ..............  ..............
  00174  C                               Anesth, pharyngeal surgery.....  ..............  ..............  ..............  ..............  ..............
  00176  C                               Anesth, pharyngeal surgery.....  ..............  ..............  ..............  ..............  ..............
  00190  N                               Anesth, facial bone surgery....  ..............  ..............  ..............  ..............  ..............
  00192  C                               Anesth, facial bone surgery....  ..............  ..............  ..............  ..............  ..............
  00210  N                               Anesth, open head surgery......  ..............  ..............  ..............  ..............  ..............
  00212  N                               Anesth, skull drainage.........  ..............  ..............  ..............  ..............  ..............

[[Page 18558]]

 
  00214  C                               Anesth, skull drainage.........  ..............  ..............  ..............  ..............  ..............
  00215  C                               Anesth, skull fracture.........  ..............  ..............  ..............  ..............  ..............
  00216  N                               Anesth, head vessel surgery....  ..............  ..............  ..............  ..............  ..............
  00218  N                               Anesth, special head surgery...  ..............  ..............  ..............  ..............  ..............
  00220  N                               Anesth, spinal fluid shunt.....  ..............  ..............  ..............  ..............  ..............
  00222  N                               Anesth, head nerve surgery.....  ..............  ..............  ..............  ..............  ..............
  00300  N                               Anesth, head/neck/ptrunk.......  ..............  ..............  ..............  ..............  ..............
  00320  N                               Anesth, neck organ surgery.....  ..............  ..............  ..............  ..............  ..............
  00322  N                               Anesth, biopsy of thyroid......  ..............  ..............  ..............  ..............  ..............
  00350  N                               Anesth, neck vessel surgery....  ..............  ..............  ..............  ..............  ..............
  00352  N                               Anesth, neck vessel surgery....  ..............  ..............  ..............  ..............  ..............
  00400  N                               Anesth, skin, ext/per/atrunk...  ..............  ..............  ..............  ..............  ..............
  00402  N                               Anesth, surgery of breast......  ..............  ..............  ..............  ..............  ..............
  00404  C                               Anesth, surgery of breast......  ..............  ..............  ..............  ..............  ..............
  00406  C                               Anesth, surgery of breast......  ..............  ..............  ..............  ..............  ..............
  00410  N                               Anesth, correct heart rhythm...  ..............  ..............  ..............  ..............  ..............
  00450  N                               Anesth, surgery of shoulder....  ..............  ..............  ..............  ..............  ..............
  00452  C                               Anesth, surgery of shoulder....  ..............  ..............  ..............  ..............  ..............
  00454  N                               Anesth, collar bone biopsy.....  ..............  ..............  ..............  ..............  ..............
  00470  N                               Anesth, removal of rib.........  ..............  ..............  ..............  ..............  ..............
  00472  N                               Anesth, chest wall repair......  ..............  ..............  ..............  ..............  ..............
  00474  C                               Anesth, surgery of rib(s)......  ..............  ..............  ..............  ..............  ..............
  00500  N                               Anesth, esophageal surgery.....  ..............  ..............  ..............  ..............  ..............
  00520  N                               Anesth, chest procedure........  ..............  ..............  ..............  ..............  ..............
  00522  N                               Anesth, chest lining biopsy....  ..............  ..............  ..............  ..............  ..............
  00524  C                               Anesth, chest drainage.........  ..............  ..............  ..............  ..............  ..............
  00528  N                               Anesth, chest partition view...  ..............  ..............  ..............  ..............  ..............
  00530  C                               Anesth, pacemaker insertion....  ..............  ..............  ..............  ..............  ..............
  00532  N                               Anesth, vascular access........  ..............  ..............  ..............  ..............  ..............
  00534  N                               Anesth, cardioverter/defib.....  ..............  ..............  ..............  ..............  ..............
  00540  C                               Anesth, chest surgery..........  ..............  ..............  ..............  ..............  ..............
  00542  C                               Anesth, release of lung........  ..............  ..............  ..............  ..............  ..............
  00544  C                               Anesth, chest lining removal...  ..............  ..............  ..............  ..............  ..............
  00546  C                               Anesth, lung, chest wall surg..  ..............  ..............  ..............  ..............  ..............
  00548  N                               Anesth, trachea, bronchi surg..  ..............  ..............  ..............  ..............  ..............
  00560  C                               Anesth, open heart surgery.....  ..............  ..............  ..............  ..............  ..............
  00562  C                               Anesth, open heart surgery.....  ..............  ..............  ..............  ..............  ..............
  00580  C                               Anesth heart/lung transplant...  ..............  ..............  ..............  ..............  ..............
  00600  N                               Anesth, spine, cord surgery....  ..............  ..............  ..............  ..............  ..............
  00604  C                               Anesth, surgery of vertebra....  ..............  ..............  ..............  ..............  ..............
  00620  N                               Anesth, spine, cord surgery....  ..............  ..............  ..............  ..............  ..............
  00622  C                               Anesth, removal of nerves......  ..............  ..............  ..............  ..............  ..............
  00630  N                               Anesth, spine, cord surgery....  ..............  ..............  ..............  ..............  ..............
  00632  C                               Anesth, removal of nerves......  ..............  ..............  ..............  ..............  ..............
  00634  C                               Anesth for chemonucleolysis....  ..............  ..............  ..............  ..............  ..............
  00670  C                               Anesth, spine, cord surgery....  ..............  ..............  ..............  ..............  ..............
  00700  N                               Anesth, abdominal wall surg....  ..............  ..............  ..............  ..............  ..............
  00702  N                               Anesth, for liver biopsy.......  ..............  ..............  ..............  ..............  ..............
  00730  N                               Anesth, abdominal wall surg....  ..............  ..............  ..............  ..............  ..............
  00740  N                               Anesth, upper gi visualize.....  ..............  ..............  ..............  ..............  ..............
  00750  N                               Anesth, repair of hernia.......  ..............  ..............  ..............  ..............  ..............
  00752  N                               Anesth, repair of hernia.......  ..............  ..............  ..............  ..............  ..............
  00754  N                               Anesth, repair of hernia.......  ..............  ..............  ..............  ..............  ..............
  00756  N                               Anesth, repair of hernia.......  ..............  ..............  ..............  ..............  ..............
  00770  N                               Anesth, blood vessel repair....  ..............  ..............  ..............  ..............  ..............
  00790  N                               Anesth, surg upper abdomen.....  ..............  ..............  ..............  ..............  ..............
  00792  C                               Anesth, part liver removal.....  ..............  ..............  ..............  ..............  ..............
  00794  C                               Anesth, pancreas removal.......  ..............  ..............  ..............  ..............  ..............
  00796  C                               Anesth, for liver transplant...  ..............  ..............  ..............  ..............  ..............
  00800  N                               Anesth, abdominal wall surg....  ..............  ..............  ..............  ..............  ..............
  00802  C                               Anesth, fat layer removal......  ..............  ..............  ..............  ..............  ..............
  00810  N                               Anesth, low intestine scope....  ..............  ..............  ..............  ..............  ..............
  00820  N                               Anesth, abdominal wall surg....  ..............  ..............  ..............  ..............  ..............
  00830  N                               Anesth, repair of hernia.......  ..............  ..............  ..............  ..............  ..............
  00832  N                               Anesth, repair of hernia.......  ..............  ..............  ..............  ..............  ..............
  00840  N                               Anesth, surg lower abdomen.....  ..............  ..............  ..............  ..............  ..............
  00842  N                               Anesth, amniocentesis..........  ..............  ..............  ..............  ..............  ..............
  00844  C                               Anesth, pelvis surgery.........  ..............  ..............  ..............  ..............  ..............
  00846  C                               Anesth, hysterectomy...........  ..............  ..............  ..............  ..............  ..............
  00848  C                               Anesth, pelvic organ surg......  ..............  ..............  ..............  ..............  ..............
  00850  C                               Anesth, cesarean section.......  ..............  ..............  ..............  ..............  ..............
  00855  C                               Anesth, hysterectomy...........  ..............  ..............  ..............  ..............  ..............
  00857  C                               Analgesia, labor & c-section...  ..............  ..............  ..............  ..............  ..............

[[Page 18559]]

 
  00860  N                               Anesth, surgery of abdomen.....  ..............  ..............  ..............  ..............  ..............
  00862  N                               Anesth, kidney/ureter surg.....  ..............  ..............  ..............  ..............  ..............
  00864  C                               Anesth, removal of bladder.....  ..............  ..............  ..............  ..............  ..............
  00865  C                               Anesth, removal of prostate....  ..............  ..............  ..............  ..............  ..............
  00866  C                               Anesth, removal of adrenal.....  ..............  ..............  ..............  ..............  ..............
  00868  C                               Anesth, kidney transplant......  ..............  ..............  ..............  ..............  ..............
  00870  N                               Anesth, bladder stone surg.....  ..............  ..............  ..............  ..............  ..............
  00872  N                               Anesth kidney stone destruct...  ..............  ..............  ..............  ..............  ..............
  00873  N                               Anesth kidney stone destruct...  ..............  ..............  ..............  ..............  ..............
  00880  N                               Anesth, abdomen vessel surg....  ..............  ..............  ..............  ..............  ..............
  00882  C                               Anesth, major vein ligation....  ..............  ..............  ..............  ..............  ..............
  00884  C                               Anesth, major vein revision....  ..............  ..............  ..............  ..............  ..............
  00900  N                               Anesth, perineal procedure.....  ..............  ..............  ..............  ..............  ..............
  00902  N                               Anesth, anorectal surgery......  ..............  ..............  ..............  ..............  ..............
  00904  C                               Anesth, perineal surgery.......  ..............  ..............  ..............  ..............  ..............
  00906  N                               Anesth, removal of vulva.......  ..............  ..............  ..............  ..............  ..............
  00908  C                               Anesth, removal of prostate....  ..............  ..............  ..............  ..............  ..............
  00910  N                               Anesth, bladder surgery........  ..............  ..............  ..............  ..............  ..............
  00912  N                               Anesth, bladder tumor surg.....  ..............  ..............  ..............  ..............  ..............
  00914  N                               Anesth, removal of prostate....  ..............  ..............  ..............  ..............  ..............
  00916  N                               Anesth, bleeding control.......  ..............  ..............  ..............  ..............  ..............
  00918  N                               Anesth, stone removal..........  ..............  ..............  ..............  ..............  ..............
  00920  N                               Anesth, genitalia surgery......  ..............  ..............  ..............  ..............  ..............
  00922  N                               Anesth, sperm duct surgery.....  ..............  ..............  ..............  ..............  ..............
  00924  N                               Anesth, testis exploration.....  ..............  ..............  ..............  ..............  ..............
  00926  N                               Anesth, removal of testis......  ..............  ..............  ..............  ..............  ..............
  00928  C                               Anesth, removal of testis......  ..............  ..............  ..............  ..............  ..............
  00930  N                               Anesth, testis suspension......  ..............  ..............  ..............  ..............  ..............
  00932  C                               Anesth, amputation of penis....  ..............  ..............  ..............  ..............  ..............
  00934  C                               Anesth, penis, nodes removal...  ..............  ..............  ..............  ..............  ..............
  00936  C                               Anesth, penis, nodes removal...  ..............  ..............  ..............  ..............  ..............
  00938  N                               Anesth, insert penis device....  ..............  ..............  ..............  ..............  ..............
  00940  N                               Anesth, vaginal procedures.....  ..............  ..............  ..............  ..............  ..............
  00942  N                               Anesth, surgery on vagina......  ..............  ..............  ..............  ..............  ..............
  00944  C                               Anesth, vaginal hysterectomy...  ..............  ..............  ..............  ..............  ..............
  00946  N                               Anesth, vaginal delivery.......  ..............  ..............  ..............  ..............  ..............
  00948  N                               Anesth, repair of cervix.......  ..............  ..............  ..............  ..............  ..............
  00950  N                               Anesth, vaginal endoscopy......  ..............  ..............  ..............  ..............  ..............
  00952  N                               Anesth, hysteroscope/graph.....  ..............  ..............  ..............  ..............  ..............
  00955  C                               Analgesia, vaginal delivery....  ..............  ..............  ..............  ..............  ..............
  01120  N                               Anesth, pelvis surgery.........  ..............  ..............  ..............  ..............  ..............
  01130  N                               Anesth, body cast procedure....  ..............  ..............  ..............  ..............  ..............
  01140  C                               Anesth, amputation at pelvis...  ..............  ..............  ..............  ..............  ..............
  01150  C                               Anesth, pelvic tumor surgery...  ..............  ..............  ..............  ..............  ..............
  01160  N                               Anesth, pelvis procedure.......  ..............  ..............  ..............  ..............  ..............
  01170  N                               Anesth, pelvis surgery.........  ..............  ..............  ..............  ..............  ..............
  01180  N                               Anesth, pelvis nerve removal...  ..............  ..............  ..............  ..............  ..............
  01190  C                               Anesth, pelvis nerve removal...  ..............  ..............  ..............  ..............  ..............
  01200  N                               Anesth, hip joint procedure....  ..............  ..............  ..............  ..............  ..............
  01202  N                               Anesth, arthroscopy of hip.....  ..............  ..............  ..............  ..............  ..............
  01210  N                               Anesth, hip joint surgery......  ..............  ..............  ..............  ..............  ..............
  01212  C                               Anesth, hip disarticulation....  ..............  ..............  ..............  ..............  ..............
  01214  C                               Anesth, replacement of hip.....  ..............  ..............  ..............  ..............  ..............
  01220  N                               Anesth, procedure on femur.....  ..............  ..............  ..............  ..............  ..............
  01230  N                               Anesth, surgery of femur.......  ..............  ..............  ..............  ..............  ..............
  01232  C                               Anesth, amputation of femur....  ..............  ..............  ..............  ..............  ..............
  01234  C                               Anesth, radical femur surg.....  ..............  ..............  ..............  ..............  ..............
  01250  N                               Anesth, upper leg surgery......  ..............  ..............  ..............  ..............  ..............
  01260  N                               Anesth, upper leg veins surg...  ..............  ..............  ..............  ..............  ..............
  01270  N                               Anesth, thigh arteries surg....  ..............  ..............  ..............  ..............  ..............
  01272  C                               Anesth, femoral artery surg....  ..............  ..............  ..............  ..............  ..............
  01274  C                               Anesth, femoral embolectomy....  ..............  ..............  ..............  ..............  ..............
  01320  N                               Anesth, knee area surgery......  ..............  ..............  ..............  ..............  ..............
  01340  N                               Anesth, knee area procedure....  ..............  ..............  ..............  ..............  ..............
  01360  N                               Anesth, knee area surgery......  ..............  ..............  ..............  ..............  ..............
  01380  N                               Anesth, knee joint procedure...  ..............  ..............  ..............  ..............  ..............
  01382  N                               Anesth, knee arthroscopy.......  ..............  ..............  ..............  ..............  ..............
  01390  N                               Anesth, knee area procedure....  ..............  ..............  ..............  ..............  ..............
  01392  N                               Anesth, knee area surgery......  ..............  ..............  ..............  ..............  ..............
  01400  N                               Anesth, knee joint surgery.....  ..............  ..............  ..............  ..............  ..............
  01402  C                               Anesth, replacement of knee....  ..............  ..............  ..............  ..............  ..............
  01404  C                               Anesth, amputation at knee.....  ..............  ..............  ..............  ..............  ..............
  01420  N                               Anesth, knee joint casting.....  ..............  ..............  ..............  ..............  ..............

[[Page 18560]]

 
  01430  N                               Anesth, knee veins surgery.....  ..............  ..............  ..............  ..............  ..............
  01432  N                               Anesth, knee vessel surg.......  ..............  ..............  ..............  ..............  ..............
  01440  N                               Anesth, knee arteries surg.....  ..............  ..............  ..............  ..............  ..............
  01442  C                               Anesth, knee artery surg.......  ..............  ..............  ..............  ..............  ..............
  01444  C                               Anesth, knee artery repair.....  ..............  ..............  ..............  ..............  ..............
  01462  N                               Anesth, lower leg procedure....  ..............  ..............  ..............  ..............  ..............
  01464  N                               Anesth, ankle arthroscopy......  ..............  ..............  ..............  ..............  ..............
  01470  N                               Anesth, lower leg surgery......  ..............  ..............  ..............  ..............  ..............
  01472  N                               Anesth, achilles tendon surg...  ..............  ..............  ..............  ..............  ..............
  01474  N                               Anesth, lower leg surgery......  ..............  ..............  ..............  ..............  ..............
  01480  N                               Anesth, lower leg bone surg....  ..............  ..............  ..............  ..............  ..............
  01482  N                               Anesth, radical leg surgery....  ..............  ..............  ..............  ..............  ..............
  01484  N                               Anesth, lower leg revision.....  ..............  ..............  ..............  ..............  ..............
  01486  C                               Anesth, ankle replacement......  ..............  ..............  ..............  ..............  ..............
  01490  N                               Anesth, lower leg casting......  ..............  ..............  ..............  ..............  ..............
  01500  N                               Anesth, leg arteries surg......  ..............  ..............  ..............  ..............  ..............
  01502  C                               Anesth, lwr leg embolectomy....  ..............  ..............  ..............  ..............  ..............
  01520  N                               Anesth, lower leg vein surg....  ..............  ..............  ..............  ..............  ..............
  01522  N                               Anesth, lower leg vein surg....  ..............  ..............  ..............  ..............  ..............
  01610  N                               Anesth, surgery of shoulder....  ..............  ..............  ..............  ..............  ..............
  01620  N                               Anesth, shoulder procedure.....  ..............  ..............  ..............  ..............  ..............
  01622  N                               Anesth, shoulder arthroscopy...  ..............  ..............  ..............  ..............  ..............
  01630  N                               Anesth, surgery of shoulder....  ..............  ..............  ..............  ..............  ..............
  01632  C                               Anesth, surgery of shoulder....  ..............  ..............  ..............  ..............  ..............
  01634  C                               Anesth, shoulder joint amput...  ..............  ..............  ..............  ..............  ..............
  01636  C                               Anesth, forequarter amput......  ..............  ..............  ..............  ..............  ..............
  01638  C                               Anesth, shoulder replacement...  ..............  ..............  ..............  ..............  ..............
  01650  N                               Anesth, shoulder artery surg...  ..............  ..............  ..............  ..............  ..............
  01652  C                               Anesth, shoulder vessel surg...  ..............  ..............  ..............  ..............  ..............
  01654  C                               Anesth, shoulder vessel surg...  ..............  ..............  ..............  ..............  ..............
  01656  C                               Anesth, arm-leg vessel surg....  ..............  ..............  ..............  ..............  ..............
  01670  N                               Anesth, shoulder vein surg.....  ..............  ..............  ..............  ..............  ..............
  01680  N                               Anesth, shoulder casting.......  ..............  ..............  ..............  ..............  ..............
  01682  N                               Anesth, airplane cast..........  ..............  ..............  ..............  ..............  ..............
  01710  N                               Anesth, elbow area surgery.....  ..............  ..............  ..............  ..............  ..............
  01712  N                               Anesth, uppr arm tendon surg...  ..............  ..............  ..............  ..............  ..............
  01714  N                               Anesth, uppr arm tendon surg...  ..............  ..............  ..............  ..............  ..............
  01716  N                               Anesth, biceps tendon repair...  ..............  ..............  ..............  ..............  ..............
  01730  N                               Anesth, uppr arm procedure.....  ..............  ..............  ..............  ..............  ..............
  01732  N                               Anesth, elbow arthroscopy......  ..............  ..............  ..............  ..............  ..............
  01740  N                               Anesth, upper arm surgery......  ..............  ..............  ..............  ..............  ..............
  01742  N                               Anesth, humerus surgery........  ..............  ..............  ..............  ..............  ..............
  01744  N                               Anesth, humerus repair.........  ..............  ..............  ..............  ..............  ..............
  01756  C                               Anesth, radical humerus surg...  ..............  ..............  ..............  ..............  ..............
  01758  N                               Anesth, humeral lesion surg....  ..............  ..............  ..............  ..............  ..............
  01760  N                               Anesth, elbow replacement......  ..............  ..............  ..............  ..............  ..............
  01770  N                               Anesth, uppr arm artery surg...  ..............  ..............  ..............  ..............  ..............
  01772  C                               Anesth, uppr arm embolectomy...  ..............  ..............  ..............  ..............  ..............
  01780  N                               Anesth, upper arm vein surg....  ..............  ..............  ..............  ..............  ..............
  01782  C                               Anesth, uppr arm vein repair...  ..............  ..............  ..............  ..............  ..............
  01784  N                               Anesth, av fistula repair......  ..............  ..............  ..............  ..............  ..............
  01810  N                               Anesth, lower arm surgery......  ..............  ..............  ..............  ..............  ..............
  01820  N                               Anesth, lower arm procedure....  ..............  ..............  ..............  ..............  ..............
  01830  N                               Anesth, lower arm surgery......  ..............  ..............  ..............  ..............  ..............
  01832  N                               Anesth, wrist replacement......  ..............  ..............  ..............  ..............  ..............
  01840  N                               Anesth, lwr arm artery surg....  ..............  ..............  ..............  ..............  ..............
  01842  C                               Anesth, lwr arm embolectomy....  ..............  ..............  ..............  ..............  ..............
  01844  N                               Anesth, vascular shunt surg....  ..............  ..............  ..............  ..............  ..............
  01850  N                               Anesth, lower arm vein surg....  ..............  ..............  ..............  ..............  ..............
  01852  C                               Anesth, lwr arm vein repair....  ..............  ..............  ..............  ..............  ..............
  01860  N                               Anesth, lower arm casting......  ..............  ..............  ..............  ..............  ..............
  01904  C                               Anesth, skull x-ray inject.....  ..............  ..............  ..............  ..............  ..............
  01906  N                               Anesth, lumbar myelography.....  ..............  ..............  ..............  ..............  ..............
  01908  N                               Anesth, cervical myelography...  ..............  ..............  ..............  ..............  ..............
  01910  N                               Anesth, skull myelography......  ..............  ..............  ..............  ..............  ..............
  01912  N                               Anesth, lumbar diskography.....  ..............  ..............  ..............  ..............  ..............
  01914  N                               Anesth, cervical diskography...  ..............  ..............  ..............  ..............  ..............
  01916  N                               Anesth, head arteriogram.......  ..............  ..............  ..............  ..............  ..............
  01918  N                               Anesth, limb arteriogram.......  ..............  ..............  ..............  ..............  ..............
  01920  N                               Anesth, catheterize heart......  ..............  ..............  ..............  ..............  ..............
  01921  N                               Anesth, vessel surgery.........  ..............  ..............  ..............  ..............  ..............
  01922  N                               Anesth, cat or MRI scan........  ..............  ..............  ..............  ..............  ..............
  01990  C                               Support for organ donor........  ..............  ..............  ..............  ..............  ..............

[[Page 18561]]

 
  01995  N                               Regional anesthesia, limb......  ..............  ..............  ..............  ..............  ..............
  01996  N                               Manage daily drug therapy......  ..............  ..............  ..............  ..............  ..............
  01999  N                               Unlisted anesth procedure......  ..............  ..............  ..............  ..............  ..............
  10040  T                               Acne surgery of skin abscess...            0006            2.00          $96.97          $33.95          $19.39
  10060  T                               Drainage of skin abscess.......            0006            2.00          $96.97          $33.95          $19.39
  10061  T                               Drainage of skin abscess.......            0006            2.00          $96.97          $33.95          $19.39
  10080  T                               Drainage of pilonidal cyst.....            0006            2.00          $96.97          $33.95          $19.39
  10081  T                               Drainage of pilonidal cyst.....            0007            3.68         $178.43          $72.03          $35.69
  10120  T                               Remove foreign body............            0006            2.00          $96.97          $33.95          $19.39
  10121  T                               Remove foreign body............            0020            6.51         $315.65         $130.53          $63.13
  10140  T                               Drainage of hematoma/fluid.....            0007            3.68         $178.43          $72.03          $35.69
  10160  T                               Puncture drainage of lesion....            0006            2.00          $96.97          $33.95          $19.39
  10180  T                               Complex drainage, wound........            0007            3.68         $178.43          $72.03          $35.69
  11000  T                               Debride infected skin..........            0015            1.77          $85.82          $31.20          $17.16
  11001  T                               Debride infected skin add-on...            0015            1.77          $85.82          $31.20          $17.16
  11010  T                               Debride skin, fx...............            0022           12.49         $605.60         $292.94         $121.12
  11011  T                               Debride skin/muscle, fx........            0022           12.49         $605.60         $292.94         $121.12
  11012  T                               Debride skin/muscle/bone, fx...            0022           12.49         $605.60         $292.94         $121.12
  11040  T                               Debride skin, partial..........            0015            1.77          $85.82          $31.20          $17.16
  11041  T                               Debride skin, full.............            0015            1.77          $85.82          $31.20          $17.16
  11042  T                               Debride skin/tissue............            0016            3.53         $171.16          $74.67          $34.23
  11043  T                               Debride tissue/muscle..........            0016            3.53         $171.16          $74.67          $34.23
  11044  T                               Debride tissue/muscle/bone.....            0017           12.45         $603.66         $289.16         $120.73
  11055  T                               Trim skin lesion...............            0015            1.77          $85.82          $31.20          $17.16
  11056  T                               Trim skin lesions, 2 to 4......            0015            1.77          $85.82          $31.20          $17.16
  11057  T                               Trim skin lesions, over 4......            0015            1.77          $85.82          $31.20          $17.16
  11100  T                               Biopsy of skin lesion..........            0018            0.94          $45.58          $17.66           $9.12
  11101  T                               Biopsy, skin add-on............            0018            0.94          $45.58          $17.66           $9.12
  11200  T                               Removal of skin tags...........            0015            1.77          $85.82          $31.20          $17.16
  11201  T                               Remove skin tags add-on........            0015            1.77          $85.82          $31.20          $17.16
  11300  T                               Shave skin lesion..............            0013            0.91          $44.12          $17.66           $8.82
  11301  T                               Shave skin lesion..............            0013            0.91          $44.12          $17.66           $8.82
  11302  T                               Shave skin lesion..............            0014            1.50          $72.73          $24.55          $14.55
  11303  T                               Shave skin lesion..............            0015            1.77          $85.82          $31.20          $17.16
  11305  T                               Shave skin lesion..............            0013            0.91          $44.12          $17.66           $8.82
  11306  T                               Shave skin lesion..............            0013            0.91          $44.12          $17.66           $8.82
  11307  T                               Shave skin lesion..............            0014            1.50          $72.73          $24.55          $14.55
  11308  T                               Shave skin lesion..............            0015            1.77          $85.82          $31.20          $17.16
  11310  T                               Shave skin lesion..............            0013            0.91          $44.12          $17.66           $8.82
  11311  T                               Shave skin lesion..............            0013            0.91          $44.12          $17.66           $8.82
  11312  T                               Shave skin lesion..............            0015            1.77          $85.82          $31.20          $17.16
  11313  T                               Shave skin lesion..............            0016            3.53         $171.16          $74.67          $34.23
  11400  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11401  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11402  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11403  T                               Removal of skin lesion.........            0020            6.51         $315.65         $130.53          $63.13
  11404  T                               Removal of skin lesion.........            0020            6.51         $315.65         $130.53          $63.13
  11406  T                               Removal of skin lesion.........            0020            6.51         $315.65         $130.53          $63.13
  11420  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11421  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11422  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11423  T                               Removal of skin lesion.........            0020            6.51         $315.65         $130.53          $63.13
  11424  T                               Removal of skin lesion.........            0020            6.51         $315.65         $130.53          $63.13
  11426  T                               Removal of skin lesion.........            0022           12.49         $605.60         $292.94         $121.12
  11440  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11441  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11442  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11443  T                               Removal of skin lesion.........            0020            6.51         $315.65         $130.53          $63.13
  11444  T                               Removal of skin lesion.........            0020            6.51         $315.65         $130.53          $63.13
  11446  T                               Removal of skin lesion.........            0022           12.49         $605.60         $292.94         $121.12
  11450  T                               Removal, sweat gland lesion....            0022           12.49         $605.60         $292.94         $121.12
  11451  T                               Removal, sweat gland lesion....            0022           12.49         $605.60         $292.94         $121.12
  11462  T                               Removal, sweat gland lesion....            0022           12.49         $605.60         $292.94         $121.12
  11463  T                               Removal, sweat gland lesion....            0022           12.49         $605.60         $292.94         $121.12
  11470  T                               Removal, sweat gland lesion....            0022           12.49         $605.60         $292.94         $121.12
  11471  T                               Removal, sweat gland lesion....            0022           12.49         $605.60         $292.94         $121.12
  11600  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11601  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11602  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11603  T                               Removal of skin lesion.........            0020            6.51         $315.65         $130.53          $63.13
  11604  T                               Removal of skin lesion.........            0020            6.51         $315.65         $130.53          $63.13
  11606  T                               Removal of skin lesion.........            0021           10.49         $508.63         $236.51         $101.73
  11620  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79

[[Page 18562]]

 
  11621  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11622  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11623  T                               Removal of skin lesion.........            0020            6.51         $315.65         $130.53          $63.13
  11624  T                               Removal of skin lesion.........            0020            6.51         $315.65         $130.53          $63.13
  11626  T                               Removal of skin lesion.........            0022           12.49         $605.60         $292.94         $121.12
  11640  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11641  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11642  T                               Removal of skin lesion.........            0019            4.00         $193.95          $78.91          $38.79
  11643  T                               Removal of skin lesion.........            0020            6.51         $315.65         $130.53          $63.13
  11644  T                               Removal of skin lesion.........            0020            6.51         $315.65         $130.53          $63.13
  11646  T                               Removal of skin lesion.........            0022           12.49         $605.60         $292.94         $121.12
  11719  T                               Trim nail(s)...................            0009            0.74          $35.88           $9.63           $7.18
  11720  T                               Debride nail, 1-5..............            0009            0.74          $35.88           $9.63           $7.18
  11721  T                               Debride nail, 6 or more........            0009            0.74          $35.88           $9.63           $7.18
  11730  T                               Removal of nail plate..........            0013            0.91          $44.12          $17.66           $8.82
  11732  T                               Remove nail plate, add-on......            0012            0.53          $25.70           $9.18           $5.14
  11740  T                               Drain blood from under nail....            0009            0.74          $35.88           $9.63           $7.18
  11750  T                               Removal of nail bed............            0019            4.00         $193.95          $78.91          $38.79
  11752  T                               Remove nail bed/finger tip.....            0022           12.49         $605.60         $292.94         $121.12
  11755  T                               Biopsy, nail unit..............            0019            4.00         $193.95          $78.91          $38.79
  11760  T                               Repair of nail bed.............            0024            2.43         $117.82          $44.50          $23.56
  11762  T                               Reconstruction of nail bed.....            0024            2.43         $117.82          $44.50          $23.56
  11765  T                               Excision of nail fold, toe.....            0015            1.77          $85.82          $31.20          $17.16
  11770  T                               Removal of pilonidal lesion....            0021           10.49         $508.63         $236.51         $101.73
  11771  T                               Removal of pilonidal lesion....            0022           12.49         $605.60         $292.94         $121.12
  11772  T                               Removal of pilonidal lesion....            0022           12.49         $605.60         $292.94         $121.12
  11900  T                               Injection into skin lesions....            0012            0.53          $25.70           $9.18           $5.14
  11901  T                               Added skin lesions injection...            0013            0.91          $44.12          $17.66           $8.82
  11920  T                               Correct skin color defects.....            0024            2.43         $117.82          $44.50          $23.56
  11921  T                               Correct skin color defects.....            0024            2.43         $117.82          $44.50          $23.56
  11922  T                               Correct skin color defects.....            0024            2.43         $117.82          $44.50          $23.56
  11950  T                               Therapy for contour defects....            0024            2.43         $117.82          $44.50          $23.56
  11951  T                               Therapy for contour defects....            0024            2.43         $117.82          $44.50          $23.56
  11952  T                               Therapy for contour defects....            0024            2.43         $117.82          $44.50          $23.56
  11954  T                               Therapy for contour defects....            0024            2.43         $117.82          $44.50          $23.56
  11960  T                               Insert tissue expander(s)......            0026           12.11         $587.18         $277.92         $117.44
  11970  T                               Replace tissue expander........            0026           12.11         $587.18         $277.92         $117.44
  11971  T                               Remove tissue expander(s)......            0022           12.49         $605.60         $292.94         $121.12
  11975  E                               Insert contraceptive cap.......  ..............  ..............  ..............  ..............  ..............
  11976  T                               Removal of contraceptive cap...            0019            4.00         $193.95          $78.91          $38.79
  11977  E                               Removal/reinsert contra cap....  ..............  ..............  ..............  ..............  ..............
  11980  E                               Implant hormone pellet(s)......  ..............  ..............  ..............  ..............  ..............
  12001  T                               Repair superficial wound(s)....            0024            2.43         $117.82          $44.50          $23.56
  12002  T                               Repair superficial wound(s)....            0024            2.43         $117.82          $44.50          $23.56
  12004  T                               Repair superficial wound(s)....            0024            2.43         $117.82          $44.50          $23.56
  12005  T                               Repair superficial wound(s)....            0024            2.43         $117.82          $44.50          $23.56
  12006  T                               Repair superficial wound(s)....            0024            2.43         $117.82          $44.50          $23.56
  12007  T                               Repair superficial wound(s)....            0024            2.43         $117.82          $44.50          $23.56
  12011  T                               Repair superficial wound(s)....            0024            2.43         $117.82          $44.50          $23.56
  12013  T                               Repair superficial wound(s)....            0024            2.43         $117.82          $44.50          $23.56
  12014  T                               Repair superficial wound(s)....            0024            2.43         $117.82          $44.50          $23.56
  12015  T                               Repair superficial wound(s)....            0024            2.43         $117.82          $44.50          $23.56
  12016  T                               Repair superficial wound(s)....            0024            2.43         $117.82          $44.50          $23.56
  12017  T                               Repair superficial wound(s)....            0024            2.43         $117.82          $44.50          $23.56
  12018  T                               Repair superficial wound(s)....            0024            2.43         $117.82          $44.50          $23.56
  12020  T                               Closure of split wound.........            0024            2.43         $117.82          $44.50          $23.56
  12021  T                               Closure of split wound.........            0024            2.43         $117.82          $44.50          $23.56
  12031  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12032  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12034  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12035  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12036  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12037  T                               Layer closure of wound(s)......            0026           12.11         $587.18         $277.92         $117.44
  12041  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12042  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12044  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12045  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12046  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12047  T                               Layer closure of wound(s)......            0026           12.11         $587.18         $277.92         $117.44
  12051  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12052  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12053  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12054  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56

[[Page 18563]]

 
  12055  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12056  T                               Layer closure of wound(s)......            0024            2.43         $117.82          $44.50          $23.56
  12057  T                               Layer closure of wound(s)......            0026           12.11         $587.18         $277.92         $117.44
  13100  T                               Repair of wound or lesion......            0025            3.74         $181.34          $70.66          $36.27
  13101  T                               Repair of wound or lesion......            0025            3.74         $181.34          $70.66          $36.27
  13102  T                               Repair wound/lesion add-on.....            0025            3.74         $181.34          $70.66          $36.27
  13120  T                               Repair of wound or lesion......            0025            3.74         $181.34          $70.66          $36.27
  13121  T                               Repair of wound or lesion......            0025            3.74         $181.34          $70.66          $36.27
  13122  T                               Repair wound/lesion add-on.....            0025            3.74         $181.34          $70.66          $36.27
  13131  T                               Repair of wound or lesion......            0025            3.74         $181.34          $70.66          $36.27
  13132  T                               Repair of wound or lesion......            0025            3.74         $181.34          $70.66          $36.27
  13133  T                               Repair wound/lesion add-on.....            0025            3.74         $181.34          $70.66          $36.27
  13150  T                               Repair of wound or lesion......            0026           12.11         $587.18         $277.92         $117.44
  13151  T                               Repair of wound or lesion......            0025            3.74         $181.34          $70.66          $36.27
  13152  T                               Repair of wound or lesion......            0025            3.74         $181.34          $70.66          $36.27
  13153  T                               Repair wound/lesion add-on.....            0025            3.74         $181.34          $70.66          $36.27
  13160  T                               Late closure of wound..........            0026           12.11         $587.18         $277.92         $117.44
  14000  T                               Skin tissue rearrangement......            0026           12.11         $587.18         $277.92         $117.44
  14001  T                               Skin tissue rearrangement......            0026           12.11         $587.18         $277.92         $117.44
  14020  T                               Skin tissue rearrangement......            0026           12.11         $587.18         $277.92         $117.44
  14021  T                               Skin tissue rearrangement......            0026           12.11         $587.18         $277.92         $117.44
  14040  T                               Skin tissue rearrangement......            0026           12.11         $587.18         $277.92         $117.44
  14041  T                               Skin tissue rearrangement......            0026           12.11         $587.18         $277.92         $117.44
  14060  T                               Skin tissue rearrangement......            0026           12.11         $587.18         $277.92         $117.44
  14061  T                               Skin tissue rearrangement......            0026           12.11         $587.18         $277.92         $117.44
  14300  T                               Skin tissue rearrangement......            0026           12.11         $587.18         $277.92         $117.44
  14350  T                               Skin tissue rearrangement......            0026           12.11         $587.18         $277.92         $117.44
  15000  T                               Skin graft.....................            0026           12.11         $587.18         $277.92         $117.44
  15001  T                               Skin graft add-on..............            0026           12.11         $587.18         $277.92         $117.44
  15050  T                               Skin pinch graft...............            0026           12.11         $587.18         $277.92         $117.44
  15100  T                               Skin split graft...............            0026           12.11         $587.18         $277.92         $117.44
  15101  T                               Skin split graft add-on........            0026           12.11         $587.18         $277.92         $117.44
  15120  T                               Skin split graft...............            0026           12.11         $587.18         $277.92         $117.44
  15121  T                               Skin split graft add-on........            0026           12.11         $587.18         $277.92         $117.44
  15200  T                               Skin full graft................            0026           12.11         $587.18         $277.92         $117.44
  15201  T                               Skin full graft add-on.........            0026           12.11         $587.18         $277.92         $117.44
  15220  T                               Skin full graft................            0026           12.11         $587.18         $277.92         $117.44
  15221  T                               Skin full graft add-on.........            0026           12.11         $587.18         $277.92         $117.44
  15240  T                               Skin full graft................            0026           12.11         $587.18         $277.92         $117.44
  15241  T                               Skin full graft add-on.........            0026           12.11         $587.18         $277.92         $117.44
  15260  T                               Skin full graft................            0026           12.11         $587.18         $277.92         $117.44
  15261  T                               Skin full graft add-on.........            0026           12.11         $587.18         $277.92         $117.44
  15350  T                               Skin homograft.................            0026           12.11         $587.18         $277.92         $117.44
  15351  T                               Skin homograft add-on..........            0026           12.11         $587.18         $277.92         $117.44
  15400  T                               Skin heterograft...............            0026           12.11         $587.18         $277.92         $117.44
  15401  T                               Skin heterograft add-on........            0026           12.11         $587.18         $277.92         $117.44
  15570  T                               Form skin pedicle flap.........            0026           12.11         $587.18         $277.92         $117.44
  15572  T                               Form skin pedicle flap.........            0026           12.11         $587.18         $277.92         $117.44
  15574  T                               Form skin pedicle flap.........            0026           12.11         $587.18         $277.92         $117.44
  15576  T                               Form skin pedicle flap.........            0026           12.11         $587.18         $277.92         $117.44
  15600  T                               Skin graft.....................            0026           12.11         $587.18         $277.92         $117.44
  15610  T                               Skin graft.....................            0026           12.11         $587.18         $277.92         $117.44
  15620  T                               Skin graft.....................            0026           12.11         $587.18         $277.92         $117.44
  15630  T                               Skin graft.....................            0026           12.11         $587.18         $277.92         $117.44
  15650  T                               Transfer skin pedicle flap.....            0026           12.11         $587.18         $277.92         $117.44
  15732  T                               Muscle-skin graft, head/neck...            0027           15.80         $766.10         $383.10         $153.22
  15734  T                               Muscle-skin graft, trunk.......            0027           15.80         $766.10         $383.10         $153.22
  15736  T                               Muscle-skin graft, arm.........            0027           15.80         $766.10         $383.10         $153.22
  15738  T                               Muscle-skin graft, leg.........            0027           15.80         $766.10         $383.10         $153.22
  15740  T                               Island pedicle flap graft......            0027           15.80         $766.10         $383.10         $153.22
  15750  T                               Neurovascular pedicle graft....            0027           15.80         $766.10         $383.10         $153.22
  15756  C                               Free muscle flap, microvasc....  ..............  ..............  ..............  ..............  ..............
  15757  C                               Free skin flap, microvasc......  ..............  ..............  ..............  ..............  ..............
  15758  C                               Free fascial flap, microvasc...  ..............  ..............  ..............  ..............  ..............
  15760  T                               Composite skin graft...........            0027           15.80         $766.10         $383.10         $153.22
  15770  T                               Derma-fat-fascia graft.........            0027           15.80         $766.10         $383.10         $153.22
  15775  T                               Hair transplant punch grafts...            0026           12.11         $587.18         $277.92         $117.44
  15776  T                               Hair transplant punch grafts...            0026           12.11         $587.18         $277.92         $117.44
  15780  T                               Abrasion treatment of skin.....            0022           12.49         $605.60         $292.94         $121.12
  15781  T                               Abrasion treatment of skin.....            0022           12.49         $605.60         $292.94         $121.12
  15782  T                               Abrasion treatment of skin.....            0022           12.49         $605.60         $292.94         $121.12
  15783  T                               Abrasion treatment of skin.....            0015            1.77          $85.82          $31.20          $17.16
  15786  T                               Abrasion, lesion, single.......            0013            0.91          $44.12          $17.66           $8.82

[[Page 18564]]

 
  15787  T                               Abrasion, lesions, add-on......            0016            3.53         $171.16          $74.67          $34.23
  15788  T                               Chemical peel, face, epiderm...            0013            0.91          $44.12          $17.66           $8.82
  15789  T                               Chemical peel, face, dermal....            0015            1.77          $85.82          $31.20          $17.16
  15792  T                               Chemical peel, nonfacial.......            0016            3.53         $171.16          $74.67          $34.23
  15793  T                               Chemical peel, nonfacial.......            0016            3.53         $171.16          $74.67          $34.23
  15810  T                               Salabrasion....................            0016            3.53         $171.16          $74.67          $34.23
  15811  T                               Salabrasion....................            0022           12.49         $605.60         $292.94         $121.12
  15819  T                               Plastic surgery, neck..........            0026           12.11         $587.18         $277.92         $117.44
  15820  T                               Revision of lower eyelid.......            0026           12.11         $587.18         $277.92         $117.44
  15821  T                               Revision of lower eyelid.......            0026           12.11         $587.18         $277.92         $117.44
  15822  T                               Revision of upper eyelid.......            0026           12.11         $587.18         $277.92         $117.44
  15823  T                               Revision of upper eyelid.......            0026           12.11         $587.18         $277.92         $117.44
  15824  T                               Removal of forehead wrinkles...            0027           15.80         $766.10         $383.10         $153.22
  15825  T                               Removal of neck wrinkles.......            0026           12.11         $587.18         $277.92         $117.44
  15826  T                               Removal of brow wrinkles.......            0027           15.80         $766.10         $383.10         $153.22
  15828  T                               Removal of face wrinkles.......            0027           15.80         $766.10         $383.10         $153.22
  15829  T                               Removal of skin wrinkles.......            0026           12.11         $587.18         $277.92         $117.44
  15831  T                               Excise excessive skin tissue...            0027           15.80         $766.10         $383.10         $153.22
  15832  T                               Excise excessive skin tissue...            0027           15.80         $766.10         $383.10         $153.22
  15833  T                               Excise excessive skin tissue...            0027           15.80         $766.10         $383.10         $153.22
  15834  T                               Excise excessive skin tissue...            0027           15.80         $766.10         $383.10         $153.22
  15835  T                               Excise excessive skin tissue...            0026           12.11         $587.18         $277.92         $117.44
  15836  T                               Excise excessive skin tissue...            0027           15.80         $766.10         $383.10         $153.22
  15837  T                               Excise excessive skin tissue...            0027           15.80         $766.10         $383.10         $153.22
  15838  T                               Excise excessive skin tissue...            0022           12.49         $605.60         $292.94         $121.12
  15839  T                               Excise excessive skin tissue...            0027           15.80         $766.10         $383.10         $153.22
  15840  T                               Graft for face nerve palsy.....            0027           15.80         $766.10         $383.10         $153.22
  15841  T                               Graft for face nerve palsy.....            0027           15.80         $766.10         $383.10         $153.22
  15842  T                               Graft for face nerve palsy.....            0027           15.80         $766.10         $383.10         $153.22
  15845  T                               Skin and muscle repair, face...            0027           15.80         $766.10         $383.10         $153.22
  15850  T                               Removal of sutures.............            0013            0.91          $44.12          $17.66           $8.82
  15851  T                               Removal of sutures.............            0013            0.91          $44.12          $17.66           $8.82
  15852  T                               Dressing change, not for burn..            0012            0.53          $25.70           $9.18           $5.14
  15860  N                               Test for blood flow in graft...  ..............  ..............  ..............  ..............  ..............
  15876  T                               Suction assisted lipectomy.....            0027           15.80         $766.10         $383.10         $153.22
  15877  T                               Suction assisted lipectomy.....            0027           15.80         $766.10         $383.10         $153.22
  15878  T                               Suction assisted lipectomy.....            0027           15.80         $766.10         $383.10         $153.22
  15879  T                               Suction assisted lipectomy.....            0027           15.80         $766.10         $383.10         $153.22
  15920  T                               Removal of tail bone ulcer.....            0022           12.49         $605.60         $292.94         $121.12
  15922  T                               Removal of tail bone ulcer.....            0027           15.80         $766.10         $383.10         $153.22
  15931  T                               Remove sacrum pressure sore....            0022           12.49         $605.60         $292.94         $121.12
  15933  T                               Remove sacrum pressure sore....            0022           12.49         $605.60         $292.94         $121.12
  15934  T                               Remove sacrum pressure sore....            0027           15.80         $766.10         $383.10         $153.22
  15935  T                               Remove sacrum pressure sore....            0027           15.80         $766.10         $383.10         $153.22
  15936  T                               Remove sacrum pressure sore....            0027           15.80         $766.10         $383.10         $153.22
  15937  T                               Remove sacrum pressure sore....            0027           15.80         $766.10         $383.10         $153.22
  15940  T                               Remove hip pressure sore.......            0022           12.49         $605.60         $292.94         $121.12
  15941  T                               Remove hip pressure sore.......            0022           12.49         $605.60         $292.94         $121.12
  15944  T                               Remove hip pressure sore.......            0027           15.80         $766.10         $383.10         $153.22
  15945  T                               Remove hip pressure sore.......            0027           15.80         $766.10         $383.10         $153.22
  15946  T                               Remove hip pressure sore.......            0027           15.80         $766.10         $383.10         $153.22
  15950  T                               Remove thigh pressure sore.....            0022           12.49         $605.60         $292.94         $121.12
  15951  T                               Remove thigh pressure sore.....            0022           12.49         $605.60         $292.94         $121.12
  15952  T                               Remove thigh pressure sore.....            0027           15.80         $766.10         $383.10         $153.22
  15953  T                               Remove thigh pressure sore.....            0027           15.80         $766.10         $383.10         $153.22
  15956  T                               Remove thigh pressure sore.....            0027           15.80         $766.10         $383.10         $153.22
  15958  T                               Remove thigh pressure sore.....            0027           15.80         $766.10         $383.10         $153.22
  15999  T                               Removal of pressure sore.......            0022           12.49         $605.60         $292.94         $121.12
  16000  T                               Initial treatment of burn(s)...            0015            1.77          $85.82          $31.20          $17.16
  16010  T                               Treatment of burn(s)...........            0015            1.77          $85.82          $31.20          $17.16
  16015  T                               Treatment of burn(s)...........            0017           12.45         $603.66         $289.16         $120.73
  16020  T                               Treatment of burn(s)...........            0015            1.77          $85.82          $31.20          $17.16
  16025  T                               Treatment of burn(s)...........            0014            1.50          $72.73          $24.55          $14.55
  16030  T                               Treatment of burn(s)...........            0015            1.77          $85.82          $31.20          $17.16
  16035  T                               Incision of burn scab..........            0020            6.51         $315.65         $130.53          $63.13
  17000  T                               Destroy benign/premal lesion...            0010            0.55          $26.67           $9.86           $5.33
  17003  T                               Destroy lesions, 2-14..........            0010            0.55          $26.67           $9.86           $5.33
  17004  T                               Destroy lesions, 15 or more....            0011            2.72         $131.88          $50.01          $26.38
  17106  T                               Destruction of skin lesions....            0011            2.72         $131.88          $50.01          $26.38
  17107  T                               Destruction of skin lesions....            0011            2.72         $131.88          $50.01          $26.38
  17108  T                               Destruction of skin lesions....            0011            2.72         $131.88          $50.01          $26.38
  17110  T                               Destruct lesion, 1-14..........            0010            0.55          $26.67           $9.86           $5.33
  17111  T                               Destruct lesion, 15 or more....            0011            2.72         $131.88          $50.01          $26.38

[[Page 18565]]

 
  17250  T                               Chemical cautery, tissue.......            0014            1.50          $72.73          $24.55          $14.55
  17260  T                               Destruction of skin lesions....            0013            0.91          $44.12          $17.66           $8.82
  17261  T                               Destruction of skin lesions....            0013            0.91          $44.12          $17.66           $8.82
  17262  T                               Destruction of skin lesions....            0013            0.91          $44.12          $17.66           $8.82
  17263  T                               Destruction of skin lesions....            0013            0.91          $44.12          $17.66           $8.82
  17264  T                               Destruction of skin lesions....            0015            1.77          $85.82          $31.20          $17.16
  17266  T                               Destruction of skin lesions....            0016            3.53         $171.16          $74.67          $34.23
  17270  T                               Destruction of skin lesions....            0015            1.77          $85.82          $31.20          $17.16
  17271  T                               Destruction of skin lesions....            0013            0.91          $44.12          $17.66           $8.82
  17272  T                               Destruction of skin lesions....            0013            0.91          $44.12          $17.66           $8.82
  17273  T                               Destruction of skin lesions....            0015            1.77          $85.82          $31.20          $17.16
  17274  T                               Destruction of skin lesions....            0015            1.77          $85.82          $31.20          $17.16
  17276  T                               Destruction of skin lesions....            0015            1.77          $85.82          $31.20          $17.16
  17280  T                               Destruction of skin lesions....            0015            1.77          $85.82          $31.20          $17.16
  17281  T                               Destruction of skin lesions....            0015            1.77          $85.82          $31.20          $17.16
  17282  T                               Destruction of skin lesions....            0015            1.77          $85.82          $31.20          $17.16
  17283  T                               Destruction of skin lesions....            0015            1.77          $85.82          $31.20          $17.16
  17284  T                               Destruction of skin lesions....            0016            3.53         $171.16          $74.67          $34.23
  17286  T                               Destruction of skin lesions....            0016            3.53         $171.16          $74.67          $34.23
  17304  T                               Chemosurgery of skin lesion....            0020            6.51         $315.65         $130.53          $63.13
  17305  T                               2nd stage chemosurgery.........            0020            6.51         $315.65         $130.53          $63.13
  17306  T                               3rd stage chemosurgery.........            0020            6.51         $315.65         $130.53          $63.13
  17307  T                               Followup skin lesion therapy...            0020            6.51         $315.65         $130.53          $63.13
  17310  T                               Extensive skin chemosurgery....            0020            6.51         $315.65         $130.53          $63.13
  17340  T                               Cryotherapy of skin............            0012            0.53          $25.70           $9.18           $5.14
  17360  T                               Skin peel therapy..............            0016            3.53         $171.16          $74.67          $34.23
  17380  T                               Hair removal by electrolysis...            0016            3.53         $171.16          $74.67          $34.23
  17999  T                               Skin tissue procedure..........            0004            1.84          $89.22          $32.57          $17.84
  19000  T                               Drainage of breast lesion......            0004            1.84          $89.22          $32.57          $17.84
  19001  T                               Drain breast lesion add-on.....            0004            1.84          $89.22          $32.57          $17.84
  19020  T                               Incision of breast lesion......            0008            6.15         $298.20         $113.67          $59.64
  19030  N                               Injection for breast x-ray.....  ..............  ..............  ..............  ..............  ..............
  19100  T                               Biopsy of breast...............            0005            5.41         $262.32         $119.75          $52.46
  19101  T                               Biopsy of breast...............            0029           12.85         $623.06         $303.50         $124.61
  19110  T                               Nipple exploration.............            0029           12.85         $623.06         $303.50         $124.61
  19112  T                               Excise breast duct fistula.....            0029           12.85         $623.06         $303.50         $124.61
  19120  T                               Removal of breast lesion.......            0029           12.85         $623.06         $303.50         $124.61
  19125  T                               Excision, breast lesion........            0029           12.85         $623.06         $303.50         $124.61
  19126  T                               Excision, addl breast lesion...            0029           12.85         $623.06         $303.50         $124.61
  19140  T                               Removal of breast tissue.......            0029           12.85         $623.06         $303.50         $124.61
  19160  T                               Removal of breast tissue.......            0030           20.19         $978.95         $523.95         $195.79
  19162  T                               Remove breast tissue, nodes....            0030           20.19         $978.95         $523.95         $195.79
  19180  T                               Removal of breast..............            0030           20.19         $978.95         $523.95         $195.79
  19182  T                               Removal of breast..............            0030           20.19         $978.95         $523.95         $195.79
  19200  C                               Removal of breast..............  ..............  ..............  ..............  ..............  ..............
  19220  C                               Removal of breast..............  ..............  ..............  ..............  ..............  ..............
  19240  C                               Removal of breast..............  ..............  ..............  ..............  ..............  ..............
  19260  C                               Removal of chest wall lesion...  ..............  ..............  ..............  ..............  ..............
  19271  C                               Revision of chest wall.........  ..............  ..............  ..............  ..............  ..............
  19272  C                               Extensive chest wall surgery...  ..............  ..............  ..............  ..............  ..............
  19290  T                               Place needle wire, breast......            0029           12.85         $623.06         $303.50         $124.61
  19291  T                               Place needle wire, breast......            0029           12.85         $623.06         $303.50         $124.61
  19316  T                               Suspension of breast...........            0030           20.19         $978.95         $523.95         $195.79
  19318  T                               Reduction of large breast......            0030           20.19         $978.95         $523.95         $195.79
  19324  T                               Enlarge breast.................            0030           20.19         $978.95         $523.95         $195.79
  19325  T                               Enlarge breast with implant....            0030           20.19         $978.95         $523.95         $195.79
  19328  T                               Removal of breast implant......            0030           20.19         $978.95         $523.95         $195.79
  19330  T                               Removal of implant material....            0030           20.19         $978.95         $523.95         $195.79
  19340  T                               Immediate breast prosthesis....            0030           20.19         $978.95         $523.95         $195.79
  19342  T                               Delayed breast prosthesis......            0030           20.19         $978.95         $523.95         $195.79
  19350  T                               Breast reconstruction..........            0030           20.19         $978.95         $523.95         $195.79
  19355  T                               Correct inverted nipple(s).....            0030           20.19         $978.95         $523.95         $195.79
  19357  T                               Breast reconstruction..........            0030           20.19         $978.95         $523.95         $195.79
  19361  C                               Breast reconstruction..........  ..............  ..............  ..............  ..............  ..............
  19364  C                               Breast reconstruction..........  ..............  ..............  ..............  ..............  ..............
  19366  T                               Breast reconstruction..........            0030           20.19         $978.95         $523.95         $195.79
  19367  C                               Breast reconstruction..........  ..............  ..............  ..............  ..............  ..............
  19368  C                               Breast reconstruction..........  ..............  ..............  ..............  ..............  ..............
  19369  C                               Breast reconstruction..........  ..............  ..............  ..............  ..............  ..............
  19370  T                               Surgery of breast capsule......            0030           20.19         $978.95         $523.95         $195.79
  19371  T                               Removal of breast capsule......            0030           20.19         $978.95         $523.95         $195.79
  19380  T                               Revise breast reconstruction...            0030           20.19         $978.95         $523.95         $195.79
  19396  T                               Design custom breast implant...            0029           12.85         $623.06         $303.50         $124.61

[[Page 18566]]

 
  19499  T                               Breast surgery procedure.......            0029           12.85         $623.06         $303.50         $124.61
  20000  T                               Incision of abscess............            0006            2.00          $96.97          $33.95          $19.39
  20005  T                               Incision of deep abscess.......            0049           15.04         $729.25         $356.95         $145.85
  20100  T                               Explore wound, neck............            0023            1.98          $96.00          $40.37          $19.20
  20101  T                               Explore wound, chest...........            0026           12.11         $587.18         $277.92         $117.44
  20102  T                               Explore wound, abdomen.........            0026           12.11         $587.18         $277.92         $117.44
  20103  T                               Explore wound, extremity.......            0023            1.98          $96.00          $40.37          $19.20
  20150  T                               Excise epiphyseal bar..........            0051           27.76       $1,346.00         $675.24         $269.20
  20200  T                               Muscle biopsy..................            0020            6.51         $315.65         $130.53          $63.13
  20205  T                               Deep muscle biopsy.............            0021           10.49         $508.63         $236.51         $101.73
  20206  T                               Needle biopsy, muscle..........            0005            5.41         $262.32         $119.75          $52.46
  20220  T                               Bone biopsy, trocar/needle.....            0019            4.00         $193.95          $78.91          $38.79
  20225  T                               Bone biopsy, trocar/needle.....            0020            6.51         $315.65         $130.53          $63.13
  20240  T                               Bone biopsy, excisional........            0022           12.49         $605.60         $292.94         $121.12
  20245  T                               Bone biopsy, excisional........            0022           12.49         $605.60         $292.94         $121.12
  20250  T                               Open bone biopsy...............            0049           15.04         $729.25         $356.95         $145.85
  20251  T                               Open bone biopsy...............            0049           15.04         $729.25         $356.95         $145.85
  20500  T                               Injection of sinus tract.......            0252            5.18         $251.16         $114.24          $50.23
  20501  N                               Inject sinus tract for x-ray...  ..............  ..............  ..............  ..............  ..............
  20520  T                               Removal of foreign body........            0019            4.00         $193.95          $78.91          $38.79
  20525  T                               Removal of foreign body........            0022           12.49         $605.60         $292.94         $121.12
  20550  T                               Inject tendon/ligament/cyst....            0040            2.11         $102.31          $40.60          $20.46
  20600  T                               Drain/inject, joint/bursa......            0040            2.11         $102.31          $40.60          $20.46
  20605  T                               Drain/inject, joint/bursa......            0040            2.11         $102.31          $40.60          $20.46
  20610  T                               Drain/inject, joint/bursa......            0040            2.11         $102.31          $40.60          $20.46
  20615  T                               Treatment of bone cyst.........            0004            1.84          $89.22          $32.57          $17.84
  20650  T                               Insert and remove bone pin.....            0049           15.04         $729.25         $356.95         $145.85
  20660  C                               Apply, remove fixation device..  ..............  ..............  ..............  ..............  ..............
  20661  C                               Application of head brace......  ..............  ..............  ..............  ..............  ..............
  20662  C                               Application of pelvis brace....  ..............  ..............  ..............  ..............  ..............
  20663  C                               Application of thigh brace.....  ..............  ..............  ..............  ..............  ..............
  20664  C                               Halo brace application.........  ..............  ..............  ..............  ..............  ..............
  20665  N                               Removal of fixation device.....  ..............  ..............  ..............  ..............  ..............
  20670  T                               Removal of support implant.....            0021           10.49         $508.63         $236.51         $101.73
  20680  T                               Removal of support implant.....            0022           12.49         $605.60         $292.94         $121.12
  20690  T                               Apply bone fixation device.....            0050           21.13       $1,024.53         $513.86         $204.91
  20692  T                               Apply bone fixation device.....            0050           21.13       $1,024.53         $513.86         $204.91
  20693  T                               Adjust bone fixation device....            0049           15.04         $729.25         $356.95         $145.85
  20694  T                               Remove bone fixation device....            0049           15.04         $729.25         $356.95         $145.85
  20802  C                               Replantation, arm, complete....  ..............  ..............  ..............  ..............  ..............
  20805  C                               Replant, forearm, complete.....  ..............  ..............  ..............  ..............  ..............
  20808  C                               Replantation hand, complete....  ..............  ..............  ..............  ..............  ..............
  20816  C                               Replantation digit, complete...  ..............  ..............  ..............  ..............  ..............
  20822  C                               Replantation digit, complete...  ..............  ..............  ..............  ..............  ..............
  20824  C                               Replantation thumb, complete...  ..............  ..............  ..............  ..............  ..............
  20827  C                               Replantation thumb, complete...  ..............  ..............  ..............  ..............  ..............
  20838  C                               Replantation foot, complete....  ..............  ..............  ..............  ..............  ..............
  20900  T                               Removal of bone for graft......            0050           21.13       $1,024.53         $513.86         $204.91
  20902  T                               Removal of bone for graft......            0050           21.13       $1,024.53         $513.86         $204.91
  20910  T                               Remove cartilage for graft.....            0026           12.11         $587.18         $277.92         $117.44
  20912  T                               Remove cartilage for graft.....            0026           12.11         $587.18         $277.92         $117.44
  20920  T                               Removal of fascia for graft....            0026           12.11         $587.18         $277.92         $117.44
  20922  T                               Removal of fascia for graft....            0026           12.11         $587.18         $277.92         $117.44
  20924  T                               Removal of tendon for graft....            0050           21.13       $1,024.53         $513.86         $204.91
  20926  T                               Removal of tissue for graft....            0026           12.11         $587.18         $277.92         $117.44
  20930  C                               Spinal bone allograft..........  ..............  ..............  ..............  ..............  ..............
  20931  C                               Spinal bone allograft..........  ..............  ..............  ..............  ..............  ..............
  20936  C                               Spinal bone autograft..........  ..............  ..............  ..............  ..............  ..............
  20937  C                               Spinal bone autograft..........  ..............  ..............  ..............  ..............  ..............
  20938  C                               Spinal bone autograft..........  ..............  ..............  ..............  ..............  ..............
  20950  T                               Fluid pressure, muscle.........            0008            6.15         $298.20         $113.67          $59.64
  20955  C                               Fibula bone graft, microvasc...  ..............  ..............  ..............  ..............  ..............
  20956  C                               Iliac bone graft, microvasc....  ..............  ..............  ..............  ..............  ..............
  20957  C                               Mt bone graft, microvasc.......  ..............  ..............  ..............  ..............  ..............
  20962  C                               Other bone graft, microvasc....  ..............  ..............  ..............  ..............  ..............
  20969  C                               Bone/skin graft, microvasc.....  ..............  ..............  ..............  ..............  ..............
  20970  C                               Bone/skin graft, iliac crest...  ..............  ..............  ..............  ..............  ..............
  20972  C                               Bone/skin graft, metatarsal....  ..............  ..............  ..............  ..............  ..............
  20973  C                               Bone/skin graft, great toe.....  ..............  ..............  ..............  ..............  ..............
  20974  A                               Electrical bone stimulation....  ..............  ..............  ..............  ..............  ..............
  20975  T                               Electrical bone stimulation....            0049           15.04         $729.25         $356.95         $145.85
  20979  T                               Us bone stimulation............            0049           15.04         $729.25         $356.95         $145.85
  20999  N                               Musculoskeletal surgery........  ..............  ..............  ..............  ..............  ..............

[[Page 18567]]

 
  21010  T                               Incision of jaw joint..........            0254           12.45         $603.66         $272.41         $120.73
  21015  T                               Resection of facial tumor......            0254           12.45         $603.66         $272.41         $120.73
  21025  T                               Excision of bone, lower jaw....            0256           25.40       $1,231.57         $623.05         $246.31
  21026  T                               Excision of facial bone(s).....            0256           25.40       $1,231.57         $623.05         $246.31
  21029  T                               Contour of face bone lesion....            0256           25.40       $1,231.57         $623.05         $246.31
  21030  T                               Removal of face bone lesion....            0254           12.45         $603.66         $272.41         $120.73
  21031  T                               Remove exostosis, mandible.....            0253           12.02         $582.81         $284.00         $116.56
  21032  T                               Remove exostosis, maxilla......            0253           12.02         $582.81         $284.00         $116.56
  21034  T                               Removal of face bone lesion....            0256           25.40       $1,231.57         $623.05         $246.31
  21040  T                               Removal of jaw bone lesion.....            0253           12.02         $582.81         $284.00         $116.56
  21041  T                               Removal of jaw bone lesion.....            0256           25.40       $1,231.57         $623.05         $246.31
  21044  T                               Removal of jaw bone lesion.....            0256           25.40       $1,231.57         $623.05         $246.31
  21045  C                               Extensive jaw surgery..........  ..............  ..............  ..............  ..............  ..............
  21050  T                               Removal of jaw joint...........            0256           25.40       $1,231.57         $623.05         $246.31
  21060  T                               Remove jaw joint cartilage.....            0256           25.40       $1,231.57         $623.05         $246.31
  21070  T                               Remove coronoid process........            0256           25.40       $1,231.57         $623.05         $246.31
  21076  T                               Prepare face/oral prosthesis...            0254           12.45         $603.66         $272.41         $120.73
  21077  T                               Prepare face/oral prosthesis...            0256           25.40       $1,231.57         $623.05         $246.31
  21079  T                               Prepare face/oral prosthesis...            0256           25.40       $1,231.57         $623.05         $246.31
  21080  T                               Prepare face/oral prosthesis...            0256           25.40       $1,231.57         $623.05         $246.31
  21081  T                               Prepare face/oral prosthesis...            0256           25.40       $1,231.57         $623.05         $246.31
  21082  T                               Prepare face/oral prosthesis...            0256           25.40       $1,231.57         $623.05         $246.31
  21083  T                               Prepare face/oral prosthesis...            0256           25.40       $1,231.57         $623.05         $246.31
  21084  T                               Prepare face/oral prosthesis...            0256           25.40       $1,231.57         $623.05         $246.31
  21085  T                               Prepare face/oral prosthesis...            0253           12.02         $582.81         $284.00         $116.56
  21086  T                               Prepare face/oral prosthesis...            0256           25.40       $1,231.57         $623.05         $246.31
  21087  T                               Prepare face/oral prosthesis...            0256           25.40       $1,231.57         $623.05         $246.31
  21088  T                               Prepare face/oral prosthesis...            0256           25.40       $1,231.57         $623.05         $246.31
  21089  T                               Prepare face/oral prosthesis...            0253           12.02         $582.81         $284.00         $116.56
  21100  T                               Maxillofacial fixation.........            0256           25.40       $1,231.57         $623.05         $246.31
  21110  T                               Interdental fixation...........            0254           12.45         $603.66         $272.41         $120.73
  21116  N                               Injection, jaw joint x-ray.....  ..............  ..............  ..............  ..............  ..............
  21120  T                               Reconstruction of chin.........            0254           12.45         $603.66         $272.41         $120.73
  21121  T                               Reconstruction of chin.........            0254           12.45         $603.66         $272.41         $120.73
  21122  T                               Reconstruction of chin.........            0254           12.45         $603.66         $272.41         $120.73
  21123  T                               Reconstruction of chin.........            0254           12.45         $603.66         $272.41         $120.73
  21125  T                               Augmentation, lower jaw bone...            0254           12.45         $603.66         $272.41         $120.73
  21127  T                               Augmentation, lower jaw bone...            0256           25.40       $1,231.57         $623.05         $246.31
  21137  T                               Reduction of forehead..........            0254           12.45         $603.66         $272.41         $120.73
  21138  T                               Reduction of forehead..........            0256           25.40       $1,231.57         $623.05         $246.31
  21139  T                               Reduction of forehead..........            0256           25.40       $1,231.57         $623.05         $246.31
  21141  C                               Reconstruct midface, lefort....  ..............  ..............  ..............  ..............  ..............
  21142  C                               Reconstruct midface, lefort....  ..............  ..............  ..............  ..............  ..............
  21143  C                               Reconstruct midface, lefort....  ..............  ..............  ..............  ..............  ..............
  21145  C                               Reconstruct midface, lefort....  ..............  ..............  ..............  ..............  ..............
  21146  C                               Reconstruct midface, lefort....  ..............  ..............  ..............  ..............  ..............
  21147  C                               Reconstruct midface, lefort....  ..............  ..............  ..............  ..............  ..............
  21150  C                               Reconstruct midface, lefort....  ..............  ..............  ..............  ..............  ..............
  21151  C                               Reconstruct midface, lefort....  ..............  ..............  ..............  ..............  ..............
  21154  C                               Reconstruct midface, lefort....  ..............  ..............  ..............  ..............  ..............
  21155  C                               Reconstruct midface, lefort....  ..............  ..............  ..............  ..............  ..............
  21159  C                               Reconstruct midface, lefort....  ..............  ..............  ..............  ..............  ..............
  21160  C                               Reconstruct midface, lefort....  ..............  ..............  ..............  ..............  ..............
  21172  C                               Reconstruct orbit/forehead.....  ..............  ..............  ..............  ..............  ..............
  21175  C                               Reconstruct orbit/forehead.....  ..............  ..............  ..............  ..............  ..............
  21179  C                               Reconstruct entire forehead....  ..............  ..............  ..............  ..............  ..............
  21180  C                               Reconstruct entire forehead....  ..............  ..............  ..............  ..............  ..............
  21181  T                               Contour cranial bone lesion....            0254           12.45         $603.66         $272.41         $120.73
  21182  C                               Reconstruct cranial bone.......  ..............  ..............  ..............  ..............  ..............
  21183  C                               Reconstruct cranial bone.......  ..............  ..............  ..............  ..............  ..............
  21184  C                               Reconstruct cranial bone.......  ..............  ..............  ..............  ..............  ..............
  21188  C                               Reconstruction of midface......  ..............  ..............  ..............  ..............  ..............
  21193  C                               Reconstruct lower jaw bone.....  ..............  ..............  ..............  ..............  ..............
  21194  C                               Reconstruct lower jaw bone.....  ..............  ..............  ..............  ..............  ..............
  21195  C                               Reconstruct lower jaw bone.....  ..............  ..............  ..............  ..............  ..............
  21196  C                               Reconstruct lower jaw bone.....  ..............  ..............  ..............  ..............  ..............
  21198  T                               Reconstruct lower jaw bone.....            0256           25.40       $1,231.57         $623.05         $246.31
  21206  T                               Reconstruct upper jaw bone.....            0256           25.40       $1,231.57         $623.05         $246.31
  21208  T                               Augmentation of facial bones...            0256           25.40       $1,231.57         $623.05         $246.31
  21209  T                               Reduction of facial bones......            0256           25.40       $1,231.57         $623.05         $246.31
  21210  T                               Face bone graft................            0256           25.40       $1,231.57         $623.05         $246.31
  21215  T                               Lower jaw bone graft...........            0256           25.40       $1,231.57         $623.05         $246.31
  21230  T                               Rib cartilage graft............            0256           25.40       $1,231.57         $623.05         $246.31

[[Page 18568]]

 
  21235  T                               Ear cartilage graft............            0254           12.45         $603.66         $272.41         $120.73
  21240  T                               Reconstruction of jaw joint....            0256           25.40       $1,231.57         $623.05         $246.31
  21242  T                               Reconstruction of jaw joint....            0256           25.40       $1,231.57         $623.05         $246.31
  21243  T                               Reconstruction of jaw joint....            0256           25.40       $1,231.57         $623.05         $246.31
  21244  T                               Reconstruction of lower jaw....            0256           25.40       $1,231.57         $623.05         $246.31
  21245  T                               Reconstruction of jaw..........            0256           25.40       $1,231.57         $623.05         $246.31
  21246  T                               Reconstruction of jaw..........            0256           25.40       $1,231.57         $623.05         $246.31
  21247  C                               Reconstruct lower jaw bone.....  ..............  ..............  ..............  ..............  ..............
  21248  T                               Reconstruction of jaw..........            0256           25.40       $1,231.57         $623.05         $246.31
  21249  T                               Reconstruction of jaw..........            0256           25.40       $1,231.57         $623.05         $246.31
  21255  C                               Reconstruct lower jaw bone.....  ..............  ..............  ..............  ..............  ..............
  21256  C                               Reconstruction of orbit........  ..............  ..............  ..............  ..............  ..............
  21260  T                               Revise eye sockets.............            0256           25.40       $1,231.57         $623.05         $246.31
  21261  T                               Revise eye sockets.............            0256           25.40       $1,231.57         $623.05         $246.31
  21263  T                               Revise eye sockets.............            0256           25.40       $1,231.57         $623.05         $246.31
  21267  T                               Revise eye sockets.............            0256           25.40       $1,231.57         $623.05         $246.31
  21268  C                               Revise eye sockets.............  ..............  ..............  ..............  ..............  ..............
  21270  T                               Augmentation, cheek bone.......            0256           25.40       $1,231.57         $623.05         $246.31
  21275  T                               Revision, orbitofacial bones...            0256           25.40       $1,231.57         $623.05         $246.31
  21280  T                               Revision of eyelid.............            0256           25.40       $1,231.57         $623.05         $246.31
  21282  T                               Revision of eyelid.............            0253           12.02         $582.81         $284.00         $116.56
  21295  T                               Revision of jaw muscle/bone....            0253           12.02         $582.81         $284.00         $116.56
  21296  T                               Revision of jaw muscle/bone....            0254           12.45         $603.66         $272.41         $120.73
  21299  T                               Cranio/maxillofacial surgery...            0253           12.02         $582.81         $284.00         $116.56
  21300  T                               Treatment of skull fracture....            0253           12.02         $582.81         $284.00         $116.56
  21310  T                               Treatment of nose fracture.....            0253           12.02         $582.81         $284.00         $116.56
  21315  T                               Treatment of nose fracture.....            0253           12.02         $582.81         $284.00         $116.56
  21320  T                               Treatment of nose fracture.....            0253           12.02         $582.81         $284.00         $116.56
  21325  T                               Treatment of nose fracture.....            0253           12.02         $582.81         $284.00         $116.56
  21330  T                               Treatment of nose fracture.....            0254           12.45         $603.66         $272.41         $120.73
  21335  T                               Treatment of nose fracture.....            0254           12.45         $603.66         $272.41         $120.73
  21336  T                               Treat nasal septal fracture....            0046           22.29       $1,080.78         $535.76         $216.16
  21337  T                               Treat nasal septal fracture....            0253           12.02         $582.81         $284.00         $116.56
  21338  T                               Treat nasoethmoid fracture.....            0254           12.45         $603.66         $272.41         $120.73
  21339  T                               Treat nasoethmoid fracture.....            0254           12.45         $603.66         $272.41         $120.73
  21340  T                               Treatment of nose fracture.....            0256           25.40       $1,231.57         $623.05         $246.31
  21343  C                               Treatment of sinus fracture....  ..............  ..............  ..............  ..............  ..............
  21344  C                               Treatment of sinus fracture....  ..............  ..............  ..............  ..............  ..............
  21345  T                               Treat nose/jaw fracture........            0254           12.45         $603.66         $272.41         $120.73
  21346  C                               Treat nose/jaw fracture........  ..............  ..............  ..............  ..............  ..............
  21347  C                               Treat nose/jaw fracture........  ..............  ..............  ..............  ..............  ..............
  21348  C                               Treat nose/jaw fracture........  ..............  ..............  ..............  ..............  ..............
  21355  T                               Treat cheek bone fracture......            0256           25.40       $1,231.57         $623.05         $246.31
  21356  C                               Treat cheek bone fracture......  ..............  ..............  ..............  ..............  ..............
  21360  C                               Treat cheek bone fracture......  ..............  ..............  ..............  ..............  ..............
  21365  C                               Treat cheek bone fracture......  ..............  ..............  ..............  ..............  ..............
  21366  C                               Treat cheek bone fracture......  ..............  ..............  ..............  ..............  ..............
  21385  C                               Treat eye socket fracture......  ..............  ..............  ..............  ..............  ..............
  21386  C                               Treat eye socket fracture......  ..............  ..............  ..............  ..............  ..............
  21387  C                               Treat eye socket fracture......  ..............  ..............  ..............  ..............  ..............
  21390  C                               Treat eye socket fracture......  ..............  ..............  ..............  ..............  ..............
  21395  C                               Treat eye socket fracture......  ..............  ..............  ..............  ..............  ..............
  21400  T                               Treat eye socket fracture......            0252            5.18         $251.16         $114.24          $50.23
  21401  T                               Treat eye socket fracture......            0253           12.02         $582.81         $284.00         $116.56
  21406  T                               Treat eye socket fracture......            0256           25.40       $1,231.57         $623.05         $246.31
  21407  T                               Treat eye socket fracture......            0256           25.40       $1,231.57         $623.05         $246.31
  21408  C                               Treat eye socket fracture......  ..............  ..............  ..............  ..............  ..............
  21421  T                               Treat mouth roof fracture......            0254           12.45         $603.66         $272.41         $120.73
  21422  C                               Treat mouth roof fracture......  ..............  ..............  ..............  ..............  ..............
  21423  C                               Treat mouth roof fracture......  ..............  ..............  ..............  ..............  ..............
  21431  C                               Treat craniofacial fracture....  ..............  ..............  ..............  ..............  ..............
  21432  C                               Treat craniofacial fracture....  ..............  ..............  ..............  ..............  ..............
  21433  C                               Treat craniofacial fracture....  ..............  ..............  ..............  ..............  ..............
  21435  C                               Treat craniofacial fracture....  ..............  ..............  ..............  ..............  ..............
  21436  C                               Treat craniofacial fracture....  ..............  ..............  ..............  ..............  ..............
  21440  T                               Treat dental ridge fracture....            0253           12.02         $582.81         $284.00         $116.56
  21445  T                               Treat dental ridge fracture....            0254           12.45         $603.66         $272.41         $120.73
  21450  T                               Treat lower jaw fracture.......            0251            1.68          $81.46          $27.99          $16.29
  21451  T                               Treat lower jaw fracture.......            0254           12.45         $603.66         $272.41         $120.73
  21452  T                               Treat lower jaw fracture.......            0253           12.02         $582.81         $284.00         $116.56
  21453  T                               Treat lower jaw fracture.......            0256           25.40       $1,231.57         $623.05         $246.31
  21454  T                               Treat lower jaw fracture.......            0254           12.45         $603.66         $272.41         $120.73
  21461  T                               Treat lower jaw fracture.......            0256           25.40       $1,231.57         $623.05         $246.31

[[Page 18569]]

 
  21462  T                               Treat lower jaw fracture.......            0256           25.40       $1,231.57         $623.05         $246.31
  21465  T                               Treat lower jaw fracture.......            0256           25.40       $1,231.57         $623.05         $246.31
  21470  T                               Treat lower jaw fracture.......            0256           25.40       $1,231.57         $623.05         $246.31
  21480  T                               Reset dislocated jaw...........            0251            1.68          $81.46          $27.99          $16.29
  21485  T                               Reset dislocated jaw...........            0253           12.02         $582.81         $284.00         $116.56
  21490  T                               Repair dislocated jaw..........            0256           25.40       $1,231.57         $623.05         $246.31
  21493  T                               Treat hyoid bone fracture......            0252            5.18         $251.16         $114.24          $50.23
  21494  T                               Treat hyoid bone fracture......            0252            5.18         $251.16         $114.24          $50.23
  21495  C                               Treat hyoid bone fracture......  ..............  ..............  ..............  ..............  ..............
  21497  T                               Interdental wiring.............            0253           12.02         $582.81         $284.00         $116.56
  21499  T                               Head surgery procedure.........            0253           12.02         $582.81         $284.00         $116.56
  21501  T                               Drain neck/chest lesion........            0008            6.15         $298.20         $113.67          $59.64
  21502  T                               Drain chest lesion.............            0050           21.13       $1,024.53         $513.86         $204.91
  21510  C                               Drainage of bone lesion........  ..............  ..............  ..............  ..............  ..............
  21550  T                               Biopsy of neck/chest...........            0019            4.00         $193.95          $78.91          $38.79
  21555  T                               Remove lesion, neck/chest......            0022           12.49         $605.60         $292.94         $121.12
  21556  T                               Remove lesion, neck/chest......            0022           12.49         $605.60         $292.94         $121.12
  21557  C                               Remove tumor, neck/chest.......  ..............  ..............  ..............  ..............  ..............
  21600  T                               Partial removal of rib.........            0050           21.13       $1,024.53         $513.86         $204.91
  21610  T                               Partial removal of rib.........            0050           21.13       $1,024.53         $513.86         $204.91
  21615  C                               Removal of rib.................  ..............  ..............  ..............  ..............  ..............
  21616  C                               Removal of rib and nerves......  ..............  ..............  ..............  ..............  ..............
  21620  C                               Partial removal of sternum.....  ..............  ..............  ..............  ..............  ..............
  21627  C                               Sternal debridement............  ..............  ..............  ..............  ..............  ..............
  21630  C                               Extensive sternum surgery......  ..............  ..............  ..............  ..............  ..............
  21632  C                               Extensive sternum surgery......  ..............  ..............  ..............  ..............  ..............
  21700  T                               Revision of neck muscle........            0008            6.15         $298.20         $113.67          $59.64
  21705  C                               Revision of neck muscle/rib....  ..............  ..............  ..............  ..............  ..............
  21720  T                               Revision of neck muscle........            0008            6.15         $298.20         $113.67          $59.64
  21725  T                               Revision of neck muscle........            0008            6.15         $298.20         $113.67          $59.64
  21740  C                               Reconstruction of sternum......  ..............  ..............  ..............  ..............  ..............
  21750  C                               Repair of sternum separation...  ..............  ..............  ..............  ..............  ..............
  21800  T                               Treatment of rib fracture......            0043            1.64          $79.52          $25.46          $15.90
  21805  T                               Treatment of rib fracture......            0046           22.29       $1,080.78         $535.76         $216.16
  21810  C                               Treatment of rib fracture(s)...  ..............  ..............  ..............  ..............  ..............
  21820  T                               Treat sternum fracture.........            0043            1.64          $79.52          $25.46          $15.90
  21825  C                               Treat sternum fracture.........  ..............  ..............  ..............  ..............  ..............
  21899  T                               Neck/chest surgery procedure...            0252            5.18         $251.16         $114.24          $50.23
  21920  T                               Biopsy soft tissue of back.....            0020            6.51         $315.65         $130.53          $63.13
  21925  T                               Biopsy soft tissue of back.....            0022           12.49         $605.60         $292.94         $121.12
  21930  T                               Remove lesion, back or flank...            0022           12.49         $605.60         $292.94         $121.12
   1935  T                               Remove tumor, back.............            0022           12.49         $605.60         $292.94         $121.12
  22100  C                               Remove part of neck vertebra...  ..............  ..............  ..............  ..............  ..............
  22101  C                               Remove part, thorax vertebra...  ..............  ..............  ..............  ..............  ..............
  22102  C                               Remove part, lumbar vertebra...  ..............  ..............  ..............  ..............  ..............
  22103  C                               Remove extra spine segment.....  ..............  ..............  ..............  ..............  ..............
  22110  C                               Remove part of neck vertebra...  ..............  ..............  ..............  ..............  ..............
  22112  C                               Remove part, thorax vertebra...  ..............  ..............  ..............  ..............  ..............
  22114  C                               Remove part, lumbar vertebra...  ..............  ..............  ..............  ..............  ..............
  22116  C                               Remove extra spine segment.....  ..............  ..............  ..............  ..............  ..............
  22210  C                               Revision of neck spine.........  ..............  ..............  ..............  ..............  ..............
  22212  C                               Revision of thorax spine.......  ..............  ..............  ..............  ..............  ..............
  22214  C                               Revision of lumbar spine.......  ..............  ..............  ..............  ..............  ..............
  22216  C                               Revise, extra spine segment....  ..............  ..............  ..............  ..............  ..............
  22220  C                               Revision of neck spine.........  ..............  ..............  ..............  ..............  ..............
  22222  C                               Revision of thorax spine.......  ..............  ..............  ..............  ..............  ..............
  22224  C                               Revision of lumbar spine.......  ..............  ..............  ..............  ..............  ..............
  22226  C                               Revise, extra spine segment....  ..............  ..............  ..............  ..............  ..............
  22305  T                               Treat spine process fracture...            0043            1.64          $79.52          $25.46          $15.90
  22310  T                               Treat spine fracture...........            0043            1.64          $79.52          $25.46          $15.90
  22315  T                               Treat spine fracture...........            0043            1.64          $79.52          $25.46          $15.90
  22318  C                               Treat odontoid fx w/o graft....  ..............  ..............  ..............  ..............  ..............
  22319  C                               Treat odontoid fx w/graft......  ..............  ..............  ..............  ..............  ..............
  22325  C                               Treat spine fracture...........  ..............  ..............  ..............  ..............  ..............
  22326  C                               Treat neck spine fracture......  ..............  ..............  ..............  ..............  ..............
  22327  C                               Treat thorax spine fracture....  ..............  ..............  ..............  ..............  ..............
  22328  C                               Treat each add spine fx........  ..............  ..............  ..............  ..............  ..............
  22505  T                               Manipulation of spine..........            0045           11.02         $534.33         $277.12         $106.87
  22548  C                               Neck spine fusion..............  ..............  ..............  ..............  ..............  ..............
  22554  C                               Neck spine fusion..............  ..............  ..............  ..............  ..............  ..............
  22556  C                               Thorax spine fusion............  ..............  ..............  ..............  ..............  ..............
  22558  C                               Lumbar spine fusion............  ..............  ..............  ..............  ..............  ..............
  22585  C                               Additional spinal fusion.......  ..............  ..............  ..............  ..............  ..............

[[Page 18570]]

 
  22590  C                               Spine & skull spinal fusion....  ..............  ..............  ..............  ..............  ..............
  22595  C                               Neck spinal fusion.............  ..............  ..............  ..............  ..............  ..............
  22600  C                               Neck spine fusion..............  ..............  ..............  ..............  ..............  ..............
  22610  C                               Thorax spine fusion............  ..............  ..............  ..............  ..............  ..............
  22612  C                               Lumbar spine fusion............  ..............  ..............  ..............  ..............  ..............
  22614  C                               Spine fusion, extra segment....  ..............  ..............  ..............  ..............  ..............
  22630  C                               Lumbar spine fusion............  ..............  ..............  ..............  ..............  ..............
  22632  C                               Spine fusion, extra segment....  ..............  ..............  ..............  ..............  ..............
  22800  C                               Fusion of spine................  ..............  ..............  ..............  ..............  ..............
  22802  C                               Fusion of spine................  ..............  ..............  ..............  ..............  ..............
  22804  C                               Fusion of spine................  ..............  ..............  ..............  ..............  ..............
  22808  C                               Fusion of spine................  ..............  ..............  ..............  ..............  ..............
  22810  C                               Fusion of spine................  ..............  ..............  ..............  ..............  ..............
  22812  C                               Fusion of spine................  ..............  ..............  ..............  ..............  ..............
  22818  C                               Kyphectomy, 1-2 segments.......  ..............  ..............  ..............  ..............  ..............
  22819  C                               Kyphectomy, 3 or more..........  ..............  ..............  ..............  ..............  ..............
  22830  C                               Exploration of spinal fusion...  ..............  ..............  ..............  ..............  ..............
  22840  C                               Insert spine fixation device...  ..............  ..............  ..............  ..............  ..............
  22841  C                               Insert spine fixation device...  ..............  ..............  ..............  ..............  ..............
  22842  C                               Insert spine fixation device...  ..............  ..............  ..............  ..............  ..............
  22843  C                               Insert spine fixation device...  ..............  ..............  ..............  ..............  ..............
  22844  C                               Insert spine fixation device...  ..............  ..............  ..............  ..............  ..............
  22845  C                               Insert spine fixation device...  ..............  ..............  ..............  ..............  ..............
  22846  C                               Insert spine fixation device...  ..............  ..............  ..............  ..............  ..............
  22847  C                               Insert spine fixation device...  ..............  ..............  ..............  ..............  ..............
  22848  C                               Insert pelv fixation device....  ..............  ..............  ..............  ..............  ..............
  22849  C                               Reinsert spinal fixation.......  ..............  ..............  ..............  ..............  ..............
  22850  C                               Remove spine fixation device...  ..............  ..............  ..............  ..............  ..............
  22851  C                               Apply spine prosth device......  ..............  ..............  ..............  ..............  ..............
  22852  C                               Remove spine fixation device...  ..............  ..............  ..............  ..............  ..............
  22855  C                               Remove spine fixation device...  ..............  ..............  ..............  ..............  ..............
  22899  T                               Spine surgery procedure........            0043            1.64          $79.52          $25.46          $15.90
  22900  T                               Remove abdominal wall lesion...            0022           12.49         $605.60         $292.94         $121.12
  22999  T                               Abdomen surgery procedure......            0022           12.49         $605.60         $292.94         $121.12
  23000  T                               Removal of calcium deposits....            0021           10.49         $508.63         $236.51         $101.73
  23020  T                               Release shoulder joint.........            0051           27.76       $1,346.00         $675.24         $269.20
  23030  T                               Drain shoulder lesion..........            0008            6.15         $298.20         $113.67          $59.64
  23031  T                               Drain shoulder bursa...........            0008            6.15         $298.20         $113.67          $59.64
  23035  C                               Drain shoulder bone lesion.....  ..............  ..............  ..............  ..............  ..............
  23040  T                               Exploratory shoulder surgery...            0050           21.13       $1,024.53         $513.86         $204.91
  23044  T                               Exploratory shoulder surgery...            0050           21.13       $1,024.53         $513.86         $204.91
  23065  T                               Biopsy shoulder tissues........            0021           10.49         $508.63         $236.51         $101.73
  23066  T                               Biopsy shoulder tissues........            0022           12.49         $605.60         $292.94         $121.12
  23075  T                               Removal of shoulder lesion.....            0021           10.49         $508.63         $236.51         $101.73
  23076  T                               Removal of shoulder lesion.....            0022           12.49         $605.60         $292.94         $121.12
  23077  T                               Remove tumor of shoulder.......            0022           12.49         $605.60         $292.94         $121.12
  23100  T                               Biopsy of shoulder joint.......            0049           15.04         $729.25         $356.95         $145.85
  23101  T                               Shoulder joint surgery.........            0050           21.13       $1,024.53         $513.86         $204.91
  23105  T                               Remove shoulder joint lining...            0050           21.13       $1,024.53         $513.86         $204.91
  23106  T                               Incision of collarbone joint...            0050           21.13       $1,024.53         $513.86         $204.91
  23107  T                               Explore treat shoulder joint...            0050           21.13       $1,024.53         $513.86         $204.91
  23120  T                               Partial removal, collar bone...            0051           27.76       $1,346.00         $675.24         $269.20
  23125  C                               Removal of collar bone.........  ..............  ..............  ..............  ..............  ..............
  23130  T                               Remove shoulder bone, part.....            0051           27.76       $1,346.00         $675.24         $269.20
  23140  T                               Removal of bone lesion.........            0049           15.04         $729.25         $356.95         $145.85
  23145  T                               Removal of bone lesion.........            0050           21.13       $1,024.53         $513.86         $204.91
  23146  T                               Removal of bone lesion.........            0050           21.13       $1,024.53         $513.86         $204.91
  23150  T                               Removal of humerus lesion......            0050           21.13       $1,024.53         $513.86         $204.91
  23155  T                               Removal of humerus lesion......            0050           21.13       $1,024.53         $513.86         $204.91
  23156  T                               Removal of humerus lesion......            0050           21.13       $1,024.53         $513.86         $204.91
  23170  T                               Remove collar bone lesion......            0050           21.13       $1,024.53         $513.86         $204.91
  23172  T                               Remove shoulder blade lesion...            0050           21.13       $1,024.53         $513.86         $204.91
  23174  T                               Remove humerus lesion..........            0050           21.13       $1,024.53         $513.86         $204.91
  23180  T                               Remove collar bone lesion......            0050           21.13       $1,024.53         $513.86         $204.91
  23182  T                               Remove shoulder blade lesion...            0050           21.13       $1,024.53         $513.86         $204.91
  23184  T                               Remove humerus lesion..........            0050           21.13       $1,024.53         $513.86         $204.91
  23190  T                               Partial removal of scapula.....            0050           21.13       $1,024.53         $513.86         $204.91
  23195  C                               Removal of head of humerus.....  ..............  ..............  ..............  ..............  ..............
  23200  C                               Removal of collar bone.........  ..............  ..............  ..............  ..............  ..............
  23210  C                               Removal of shoulder blade......  ..............  ..............  ..............  ..............  ..............
  23220  C                               Partial removal of humerus.....  ..............  ..............  ..............  ..............  ..............
  23221  C                               Partial removal of humerus.....  ..............  ..............  ..............  ..............  ..............
  23222  C                               Partial removal of humerus.....  ..............  ..............  ..............  ..............  ..............

[[Page 18571]]

 
  23330  T                               Remove shoulder foreign body...            0019            4.00         $193.95          $78.91          $38.79
  23331  T                               Remove shoulder foreign body...            0022           12.49         $605.60         $292.94         $121.12
  23332  C                               Remove shoulder foreign body...  ..............  ..............  ..............  ..............  ..............
  23350  N                               Injection for shoulder x-ray...  ..............  ..............  ..............  ..............  ..............
  23395  C                               Muscle transfer, shoulder/arm..  ..............  ..............  ..............  ..............  ..............
  23397  C                               Muscle transfers...............  ..............  ..............  ..............  ..............  ..............
  23400  C                               Fixation of shoulder blade.....  ..............  ..............  ..............  ..............  ..............
  23405  T                               Incision of tendon & muscle....            0050           21.13       $1,024.53         $513.86         $204.91
  23406  T                               Incise tendon(s) & muscle(s)...            0050           21.13       $1,024.53         $513.86         $204.91
  23410  T                               Repair of tendon(s)............            0052           36.16       $1,753.29         $930.91         $350.66
  23412  T                               Repair of tendon(s)............            0052           36.16       $1,753.29         $930.91         $350.66
  23415  T                               Release of shoulder ligament...            0051           27.76       $1,346.00         $675.24         $269.20
  23420  T                               Repair of shoulder.............            0052           36.16       $1,753.29         $930.91         $350.66
  23430  T                               Repair biceps tendon...........            0052           36.16       $1,753.29         $930.91         $350.66
  23440  C                               Remove/transplant tendon.......  ..............  ..............  ..............  ..............  ..............
  23450  T                               Repair shoulder capsule........            0052           36.16       $1,753.29         $930.91         $350.66
  23455  T                               Repair shoulder capsule........            0052           36.16       $1,753.29         $930.91         $350.66
  23460  T                               Repair shoulder capsule........            0052           36.16       $1,753.29         $930.91         $350.66
  23462  T                               Repair shoulder capsule........            0052           36.16       $1,753.29         $930.91         $350.66
  23465  T                               Repair shoulder capsule........            0052           36.16       $1,753.29         $930.91         $350.66
  23466  T                               Repair shoulder capsule........            0052           36.16       $1,753.29         $930.91         $350.66
  23470  C                               Reconstruct shoulder joint.....  ..............  ..............  ..............  ..............  ..............
  23472  C                               Reconstruct shoulder joint.....  ..............  ..............  ..............  ..............  ..............
  23480  T                               Revision of collar bone........            0051           27.76       $1,346.00         $675.24         $269.20
  23485  T                               Revision of collar bone........            0051           27.76       $1,346.00         $675.24         $269.20
  23490  T                               Reinforce clavicle.............            0051           27.76       $1,346.00         $675.24         $269.20
  23491  T                               Reinforce shoulder bones.......            0051           27.76       $1,346.00         $675.24         $269.20
  23500  T                               Treat clavicle fracture........            0043            1.64          $79.52          $25.46          $15.90
  23505  T                               Treat clavicle fracture........            0043            1.64          $79.52          $25.46          $15.90
  23515  T                               Treat clavicle fracture........            0046           22.29       $1,080.78         $535.76         $216.16
  23520  T                               Treat clavicle dislocation.....            0043            1.64          $79.52          $25.46          $15.90
  23525  T                               Treat clavicle dislocation.....            0043            1.64          $79.52          $25.46          $15.90
  23530  T                               Treat clavicle dislocation.....            0046           22.29       $1,080.78         $535.76         $216.16
  23532  T                               Treat clavicle dislocation.....            0046           22.29       $1,080.78         $535.76         $216.16
  23540  T                               Treat clavicle dislocation.....            0043            1.64          $79.52          $25.46          $15.90
  23545  T                               Treat clavicle dislocation.....            0043            1.64          $79.52          $25.46          $15.90
  23550  T                               Treat clavicle dislocation.....            0046           22.29       $1,080.78         $535.76         $216.16
  23552  T                               Treat clavicle dislocation.....            0046           22.29       $1,080.78         $535.76         $216.16
  23570  T                               Treat shoulder blade fx........            0043            1.64          $79.52          $25.46          $15.90
  23575  T                               Treat shoulder blade fx........            0043            1.64          $79.52          $25.46          $15.90
  23585  T                               Treat scapula fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  23600  T                               Treat humerus fracture.........            0044            2.17         $105.22          $38.08          $21.04
  23605  T                               Treat humerus fracture.........            0044            2.17         $105.22          $38.08          $21.04
  23615  T                               Treat humerus fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  23616  T                               Treat humerus fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  23620  T                               Treat humerus fracture.........            0044            2.17         $105.22          $38.08          $21.04
  23625  T                               Treat humerus fracture.........            0044            2.17         $105.22          $38.08          $21.04
  23630  T                               Treat humerus fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  23650  T                               Treat shoulder dislocation.....            0043            1.64          $79.52          $25.46          $15.90
  23655  T                               Treat shoulder dislocation.....            0045           11.02         $534.33         $277.12         $106.87
  23660  T                               Treat shoulder dislocation.....            0046           22.29       $1,080.78         $535.76         $216.16
  23665  T                               Treat dislocation/fracture.....            0044            2.17         $105.22          $38.08          $21.04
  23670  T                               Treat dislocation/fracture.....            0046           22.29       $1,080.78         $535.76         $216.16
  23675  T                               Treat dislocation/fracture.....            0044            2.17         $105.22          $38.08          $21.04
  23680  T                               Treat dislocation/fracture.....            0046           22.29       $1,080.78         $535.76         $216.16
  23700  T                               Fixation of shoulder...........            0045           11.02         $534.33         $277.12         $106.87
  23800  T                               Fusion of shoulder joint.......            0051           27.76       $1,346.00         $675.24         $269.20
  23802  T                               Fusion of shoulder joint.......            0051           27.76       $1,346.00         $675.24         $269.20
  23900  C                               Amputation of arm & girdle.....  ..............  ..............  ..............  ..............  ..............
  23920  C                               Amputation at shoulder joint...  ..............  ..............  ..............  ..............  ..............
  23921  T                               Amputation follow-up surgery...            0026           12.11         $587.18         $277.92         $117.44
  23929  T                               Shoulder surgery procedure.....            0043            1.64          $79.52          $25.46          $15.90
  23930  T                               Drainage of arm lesion.........            0008            6.15         $298.20         $113.67          $59.64
  23931  T                               Drainage of arm bursa..........            0008            6.15         $298.20         $113.67          $59.64
  23935  T                               Drain arm/elbow bone lesion....            0049           15.04         $729.25         $356.95         $145.85
  24000  T                               Exploratory elbow surgery......            0050           21.13       $1,024.53         $513.86         $204.91
  24006  T                               Release elbow joint............            0050           21.13       $1,024.53         $513.86         $204.91
  24065  T                               Biopsy arm/elbow soft tissue...            0020            6.51         $315.65         $130.53          $63.13
  24066  T                               Biopsy arm/elbow soft tissue...            0020            6.51         $315.65         $130.53          $63.13
  24075  T                               Remove arm/elbow lesion........            0021           10.49         $508.63         $236.51         $101.73
  24076  T                               Remove arm/elbow lesion........            0022           12.49         $605.60         $292.94         $121.12
  24077  T                               Remove tumor of arm/elbow......            0022           12.49         $605.60         $292.94         $121.12
  24100  T                               Biopsy elbow joint lining......            0049           15.04         $729.25         $356.95         $145.85

[[Page 18572]]

 
  24101  T                               Explore/treat elbow joint......            0050           21.13       $1,024.53         $513.86         $204.91
  24102  T                               Remove elbow joint lining......            0050           21.13       $1,024.53         $513.86         $204.91
  24105  T                               Removal of elbow bursa.........            0049           15.04         $729.25         $356.95         $145.85
  24110  T                               Remove humerus lesion..........            0049           15.04         $729.25         $356.95         $145.85
  24115  T                               Remove/graft bone lesion.......            0050           21.13       $1,024.53         $513.86         $204.91
  24116  T                               Remove/graft bone lesion.......            0050           21.13       $1,024.53         $513.86         $204.91
  24120  T                               Remove elbow lesion............            0049           15.04         $729.25         $356.95         $145.85
  24125  T                               Remove/graft bone lesion.......            0050           21.13       $1,024.53         $513.86         $204.91
  24126  T                               Remove/graft bone lesion.......            0050           21.13       $1,024.53         $513.86         $204.91
  24130  T                               Removal of head of radius......            0050           21.13       $1,024.53         $513.86         $204.91
  24134  T                               Removal of arm bone lesion.....            0050           21.13       $1,024.53         $513.86         $204.91
  24136  T                               Remove radius bone lesion......            0050           21.13       $1,024.53         $513.86         $204.91
  24138  T                               Remove elbow bone lesion.......            0050           21.13       $1,024.53         $513.86         $204.91
  24140  T                               Partial removal of arm bone....            0050           21.13       $1,024.53         $513.86         $204.91
  24145  T                               Partial removal of radius......            0050           21.13       $1,024.53         $513.86         $204.91
  24147  T                               Partial removal of elbow.......            0050           21.13       $1,024.53         $513.86         $204.91
  24149  C                               Radical resection of elbow.....  ..............  ..............  ..............  ..............  ..............
  24150  C                               Extensive humerus surgery......  ..............  ..............  ..............  ..............  ..............
  24151  C                               Extensive humerus surgery......  ..............  ..............  ..............  ..............  ..............
  24152  C                               Extensive radius surgery.......  ..............  ..............  ..............  ..............  ..............
  24153  C                               Extensive radius surgery.......  ..............  ..............  ..............  ..............  ..............
  24155  T                               Removal of elbow joint.........            0051           27.76       $1,346.00         $675.24         $269.20
  24160  T                               Remove elbow joint implant.....            0050           21.13       $1,024.53         $513.86         $204.91
  24164  T                               Remove radius head implant.....            0050           21.13       $1,024.53         $513.86         $204.91
  24200  T                               Removal of arm foreign body....            0019            4.00         $193.95          $78.91          $38.79
  24201  T                               Removal of arm foreign body....            0021           10.49         $508.63         $236.51         $101.73
  24220  N                               Injection for elbow x-ray......  ..............  ..............  ..............  ..............  ..............
  24301  T                               Muscle/tendon transfer.........            0050           21.13       $1,024.53         $513.86         $204.91
  24305  T                               Arm tendon lengthening.........            0050           21.13       $1,024.53         $513.86         $204.91
  24310  T                               Revision of arm tendon.........            0049           15.04         $729.25         $356.95         $145.85
  24320  T                               Repair of arm tendon...........            0051           27.76       $1,346.00         $675.24         $269.20
  24330  T                               Revision of arm muscles........            0051           27.76       $1,346.00         $675.24         $269.20
  24331  T                               Revision of arm muscles........            0051           27.76       $1,346.00         $675.24         $269.20
  24340  T                               Repair of biceps tendon........            0051           27.76       $1,346.00         $675.24         $269.20
  24341  T                               Repair arm tendon/muscle.......            0051           27.76       $1,346.00         $675.24         $269.20
  24342  T                               Repair of ruptured tendon......            0051           27.76       $1,346.00         $675.24         $269.20
  24350  T                               Repair of tennis elbow.........            0050           21.13       $1,024.53         $513.86         $204.91
  24351  T                               Repair of tennis elbow.........            0050           21.13       $1,024.53         $513.86         $204.91
  24352  T                               Repair of tennis elbow.........            0050           21.13       $1,024.53         $513.86         $204.91
  24354  T                               Repair of tennis elbow.........            0050           21.13       $1,024.53         $513.86         $204.91
  24356  T                               Revision of tennis elbow.......            0050           21.13       $1,024.53         $513.86         $204.91
  24360  T                               Reconstruct elbow joint........            0047           22.09       $1,071.08         $537.03         $214.22
  24361  T                               Reconstruct elbow joint........            0048           29.06       $1,409.03         $725.94         $281.81
  24362  T                               Reconstruct elbow joint........            0048           29.06       $1,409.03         $725.94         $281.81
  24363  T                               Replace elbow joint............            0048           29.06       $1,409.03         $725.94         $281.81
  24365  T                               Reconstruct head of radius.....            0047           22.09       $1,071.08         $537.03         $214.22
  24366  T                               Reconstruct head of radius.....            0048           29.06       $1,409.03         $725.94         $281.81
  24400  T                               Revision of humerus............            0050           21.13       $1,024.53         $513.86         $204.91
  24410  T                               Revision of humerus............            0050           21.13       $1,024.53         $513.86         $204.91
  24420  T                               Revision of humerus............            0051           27.76       $1,346.00         $675.24         $269.20
  24430  T                               Repair of humerus..............            0051           27.76       $1,346.00         $675.24         $269.20
  24435  T                               Repair humerus with graft......            0051           27.76       $1,346.00         $675.24         $269.20
  24470  T                               Revision of elbow joint........            0051           27.76       $1,346.00         $675.24         $269.20
  24495  T                               Decompression of forearm.......            0050           21.13       $1,024.53         $513.86         $204.91
  24498  T                               Reinforce humerus..............            0051           27.76       $1,346.00         $675.24         $269.20
  24500  T                               Treat humerus fracture.........            0044            2.17         $105.22          $38.08          $21.04
  24505  T                               Treat humerus fracture.........            0044            2.17         $105.22          $38.08          $21.04
  24515  T                               Treat humerus fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  24516  T                               Treat humerus fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  24530  T                               Treat humerus fracture.........            0044            2.17         $105.22          $38.08          $21.04
  24535  T                               Treat humerus fracture.........            0044            2.17         $105.22          $38.08          $21.04
  24538  T                               Treat humerus fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  24545  T                               Treat humerus fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  24546  T                               Treat humerus fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  24560  T                               Treat humerus fracture.........            0044            2.17         $105.22          $38.08          $21.04
  24565  T                               Treat humerus fracture.........            0044            2.17         $105.22          $38.08          $21.04
  24566  T                               Treat humerus fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  24575  T                               Treat humerus fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  24576  T                               Treat humerus fracture.........            0044            2.17         $105.22          $38.08          $21.04
  24577  T                               Treat humerus fracture.........            0044            2.17         $105.22          $38.08          $21.04
  24579  T                               Treat humerus fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  24582  T                               Treat humerus fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  24586  T                               Treat elbow fracture...........            0046           22.29       $1,080.78         $535.76         $216.16

[[Page 18573]]

 
  24587  T                               Treat elbow fracture...........            0046           22.29       $1,080.78         $535.76         $216.16
  24600  T                               Treat elbow dislocation........            0044            2.17         $105.22          $38.08          $21.04
  24605  T                               Treat elbow dislocation........            0045           11.02         $534.33         $277.12         $106.87
  24615  T                               Treat elbow dislocation........            0046           22.29       $1,080.78         $535.76         $216.16
  24620  T                               Treat elbow fracture...........            0044            2.17         $105.22          $38.08          $21.04
  24635  T                               Treat elbow fracture...........            0046           22.29       $1,080.78         $535.76         $216.16
  24640  T                               Treat elbow dislocation........            0044            2.17         $105.22          $38.08          $21.04
  24650  T                               Treat radius fracture..........            0044            2.17         $105.22          $38.08          $21.04
  24655  T                               Treat radius fracture..........            0044            2.17         $105.22          $38.08          $21.04
  24665  T                               Treat radius fracture..........            0046           22.29       $1,080.78         $535.76         $216.16
  24666  T                               Treat radius fracture..........            0046           22.29       $1,080.78         $535.76         $216.16
  24670  T                               Treat ulnar fracture...........            0044            2.17         $105.22          $38.08          $21.04
  24675  T                               Treat ulnar fracture...........            0044            2.17         $105.22          $38.08          $21.04
  24685  T                               Treat ulnar fracture...........            0046           22.29       $1,080.78         $535.76         $216.16
  24800  T                               Fusion of elbow joint..........            0051           27.76       $1,346.00         $675.24         $269.20
  24802  T                               Fusion/graft of elbow joint....            0051           27.76       $1,346.00         $675.24         $269.20
  24900  C                               Amputation of upper arm........  ..............  ..............  ..............  ..............  ..............
  24920  C                               Amputation of upper arm........  ..............  ..............  ..............  ..............  ..............
  24925  T                               Amputation follow-up surgery...            0049           15.04         $729.25         $356.95         $145.85
  24930  C                               Amputation follow-up surgery...  ..............  ..............  ..............  ..............  ..............
  24931  C                               Amputate upper arm & implant...  ..............  ..............  ..............  ..............  ..............
  24935  T                               Revision of amputation.........            0052           36.16       $1,753.29         $930.91         $350.66
  24940  C                               Revision of upper arm..........  ..............  ..............  ..............  ..............  ..............
  24999  T                               Upper arm/elbow surgery........            0044            2.17         $105.22          $38.08          $21.04
  25000  T                               Incision of tendon sheath......            0049           15.04         $729.25         $356.95         $145.85
  25020  T                               Decompression of forearm.......            0049           15.04         $729.25         $356.95         $145.85
  25023  T                               Decompression of forearm.......            0050           21.13       $1,024.53         $513.86         $204.91
  25028  T                               Drainage of forearm lesion.....            0049           15.04         $729.25         $356.95         $145.85
  25031  T                               Drainage of forearm bursa......            0049           15.04         $729.25         $356.95         $145.85
  25035  T                               Treat forearm bone lesion......            0049           15.04         $729.25         $356.95         $145.85
  25040  T                               Explore/treat wrist joint......            0050           21.13       $1,024.53         $513.86         $204.91
  25065  T                               Biopsy forearm soft tissues....            0020            6.51         $315.65         $130.53          $63.13
  25066  T                               Biopsy forearm soft tissues....            0022           12.49         $605.60         $292.94         $121.12
  25075  T                               Removal of forearm lesion......            0020            6.51         $315.65         $130.53          $63.13
  25076  T                               Removal of forearm lesion......            0022           12.49         $605.60         $292.94         $121.12
  25077  T                               Remove tumor, forearm/wrist....            0022           12.49         $605.60         $292.94         $121.12
  25085  T                               Incision of wrist capsule......            0049           15.04         $729.25         $356.95         $145.85
  25100  T                               Biopsy of wrist joint..........            0049           15.04         $729.25         $356.95         $145.85
  25101  T                               Explore/treat wrist joint......            0050           21.13       $1,024.53         $513.86         $204.91
  25105  T                               Remove wrist joint lining......            0050           21.13       $1,024.53         $513.86         $204.91
  25107  T                               Remove wrist joint cartilage...            0050           21.13       $1,024.53         $513.86         $204.91
  25110  T                               Remove wrist tendon lesion.....            0049           15.04         $729.25         $356.95         $145.85
  25111  T                               Remove wrist tendon lesion.....            0053           11.32         $548.87         $253.49         $109.77
  25112  T                               Reremove wrist tendon lesion...            0053           11.32         $548.87         $253.49         $109.77
  25115  T                               Remove wrist/forearm lesion....            0049           15.04         $729.25         $356.95         $145.85
  25116  T                               Remove wrist/forearm lesion....            0049           15.04         $729.25         $356.95         $145.85
  25118  T                               Excise wrist tendon sheath.....            0050           21.13       $1,024.53         $513.86         $204.91
  25119  T                               Partial removal of ulna........            0050           21.13       $1,024.53         $513.86         $204.91
  25120  T                               Removal of forearm lesion......            0050           21.13       $1,024.53         $513.86         $204.91
  25125  T                               Remove/graft forearm lesion....            0050           21.13       $1,024.53         $513.86         $204.91
  25126  T                               Remove/graft forearm lesion....            0050           21.13       $1,024.53         $513.86         $204.91
  25130  T                               Removal of wrist lesion........            0050           21.13       $1,024.53         $513.86         $204.91
  25135  T                               Remove & graft wrist lesion....            0050           21.13       $1,024.53         $513.86         $204.91
  25136  T                               Remove & graft wrist lesion....            0050           21.13       $1,024.53         $513.86         $204.91
  25145  T                               Remove forearm bone lesion.....            0050           21.13       $1,024.53         $513.86         $204.91
  25150  T                               Partial removal of ulna........            0050           21.13       $1,024.53         $513.86         $204.91
  25151  T                               Partial removal of radius......            0050           21.13       $1,024.53         $513.86         $204.91
  25170  C                               Extensive forearm surgery......  ..............  ..............  ..............  ..............  ..............
  25210  T                               Removal of wrist bone..........            0054           19.66         $953.26         $472.33         $190.65
  25215  T                               Removal of wrist bones.........            0054           19.66         $953.26         $472.33         $190.65
  25230  T                               Partial removal of radius......            0050           21.13       $1,024.53         $513.86         $204.91
  25240  T                               Partial removal of ulna........            0050           21.13       $1,024.53         $513.86         $204.91
  25246  N                               Injection for wrist x-ray......  ..............  ..............  ..............  ..............  ..............
  25248  T                               Remove forearm foreign body....            0049           15.04         $729.25         $356.95         $145.85
  25250  T                               Removal of wrist prosthesis....            0050           21.13       $1,024.53         $513.86         $204.91
  25251  T                               Removal of wrist prosthesis....            0050           21.13       $1,024.53         $513.86         $204.91
  25260  T                               Repair forearm tendon/muscle...            0050           21.13       $1,024.53         $513.86         $204.91
  25263  T                               Repair forearm tendon/muscle...            0050           21.13       $1,024.53         $513.86         $204.91
  25265  T                               Repair forearm tendon/muscle...            0050           21.13       $1,024.53         $513.86         $204.91
  25270  T                               Repair forearm tendon/muscle...            0050           21.13       $1,024.53         $513.86         $204.91
  25272  T                               Repair forearm tendon/muscle...            0050           21.13       $1,024.53         $513.86         $204.91
  25274  T                               Repair forearm tendon/muscle...            0050           21.13       $1,024.53         $513.86         $204.91
  25280  T                               Revise wrist/forearm tendon....            0050           21.13       $1,024.53         $513.86         $204.91

[[Page 18574]]

 
  25290  T                               Incise wrist/forearm tendon....            0050           21.13       $1,024.53         $513.86         $204.91
  25295  T                               Release wrist/forearm tendon...            0049           15.04         $729.25         $356.95         $145.85
  25300  T                               Fusion of tendons at wrist.....            0050           21.13       $1,024.53         $513.86         $204.91
  25301  T                               Fusion of tendons at wrist.....            0050           21.13       $1,024.53         $513.86         $204.91
  25310  T                               Transplant forearm tendon......            0051           27.76       $1,346.00         $675.24         $269.20
  25312  T                               Transplant forearm tendon......            0051           27.76       $1,346.00         $675.24         $269.20
  25315  T                               Revise palsy hand tendon(s)....            0051           27.76       $1,346.00         $675.24         $269.20
  25316  T                               Revise palsy hand tendon(s)....            0051           27.76       $1,346.00         $675.24         $269.20
  25320  T                               Repair/revise wrist joint......            0051           27.76       $1,346.00         $675.24         $269.20
  25332  T                               Revise wrist joint.............            0047           22.09       $1,071.08         $537.03         $214.22
  25335  T                               Realignment of hand............            0051           27.76       $1,346.00         $675.24         $269.20
  25337  T                               Reconstruct ulna/radioulnar....            0051           27.76       $1,346.00         $675.24         $269.20
  25350  T                               Revision of radius.............            0051           27.76       $1,346.00         $675.24         $269.20
  25355  T                               Revision of radius.............            0051           27.76       $1,346.00         $675.24         $269.20
  25360  T                               Revision of ulna...............            0050           21.13       $1,024.53         $513.86         $204.91
  25365  T                               Revise radius & ulna...........            0050           21.13       $1,024.53         $513.86         $204.91
  25370  T                               Revise radius or ulna..........            0051           27.76       $1,346.00         $675.24         $269.20
  25375  T                               Revise radius & ulna...........            0051           27.76       $1,346.00         $675.24         $269.20
  25390  C                               Shorten radius or ulna.........  ..............  ..............  ..............  ..............  ..............
  25391  C                               Lengthen radius or ulna........  ..............  ..............  ..............  ..............  ..............
  25392  C                               Shorten radius & ulna..........  ..............  ..............  ..............  ..............  ..............
  25393  C                               Lengthen radius & ulna.........  ..............  ..............  ..............  ..............  ..............
  25400  T                               Repair radius or ulna..........            0050           21.13       $1,024.53         $513.86         $204.91
  25405  C                               Repair/graft radius or ulna....  ..............  ..............  ..............  ..............  ..............
  25415  T                               Repair radius & ulna...........            0050           21.13       $1,024.53         $513.86         $204.91
  25420  C                               Repair/graft radius & ulna.....  ..............  ..............  ..............  ..............  ..............
  25425  T                               Repair/graft radius or ulna....            0051           27.76       $1,346.00         $675.24         $269.20
  25426  T                               Repair/graft radius & ulna.....            0051           27.76       $1,346.00         $675.24         $269.20
  25440  T                               Repair/graft wrist bone........            0051           27.76       $1,346.00         $675.24         $269.20
  25441  T                               Reconstruct wrist joint........            0048           29.06       $1,409.03         $725.94         $281.81
  25442  T                               Reconstruct wrist joint........            0048           29.06       $1,409.03         $725.94         $281.81
  25443  T                               Reconstruct wrist joint........            0048           29.06       $1,409.03         $725.94         $281.81
  25444  T                               Reconstruct wrist joint........            0048           29.06       $1,409.03         $725.94         $281.81
  25445  T                               Reconstruct wrist joint........            0048           29.06       $1,409.03         $725.94         $281.81
  25446  T                               Wrist replacement..............            0048           29.06       $1,409.03         $725.94         $281.81
  25447  T                               Repair wrist joint(s)..........            0047           22.09       $1,071.08         $537.03         $214.22
  25449  T                               Remove wrist joint implant.....            0047           22.09       $1,071.08         $537.03         $214.22
  25450  T                               Revision of wrist joint........            0051           27.76       $1,346.00         $675.24         $269.20
  25455  T                               Revision of wrist joint........            0051           27.76       $1,346.00         $675.24         $269.20
  25490  T                               Reinforce radius...............            0051           27.76       $1,346.00         $675.24         $269.20
  25491  T                               Reinforce ulna.................            0051           27.76       $1,346.00         $675.24         $269.20
  25492  T                               Reinforce radius and ulna......            0051           27.76       $1,346.00         $675.24         $269.20
  25500  T                               Treat fracture of radius.......            0044            2.17         $105.22          $38.08          $21.04
  25505  T                               Treat fracture of radius.......            0044            2.17         $105.22          $38.08          $21.04
  25515  T                               Treat fracture of radius.......            0046           22.29       $1,080.78         $535.76         $216.16
  25520  T                               Treat fracture of radius.......            0044            2.17         $105.22          $38.08          $21.04
  25525  T                               Treat fracture of radius.......            0046           22.29       $1,080.78         $535.76         $216.16
  25526  T                               Treat fracture of radius.......            0046           22.29       $1,080.78         $535.76         $216.16
  25530  T                               Treat fracture of ulna.........            0044            2.17         $105.22          $38.08          $21.04
  25535  T                               Treat fracture of ulna.........            0044            2.17         $105.22          $38.08          $21.04
  25545  T                               Treat fracture of ulna.........            0046           22.29       $1,080.78         $535.76         $216.16
  25560  T                               Treat fracture radius & ulna...            0044            2.17         $105.22          $38.08          $21.04
  25565  T                               Treat fracture radius & ulna...            0044            2.17         $105.22          $38.08          $21.04
  25574  T                               Treat fracture radius & ulna...            0046           22.29       $1,080.78         $535.76         $216.16
  25575  T                               Treat fracture radius/ulna.....            0046           22.29       $1,080.78         $535.76         $216.16
  25600  T                               Treat fracture radius/ulna.....            0044            2.17         $105.22          $38.08          $21.04
  25605  T                               Treat fracture radius/ulna.....            0044            2.17         $105.22          $38.08          $21.04
  25611  T                               Treat fracture radius/ulna.....            0046           22.29       $1,080.78         $535.76         $216.16
  25620  T                               Treat fracture radius/ulna.....            0046           22.29       $1,080.78         $535.76         $216.16
  25622  T                               Treat wrist bone fracture......            0044            2.17         $105.22          $38.08          $21.04
  25624  T                               Treat wrist bone fracture......            0044            2.17         $105.22          $38.08          $21.04
  25628  T                               Treat wrist bone fracture......            0046           22.29       $1,080.78         $535.76         $216.16
  25630  T                               Treat wrist bone fracture......            0044            2.17         $105.22          $38.08          $21.04
  25635  T                               Treat wrist bone fracture......            0044            2.17         $105.22          $38.08          $21.04
  25645  T                               Treat wrist bone fracture......            0046           22.29       $1,080.78         $535.76         $216.16
  25650  T                               Treat wrist bone fracture......            0044            2.17         $105.22          $38.08          $21.04
  25660  T                               Treat wrist dislocation........            0044            2.17         $105.22          $38.08          $21.04
  25670  T                               Treat wrist dislocation........            0046           22.29       $1,080.78         $535.76         $216.16
  25675  T                               Treat wrist dislocation........            0044            2.17         $105.22          $38.08          $21.04
  25676  T                               Treat wrist dislocation........            0046           22.29       $1,080.78         $535.76         $216.16
  25680  T                               Treat wrist fracture...........            0044            2.17         $105.22          $38.08          $21.04
  25685  T                               Treat wrist fracture...........            0046           22.29       $1,080.78         $535.76         $216.16
  25690  T                               Treat wrist dislocation........            0044            2.17         $105.22          $38.08          $21.04

[[Page 18575]]

 
  25695  T                               Treat wrist dislocation........            0046           22.29       $1,080.78         $535.76         $216.16
  25800  T                               Fusion of wrist joint..........            0051           27.76       $1,346.00         $675.24         $269.20
  25805  T                               Fusion/graft of wrist joint....            0051           27.76       $1,346.00         $675.24         $269.20
  25810  T                               Fusion/graft of wrist joint....            0051           27.76       $1,346.00         $675.24         $269.20
  25820  T                               Fusion of hand bones...........            0053           11.32         $548.87         $253.49         $109.77
  25825  T                               Fuse hand bones with graft.....            0054           19.66         $953.26         $472.33         $190.65
  25830  T                               Fusion, radioulnar jnt/ulna....            0051           27.76       $1,346.00         $675.24         $269.20
  25900  C                               Amputation of forearm..........  ..............  ..............  ..............  ..............  ..............
  25905  C                               Amputation of forearm..........  ..............  ..............  ..............  ..............  ..............
  25907  T                               Amputation follow-up surgery...            0049           15.04         $729.25         $356.95         $145.85
  25909  C                               Amputation follow-up surgery...  ..............  ..............  ..............  ..............  ..............
  25915  C                               Amputation of forearm..........  ..............  ..............  ..............  ..............  ..............
  25920  C                               Amputate hand at wrist.........  ..............  ..............  ..............  ..............  ..............
  25922  T                               Amputate hand at wrist.........            0049           15.04         $729.25         $356.95         $145.85
  25924  C                               Amputation follow-up surgery...  ..............  ..............  ..............  ..............  ..............
  25927  C                               Amputation of hand.............  ..............  ..............  ..............  ..............  ..............
  25929  T                               Amputation follow-up surgery...            0026           12.11         $587.18         $277.92         $117.44
  25931  C                               Amputation follow-up surgery...  ..............  ..............  ..............  ..............  ..............
  25999  T                               Forearm or wrist surgery.......            0044            2.17         $105.22          $38.08          $21.04
  26010  T                               Drainage of finger abscess.....            0006            2.00          $96.97          $33.95          $19.39
  26011  T                               Drainage of finger abscess.....            0007            3.68         $178.43          $72.03          $35.69
  26020  T                               Drain hand tendon sheath.......            0053           11.32         $548.87         $253.49         $109.77
  26025  T                               Drainage of palm bursa.........            0053           11.32         $548.87         $253.49         $109.77
  26030  T                               Drainage of palm bursa(s)......            0053           11.32         $548.87         $253.49         $109.77
  26034  T                               Treat hand bone lesion.........            0053           11.32         $548.87         $253.49         $109.77
  26035  T                               Decompress fingers/hand........            0053           11.32         $548.87         $253.49         $109.77
  26037  T                               Decompress fingers/hand........            0053           11.32         $548.87         $253.49         $109.77
  26040  T                               Release palm contracture.......            0054           19.66         $953.26         $472.33         $190.65
  26045  T                               Release palm contracture.......            0054           19.66         $953.26         $472.33         $190.65
  26055  T                               Incise finger tendon sheath....            0053           11.32         $548.87         $253.49         $109.77
  26060  T                               Incision of finger tendon......            0053           11.32         $548.87         $253.49         $109.77
  26070  T                               Explore/treat hand joint.......            0053           11.32         $548.87         $253.49         $109.77
  26075  T                               Explore/treat finger joint.....            0053           11.32         $548.87         $253.49         $109.77
  26080  T                               Explore/treat finger joint.....            0053           11.32         $548.87         $253.49         $109.77
  26100  T                               Biopsy hand joint lining.......            0053           11.32         $548.87         $253.49         $109.77
  26105  T                               Biopsy finger joint lining.....            0053           11.32         $548.87         $253.49         $109.77
  26110  T                               Biopsy finger joint lining.....            0053           11.32         $548.87         $253.49         $109.77
  26115  T                               Removal of hand lesion.........            0022           12.49         $605.60         $292.94         $121.12
  26116  T                               Removal of hand lesion.........            0022           12.49         $605.60         $292.94         $121.12
  26117  T                               Remove tumor, hand/finger......            0022           12.49         $605.60         $292.94         $121.12
  26121  T                               Release palm contracture.......            0054           19.66         $953.26         $472.33         $190.65
  26123  T                               Release palm contracture.......            0054           19.66         $953.26         $472.33         $190.65
  26125  T                               Release palm contracture.......            0054           19.66         $953.26         $472.33         $190.65
  26130  T                               Remove wrist joint lining......            0053           11.32         $548.87         $253.49         $109.77
  26135  T                               Revise finger joint, each......            0054           19.66         $953.26         $472.33         $190.65
  26140  T                               Revise finger joint, each......            0053           11.32         $548.87         $253.49         $109.77
  26145  T                               Tendon excision, palm/finger...            0053           11.32         $548.87         $253.49         $109.77
  26160  T                               Remove tendon sheath lesion....            0053           11.32         $548.87         $253.49         $109.77
  26170  T                               Removal of palm tendon, each...            0053           11.32         $548.87         $253.49         $109.77
  26180  T                               Removal of finger tendon.......            0053           11.32         $548.87         $253.49         $109.77
  26185  T                               Remove finger bone.............            0053           11.32         $548.87         $253.49         $109.77
  26200  T                               Remove hand bone lesion........            0053           11.32         $548.87         $253.49         $109.77
  26205  T                               Remove/graft bone lesion.......            0054           19.66         $953.26         $472.33         $190.65
  26210  T                               Removal of finger lesion.......            0053           11.32         $548.87         $253.49         $109.77
  26215  T                               Remove/graft finger lesion.....            0053           11.32         $548.87         $253.49         $109.77
  26230  T                               Partial removal of hand bone...            0053           11.32         $548.87         $253.49         $109.77
  26235  T                               Partial removal, finger bone...            0053           11.32         $548.87         $253.49         $109.77
  26236  T                               Partial removal, finger bone...            0053           11.32         $548.87         $253.49         $109.77
  26250  T                               Extensive hand surgery.........            0053           11.32         $548.87         $253.49         $109.77
  26255  T                               Extensive hand surgery.........            0054           19.66         $953.26         $472.33         $190.65
  26260  T                               Extensive finger surgery.......            0053           11.32         $548.87         $253.49         $109.77
  26261  T                               Extensive finger surgery.......            0053           11.32         $548.87         $253.49         $109.77
  26262  T                               Partial removal of finger......            0053           11.32         $548.87         $253.49         $109.77
  26320  T                               Removal of implant from hand...            0020            6.51         $315.65         $130.53          $63.13
  26350  T                               Repair finger/hand tendon......            0054           19.66         $953.26         $472.33         $190.65
  26352  T                               Repair/graft hand tendon.......            0054           19.66         $953.26         $472.33         $190.65
  26356  T                               Repair finger/hand tendon......            0054           19.66         $953.26         $472.33         $190.65
  26357  T                               Repair finger/hand tendon......            0054           19.66         $953.26         $472.33         $190.65
  26358  T                               Repair/graft hand tendon.......            0054           19.66         $953.26         $472.33         $190.65
  26370  T                               Repair finger/hand tendon......            0054           19.66         $953.26         $472.33         $190.65
  26372  T                               Repair/graft hand tendon.......            0054           19.66         $953.26         $472.33         $190.65
  26373  T                               Repair finger/hand tendon......            0054           19.66         $953.26         $472.33         $190.65
  26390  T                               Revise hand/finger tendon......            0054           19.66         $953.26         $472.33         $190.65

[[Page 18576]]

 
  26392  T                               Repair/graft hand tendon.......            0054           19.66         $953.26         $472.33         $190.65
  26410  T                               Repair hand tendon.............            0053           11.32         $548.87         $253.49         $109.77
  26412  T                               Repair/graft hand tendon.......            0054           19.66         $953.26         $472.33         $190.65
  26415  T                               Excision, hand/finger tendon...            0054           19.66         $953.26         $472.33         $190.65
  26416  T                               Graft hand or finger tendon....            0054           19.66         $953.26         $472.33         $190.65
  26418  T                               Repair finger tendon...........            0053           11.32         $548.87         $253.49         $109.77
  26420  T                               Repair/graft finger tendon.....            0054           19.66         $953.26         $472.33         $190.65
  26426  T                               Repair finger/hand tendon......            0054           19.66         $953.26         $472.33         $190.65
  26428  T                               Repair/graft finger tendon.....            0054           19.66         $953.26         $472.33         $190.65
  26432  T                               Repair finger tendon...........            0053           11.32         $548.87         $253.49         $109.77
  26433  T                               Repair finger tendon...........            0053           11.32         $548.87         $253.49         $109.77
  26434  T                               Repair/graft finger tendon.....            0054           19.66         $953.26         $472.33         $190.65
  26437  T                               Realignment of tendons.........            0053           11.32         $548.87         $253.49         $109.77
  26440  T                               Release palm/finger tendon.....            0053           11.32         $548.87         $253.49         $109.77
  26442  T                               Release palm & finger tendon...            0054           19.66         $953.26         $472.33         $190.65
  26445  T                               Release hand/finger tendon.....            0053           11.32         $548.87         $253.49         $109.77
  26449  T                               Release forearm/hand tendon....            0054           19.66         $953.26         $472.33         $190.65
  26450  T                               Incision of palm tendon........            0053           11.32         $548.87         $253.49         $109.77
  26455  T                               Incision of finger tendon......            0053           11.32         $548.87         $253.49         $109.77
  26460  T                               Incise hand/finger tendon......            0053           11.32         $548.87         $253.49         $109.77
  26471  T                               Fusion of finger tendons.......            0053           11.32         $548.87         $253.49         $109.77
  26474  T                               Fusion of finger tendons.......            0053           11.32         $548.87         $253.49         $109.77
  26476  T                               Tendon lengthening.............            0053           11.32         $548.87         $253.49         $109.77
  26477  T                               Tendon shortening..............            0053           11.32         $548.87         $253.49         $109.77
  26478  T                               Lengthening of hand tendon.....            0053           11.32         $548.87         $253.49         $109.77
  26479  T                               Shortening of hand tendon......            0053           11.32         $548.87         $253.49         $109.77
  26480  T                               Transplant hand tendon.........            0054           19.66         $953.26         $472.33         $190.65
  26483  T                               Transplant/graft hand tendon...            0054           19.66         $953.26         $472.33         $190.65
  26485  T                               Transplant palm tendon.........            0054           19.66         $953.26         $472.33         $190.65
  26489  T                               Transplant/graft palm tendon...            0054           19.66         $953.26         $472.33         $190.65
  26490  T                               Revise thumb tendon............            0054           19.66         $953.26         $472.33         $190.65
  26492  T                               Tendon transfer with graft.....            0054           19.66         $953.26         $472.33         $190.65
  26494  T                               Hand tendon/muscle transfer....            0054           19.66         $953.26         $472.33         $190.65
  26496  T                               Revise thumb tendon............            0054           19.66         $953.26         $472.33         $190.65
  26497  T                               Finger tendon transfer.........            0054           19.66         $953.26         $472.33         $190.65
  26498  T                               Finger tendon transfer.........            0054           19.66         $953.26         $472.33         $190.65
  26499  T                               Revision of finger.............            0054           19.66         $953.26         $472.33         $190.65
  26500  T                               Hand tendon reconstruction.....            0053           11.32         $548.87         $253.49         $109.77
  26502  T                               Hand tendon reconstruction.....            0054           19.66         $953.26         $472.33         $190.65
  26504  T                               Hand tendon reconstruction.....            0054           19.66         $953.26         $472.33         $190.65
  26508  T                               Release thumb contracture......            0053           11.32         $548.87         $253.49         $109.77
  26510  T                               Thumb tendon transfer..........            0054           19.66         $953.26         $472.33         $190.65
  26516  T                               Fusion of knuckle joint........            0054           19.66         $953.26         $472.33         $190.65
  26517  T                               Fusion of knuckle joints.......            0054           19.66         $953.26         $472.33         $190.65
  26518  T                               Fusion of knuckle joints.......            0054           19.66         $953.26         $472.33         $190.65
  26520  T                               Release knuckle contracture....            0053           11.32         $548.87         $253.49         $109.77
  26525  T                               Release finger contracture.....            0053           11.32         $548.87         $253.49         $109.77
  26530  T                               Revise knuckle joint...........            0047           22.09       $1,071.08         $537.03         $214.22
  26531  T                               Revise knuckle with implant....            0048           29.06       $1,409.03         $725.94         $281.81
  26535  T                               Revise finger joint............            0047           22.09       $1,071.08         $537.03         $214.22
  26536  T                               Revise/implant finger joint....            0048           29.06       $1,409.03         $725.94         $281.81
  26540  T                               Repair hand joint..............            0053           11.32         $548.87         $253.49         $109.77
  26541  T                               Repair hand joint with graft...            0054           19.66         $953.26         $472.33         $190.65
  26542  T                               Repair hand joint with graft...            0053           11.32         $548.87         $253.49         $109.77
  26545  T                               Reconstruct finger joint.......            0054           19.66         $953.26         $472.33         $190.65
  26546  T                               Repair nonunion hand...........            0054           19.66         $953.26         $472.33         $190.65
  26548  T                               Reconstruct finger joint.......            0054           19.66         $953.26         $472.33         $190.65
  26550  T                               Construct thumb replacement....            0054           19.66         $953.26         $472.33         $190.65
  26551  C                               Great toe-hand transfer........  ..............  ..............  ..............  ..............  ..............
  26553  C                               Single transfer, toe-hand......  ..............  ..............  ..............  ..............  ..............
  26554  C                               Double transfer, toe-hand......  ..............  ..............  ..............  ..............  ..............
  26555  T                               Positional change of finger....            0054           19.66         $953.26         $472.33         $190.65
  26556  C                               Toe joint transfer.............  ..............  ..............  ..............  ..............  ..............
  26560  T                               Repair of web finger...........            0053           11.32         $548.87         $253.49         $109.77
  26561  T                               Repair of web finger...........            0054           19.66         $953.26         $472.33         $190.65
  26562  T                               Repair of web finger...........            0054           19.66         $953.26         $472.33         $190.65
  26565  T                               Correct metacarpal flaw........            0054           19.66         $953.26         $472.33         $190.65
  26567  T                               Correct finger deformity.......            0054           19.66         $953.26         $472.33         $190.65
  26568  T                               Lengthen metacarpal/finger.....            0054           19.66         $953.26         $472.33         $190.65
  26580  T                               Repair hand deformity..........            0054           19.66         $953.26         $472.33         $190.65
  26585  T                               Repair finger deformity........            0054           19.66         $953.26         $472.33         $190.65
  26587  T                               Reconstruct extra finger.......            0053           11.32         $548.87         $253.49         $109.77
  26590  T                               Repair finger deformity........            0054           19.66         $953.26         $472.33         $190.65

[[Page 18577]]

 
  26591  T                               Repair muscles of hand.........            0054           19.66         $953.26         $472.33         $190.65
  26593  T                               Release muscles of hand........            0053           11.32         $548.87         $253.49         $109.77
  26596  T                               Excision constricting tissue...            0054           19.66         $953.26         $472.33         $190.65
  26597  T                               Release of scar contracture....            0054           19.66         $953.26         $472.33         $190.65
  26600  T                               Treat metacarpal fracture......            0044            2.17         $105.22          $38.08          $21.04
  26605  T                               Treat metacarpal fracture......            0044            2.17         $105.22          $38.08          $21.04
  26607  T                               Treat metacarpal fracture......            0044            2.17         $105.22          $38.08          $21.04
  26608  T                               Treat metacarpal fracture......            0046           22.29       $1,080.78         $535.76         $216.16
  26615  T                               Treat metacarpal fracture......            0046           22.29       $1,080.78         $535.76         $216.16
  26641  T                               Treat thumb dislocation........            0044            2.17         $105.22          $38.08          $21.04
  26645  T                               Treat thumb fracture...........            0044            2.17         $105.22          $38.08          $21.04
  26650  T                               Treat thumb fracture...........            0046           22.29       $1,080.78         $535.76         $216.16
  26665  T                               Treat thumb fracture...........            0046           22.29       $1,080.78         $535.76         $216.16
  26670  T                               Treat hand dislocation.........            0044            2.17         $105.22          $38.08          $21.04
  26675  T                               Treat hand dislocation.........            0045           11.02         $534.33         $277.12         $106.87
  26676  T                               Pin hand dislocation...........            0046           22.29       $1,080.78         $535.76         $216.16
  26685  T                               Treat hand dislocation.........            0046           22.29       $1,080.78         $535.76         $216.16
  26686  T                               Treat hand dislocation.........            0046           22.29       $1,080.78         $535.76         $216.16
  26700  T                               Treat knuckle dislocation......            0043            1.64          $79.52          $25.46          $15.90
  26705  T                               Treat knuckle dislocation......            0045           11.02         $534.33         $277.12         $106.87
  26706  T                               Pin knuckle dislocation........            0044            2.17         $105.22          $38.08          $21.04
  26715  T                               Treat knuckle dislocation......            0046           22.29       $1,080.78         $535.76         $216.16
  26720  T                               Treat finger fracture, each....            0043            1.64          $79.52          $25.46          $15.90
  26725  T                               Treat finger fracture, each....            0043            1.64          $79.52          $25.46          $15.90
  26727  T                               Treat finger fracture, each....            0046           22.29       $1,080.78         $535.76         $216.16
  26735  T                               Treat finger fracture, each....            0046           22.29       $1,080.78         $535.76         $216.16
  26740  T                               Treat finger fracture, each....            0043            1.64          $79.52          $25.46          $15.90
  26742  T                               Treat finger fracture, each....            0044            2.17         $105.22          $38.08          $21.04
  26746  T                               Treat finger fracture, each....            0046           22.29       $1,080.78         $535.76         $216.16
  26750  T                               Treat finger fracture, each....            0043            1.64          $79.52          $25.46          $15.90
  26755  T                               Treat finger fracture, each....            0043            1.64          $79.52          $25.46          $15.90
  26756  T                               Pin finger fracture, each......            0046           22.29       $1,080.78         $535.76         $216.16
  26765  T                               Treat finger fracture, each....            0046           22.29       $1,080.78         $535.76         $216.16
  26770  T                               Treat finger dislocation.......            0043            1.64          $79.52          $25.46          $15.90
  26775  T                               Treat finger dislocation.......            0045           11.02         $534.33         $277.12         $106.87
  26776  T                               Pin finger dislocation.........            0046           22.29       $1,080.78         $535.76         $216.16
  26785  T                               Treat finger dislocation.......            0046           22.29       $1,080.78         $535.76         $216.16
  26820  T                               Thumb fusion with graft........            0054           19.66         $953.26         $472.33         $190.65
  26841  T                               Fusion of thumb................            0054           19.66         $953.26         $472.33         $190.65
  26842  T                               Thumb fusion with graft........            0054           19.66         $953.26         $472.33         $190.65
  26843  T                               Fusion of hand joint...........            0054           19.66         $953.26         $472.33         $190.65
  26844  T                               Fusion/graft of hand joint.....            0054           19.66         $953.26         $472.33         $190.65
  26850  T                               Fusion of knuckle..............            0054           19.66         $953.26         $472.33         $190.65
  26852  T                               Fusion of knuckle with graft...            0054           19.66         $953.26         $472.33         $190.65
  26860  T                               Fusion of finger joint.........            0054           19.66         $953.26         $472.33         $190.65
  26861  T                               Fusion of finger jnt, add-on...            0054           19.66         $953.26         $472.33         $190.65
  26862  T                               Fusion/graft of finger joint...            0054           19.66         $953.26         $472.33         $190.65
  26863  T                               Fuse/graft added joint.........            0054           19.66         $953.26         $472.33         $190.65
  26910  T                               Amputate metacarpal bone.......            0054           19.66         $953.26         $472.33         $190.65
  26951  T                               Amputation of finger/thumb.....            0053           11.32         $548.87         $253.49         $109.77
  26952  T                               Amputation of finger/thumb.....            0053           11.32         $548.87         $253.49         $109.77
  26989  T                               Hand/finger surgery............            0043            1.64          $79.52          $25.46          $15.90
  26990  T                               Drainage of pelvis lesion......            0049           15.04         $729.25         $356.95         $145.85
  26991  T                               Drainage of pelvis bursa.......            0049           15.04         $729.25         $356.95         $145.85
  26992  C                               Drainage of bone lesion........  ..............  ..............  ..............  ..............  ..............
  27000  T                               Incision of hip tendon.........            0049           15.04         $729.25         $356.95         $145.85
  27001  T                               Incision of hip tendon.........            0050           21.13       $1,024.53         $513.86         $204.91
  27003  T                               Incision of hip tendon.........            0050           21.13       $1,024.53         $513.86         $204.91
  27005  C                               Incision of hip tendon.........  ..............  ..............  ..............  ..............  ..............
  27006  C                               Incision of hip tendons........  ..............  ..............  ..............  ..............  ..............
  27025  C                               Incision of hip/thigh fascia...  ..............  ..............  ..............  ..............  ..............
  27030  C                               Drainage of hip joint..........  ..............  ..............  ..............  ..............  ..............
  27033  T                               Exploration of hip joint.......            0051           27.76       $1,346.00         $675.24         $269.20
  27035  C                               Denervation of hip joint.......  ..............  ..............  ..............  ..............  ..............
  27036  C                               Excision of hip joint/muscle...  ..............  ..............  ..............  ..............  ..............
  27040  T                               Biopsy of soft tissues.........            0021           10.49         $508.63         $236.51         $101.73
  27041  T                               Biopsy of soft tissues.........            0022           12.49         $605.60         $292.94         $121.12
  27047  T                               Remove hip/pelvis lesion.......            0022           12.49         $605.60         $292.94         $121.12
  27048  T                               Remove hip/pelvis lesion.......            0022           12.49         $605.60         $292.94         $121.12
  27049  T                               Remove tumor, hip/pelvis.......            0022           12.49         $605.60         $292.94         $121.12
  27050  T                               Biopsy of sacroiliac joint.....            0049           15.04         $729.25         $356.95         $145.85
  27052  T                               Biopsy of hip joint............            0049           15.04         $729.25         $356.95         $145.85
  27054  C                               Removal of hip joint lining....  ..............  ..............  ..............  ..............  ..............

[[Page 18578]]

 
  27060  T                               Removal of ischial bursa.......            0049           15.04         $729.25         $356.95         $145.85
  27062  T                               Remove femur lesion/bursa......            0049           15.04         $729.25         $356.95         $145.85
  27065  T                               Removal of hip bone lesion.....            0049           15.04         $729.25         $356.95         $145.85
  27066  T                               Removal of hip bone lesion.....            0050           21.13       $1,024.53         $513.86         $204.91
  27067  T                               Remove/graft hip bone lesion...            0050           21.13       $1,024.53         $513.86         $204.91
  27070  C                               Partial removal of hip bone....  ..............  ..............  ..............  ..............  ..............
  27071  C                               Partial removal of hip bone....  ..............  ..............  ..............  ..............  ..............
  27075  C                               Extensive hip surgery..........  ..............  ..............  ..............  ..............  ..............
  27076  C                               Extensive hip surgery..........  ..............  ..............  ..............  ..............  ..............
  27077  C                               Extensive hip surgery..........  ..............  ..............  ..............  ..............  ..............
  27078  C                               Extensive hip surgery..........  ..............  ..............  ..............  ..............  ..............
  27079  C                               Extensive hip surgery..........  ..............  ..............  ..............  ..............  ..............
  27080  T                               Removal of tail bone...........            0050           21.13       $1,024.53         $513.86         $204.91
  27086  T                               Remove hip foreign body........            0019            4.00         $193.95          $78.91          $38.79
  27087  T                               Remove hip foreign body........            0049           15.04         $729.25         $356.95         $145.85
  27090  C                               Removal of hip prosthesis......  ..............  ..............  ..............  ..............  ..............
  27091  C                               Removal of hip prosthesis......  ..............  ..............  ..............  ..............  ..............
  27093  N                               Injection for hip x-ray........  ..............  ..............  ..............  ..............  ..............
  27095  N                               Injection for hip x-ray........  ..............  ..............  ..............  ..............  ..............
  27096  N                               Inject sacroiliac joint........  ..............  ..............  ..............  ..............  ..............
  27097  T                               Revision of hip tendon.........            0050           21.13       $1,024.53         $513.86         $204.91
  27098  T                               Transfer tendon to pelvis......            0050           21.13       $1,024.53         $513.86         $204.91
  27100  T                               Transfer of abdominal muscle...            0051           27.76       $1,346.00         $675.24         $269.20
  27105  T                               Transfer of spinal muscle......            0051           27.76       $1,346.00         $675.24         $269.20
  27110  T                               Transfer of iliopsoas muscle...            0051           27.76       $1,346.00         $675.24         $269.20
  27111  T                               Transfer of iliopsoas muscle...            0051           27.76       $1,346.00         $675.24         $269.20
  27120  C                               Reconstruction of hip socket...  ..............  ..............  ..............  ..............  ..............
  27122  C                               Reconstruction of hip socket...  ..............  ..............  ..............  ..............  ..............
  27125  C                               Partial hip replacement........  ..............  ..............  ..............  ..............  ..............
  27130  C                               Total hip replacement..........  ..............  ..............  ..............  ..............  ..............
  27132  C                               Total hip replacement..........  ..............  ..............  ..............  ..............  ..............
  27134  C                               Revise hip joint replacement...  ..............  ..............  ..............  ..............  ..............
  27137  C                               Revise hip joint replacement...  ..............  ..............  ..............  ..............  ..............
  27138  C                               Revise hip joint replacement...  ..............  ..............  ..............  ..............  ..............
  27140  C                               Transplant femur ridge.........  ..............  ..............  ..............  ..............  ..............
  27146  C                               Incision of hip bone...........  ..............  ..............  ..............  ..............  ..............
  27147  C                               Revision of hip bone...........  ..............  ..............  ..............  ..............  ..............
  27151  C                               Incision of hip bones..........  ..............  ..............  ..............  ..............  ..............
  27156  C                               Revision of hip bones..........  ..............  ..............  ..............  ..............  ..............
  27158  C                               Revision of pelvis.............  ..............  ..............  ..............  ..............  ..............
  27161  C                               Incision of neck of femur......  ..............  ..............  ..............  ..............  ..............
  27165  C                               Incision/fixation of femur.....  ..............  ..............  ..............  ..............  ..............
  27170  C                               Repair/graft femur head/neck...  ..............  ..............  ..............  ..............  ..............
  27175  C                               Treat slipped epiphysis........  ..............  ..............  ..............  ..............  ..............
  27176  C                               Treat slipped epiphysis........  ..............  ..............  ..............  ..............  ..............
  27177  C                               Treat slipped epiphysis........  ..............  ..............  ..............  ..............  ..............
  27178  C                               Treat slipped epiphysis........  ..............  ..............  ..............  ..............  ..............
  27179  C                               Revise head/neck of femur......  ..............  ..............  ..............  ..............  ..............
  27181  C                               Treat slipped epiphysis........  ..............  ..............  ..............  ..............  ..............
  27185  C                               Revision of femur epiphysis....  ..............  ..............  ..............  ..............  ..............
  27187  C                               Reinforce hip bones............  ..............  ..............  ..............  ..............  ..............
  27193  T                               Treat pelvic ring fracture.....            0044            2.17         $105.22          $38.08          $21.04
  27194  T                               Treat pelvic ring fracture.....            0045           11.02         $534.33         $277.12         $106.87
  27200  T                               Treat tail bone fracture.......            0043            1.64          $79.52          $25.46          $15.90
  27202  T                               Treat tail bone fracture.......            0046           22.29       $1,080.78         $535.76         $216.16
  27215  C                               Treat pelvic fracture(s).......  ..............  ..............  ..............  ..............  ..............
  27216  C                               Treat pelvic ring fracture.....  ..............  ..............  ..............  ..............  ..............
  27217  C                               Treat pelvic ring fracture.....  ..............  ..............  ..............  ..............  ..............
  27218  C                               Treat pelvic ring fracture.....  ..............  ..............  ..............  ..............  ..............
  27220  T                               Treat hip socket fracture......            0044            2.17         $105.22          $38.08          $21.04
  27222  C                               Treat hip socket fracture......  ..............  ..............  ..............  ..............  ..............
  27226  C                               Treat hip wall fracture........  ..............  ..............  ..............  ..............  ..............
  27227  C                               Treat hip fracture(s)..........  ..............  ..............  ..............  ..............  ..............
  27228  C                               Treat hip fracture(s)..........  ..............  ..............  ..............  ..............  ..............
  27230  T                               Treat thigh fracture...........            0044            2.17         $105.22          $38.08          $21.04
  27232  C                               Treat thigh fracture...........  ..............  ..............  ..............  ..............  ..............
  27235  C                               Treat thigh fracture...........  ..............  ..............  ..............  ..............  ..............
  27236  C                               Treat thigh fracture...........  ..............  ..............  ..............  ..............  ..............
  27238  T                               Treat thigh fracture...........            0044            2.17         $105.22          $38.08          $21.04
  27240  C                               Treat thigh fracture...........  ..............  ..............  ..............  ..............  ..............
  27244  C                               Treat thigh fracture...........  ..............  ..............  ..............  ..............  ..............
  27245  C                               Treat thigh fracture...........  ..............  ..............  ..............  ..............  ..............
  27246  T                               Treat thigh fracture...........            0044            2.17         $105.22          $38.08          $21.04

[[Page 18579]]

 
  27248  C                               Treat thigh fracture...........  ..............  ..............  ..............  ..............  ..............
  27250  T                               Treat hip dislocation..........            0044            2.17         $105.22          $38.08          $21.04
  27252  T                               Treat hip dislocation..........            0045           11.02         $534.33         $277.12         $106.87
  27253  C                               Treat hip dislocation..........  ..............  ..............  ..............  ..............  ..............
  27254  C                               Treat hip dislocation..........  ..............  ..............  ..............  ..............  ..............
  27256  T                               Treat hip dislocation..........            0044            2.17         $105.22          $38.08          $21.04
  27257  T                               Treat hip dislocation..........            0045           11.02         $534.33         $277.12         $106.87
  27258  C                               Treat hip dislocation..........  ..............  ..............  ..............  ..............  ..............
  27259  C                               Treat hip dislocation..........  ..............  ..............  ..............  ..............  ..............
  27265  T                               Treat hip dislocation..........            0044            2.17         $105.22          $38.08          $21.04
  27266  T                               Treat hip dislocation..........            0047           22.09       $1,071.08         $537.03         $214.22
  27275  T                               Manipulation of hip joint......            0045           11.02         $534.33         $277.12         $106.87
  27280  C                               Fusion of sacroiliac joint.....  ..............  ..............  ..............  ..............  ..............
  27282  C                               Fusion of pubic bones..........  ..............  ..............  ..............  ..............  ..............
  27284  C                               Fusion of hip joint............  ..............  ..............  ..............  ..............  ..............
  27286  C                               Fusion of hip joint............  ..............  ..............  ..............  ..............  ..............
  27290  C                               Amputation of leg at hip.......  ..............  ..............  ..............  ..............  ..............
  27295  C                               Amputation of leg at hip.......  ..............  ..............  ..............  ..............  ..............
  27299  T                               Pelvis/hip joint surgery.......            0043            1.64          $79.52          $25.46          $15.90
  27301  T                               Drain thigh/knee lesion........            0008            6.15         $298.20         $113.67          $59.64
  27303  C                               Drainage of bone lesion........  ..............  ..............  ..............  ..............  ..............
  27305  T                               Incise thigh tendon & fascia...            0049           15.04         $729.25         $356.95         $145.85
  27306  T                               Incision of thigh tendon.......            0049           15.04         $729.25         $356.95         $145.85
  27307  T                               Incision of thigh tendons......            0049           15.04         $729.25         $356.95         $145.85
  27310  T                               Exploration of knee joint......            0050           21.13       $1,024.53         $513.86         $204.91
  27315  T                               Partial removal, thigh nerve...            0220           13.96         $676.88         $326.21         $135.38
  27320  T                               Partial removal, thigh nerve...            0220           13.96         $676.88         $326.21         $135.38
  27323  T                               Biopsy, thigh soft tissues.....            0021           10.49         $508.63         $236.51         $101.73
  27324  T                               Biopsy, thigh soft tissues.....            0022           12.49         $605.60         $292.94         $121.12
  27327  T                               Removal of thigh lesion........            0022           12.49         $605.60         $292.94         $121.12
  27328  T                               Removal of thigh lesion........            0022           12.49         $605.60         $292.94         $121.12
  27329  T                               Remove tumor, thigh/knee.......            0022           12.49         $605.60         $292.94         $121.12
  27330  T                               Biopsy, knee joint lining......            0050           21.13       $1,024.53         $513.86         $204.91
  27331  T                               Explore/treat knee joint.......            0050           21.13       $1,024.53         $513.86         $204.91
  27332  T                               Removal of knee cartilage......            0050           21.13       $1,024.53         $513.86         $204.91
  27333  T                               Removal of knee cartilage......            0050           21.13       $1,024.53         $513.86         $204.91
  27334  T                               Remove knee joint lining.......            0050           21.13       $1,024.53         $513.86         $204.91
  27335  T                               Remove knee joint lining.......            0050           21.13       $1,024.53         $513.86         $204.91
  27340  T                               Removal of kneecap bursa.......            0049           15.04         $729.25         $356.95         $145.85
  27345  T                               Removal of knee cyst...........            0049           15.04         $729.25         $356.95         $145.85
  27347  T                               Remove knee cyst...............            0049           15.04         $729.25         $356.95         $145.85
  27350  T                               Removal of kneecap.............            0050           21.13       $1,024.53         $513.86         $204.91
  27355  T                               Remove femur lesion............            0050           21.13       $1,024.53         $513.86         $204.91
  27356  T                               Remove femur lesion/graft......            0050           21.13       $1,024.53         $513.86         $204.91
  27357  T                               Remove femur lesion/graft......            0050           21.13       $1,024.53         $513.86         $204.91
  27358  T                               Remove femur lesion/fixation...            0050           21.13       $1,024.53         $513.86         $204.91
  27360  T                               Partial removal, leg bone(s)...            0050           21.13       $1,024.53         $513.86         $204.91
  27365  C                               Extensive leg surgery..........  ..............  ..............  ..............  ..............  ..............
  27370  N                               Injection for knee x-ray.......  ..............  ..............  ..............  ..............  ..............
  27372  T                               Removal of foreign body........            0022           12.49         $605.60         $292.94         $121.12
  27380  T                               Repair of kneecap tendon.......            0049           15.04         $729.25         $356.95         $145.85
  27381  T                               Repair/graft kneecap tendon....            0049           15.04         $729.25         $356.95         $145.85
  27385  T                               Repair of thigh muscle.........            0049           15.04         $729.25         $356.95         $145.85
  27386  T                               Repair/graft of thigh muscle...            0049           15.04         $729.25         $356.95         $145.85
  27390  T                               Incision of thigh tendon.......            0049           15.04         $729.25         $356.95         $145.85
  27391  T                               Incision of thigh tendons......            0049           15.04         $729.25         $356.95         $145.85
  27392  T                               Incision of thigh tendons......            0049           15.04         $729.25         $356.95         $145.85
  27393  T                               Lengthening of thigh tendon....            0050           21.13       $1,024.53         $513.86         $204.91
  27394  T                               Lengthening of thigh tendons...            0050           21.13       $1,024.53         $513.86         $204.91
  27395  T                               Lengthening of thigh tendons...            0051           27.76       $1,346.00         $675.24         $269.20
  27396  T                               Transplant of thigh tendon.....            0050           21.13       $1,024.53         $513.86         $204.91
  27397  T                               Transplants of thigh tendons...            0051           27.76       $1,346.00         $675.24         $269.20
  27400  T                               Revise thigh muscles/tendons...            0051           27.76       $1,346.00         $675.24         $269.20
  27403  T                               Repair of knee cartilage.......            0050           21.13       $1,024.53         $513.86         $204.91
  27405  T                               Repair of knee ligament........            0051           27.76       $1,346.00         $675.24         $269.20
  27407  T                               Repair of knee ligament........            0051           27.76       $1,346.00         $675.24         $269.20
  27409  T                               Repair of knee ligaments.......            0051           27.76       $1,346.00         $675.24         $269.20
  27418  T                               Repair degenerated kneecap.....            0051           27.76       $1,346.00         $675.24         $269.20
  27420  T                               Revision of unstable kneecap...            0051           27.76       $1,346.00         $675.24         $269.20
  27422  T                               Revision of unstable kneecap...            0051           27.76       $1,346.00         $675.24         $269.20
  27424  T                               Revision/removal of kneecap....            0051           27.76       $1,346.00         $675.24         $269.20
  27425  T                               Lateral retinacular release....            0050           21.13       $1,024.53         $513.86         $204.91
  27427  T                               Reconstruction, knee...........            0052           36.16       $1,753.29         $930.91         $350.66

[[Page 18580]]

 
  27428  T                               Reconstruction, knee...........            0052           36.16       $1,753.29         $930.91         $350.66
  27429  T                               Reconstruction, knee...........            0052           36.16       $1,753.29         $930.91         $350.66
  27430  T                               Revision of thigh muscles......            0051           27.76       $1,346.00         $675.24         $269.20
  27435  T                               Incision of knee joint.........            0051           27.76       $1,346.00         $675.24         $269.20
  27437  T                               Revise kneecap.................            0047           22.09       $1,071.08         $537.03         $214.22
  27438  T                               Revise kneecap with implant....            0048           29.06       $1,409.03         $725.94         $281.81
  27440  T                               Revision of knee joint.........            0047           22.09       $1,071.08         $537.03         $214.22
  27441  T                               Revision of knee joint.........            0047           22.09       $1,071.08         $537.03         $214.22
  27442  T                               Revision of knee joint.........            0047           22.09       $1,071.08         $537.03         $214.22
  27443  T                               Revision of knee joint.........            0047           22.09       $1,071.08         $537.03         $214.22
  27445  C                               Revision of knee joint.........  ..............  ..............  ..............  ..............  ..............
  27446  C                               Revision of knee joint.........  ..............  ..............  ..............  ..............  ..............
  27447  C                               Total knee replacement.........  ..............  ..............  ..............  ..............  ..............
  27448  C                               Incision of thigh..............  ..............  ..............  ..............  ..............  ..............
  27450  C                               Incision of thigh..............  ..............  ..............  ..............  ..............  ..............
  27454  C                               Realignment of thigh bone......  ..............  ..............  ..............  ..............  ..............
  27455  C                               Realignment of knee............  ..............  ..............  ..............  ..............  ..............
  27457  C                               Realignment of knee............  ..............  ..............  ..............  ..............  ..............
  27465  C                               Shortening of thigh bone.......  ..............  ..............  ..............  ..............  ..............
  27466  C                               Lengthening of thigh bone......  ..............  ..............  ..............  ..............  ..............
  27468  C                               Shorten/lengthen thighs........  ..............  ..............  ..............  ..............  ..............
  27470  C                               Repair of thigh................  ..............  ..............  ..............  ..............  ..............
  27472  C                               Repair/graft of thigh..........  ..............  ..............  ..............  ..............  ..............
  27475  C                               Surgery to stop leg growth.....  ..............  ..............  ..............  ..............  ..............
  27477  C                               Surgery to stop leg growth.....  ..............  ..............  ..............  ..............  ..............
  27479  C                               Surgery to stop leg growth.....  ..............  ..............  ..............  ..............  ..............
  27485  C                               Surgery to stop leg growth.....  ..............  ..............  ..............  ..............  ..............
  27486  C                               Revise/replace knee joint......  ..............  ..............  ..............  ..............  ..............
  27487  C                               Revise/replace knee joint......  ..............  ..............  ..............  ..............  ..............
  27488  C                               Removal of knee prosthesis.....  ..............  ..............  ..............  ..............  ..............
  27495  C                               Reinforce thigh................  ..............  ..............  ..............  ..............  ..............
  27496  T                               Decompression of thigh/knee....            0049           15.04         $729.25         $356.95         $145.85
  27497  T                               Decompression of thigh/knee....            0049           15.04         $729.25         $356.95         $145.85
  27498  T                               Decompression of thigh/knee....            0049           15.04         $729.25         $356.95         $145.85
  27499  T                               Decompression of thigh/knee....            0049           15.04         $729.25         $356.95         $145.85
  27500  T                               Treatment of thigh fracture....            0044            2.17         $105.22          $38.08          $21.04
  27501  T                               Treatment of thigh fracture....            0044            2.17         $105.22          $38.08          $21.04
  27502  T                               Treatment of thigh fracture....            0044            2.17         $105.22          $38.08          $21.04
  27503  T                               Treatment of thigh fracture....            0044            2.17         $105.22          $38.08          $21.04
  27506  C                               Treatment of thigh fracture....  ..............  ..............  ..............  ..............  ..............
  27507  C                               Treatment of thigh fracture....  ..............  ..............  ..............  ..............  ..............
  27508  T                               Treatment of thigh fracture....            0044            2.17         $105.22          $38.08          $21.04
  27509  T                               Treatment of thigh fracture....            0046           22.29       $1,080.78         $535.76         $216.16
  27510  T                               Treatment of thigh fracture....            0044            2.17         $105.22          $38.08          $21.04
  27511  C                               Treatment of thigh fracture....  ..............  ..............  ..............  ..............  ..............
  27513  C                               Treatment of thigh fracture....  ..............  ..............  ..............  ..............  ..............
  27514  C                               Treatment of thigh fracture....  ..............  ..............  ..............  ..............  ..............
  27516  T                               Treat thigh fx growth plate....            0044            2.17         $105.22          $38.08          $21.04
  27517  T                               Treat thigh fx growth plate....            0044            2.17         $105.22          $38.08          $21.04
  27519  C                               Treat thigh fx growth plate....  ..............  ..............  ..............  ..............  ..............
  27520  T                               Treat kneecap fracture.........            0044            2.17         $105.22          $38.08          $21.04
  27524  C                               Treat kneecap fracture.........  ..............  ..............  ..............  ..............  ..............
  27530  T                               Treat knee fracture............            0044            2.17         $105.22          $38.08          $21.04
  27532  T                               Treat knee fracture............            0044            2.17         $105.22          $38.08          $21.04
  27535  C                               Treat knee fracture............  ..............  ..............  ..............  ..............  ..............
  27536  C                               Treat knee fracture............  ..............  ..............  ..............  ..............  ..............
  27538  T                               Treat knee fracture(s).........            0044            2.17         $105.22          $38.08          $21.04
  27540  C                               Treat knee fracture............  ..............  ..............  ..............  ..............  ..............
  27550  T                               Treat knee dislocation.........            0044            2.17         $105.22          $38.08          $21.04
  27552  T                               Treat knee dislocation.........            0045           11.02         $534.33         $277.12         $106.87
  27556  T                               Treat knee dislocation.........            0046           22.29       $1,080.78         $535.76         $216.16
  27557  C                               Treat knee dislocation.........  ..............  ..............  ..............  ..............  ..............
  27558  C                               Treat knee dislocation.........  ..............  ..............  ..............  ..............  ..............
  27560  T                               Treat kneecap dislocation......            0044            2.17         $105.22          $38.08          $21.04
  27562  T                               Treat kneecap dislocation......            0045           11.02         $534.33         $277.12         $106.87
  27566  T                               Treat kneecap dislocation......            0046           22.29       $1,080.78         $535.76         $216.16
  27570  T                               Fixation of knee joint.........            0045           11.02         $534.33         $277.12         $106.87
  27580  C                               Fusion of knee.................  ..............  ..............  ..............  ..............  ..............
  27590  C                               Amputate leg at thigh..........  ..............  ..............  ..............  ..............  ..............
  27591  C                               Amputate leg at thigh..........  ..............  ..............  ..............  ..............  ..............
  27592  C                               Amputate leg at thigh..........  ..............  ..............  ..............  ..............  ..............
  27594  T                               Amputation follow-up surgery...            0049           15.04         $729.25         $356.95         $145.85
  27596  C                               Amputation follow-up surgery...  ..............  ..............  ..............  ..............  ..............

[[Page 18581]]

 
  27598  C                               Amputate lower leg at knee.....  ..............  ..............  ..............  ..............  ..............
  27599  T                               Leg surgery procedure..........            0044            2.17         $105.22          $38.08          $21.04
  27600  T                               Decompression of lower leg.....            0049           15.04         $729.25         $356.95         $145.85
  27601  T                               Decompression of lower leg.....            0049           15.04         $729.25         $356.95         $145.85
  27602  T                               Decompression of lower leg.....            0049           15.04         $729.25         $356.95         $145.85
  27603  T                               Drain lower leg lesion.........            0008            6.15         $298.20         $113.67          $59.64
  27604  T                               Drain lower leg bursa..........            0049           15.04         $729.25         $356.95         $145.85
  27605  T                               Incision of achilles tendon....            0055           15.47         $750.10         $355.34         $150.02
  27606  T                               Incision of achilles tendon....            0049           15.04         $729.25         $356.95         $145.85
  27607  T                               Treat lower leg bone lesion....            0049           15.04         $729.25         $356.95         $145.85
  27610  T                               Explore/treat ankle joint......            0050           21.13       $1,024.53         $513.86         $204.91
  27612  T                               Exploration of ankle joint.....            0050           21.13       $1,024.53         $513.86         $204.91
  27613  T                               Biopsy lower leg soft tissue...            0020            6.51         $315.65         $130.53          $63.13
  27614  T                               Biopsy lower leg soft tissue...            0022           12.49         $605.60         $292.94         $121.12
  27615  T                               Remove tumor, lower leg........            0046           22.29       $1,080.78         $535.76         $216.16
  27618  T                               Remove lower leg lesion........            0021           10.49         $508.63         $236.51         $101.73
  27619  T                               Remove lower leg lesion........            0022           12.49         $605.60         $292.94         $121.12
  27620  T                               Explore/treat ankle joint......            0050           21.13       $1,024.53         $513.86         $204.91
  27625  T                               Remove ankle joint lining......            0050           21.13       $1,024.53         $513.86         $204.91
  27626  T                               Remove ankle joint lining......            0050           21.13       $1,024.53         $513.86         $204.91
  27630  T                               Removal of tendon lesion.......            0049           15.04         $729.25         $356.95         $145.85
  27635  T                               Remove lower leg bone lesion...            0050           21.13       $1,024.53         $513.86         $204.91
  27637  T                               Remove/graft leg bone lesion...            0050           21.13       $1,024.53         $513.86         $204.91
  27638  T                               Remove/graft leg bone lesion...            0050           21.13       $1,024.53         $513.86         $204.91
  27640  T                               Partial removal of tibia.......            0051           27.76       $1,346.00         $675.24         $269.20
  27641  T                               Partial removal of fibula......            0050           21.13       $1,024.53         $513.86         $204.91
  27645  C                               Extensive lower leg surgery....  ..............  ..............  ..............  ..............  ..............
  27646  C                               Extensive lower leg surgery....  ..............  ..............  ..............  ..............  ..............
  27647  T                               Extensive ankle/heel surgery...            0051           27.76       $1,346.00         $675.24         $269.20
  27648  N                               Injection for ankle x-ray......  ..............  ..............  ..............  ..............  ..............
  27650  T                               Repair achilles tendon.........            0051           27.76       $1,346.00         $675.24         $269.20
  27652  T                               Repair/graft achilles tendon...            0051           27.76       $1,346.00         $675.24         $269.20
  27654  T                               Repair of achilles tendon......            0051           27.76       $1,346.00         $675.24         $269.20
  27656  T                               Repair leg fascia defect.......            0049           15.04         $729.25         $356.95         $145.85
  27658  T                               Repair of leg tendon, each.....            0049           15.04         $729.25         $356.95         $145.85
  27659  T                               Repair of leg tendon, each.....            0049           15.04         $729.25         $356.95         $145.85
  27664  T                               Repair of leg tendon, each.....            0049           15.04         $729.25         $356.95         $145.85
  27665  T                               Repair of leg tendon, each.....            0050           21.13       $1,024.53         $513.86         $204.91
  27675  T                               Repair lower leg tendons.......            0049           15.04         $729.25         $356.95         $145.85
  27676  T                               Repair lower leg tendons.......            0050           21.13       $1,024.53         $513.86         $204.91
  27680  T                               Release of lower leg tendon....            0050           21.13       $1,024.53         $513.86         $204.91
  27681  T                               Release of lower leg tendons...            0050           21.13       $1,024.53         $513.86         $204.91
  27685  T                               Revision of lower leg tendon...            0050           21.13       $1,024.53         $513.86         $204.91
  27686  T                               Revise lower leg tendons.......            0050           21.13       $1,024.53         $513.86         $204.91
  27687  T                               Revision of calf tendon........            0050           21.13       $1,024.53         $513.86         $204.91
  27690  T                               Revise lower leg tendon........            0051           27.76       $1,346.00         $675.24         $269.20
  27691  T                               Revise lower leg tendon........            0051           27.76       $1,346.00         $675.24         $269.20
  27692  T                               Revise additional leg tendon...            0051           27.76       $1,346.00         $675.24         $269.20
  27695  T                               Repair of ankle ligament.......            0050           21.13       $1,024.53         $513.86         $204.91
  27696  T                               Repair of ankle ligaments......            0050           21.13       $1,024.53         $513.86         $204.91
  27698  T                               Repair of ankle ligament.......            0050           21.13       $1,024.53         $513.86         $204.91
  27700  T                               Revision of ankle joint........            0047           22.09       $1,071.08         $537.03         $214.22
  27702  C                               Reconstruct ankle joint........  ..............  ..............  ..............  ..............  ..............
  27703  C                               Reconstruction, ankle joint....  ..............  ..............  ..............  ..............  ..............
  27704  T                               Removal of ankle implant.......            0049           15.04         $729.25         $356.95         $145.85
  27705  T                               Incision of tibia..............            0051           27.76       $1,346.00         $675.24         $269.20
  27707  T                               Incision of fibula.............            0049           15.04         $729.25         $356.95         $145.85
  27709  T                               Incision of tibia & fibula.....            0050           21.13       $1,024.53         $513.86         $204.91
  27712  C                               Realignment of lower leg.......  ..............  ..............  ..............  ..............  ..............
  27715  C                               Revision of lower leg..........  ..............  ..............  ..............  ..............  ..............
  27720  C                               Repair of tibia................  ..............  ..............  ..............  ..............  ..............
  27722  C                               Repair/graft of tibia..........  ..............  ..............  ..............  ..............  ..............
  27724  C                               Repair/graft of tibia..........  ..............  ..............  ..............  ..............  ..............
  27725  C                               Repair of lower leg............  ..............  ..............  ..............  ..............  ..............
  27727  C                               Repair of lower leg............  ..............  ..............  ..............  ..............  ..............
  27730  T                               Repair of tibia epiphysis......            0050           21.13       $1,024.53         $513.86         $204.91
  27732  T                               Repair of fibula epiphysis.....            0050           21.13       $1,024.53         $513.86         $204.91
  27734  T                               Repair lower leg epiphyses.....            0050           21.13       $1,024.53         $513.86         $204.91
  27740  T                               Repair of leg epiphyses........            0050           21.13       $1,024.53         $513.86         $204.91
  27742  T                               Repair of leg epiphyses........            0051           27.76       $1,346.00         $675.24         $269.20
  27745  T                               Reinforce tibia................            0051           27.76       $1,346.00         $675.24         $269.20
  27750  T                               Treatment of tibia fracture....            0044            2.17         $105.22          $38.08          $21.04
  27752  T                               Treatment of tibia fracture....            0044            2.17         $105.22          $38.08          $21.04

[[Page 18582]]

 
  27756  T                               Treatment of tibia fracture....            0046           22.29       $1,080.78         $535.76         $216.16
  27758  T                               Treatment of tibia fracture....            0046           22.29       $1,080.78         $535.76         $216.16
  27759  T                               Treatment of tibia fracture....            0046           22.29       $1,080.78         $535.76         $216.16
  27760  T                               Treatment of ankle fracture....            0044            2.17         $105.22          $38.08          $21.04
  27762  T                               Treatment of ankle fracture....            0044            2.17         $105.22          $38.08          $21.04
  27766  T                               Treatment of ankle fracture....            0046           22.29       $1,080.78         $535.76         $216.16
  27780  T                               Treatment of fibula fracture...            0044            2.17         $105.22          $38.08          $21.04
  27781  T                               Treatment of fibula fracture...            0044            2.17         $105.22          $38.08          $21.04
  27784  T                               Treatment of fibula fracture...            0046           22.29       $1,080.78         $535.76         $216.16
  27786  T                               Treatment of ankle fracture....            0044            2.17         $105.22          $38.08          $21.04
  27788  T                               Treatment of ankle fracture....            0044            2.17         $105.22          $38.08          $21.04
  27792  T                               Treatment of ankle fracture....            0046           22.29       $1,080.78         $535.76         $216.16
  27808  T                               Treatment of ankle fracture....            0044            2.17         $105.22          $38.08          $21.04
  27810  T                               Treatment of ankle fracture....            0044            2.17         $105.22          $38.08          $21.04
  27814  T                               Treatment of ankle fracture....            0046           22.29       $1,080.78         $535.76         $216.16
  27816  T                               Treatment of ankle fracture....            0044            2.17         $105.22          $38.08          $21.04
  27818  T                               Treatment of ankle fracture....            0044            2.17         $105.22          $38.08          $21.04
  27822  T                               Treatment of ankle fracture....            0046           22.29       $1,080.78         $535.76         $216.16
  27823  T                               Treatment of ankle fracture....            0046           22.29       $1,080.78         $535.76         $216.16
  27824  T                               Treat lower leg fracture.......            0044            2.17         $105.22          $38.08          $21.04
  27825  T                               Treat lower leg fracture.......            0044            2.17         $105.22          $38.08          $21.04
  27826  T                               Treat lower leg fracture.......            0046           22.29       $1,080.78         $535.76         $216.16
  27827  T                               Treat lower leg fracture.......            0046           22.29       $1,080.78         $535.76         $216.16
  27828  T                               Treat lower leg fracture.......            0046           22.29       $1,080.78         $535.76         $216.16
  27829  T                               Treat lower leg joint..........            0046           22.29       $1,080.78         $535.76         $216.16
  27830  T                               Treat lower leg dislocation....            0044            2.17         $105.22          $38.08          $21.04
  27831  T                               Treat lower leg dislocation....            0045           11.02         $534.33         $277.12         $106.87
  27832  T                               Treat lower leg dislocation....            0046           22.29       $1,080.78         $535.76         $216.16
  27840  T                               Treat ankle dislocation........            0044            2.17         $105.22          $38.08          $21.04
  27842  T                               Treat ankle dislocation........            0045           11.02         $534.33         $277.12         $106.87
  27846  T                               Treat ankle dislocation........            0046           22.29       $1,080.78         $535.76         $216.16
  27848  T                               Treat ankle dislocation........            0046           22.29       $1,080.78         $535.76         $216.16
  27860  T                               Fixation of ankle joint........            0045           11.02         $534.33         $277.12         $106.87
  27870  T                               Fusion of ankle joint..........            0051           27.76       $1,346.00         $675.24         $269.20
  27871  T                               Fusion of tibiofibular joint...            0051           27.76       $1,346.00         $675.24         $269.20
  27880  C                               Amputation of lower leg........  ..............  ..............  ..............  ..............  ..............
  27881  C                               Amputation of lower leg........  ..............  ..............  ..............  ..............  ..............
  27882  C                               Amputation of lower leg........  ..............  ..............  ..............  ..............  ..............
  27884  T                               Amputation follow-up surgery...            0049           15.04         $729.25         $356.95         $145.85
  27886  C                               Amputation follow-up surgery...  ..............  ..............  ..............  ..............  ..............
  27888  C                               Amputation of foot at ankle....  ..............  ..............  ..............  ..............  ..............
  27889  T                               Amputation of foot at ankle....            0050           21.13       $1,024.53         $513.86         $204.91
  27892  T                               Decompression of leg...........            0049           15.04         $729.25         $356.95         $145.85
  27893  T                               Decompression of leg...........            0049           15.04         $729.25         $356.95         $145.85
  27894  T                               Decompression of leg...........            0049           15.04         $729.25         $356.95         $145.85
  27899  T                               Leg/ankle surgery procedure....            0044            2.17         $105.22          $38.08          $21.04
  28001  T                               Drainage of bursa of foot......            0008            6.15         $298.20         $113.67          $59.64
  28002  T                               Treatment of foot infection....            0049           15.04         $729.25         $356.95         $145.85
  28003  T                               Treatment of foot infection....            0049           15.04         $729.25         $356.95         $145.85
  28005  T                               Treat foot bone lesion.........            0055           15.47         $750.10         $355.34         $150.02
  28008  T                               Incision of foot fascia........            0055           15.47         $750.10         $355.34         $150.02
  28010  T                               Incision of toe tendon.........            0055           15.47         $750.10         $355.34         $150.02
  28011  T                               Incision of toe tendons........            0055           15.47         $750.10         $355.34         $150.02
  28020  T                               Exploration of foot joint......            0055           15.47         $750.10         $355.34         $150.02
  28022  T                               Exploration of foot joint......            0055           15.47         $750.10         $355.34         $150.02
  28024  T                               Exploration of toe joint.......            0055           15.47         $750.10         $355.34         $150.02
  28030  T                               Removal of foot nerve..........            0220           13.96         $676.88         $326.21         $135.38
  28035  T                               Decompression of tibia nerve...            0220           13.96         $676.88         $326.21         $135.38
  28043  T                               Excision of foot lesion........            0021           10.49         $508.63         $236.51         $101.73
  28045  T                               Excision of foot lesion........            0055           15.47         $750.10         $355.34         $150.02
  28046  T                               Resection of tumor, foot.......            0055           15.47         $750.10         $355.34         $150.02
  28050  T                               Biopsy of foot joint lining....            0055           15.47         $750.10         $355.34         $150.02
  28052  T                               Biopsy of foot joint lining....            0055           15.47         $750.10         $355.34         $150.02
  28054  T                               Biopsy of toe joint lining.....            0055           15.47         $750.10         $355.34         $150.02
  28060  T                               Partial removal, foot fascia...            0056           17.30         $838.83         $405.81         $167.77
  28062  T                               Removal of foot fascia.........            0056           17.30         $838.83         $405.81         $167.77
  28070  T                               Removal of foot joint lining...            0056           17.30         $838.83         $405.81         $167.77
  28072  T                               Removal of foot joint lining...            0056           17.30         $838.83         $405.81         $167.77
  28080  T                               Removal of foot lesion.........            0055           15.47         $750.10         $355.34         $150.02
  28086  T                               Excise foot tendon sheath......            0055           15.47         $750.10         $355.34         $150.02
  28088  T                               Excise foot tendon sheath......            0055           15.47         $750.10         $355.34         $150.02
  28090  T                               Removal of foot lesion.........            0055           15.47         $750.10         $355.34         $150.02
  28092  T                               Removal of toe lesions.........            0055           15.47         $750.10         $355.34         $150.02

[[Page 18583]]

 
  28100  T                               Removal of ankle/heel lesion...            0055           15.47         $750.10         $355.34         $150.02
  28102  T                               Remove/graft foot lesion.......            0056           17.30         $838.83         $405.81         $167.77
  28103  T                               Remove/graft foot lesion.......            0056           17.30         $838.83         $405.81         $167.77
  28104  T                               Removal of foot lesion.........            0055           15.47         $750.10         $355.34         $150.02
  28106  T                               Remove/graft foot lesion.......            0056           17.30         $838.83         $405.81         $167.77
  28107  T                               Remove/graft foot lesion.......            0056           17.30         $838.83         $405.81         $167.77
  28108  T                               Removal of toe lesions.........            0055           15.47         $750.10         $355.34         $150.02
  28110  T                               Part removal of metatarsal.....            0057           21.00       $1,018.23         $496.65         $203.65
  28111  T                               Part removal of metatarsal.....            0055           15.47         $750.10         $355.34         $150.02
  28112  T                               Part removal of metatarsal.....            0055           15.47         $750.10         $355.34         $150.02
  28113  T                               Part removal of metatarsal.....            0055           15.47         $750.10         $355.34         $150.02
  28114  T                               Removal of metatarsal heads....            0055           15.47         $750.10         $355.34         $150.02
  28116  T                               Revision of foot...............            0055           15.47         $750.10         $355.34         $150.02
  28118  T                               Removal of heel bone...........            0055           15.47         $750.10         $355.34         $150.02
  28119  T                               Removal of heel spur...........            0055           15.47         $750.10         $355.34         $150.02
  28120  T                               Part removal of ankle/heel.....            0055           15.47         $750.10         $355.34         $150.02
  28122  T                               Partial removal of foot bone...            0055           15.47         $750.10         $355.34         $150.02
  28124  T                               Partial removal of toe.........            0055           15.47         $750.10         $355.34         $150.02
  28126  T                               Partial removal of toe.........            0055           15.47         $750.10         $355.34         $150.02
  28130  T                               Removal of ankle bone..........            0055           15.47         $750.10         $355.34         $150.02
  28140  T                               Removal of metatarsal..........            0055           15.47         $750.10         $355.34         $150.02
  28150  T                               Removal of toe.................            0055           15.47         $750.10         $355.34         $150.02
  28153  T                               Partial removal of toe.........            0055           15.47         $750.10         $355.34         $150.02
  28160  T                               Partial removal of toe.........            0055           15.47         $750.10         $355.34         $150.02
  28171  T                               Extensive foot surgery.........            0055           15.47         $750.10         $355.34         $150.02
  28173  T                               Extensive foot surgery.........            0055           15.47         $750.10         $355.34         $150.02
  28175  T                               Extensive foot surgery.........            0055           15.47         $750.10         $355.34         $150.02
  28190  T                               Removal of foot foreign body...            0019            4.00         $193.95          $78.91          $38.79
  28192  T                               Removal of foot foreign body...            0021           10.49         $508.63         $236.51         $101.73
  28193  T                               Removal of foot foreign body...            0020            6.51         $315.65         $130.53          $63.13
  28200  T                               Repair of foot tendon..........            0055           15.47         $750.10         $355.34         $150.02
  28202  T                               Repair/graft of foot tendon....            0056           17.30         $838.83         $405.81         $167.77
  28208  T                               Repair of foot tendon..........            0055           15.47         $750.10         $355.34         $150.02
  28210  T                               Repair/graft of foot tendon....            0055           15.47         $750.10         $355.34         $150.02
  28220  T                               Release of foot tendon.........            0055           15.47         $750.10         $355.34         $150.02
  28222  T                               Release of foot tendons........            0055           15.47         $750.10         $355.34         $150.02
  28225  T                               Release of foot tendon.........            0055           15.47         $750.10         $355.34         $150.02
  28226  T                               Release of foot tendons........            0055           15.47         $750.10         $355.34         $150.02
  28230  T                               Incision of foot tendon(s).....            0055           15.47         $750.10         $355.34         $150.02
  28232  T                               Incision of toe tendon.........            0055           15.47         $750.10         $355.34         $150.02
  28234  T                               Incision of foot tendon........            0055           15.47         $750.10         $355.34         $150.02
  28238  T                               Revision of foot tendon........            0056           17.30         $838.83         $405.81         $167.77
  28240  T                               Release of big toe.............            0055           15.47         $750.10         $355.34         $150.02
  28250  T                               Revision of foot fascia........            0056           17.30         $838.83         $405.81         $167.77
  28260  T                               Release of midfoot joint.......            0056           17.30         $838.83         $405.81         $167.77
  28261  T                               Revision of foot tendon........            0056           17.30         $838.83         $405.81         $167.77
  28262  T                               Revision of foot and ankle.....            0056           17.30         $838.83         $405.81         $167.77
  28264  T                               Release of midfoot joint.......            0056           17.30         $838.83         $405.81         $167.77
  28270  T                               Release of foot contracture....            0055           15.47         $750.10         $355.34         $150.02
  28272  T                               Release of toe joint, each.....            0055           15.47         $750.10         $355.34         $150.02
  28280  T                               Fusion of toes.................            0055           15.47         $750.10         $355.34         $150.02
  28285  T                               Repair of hammertoe............            0055           15.47         $750.10         $355.34         $150.02
  28286  T                               Repair of hammertoe............            0055           15.47         $750.10         $355.34         $150.02
  28288  T                               Partial removal of foot bone...            0056           17.30         $838.83         $405.81         $167.77
  28289  T                               Repair hallux rigidus..........            0056           17.30         $838.83         $405.81         $167.77
  28290  T                               Correction of bunion...........            0057           21.00       $1,018.23         $496.65         $203.65
  28292  T                               Correction of bunion...........            0057           21.00       $1,018.23         $496.65         $203.65
  28293  T                               Correction of bunion...........            0057           21.00       $1,018.23         $496.65         $203.65
  28294  T                               Correction of bunion...........            0057           21.00       $1,018.23         $496.65         $203.65
  28296  T                               Correction of bunion...........            0057           21.00       $1,018.23         $496.65         $203.65
  28297  T                               Correction of bunion...........            0057           21.00       $1,018.23         $496.65         $203.65
  28298  T                               Correction of bunion...........            0057           21.00       $1,018.23         $496.65         $203.65
  28299  T                               Correction of bunion...........            0057           21.00       $1,018.23         $496.65         $203.65
  28300  T                               Incision of heel bone..........            0056           17.30         $838.83         $405.81         $167.77
  28302  T                               Incision of ankle bone.........            0056           17.30         $838.83         $405.81         $167.77
  28304  T                               Incision of midfoot bones......            0056           17.30         $838.83         $405.81         $167.77
  28305  T                               Incise/graft midfoot bones.....            0056           17.30         $838.83         $405.81         $167.77
  28306  T                               Incision of metatarsal.........            0056           17.30         $838.83         $405.81         $167.77
  28307  T                               Incision of metatarsal.........            0056           17.30         $838.83         $405.81         $167.77
  28308  T                               Incision of metatarsal.........            0056           17.30         $838.83         $405.81         $167.77
  28309  T                               Incision of metatarsals........            0056           17.30         $838.83         $405.81         $167.77
  28310  T                               Revision of big toe............            0055           15.47         $750.10         $355.34         $150.02
  28312  T                               Revision of toe................            0055           15.47         $750.10         $355.34         $150.02

[[Page 18584]]

 
  28313  T                               Repair deformity of toe........            0055           15.47         $750.10         $355.34         $150.02
  28315  T                               Removal of sesamoid bone.......            0055           15.47         $750.10         $355.34         $150.02
  28320  T                               Repair of foot bones...........            0056           17.30         $838.83         $405.81         $167.77
  28322  T                               Repair of metatarsals..........            0056           17.30         $838.83         $405.81         $167.77
  28340  T                               Resect enlarged toe tissue.....            0055           15.47         $750.10         $355.34         $150.02
  28341  T                               Resect enlarged toe............            0055           15.47         $750.10         $355.34         $150.02
  28344  T                               Repair extra toe(s)............            0056           17.30         $838.83         $405.81         $167.77
  28345  T                               Repair webbed toe(s)...........            0056           17.30         $838.83         $405.81         $167.77
  28360  T                               Reconstruct cleft foot.........            0056           17.30         $838.83         $405.81         $167.77
  28400  T                               Treatment of heel fracture.....            0044            2.17         $105.22          $38.08          $21.04
  28405  T                               Treatment of heel fracture.....            0044            2.17         $105.22          $38.08          $21.04
  28406  T                               Treatment of heel fracture.....            0046           22.29       $1,080.78         $535.76         $216.16
  28415  T                               Treat heel fracture............            0046           22.29       $1,080.78         $535.76         $216.16
  28420  T                               Treat/graft heel fracture......            0046           22.29       $1,080.78         $535.76         $216.16
  28430  T                               Treatment of ankle fracture....            0044            2.17         $105.22          $38.08          $21.04
  28435  T                               Treatment of ankle fracture....            0044            2.17         $105.22          $38.08          $21.04
  28436  T                               Treatment of ankle fracture....            0046           22.29       $1,080.78         $535.76         $216.16
  28445  T                               Treat ankle fracture...........            0046           22.29       $1,080.78         $535.76         $216.16
  28450  T                               Treat midfoot fracture, each...            0044            2.17         $105.22          $38.08          $21.04
  28455  T                               Treat midfoot fracture, each...            0044            2.17         $105.22          $38.08          $21.04
  28456  T                               Treat midfoot fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  28465  T                               Treat midfoot fracture, each...            0046           22.29       $1,080.78         $535.76         $216.16
  28470  T                               Treat metatarsal fracture......            0044            2.17         $105.22          $38.08          $21.04
  28475  T                               Treat metatarsal fracture......            0044            2.17         $105.22          $38.08          $21.04
  28476  T                               Treat metatarsal fracture......            0046           22.29       $1,080.78         $535.76         $216.16
  28485  T                               Treat metatarsal fracture......            0046           22.29       $1,080.78         $535.76         $216.16
  28490  T                               Treat big toe fracture.........            0043            1.64          $79.52          $25.46          $15.90
  28495  T                               Treat big toe fracture.........            0043            1.64          $79.52          $25.46          $15.90
  28496  T                               Treat big toe fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  28505  T                               Treat big toe fracture.........            0046           22.29       $1,080.78         $535.76         $216.16
  28510  T                               Treatment of toe fracture......            0043            1.64          $79.52          $25.46          $15.90
  28515  T                               Treatment of toe fracture......            0043            1.64          $79.52          $25.46          $15.90
  28525  T                               Treat toe fracture.............            0046           22.29       $1,080.78         $535.76         $216.16
  28530  T                               Treat sesamoid bone fracture...            0044            2.17         $105.22          $38.08          $21.04
  28531  T                               Treat sesamoid bone fracture...            0046           22.29       $1,080.78         $535.76         $216.16
  28540  T                               Treat foot dislocation.........            0044            2.17         $105.22          $38.08          $21.04
  28545  T                               Treat foot dislocation.........            0045           11.02         $534.33         $277.12         $106.87
  28546  T                               Treat foot dislocation.........            0046           22.29       $1,080.78         $535.76         $216.16
  28555  T                               Repair foot dislocation........            0046           22.29       $1,080.78         $535.76         $216.16
  28570  T                               Treat foot dislocation.........            0044            2.17         $105.22          $38.08          $21.04
  28575  T                               Treat foot dislocation.........            0045           11.02         $534.33         $277.12         $106.87
  28576  T                               Treat foot dislocation.........            0046           22.29       $1,080.78         $535.76         $216.16
  28585  T                               Repair foot dislocation........            0046           22.29       $1,080.78         $535.76         $216.16
  28600  T                               Treat foot dislocation.........            0044            2.17         $105.22          $38.08          $21.04
  28605  T                               Treat foot dislocation.........            0045           11.02         $534.33         $277.12         $106.87
  28606  T                               Treat foot dislocation.........            0046           22.29       $1,080.78         $535.76         $216.16
  28615  T                               Repair foot dislocation........            0046           22.29       $1,080.78         $535.76         $216.16
  28630  T                               Treat toe dislocation..........            0043            1.64          $79.52          $25.46          $15.90
  28635  T                               Treat toe dislocation..........            0045           11.02         $534.33         $277.12         $106.87
  28636  T                               Treat toe dislocation..........            0046           22.29       $1,080.78         $535.76         $216.16
  28645  T                               Repair toe dislocation.........            0046           22.29       $1,080.78         $535.76         $216.16
  28660  T                               Treat toe dislocation..........            0043            1.64          $79.52          $25.46          $15.90
  28665  T                               Treat toe dislocation..........            0045           11.02         $534.33         $277.12         $106.87
  28666  T                               Treat toe dislocation..........            0046           22.29       $1,080.78         $535.76         $216.16
  28675  T                               Repair of toe dislocation......            0046           22.29       $1,080.78         $535.76         $216.16
  28705  T                               Fusion of foot bones...........            0056           17.30         $838.83         $405.81         $167.77
  28715  T                               Fusion of foot bones...........            0056           17.30         $838.83         $405.81         $167.77
  28725  T                               Fusion of foot bones...........            0056           17.30         $838.83         $405.81         $167.77
  28730  T                               Fusion of foot bones...........            0056           17.30         $838.83         $405.81         $167.77
  28735  T                               Fusion of foot bones...........            0056           17.30         $838.83         $405.81         $167.77
  28737  T                               Revision of foot bones.........            0055           15.47         $750.10         $355.34         $150.02
  28740  T                               Fusion of foot bones...........            0056           17.30         $838.83         $405.81         $167.77
  28750  T                               Fusion of big toe joint........            0055           15.47         $750.10         $355.34         $150.02
  28755  T                               Fusion of big toe joint........            0055           15.47         $750.10         $355.34         $150.02
  28760  T                               Fusion of big toe joint........            0056           17.30         $838.83         $405.81         $167.77
  28800  C                               Amputation of midfoot..........  ..............  ..............  ..............  ..............  ..............
  28805  C                               Amputation thru metatarsal.....  ..............  ..............  ..............  ..............  ..............
  28810  T                               Amputation toe & metatarsal....            0055           15.47         $750.10         $355.34         $150.02
  28820  T                               Amputation of toe..............            0055           15.47         $750.10         $355.34         $150.02
  28825  T                               Partial amputation of toe......            0055           15.47         $750.10         $355.34         $150.02
  28899  T                               Foot/toes surgery procedure....            0043            1.64          $79.52          $25.46          $15.90
  29000  S                               Application of body cast.......            0059            1.74          $84.37          $29.59          $16.87
  29010  S                               Application of body cast.......            0059            1.74          $84.37          $29.59          $16.87

[[Page 18585]]

 
  29015  S                               Application of body cast.......            0059            1.74          $84.37          $29.59          $16.87
  29020  S                               Application of body cast.......            0059            1.74          $84.37          $29.59          $16.87
  29025  S                               Application of body cast.......            0059            1.74          $84.37          $29.59          $16.87
  29035  S                               Application of body cast.......            0059            1.74          $84.37          $29.59          $16.87
  29040  S                               Application of body cast.......            0059            1.74          $84.37          $29.59          $16.87
  29044  S                               Application of body cast.......            0059            1.74          $84.37          $29.59          $16.87
  29046  S                               Application of body cast.......            0059            1.74          $84.37          $29.59          $16.87
  29049  S                               Application of figure eight....            0059            1.74          $84.37          $29.59          $16.87
  29055  S                               Application of shoulder cast...            0059            1.74          $84.37          $29.59          $16.87
  29058  S                               Application of shoulder cast...            0059            1.74          $84.37          $29.59          $16.87
  29065  S                               Application of long arm cast...            0059            1.74          $84.37          $29.59          $16.87
  29075  S                               Application of forearm cast....            0059            1.74          $84.37          $29.59          $16.87
  29085  S                               Apply hand/wrist cast..........            0059            1.74          $84.37          $29.59          $16.87
  29105  S                               Apply long arm splint..........            0059            1.74          $84.37          $29.59          $16.87
  29125  S                               Apply forearm splint...........            0059            1.74          $84.37          $29.59          $16.87
  29126  S                               Apply forearm splint...........            0059            1.74          $84.37          $29.59          $16.87
  29130  S                               Application of finger splint...            0059            1.74          $84.37          $29.59          $16.87
  29131  S                               Application of finger splint...            0059            1.74          $84.37          $29.59          $16.87
  29200  S                               Strapping of chest.............            0059            1.74          $84.37          $29.59          $16.87
  29220  S                               Strapping of low back..........            0059            1.74          $84.37          $29.59          $16.87
  29240  S                               Strapping of shoulder..........            0059            1.74          $84.37          $29.59          $16.87
  29260  S                               Strapping of elbow or wrist....            0059            1.74          $84.37          $29.59          $16.87
  29280  S                               Strapping of hand or finger....            0059            1.74          $84.37          $29.59          $16.87
  29305  S                               Application of hip cast........            0059            1.74          $84.37          $29.59          $16.87
  29325  S                               Application of hip casts.......            0059            1.74          $84.37          $29.59          $16.87
  29345  S                               Application of long leg cast...            0059            1.74          $84.37          $29.59          $16.87
  29355  S                               Application of long leg cast...            0059            1.74          $84.37          $29.59          $16.87
  29358  S                               Apply long leg cast brace......            0059            1.74          $84.37          $29.59          $16.87
  29365  S                               Application of long leg cast...            0059            1.74          $84.37          $29.59          $16.87
  29405  S                               Apply short leg cast...........            0059            1.74          $84.37          $29.59          $16.87
  29425  S                               Apply short leg cast...........            0059            1.74          $84.37          $29.59          $16.87
  29435  S                               Apply short leg cast...........            0059            1.74          $84.37          $29.59          $16.87
  29440  S                               Addition of walker to cast.....            0059            1.74          $84.37          $29.59          $16.87
  29445  S                               Apply rigid leg cast...........            0059            1.74          $84.37          $29.59          $16.87
  29450  S                               Application of leg cast........            0059            1.74          $84.37          $29.59          $16.87
  29505  S                               Application, long leg splint...            0058            1.09          $52.85          $19.27          $10.57
  29515  S                               Application lower leg splint...            0058            1.09          $52.85          $19.27          $10.57
  29520  S                               Strapping of hip...............            0058            1.09          $52.85          $19.27          $10.57
  29530  S                               Strapping of knee..............            0058            1.09          $52.85          $19.27          $10.57
  29540  S                               Strapping of ankle.............            0058            1.09          $52.85          $19.27          $10.57
  29550  S                               Strapping of toes..............            0058            1.09          $52.85          $19.27          $10.57
  29580  S                               Application of paste boot......            0058            1.09          $52.85          $19.27          $10.57
  29590  S                               Application of foot splint.....            0058            1.09          $52.85          $19.27          $10.57
  29700  S                               Removal/revision of cast.......            0058            1.09          $52.85          $19.27          $10.57
  29705  S                               Removal/revision of cast.......            0058            1.09          $52.85          $19.27          $10.57
  29710  S                               Removal/revision of cast.......            0058            1.09          $52.85          $19.27          $10.57
  29715  S                               Removal/revision of cast.......            0058            1.09          $52.85          $19.27          $10.57
  29720  S                               Repair of body cast............            0058            1.09          $52.85          $19.27          $10.57
  29730  S                               Windowing of cast..............            0058            1.09          $52.85          $19.27          $10.57
  29740  S                               Wedging of cast................            0058            1.09          $52.85          $19.27          $10.57
  29750  S                               Wedging of clubfoot cast.......            0058            1.09          $52.85          $19.27          $10.57
  29799  S                               Casting/strapping procedure....            0058            1.09          $52.85          $19.27          $10.57
  29800  T                               Jaw arthroscopy/surgery........            0041           24.57       $1,191.33         $592.08         $238.27
  29804  T                               Jaw arthroscopy/surgery........            0041           24.57       $1,191.33         $592.08         $238.27
  29815  T                               Shoulder arthroscopy...........            0041           24.57       $1,191.33         $592.08         $238.27
  29819  T                               Shoulder arthroscopy/surgery...            0041           24.57       $1,191.33         $592.08         $238.27
  29820  T                               Shoulder arthroscopy/surgery...            0041           24.57       $1,191.33         $592.08         $238.27
  29821  T                               Shoulder arthroscopy/surgery...            0041           24.57       $1,191.33         $592.08         $238.27
  29822  T                               Shoulder arthroscopy/surgery...            0041           24.57       $1,191.33         $592.08         $238.27
  29823  T                               Shoulder arthroscopy/surgery...            0041           24.57       $1,191.33         $592.08         $238.27
  29825  T                               Shoulder arthroscopy/surgery...            0041           24.57       $1,191.33         $592.08         $238.27
  29826  T                               Shoulder arthroscopy/surgery...            0041           24.57       $1,191.33         $592.08         $238.27
  29830  T                               Elbow arthroscopy..............            0041           24.57       $1,191.33         $592.08         $238.27
  29834  T                               Elbow arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27
  29835  T                               Elbow arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27
  29836  T                               Elbow arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27
  29837  T                               Elbow arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27
  29838  T                               Elbow arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27
  29840  T                               Wrist arthroscopy..............            0041           24.57       $1,191.33         $592.08         $238.27
  29843  T                               Wrist arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27
  29844  T                               Wrist arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27
  29845  T                               Wrist arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27
  29846  T                               Wrist arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27

[[Page 18586]]

 
  29847  T                               Wrist arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27
  29848  T                               Wrist endoscopy/surgery........            0041           24.57       $1,191.33         $592.08         $238.27
  29850  T                               Knee arthroscopy/surgery.......            0042           29.22       $1,416.79         $804.74         $283.36
  29851  T                               Knee arthroscopy/surgery.......            0042           29.22       $1,416.79         $804.74         $283.36
  29855  T                               Tibial arthroscopy/surgery.....            0042           29.22       $1,416.79         $804.74         $283.36
  29856  T                               Tibial arthroscopy/surgery.....            0042           29.22       $1,416.79         $804.74         $283.36
  29860  T                               Hip arthroscopy, dx............            0041           24.57       $1,191.33         $592.08         $238.27
  29861  T                               Hip arthroscopy/surgery........            0041           24.57       $1,191.33         $592.08         $238.27
  29862  T                               Hip arthroscopy/surgery........            0041           24.57       $1,191.33         $592.08         $238.27
  29863  T                               Hip arthroscopy/surgery........            0041           24.57       $1,191.33         $592.08         $238.27
  29870  T                               Knee arthroscopy, dx...........            0041           24.57       $1,191.33         $592.08         $238.27
  29871  T                               Knee arthroscopy/drainage......            0041           24.57       $1,191.33         $592.08         $238.27
  29874  T                               Knee arthroscopy/surgery.......            0041           24.57       $1,191.33         $592.08         $238.27
  29875  T                               Knee arthroscopy/surgery.......            0041           24.57       $1,191.33         $592.08         $238.27
  29876  T                               Knee arthroscopy/surgery.......            0041           24.57       $1,191.33         $592.08         $238.27
  29877  T                               Knee arthroscopy/surgery.......            0041           24.57       $1,191.33         $592.08         $238.27
  29879  T                               Knee arthroscopy/surgery.......            0041           24.57       $1,191.33         $592.08         $238.27
  29880  T                               Knee arthroscopy/surgery.......            0041           24.57       $1,191.33         $592.08         $238.27
  29881  T                               Knee arthroscopy/surgery.......            0041           24.57       $1,191.33         $592.08         $238.27
  29882  T                               Knee arthroscopy/surgery.......            0041           24.57       $1,191.33         $592.08         $238.27
  29883  T                               Knee arthroscopy/surgery.......            0041           24.57       $1,191.33         $592.08         $238.27
  29884  T                               Knee arthroscopy/surgery.......            0041           24.57       $1,191.33         $592.08         $238.27
  29885  T                               Knee arthroscopy/surgery.......            0042           29.22       $1,416.79         $804.74         $283.36
  29886  T                               Knee arthroscopy/surgery.......            0041           24.57       $1,191.33         $592.08         $238.27
  29887  T                               Knee arthroscopy/surgery.......            0041           24.57       $1,191.33         $592.08         $238.27
  29888  T                               Knee arthroscopy/surgery.......            0042           29.22       $1,416.79         $804.74         $283.36
  29889  T                               Knee arthroscopy/surgery.......            0042           29.22       $1,416.79         $804.74         $283.36
  29891  T                               Ankle arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27
  29892  T                               Ankle arthroscopy/surgery......            0042           29.22       $1,416.79         $804.74         $283.36
  29893  T                               Scope, plantar fasciotomy......            0055           15.47         $750.10         $355.34         $150.02
  29894  T                               Ankle arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27
  29895  T                               Ankle arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27
  29897  T                               Ankle arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27
  29898  T                               Ankle arthroscopy/surgery......            0041           24.57       $1,191.33         $592.08         $238.27
  29909  T                               Arthroscopy of joint...........            0041           24.57       $1,191.33         $592.08         $238.27
  30000  T                               Drainage of nose lesion........            0251            1.68          $81.46          $27.99          $16.29
  30020  T                               Drainage of nose lesion........            0251            1.68          $81.46          $27.99          $16.29
  30100  T                               Intranasal biopsy..............            0252            5.18         $251.16         $114.24          $50.23
  30110  T                               Removal of nose polyp(s).......            0253           12.02         $582.81         $284.00         $116.56
  30115  T                               Removal of nose polyp(s).......            0253           12.02         $582.81         $284.00         $116.56
  30117  T                               Removal of intranasal lesion...            0253           12.02         $582.81         $284.00         $116.56
  30118  T                               Removal of intranasal lesion...            0254           12.45         $603.66         $272.41         $120.73
  30120  T                               Revision of nose...............            0253           12.02         $582.81         $284.00         $116.56
  30124  T                               Removal of nose lesion.........            0252            5.18         $251.16         $114.24          $50.23
  30125  T                               Removal of nose lesion.........            0256           25.40       $1,231.57         $623.05         $246.31
  30130  T                               Removal of turbinate bones.....            0253           12.02         $582.81         $284.00         $116.56
  30140  T                               Removal of turbinate bones.....            0253           12.02         $582.81         $284.00         $116.56
  30150  T                               Partial removal of nose........            0256           25.40       $1,231.57         $623.05         $246.31
  30160  T                               Removal of nose................            0256           25.40       $1,231.57         $623.05         $246.31
  30200  T                               Injection treatment of nose....            0253           12.02         $582.81         $284.00         $116.56
  30210  T                               Nasal sinus therapy............            0252            5.18         $251.16         $114.24          $50.23
  30220  T                               Insert nasal septal button.....            0252            5.18         $251.16         $114.24          $50.23
  30300  T                               Remove nasal foreign body......            0251            1.68          $81.46          $27.99          $16.29
  30310  T                               Remove nasal foreign body......            0253           12.02         $582.81         $284.00         $116.56
  30320  T                               Remove nasal foreign body......            0253           12.02         $582.81         $284.00         $116.56
  30400  T                               Reconstruction of nose.........            0256           25.40       $1,231.57         $623.05         $246.31
  30410  T                               Reconstruction of nose.........            0256           25.40       $1,231.57         $623.05         $246.31
  30420  T                               Reconstruction of nose.........            0256           25.40       $1,231.57         $623.05         $246.31
  30430  T                               Revision of nose...............            0254           12.45         $603.66         $272.41         $120.73
  30435  T                               Revision of nose...............            0256           25.40       $1,231.57         $623.05         $246.31
  30450  T                               Revision of nose...............            0256           25.40       $1,231.57         $623.05         $246.31
  30460  T                               Revision of nose...............            0256           25.40       $1,231.57         $623.05         $246.31
  30462  T                               Revision of nose...............            0256           25.40       $1,231.57         $623.05         $246.31
  30520  T                               Repair of nasal septum.........            0256           25.40       $1,231.57         $623.05         $246.31
  30540  T                               Repair nasal defect............            0256           25.40       $1,231.57         $623.05         $246.31
  30545  T                               Repair nasal defect............            0256           25.40       $1,231.57         $623.05         $246.31
  30560  T                               Release of nasal adhesions.....            0251            1.68          $81.46          $27.99          $16.29
  30580  T                               Repair upper jaw fistula.......            0256           25.40       $1,231.57         $623.05         $246.31
  30600  T                               Repair mouth/nose fistula......            0256           25.40       $1,231.57         $623.05         $246.31
  30620  T                               Intranasal reconstruction......            0256           25.40       $1,231.57         $623.05         $246.31
  30630  T                               Repair nasal septum defect.....            0254           12.45         $603.66         $272.41         $120.73
  30801  T                               Cauterization, inner nose......            0252            5.18         $251.16         $114.24          $50.23
  30802  T                               Cauterization, inner nose......            0253           12.02         $582.81         $284.00         $116.56

[[Page 18587]]

 
  30901  T                               Control of nosebleed...........            0250            2.21         $107.16          $38.54          $21.43
  30903  T                               Control of nosebleed...........            0250            2.21         $107.16          $38.54          $21.43
  30905  T                               Control of nosebleed...........            0250            2.21         $107.16          $38.54          $21.43
  30906  T                               Repeat control of nosebleed....            0250            2.21         $107.16          $38.54          $21.43
  30915  T                               Ligation, nasal sinus artery...            0091           14.79         $717.12         $348.23         $143.42
  30920  T                               Ligation, upper jaw artery.....            0092           20.21         $979.92         $505.37         $195.98
  30930  T                               Therapy, fracture of nose......            0253           12.02         $582.81         $284.00         $116.56
  30999  T                               Nasal surgery procedure........            0251            1.68          $81.46          $27.99          $16.29
  31000  T                               Irrigation, maxillary sinus....            0251            1.68          $81.46          $27.99          $16.29
  31002  T                               Irrigation, sphenoid sinus.....            0252            5.18         $251.16         $114.24          $50.23
  31020  T                               Exploration, maxillary sinus...            0253           12.02         $582.81         $284.00         $116.56
  31030  T                               Exploration, maxillary sinus...            0256           25.40       $1,231.57         $623.05         $246.31
  31032  T                               Explore sinus, remove polyps...            0256           25.40       $1,231.57         $623.05         $246.31
  31040  T                               Exploration behind upper jaw...            0254           12.45         $603.66         $272.41         $120.73
  31050  T                               Exploration, sphenoid sinus....            0256           25.40       $1,231.57         $623.05         $246.31
  31051  T                               Sphenoid sinus surgery.........            0256           25.40       $1,231.57         $623.05         $246.31
  31070  T                               Exploration of frontal sinus...            0254           12.45         $603.66         $272.41         $120.73
  31075  T                               Exploration of frontal sinus...            0256           25.40       $1,231.57         $623.05         $246.31
  31080  T                               Removal of frontal sinus.......            0256           25.40       $1,231.57         $623.05         $246.31
  31081  T                               Removal of frontal sinus.......            0256           25.40       $1,231.57         $623.05         $246.31
  31084  T                               Removal of frontal sinus.......            0256           25.40       $1,231.57         $623.05         $246.31
  31085  T                               Removal of frontal sinus.......            0256           25.40       $1,231.57         $623.05         $246.31
  31086  T                               Removal of frontal sinus.......            0256           25.40       $1,231.57         $623.05         $246.31
  31087  T                               Removal of frontal sinus.......            0256           25.40       $1,231.57         $623.05         $246.31
  31090  T                               Exploration of sinuses.........            0256           25.40       $1,231.57         $623.05         $246.31
  31200  T                               Removal of ethmoid sinus.......            0256           25.40       $1,231.57         $623.05         $246.31
  31201  T                               Removal of ethmoid sinus.......            0256           25.40       $1,231.57         $623.05         $246.31
  31205  T                               Removal of ethmoid sinus.......            0256           25.40       $1,231.57         $623.05         $246.31
  31225  C                               Removal of upper jaw...........  ..............  ..............  ..............  ..............  ..............
  31230  C                               Removal of upper jaw...........  ..............  ..............  ..............  ..............  ..............
  31231  T                               Nasal endoscopy, dx............            0071            0.55          $26.67          $14.22           $5.33
  31233  T                               Nasal/sinus endoscopy, dx......            0072            1.26          $61.09          $41.52          $12.22
  31235  T                               Nasal/sinus endoscopy, dx......            0074           13.61         $659.91         $347.54         $131.98
  31237  T                               Nasal/sinus endoscopy, surg....            0074           13.61         $659.91         $347.54         $131.98
  31238  T                               Nasal/sinus endoscopy, surg....            0074           13.61         $659.91         $347.54         $131.98
  31239  T                               Nasal/sinus endoscopy, surg....            0075           18.55         $899.44         $467.29         $179.89
  31240  T                               Nasal/sinus endoscopy, surg....            0074           13.61         $659.91         $347.54         $131.98
  31254  T                               Revision of ethmoid sinus......            0075           18.55         $899.44         $467.29         $179.89
  31255  T                               Removal of ethmoid sinus.......            0075           18.55         $899.44         $467.29         $179.89
  31256  T                               Exploration maxillary sinus....            0075           18.55         $899.44         $467.29         $179.89
  31267  T                               Endoscopy, maxillary sinus.....            0075           18.55         $899.44         $467.29         $179.89
  31276  T                               Sinus endoscopy, surgical......            0075           18.55         $899.44         $467.29         $179.89
  31287  T                               Nasal/sinus endoscopy, surg....            0075           18.55         $899.44         $467.29         $179.89
  31288  T                               Nasal/sinus endoscopy, surg....            0075           18.55         $899.44         $467.29         $179.89
  31290  C                               Nasal/sinus endoscopy, surg....  ..............  ..............  ..............  ..............  ..............
  31291  C                               Nasal/sinus endoscopy, surg....  ..............  ..............  ..............  ..............  ..............
  31292  C                               Nasal/sinus endoscopy, surg....  ..............  ..............  ..............  ..............  ..............
  31293  C                               Nasal/sinus endoscopy, surg....  ..............  ..............  ..............  ..............  ..............
  31294  C                               Nasal/sinus endoscopy, surg....  ..............  ..............  ..............  ..............  ..............
  31299  T                               Sinus surgery procedure........            0252            5.18         $251.16         $114.24          $50.23
  31300  T                               Removal of larynx lesion.......            0256           25.40       $1,231.57         $623.05         $246.31
  31320  T                               Diagnostic incision, larynx....            0256           25.40       $1,231.57         $623.05         $246.31
  31360  C                               Removal of larynx..............  ..............  ..............  ..............  ..............  ..............
  31365  C                               Removal of larynx..............  ..............  ..............  ..............  ..............  ..............
  31367  C                               Partial removal of larynx......  ..............  ..............  ..............  ..............  ..............
  31368  C                               Partial removal of larynx......  ..............  ..............  ..............  ..............  ..............
  31370  C                               Partial removal of larynx......  ..............  ..............  ..............  ..............  ..............
  31375  T                               Partial removal of larynx......            0256           25.40       $1,231.57         $623.05         $246.31
  31380  C                               Partial removal of larynx......  ..............  ..............  ..............  ..............  ..............
  31382  C                               Partial removal of larynx......  ..............  ..............  ..............  ..............  ..............
  31390  C                               Removal of larynx & pharynx....  ..............  ..............  ..............  ..............  ..............
  31395  C                               Reconstruct larynx & pharynx...  ..............  ..............  ..............  ..............  ..............
  31400  T                               Revision of larynx.............            0256           25.40       $1,231.57         $623.05         $246.31
  31420  T                               Removal of epiglottis..........            0256           25.40       $1,231.57         $623.05         $246.31
  31500  S                               Insert emergency airway........            0094            4.51         $218.68         $105.29          $43.74
  31502  T                               Change of windpipe airway......            0121            2.36         $114.43          $52.53          $22.89
  31505  T                               Diagnostic laryngoscopy........            0072            1.26          $61.09          $41.52          $12.22
  31510  T                               Laryngoscopy with biopsy.......            0074           13.61         $659.91         $347.54         $131.98
  31511  T                               Remove foreign body, larynx....            0072            1.26          $61.09          $41.52          $12.22
  31512  T                               Removal of larynx lesion.......            0074           13.61         $659.91         $347.54         $131.98
  31513  T                               Injection into vocal cord......            0073            4.11         $199.28          $91.07          $39.86
  31515  T                               Laryngoscopy for aspiration....            0074           13.61         $659.91         $347.54         $131.98
  31520  T                               Diagnostic laryngoscopy........            0072            1.26          $61.09          $41.52          $12.22

[[Page 18588]]

 
  31525  T                               Diagnostic laryngoscopy........            0074           13.61         $659.91         $347.54         $131.98
  31526  T                               Diagnostic laryngoscopy........            0074           13.61         $659.91         $347.54         $131.98
  31527  T                               Laryngoscopy for treatment.....            0075           18.55         $899.44         $467.29         $179.89
  31528  T                               Laryngoscopy and dilatation....            0074           13.61         $659.91         $347.54         $131.98
  31529  T                               Laryngoscopy and dilatation....            0074           13.61         $659.91         $347.54         $131.98
  31530  T                               Operative laryngoscopy.........            0075           18.55         $899.44         $467.29         $179.89
  31531  T                               Operative laryngoscopy.........            0075           18.55         $899.44         $467.29         $179.89
  31535  T                               Operative laryngoscopy.........            0075           18.55         $899.44         $467.29         $179.89
  31536  T                               Operative laryngoscopy.........            0075           18.55         $899.44         $467.29         $179.89
  31540  T                               Operative laryngoscopy.........            0075           18.55         $899.44         $467.29         $179.89
  31541  T                               Operative laryngoscopy.........            0075           18.55         $899.44         $467.29         $179.89
  31560  T                               Operative laryngoscopy.........            0075           18.55         $899.44         $467.29         $179.89
  31561  T                               Operative laryngoscopy.........            0075           18.55         $899.44         $467.29         $179.89
  31570  T                               Laryngoscopy with injection....            0075           18.55         $899.44         $467.29         $179.89
  31571  T                               Laryngoscopy with injection....            0075           18.55         $899.44         $467.29         $179.89
  31575  T                               Diagnostic laryngoscopy........            0071            0.55          $26.67          $14.22           $5.33
  31576  T                               Laryngoscopy with biopsy.......            0074           13.61         $659.91         $347.54         $131.98
  31577  T                               Remove foreign body, larynx....            0073            4.11         $199.28          $91.07          $39.86
  31578  T                               Removal of larynx lesion.......            0074           13.61         $659.91         $347.54         $131.98
  31579  T                               Diagnostic laryngoscopy........            0073            4.11         $199.28          $91.07          $39.86
  31580  T                               Revision of larynx.............            0256           25.40       $1,231.57         $623.05         $246.31
  31582  C                               Revision of larynx.............  ..............  ..............  ..............  ..............  ..............
  31584  C                               Treat larynx fracture..........  ..............  ..............  ..............  ..............  ..............
  31585  T                               Treat larynx fracture..........            0253           12.02         $582.81         $284.00         $116.56
  31586  T                               Treat larynx fracture..........            0256           25.40       $1,231.57         $623.05         $246.31
  31587  C                               Revision of larynx.............  ..............  ..............  ..............  ..............  ..............
  31588  T                               Revision of larynx.............            0256           25.40       $1,231.57         $623.05         $246.31
  31590  T                               Reinnervate larynx.............            0256           25.40       $1,231.57         $623.05         $246.31
  31595  T                               Larynx nerve surgery...........            0256           25.40       $1,231.57         $623.05         $246.31
  31599  T                               Larynx surgery procedure.......            0253           12.02         $582.81         $284.00         $116.56
  31600  T                               Incision of windpipe...........            0254           12.45         $603.66         $272.41         $120.73
  31601  T                               Incision of windpipe...........            0254           12.45         $603.66         $272.41         $120.73
  31603  T                               Incision of windpipe...........            0254           12.45         $603.66         $272.41         $120.73
  31605  T                               Incision of windpipe...........            0254           12.45         $603.66         $272.41         $120.73
  31610  T                               Incision of windpipe...........            0254           12.45         $603.66         $272.41         $120.73
  31611  T                               Surgery/speech prosthesis......            0254           12.45         $603.66         $272.41         $120.73
  31612  T                               Puncture/clear windpipe........            0253           12.02         $582.81         $284.00         $116.56
  31613  T                               Repair windpipe opening........            0254           12.45         $603.66         $272.41         $120.73
  31614  T                               Repair windpipe opening........            0256           25.40       $1,231.57         $623.05         $246.31
  31615  T                               Visualization of windpipe......            0076            8.06         $390.81         $197.05          $78.16
  31622  T                               Dx bronchoscope/wash...........            0076            8.06         $390.81         $197.05          $78.16
  31623  T                               Dx bronchoscope/brush..........            0076            8.06         $390.81         $197.05          $78.16
  31624  T                               Dx bronchoscope/lavage.........            0076            8.06         $390.81         $197.05          $78.16
  31625  T                               Bronchoscopy with biopsy.......            0076            8.06         $390.81         $197.05          $78.16
  31628  T                               Bronchoscopy with biopsy.......            0076            8.06         $390.81         $197.05          $78.16
  31629  T                               Bronchoscopy with biopsy.......            0076            8.06         $390.81         $197.05          $78.16
  31630  T                               Bronchoscopy with repair.......            0076            8.06         $390.81         $197.05          $78.16
  31631  T                               Bronchoscopy with dilation.....            0076            8.06         $390.81         $197.05          $78.16
  31635  T                               Remove foreign body, airway....            0076            8.06         $390.81         $197.05          $78.16
  31640  T                               Bronchoscopy & remove lesion...            0076            8.06         $390.81         $197.05          $78.16
  31641  T                               Bronchoscopy, treat blockage...            0076            8.06         $390.81         $197.05          $78.16
  31643  T                               Diag bronchoscope/catheter.....            0076            8.06         $390.81         $197.05          $78.16
  31645  T                               Bronchoscopy, clear airways....            0076            8.06         $390.81         $197.05          $78.16
  31646  T                               Bronchoscopy, reclear airway...            0076            8.06         $390.81         $197.05          $78.16
  31656  T                               Bronchoscopy, inj for x-ray....            0076            8.06         $390.81         $197.05          $78.16
  31700  T                               Insertion of airway catheter...            0072            1.26          $61.09          $41.52          $12.22
  31708  N                               Instill airway contrast dye....  ..............  ..............  ..............  ..............  ..............
  31710  N                               Insertion of airway catheter...  ..............  ..............  ..............  ..............  ..............
  31715  N                               Injection for bronchus x-ray...  ..............  ..............  ..............  ..............  ..............
  31717  T                               Bronchial brush biopsy.........            0073            4.11         $199.28          $91.07          $39.86
  31720  T                               Clearance of airways...........            0072            1.26          $61.09          $41.52          $12.22
  31725  C                               Clearance of airways...........  ..............  ..............  ..............  ..............  ..............
  31730  T                               Intro, windpipe wire/tube......            0073            4.11         $199.28          $91.07          $39.86
  31750  T                               Repair of windpipe.............            0256           25.40       $1,231.57         $623.05         $246.31
  31755  T                               Repair of windpipe.............            0256           25.40       $1,231.57         $623.05         $246.31
  31760  C                               Repair of windpipe.............  ..............  ..............  ..............  ..............  ..............
  31766  C                               Reconstruction of windpipe.....  ..............  ..............  ..............  ..............  ..............
  31770  C                               Repair/graft of bronchus.......  ..............  ..............  ..............  ..............  ..............
  31775  C                               Reconstruct bronchus...........  ..............  ..............  ..............  ..............  ..............
  31780  C                               Reconstruct windpipe...........  ..............  ..............  ..............  ..............  ..............
  31781  C                               Reconstruct windpipe...........  ..............  ..............  ..............  ..............  ..............
  31785  C                               Remove windpipe lesion.........  ..............  ..............  ..............  ..............  ..............
  31786  C                               Remove windpipe lesion.........  ..............  ..............  ..............  ..............  ..............

[[Page 18589]]

 
  31800  C                               Repair of windpipe injury......  ..............  ..............  ..............  ..............  ..............
  31805  C                               Repair of windpipe injury......  ..............  ..............  ..............  ..............  ..............
  31820  T                               Closure of windpipe lesion.....            0253           12.02         $582.81         $284.00         $116.56
  31825  T                               Repair of windpipe defect......            0254           12.45         $603.66         $272.41         $120.73
  31830  T                               Revise windpipe scar...........            0254           12.45         $603.66         $272.41         $120.73
  31899  T                               Airways surgical procedure.....            0076            8.06         $390.81         $197.05          $78.16
  32000  T                               Drainage of chest..............            0070            3.64         $176.49          $79.60          $35.30
  32002  T                               Treatment of collapsed lung....            0070            3.64         $176.49          $79.60          $35.30
  32005  T                               Treat lung lining chemically...            0070            3.64         $176.49          $79.60          $35.30
  32020  T                               Insertion of chest tube........            0070            3.64         $176.49          $79.60          $35.30
  32035  C                               Exploration of chest...........  ..............  ..............  ..............  ..............  ..............
  32036  C                               Exploration of chest...........  ..............  ..............  ..............  ..............  ..............
  32095  C                               Biopsy through chest wall......  ..............  ..............  ..............  ..............  ..............
  32100  C                               Exploration/biopsy of chest....  ..............  ..............  ..............  ..............  ..............
  32110  C                               Explore/repair chest...........  ..............  ..............  ..............  ..............  ..............
  32120  C                               Re-exploration of chest........  ..............  ..............  ..............  ..............  ..............
  32124  C                               Explore chest free adhesions...  ..............  ..............  ..............  ..............  ..............
  32140  C                               Removal of lung lesion(s)......  ..............  ..............  ..............  ..............  ..............
  32141  C                               Remove/treat lung lesions......  ..............  ..............  ..............  ..............  ..............
  32150  C                               Removal of lung lesion(s)......  ..............  ..............  ..............  ..............  ..............
  32151  C                               Remove lung foreign body.......  ..............  ..............  ..............  ..............  ..............
  32160  C                               Open chest heart massage.......  ..............  ..............  ..............  ..............  ..............
  32200  C                               Drain, open, lung lesion.......  ..............  ..............  ..............  ..............  ..............
  32201  C                               Drain, percut, lung lesion.....  ..............  ..............  ..............  ..............  ..............
  32215  C                               Treat chest lining.............  ..............  ..............  ..............  ..............  ..............
  32220  C                               Release of lung................  ..............  ..............  ..............  ..............  ..............
  32225  C                               Partial release of lung........  ..............  ..............  ..............  ..............  ..............
  32310  C                               Removal of chest lining........  ..............  ..............  ..............  ..............  ..............
  32320  C                               Free/remove chest lining.......  ..............  ..............  ..............  ..............  ..............
  32400  T                               Needle biopsy chest lining.....            0005            5.41         $262.32         $119.75          $52.46
  32402  C                               Open biopsy chest lining.......  ..............  ..............  ..............  ..............  ..............
  32405  T                               Biopsy, lung or mediastinum....            0005            5.41         $262.32         $119.75          $52.46
  32420  T                               Puncture/clear lung............            0070            3.64         $176.49          $79.60          $35.30
  32440  C                               Removal of lung................  ..............  ..............  ..............  ..............  ..............
  32442  C                               Sleeve pneumonectomy...........  ..............  ..............  ..............  ..............  ..............
  32445  C                               Removal of lung................  ..............  ..............  ..............  ..............  ..............
  32480  C                               Partial removal of lung........  ..............  ..............  ..............  ..............  ..............
  32482  C                               Bilobectomy....................  ..............  ..............  ..............  ..............  ..............
  32484  C                               Segmentectomy..................  ..............  ..............  ..............  ..............  ..............
  32486  C                               Sleeve lobectomy...............  ..............  ..............  ..............  ..............  ..............
  32488  C                               Completion pneumonectomy.......  ..............  ..............  ..............  ..............  ..............
  32491  C                               Lung volume reduction..........  ..............  ..............  ..............  ..............  ..............
  32500  C                               Partial removal of lung........  ..............  ..............  ..............  ..............  ..............
  32501  C                               Repair bronchus add-on.........  ..............  ..............  ..............  ..............  ..............
  32520  C                               Remove lung & revise chest.....  ..............  ..............  ..............  ..............  ..............
  32522  C                               Remove lung & revise chest.....  ..............  ..............  ..............  ..............  ..............
  32525  C                               Remove lung & revise chest.....  ..............  ..............  ..............  ..............  ..............
  32540  C                               Removal of lung lesion.........  ..............  ..............  ..............  ..............  ..............
  32601  T                               Thoracoscopy, diagnostic.......            0076            8.06         $390.81         $197.05          $78.16
  32602  T                               Thoracoscopy, diagnostic.......            0076            8.06         $390.81         $197.05          $78.16
  32603  T                               Thoracoscopy, diagnostic.......            0076            8.06         $390.81         $197.05          $78.16
  32604  T                               Thoracoscopy, diagnostic.......            0076            8.06         $390.81         $197.05          $78.16
  32605  T                               Thoracoscopy, diagnostic.......            0076            8.06         $390.81         $197.05          $78.16
  32606  T                               Thoracoscopy, diagnostic.......            0076            8.06         $390.81         $197.05          $78.16
  32650  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32651  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32652  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32653  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32654  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32655  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32656  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32657  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32658  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32659  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32660  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32661  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32662  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32663  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32664  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32665  C                               Thoracoscopy, surgical.........  ..............  ..............  ..............  ..............  ..............
  32800  C                               Repair lung hernia.............  ..............  ..............  ..............  ..............  ..............
  32810  C                               Close chest after drainage.....  ..............  ..............  ..............  ..............  ..............
  32815  C                               Close bronchial fistula........  ..............  ..............  ..............  ..............  ..............

[[Page 18590]]

 
  32820  C                               Reconstruct injured chest......  ..............  ..............  ..............  ..............  ..............
  32850  C                               Donor pneumonectomy............  ..............  ..............  ..............  ..............  ..............
  32851  C                               Lung transplant, single........  ..............  ..............  ..............  ..............  ..............
  32852  C                               Lung transplant with bypass....  ..............  ..............  ..............  ..............  ..............
  32853  C                               Lung transplant, double........  ..............  ..............  ..............  ..............  ..............
  32854  C                               Lung transplant with bypass....  ..............  ..............  ..............  ..............  ..............
  32900  C                               Removal of rib(s)..............  ..............  ..............  ..............  ..............  ..............
  32905  C                               Revise & repair chest wall.....  ..............  ..............  ..............  ..............  ..............
  32906  C                               Revise & repair chest wall.....  ..............  ..............  ..............  ..............  ..............
  32940  C                               Revision of lung...............  ..............  ..............  ..............  ..............  ..............
  32960  T                               Therapeutic pneumothorax.......            0070            3.64         $176.49          $79.60          $35.30
  32997  C                               Total lung lavage..............  ..............  ..............  ..............  ..............  ..............
  32999  T                               Chest surgery procedure........            0070            3.64         $176.49          $79.60          $35.30
  33010  T                               Drainage of heart sac..........            0070            3.64         $176.49          $79.60          $35.30
  33011  T                               Repeat drainage of heart sac...            0070            3.64         $176.49          $79.60          $35.30
  33015  C                               Incision of heart sac..........  ..............  ..............  ..............  ..............  ..............
  33020  C                               Incision of heart sac..........  ..............  ..............  ..............  ..............  ..............
  33025  C                               Incision of heart sac..........  ..............  ..............  ..............  ..............  ..............
  33030  C                               Partial removal of heart sac...  ..............  ..............  ..............  ..............  ..............
  33031  C                               Partial removal of heart sac...  ..............  ..............  ..............  ..............  ..............
  33050  C                               Removal of heart sac lesion....  ..............  ..............  ..............  ..............  ..............
  33120  C                               Removal of heart lesion........  ..............  ..............  ..............  ..............  ..............
  33130  C                               Removal of heart lesion........  ..............  ..............  ..............  ..............  ..............
  33140  C                               Heart revascularize (tmr)......  ..............  ..............  ..............  ..............  ..............
  33200  C                               Insertion of heart pacemaker...  ..............  ..............  ..............  ..............  ..............
  33201  C                               Insertion of heart pacemaker...  ..............  ..............  ..............  ..............  ..............
  33206  T                               Insertion of heart pacemaker...            0090           20.96       $1,016.29         $573.04         $203.26
  33207  T                               Insertion of heart pacemaker...            0090           20.96       $1,016.29         $573.04         $203.26
  33208  T                               Insertion of heart pacemaker...            0090           20.96       $1,016.29         $573.04         $203.26
  33210  T                               Insertion of heart electrode...            0089            6.49         $314.68         $130.07          $62.94
  33211  T                               Insertion of heart electrode...            0089            6.49         $314.68         $130.07          $62.94
  33212  T                               Insertion of pulse generator...            0090           20.96       $1,016.29         $573.04         $203.26
  33213  T                               Insertion of pulse generator...            0090           20.96       $1,016.29         $573.04         $203.26
  33214  T                               Upgrade of pacemaker system....            0090           20.96       $1,016.29         $573.04         $203.26
  33216  T                               Revise eltrd pacing-defib......            0090           20.96       $1,016.29         $573.04         $203.26
  33217  T                               Revise eltrd pacing-defib......            0090           20.96       $1,016.29         $573.04         $203.26
  33218  T                               Revise eltrd pacing-defib......            0090           20.96       $1,016.29         $573.04         $203.26
  33220  T                               Revise eltrd pacing-defib......            0089            6.49         $314.68         $130.07          $62.94
  33222  T                               Revise pocket, pacemaker.......            0026           12.11         $587.18         $277.92         $117.44
  33223  T                               Revise pocket, pacing-defib....            0026           12.11         $587.18         $277.92         $117.44
  33233  T                               Removal of pacemaker system....            0090           20.96       $1,016.29         $573.04         $203.26
  33234  T                               Removal of pacemaker system....            0090           20.96       $1,016.29         $573.04         $203.26
  33235  T                               Removal pacemaker electrode....            0090           20.96       $1,016.29         $573.04         $203.26
  33236  C                               Remove electrode/thoracotomy...  ..............  ..............  ..............  ..............  ..............
  33237  C                               Remove electrode/thoracotomy...  ..............  ..............  ..............  ..............  ..............
  33238  C                               Remove electrode/thoracotomy...  ..............  ..............  ..............  ..............  ..............
  33240  T                               Insert pulse generator.........            0090           20.96       $1,016.29         $573.04         $203.26
  33241  T                               Remove pulse generator.........            0089            6.49         $314.68         $130.07          $62.94
  33243  C                               Remove eltrd/thoracotomy.......  ..............  ..............  ..............  ..............  ..............
  33244  T                               Remove eltrd, transven.........            0090           20.96       $1,016.29         $573.04         $203.26
  33245  C                               Insert epic eltrd pace-defib...  ..............  ..............  ..............  ..............  ..............
  33246  C                               Insert epic eltrd/generator....  ..............  ..............  ..............  ..............  ..............
  33249  T                               Eltrd/insert pace-defib........            0090           20.96       $1,016.29         $573.04         $203.26
  33250  C                               Ablate heart dysrhythm focus...  ..............  ..............  ..............  ..............  ..............
  33251  C                               Ablate heart dysrhythm focus...  ..............  ..............  ..............  ..............  ..............
  33253  C                               Reconstruct atria..............  ..............  ..............  ..............  ..............  ..............
  33261  C                               Ablate heart dysrhythm focus...  ..............  ..............  ..............  ..............  ..............
  33282  C                               Implant pat-active ht record...  ..............  ..............  ..............  ..............  ..............
  33284  C                               Remove pat-active ht record....  ..............  ..............  ..............  ..............  ..............
  33300  C                               Repair of heart wound..........  ..............  ..............  ..............  ..............  ..............
  33305  C                               Repair of heart wound..........  ..............  ..............  ..............  ..............  ..............
  33310  C                               Exploratory heart surgery......  ..............  ..............  ..............  ..............  ..............
  33315  C                               Exploratory heart surgery......  ..............  ..............  ..............  ..............  ..............
  33320  C                               Repair major blood vessel(s)...  ..............  ..............  ..............  ..............  ..............
  33321  C                               Repair major vessel............  ..............  ..............  ..............  ..............  ..............
  33322  C                               Repair major blood vessel(s)...  ..............  ..............  ..............  ..............  ..............
  33330  C                               Insert major vessel graft......  ..............  ..............  ..............  ..............  ..............
  33332  C                               Insert major vessel graft......  ..............  ..............  ..............  ..............  ..............
  33335  C                               Insert major vessel graft......  ..............  ..............  ..............  ..............  ..............
  33400  C                               Repair of aortic valve.........  ..............  ..............  ..............  ..............  ..............
  33401  C                               Valvuloplasty, open............  ..............  ..............  ..............  ..............  ..............
  33403  C                               Valvuloplasty, w/cp bypass.....  ..............  ..............  ..............  ..............  ..............
  33404  C                               Prepare heart-aorta conduit....  ..............  ..............  ..............  ..............  ..............

[[Page 18591]]

 
  33405  C                               Replacement of aortic valve....  ..............  ..............  ..............  ..............  ..............
  33406  C                               Replacement of aortic valve....  ..............  ..............  ..............  ..............  ..............
  33410  C                               Replacement of aortic valve....  ..............  ..............  ..............  ..............  ..............
  33411  C                               Replacement of aortic valve....  ..............  ..............  ..............  ..............  ..............
  33412  C                               Replacement of aortic valve....  ..............  ..............  ..............  ..............  ..............
  33413  C                               Replacement of aortic valve....  ..............  ..............  ..............  ..............  ..............
  33414  C                               Repair of aortic valve.........  ..............  ..............  ..............  ..............  ..............
  33415  C                               Revision, subvalvular tissue...  ..............  ..............  ..............  ..............  ..............
  33416  C                               Revise ventricle muscle........  ..............  ..............  ..............  ..............  ..............
  33417  C                               Repair of aortic valve.........  ..............  ..............  ..............  ..............  ..............
  33420  C                               Revision of mitral valve.......  ..............  ..............  ..............  ..............  ..............
  33422  C                               Revision of mitral valve.......  ..............  ..............  ..............  ..............  ..............
  33425  C                               Repair of mitral valve.........  ..............  ..............  ..............  ..............  ..............
  33426  C                               Repair of mitral valve.........  ..............  ..............  ..............  ..............  ..............
  33427  C                               Repair of mitral valve.........  ..............  ..............  ..............  ..............  ..............
  33430  C                               Replacement of mitral valve....  ..............  ..............  ..............  ..............  ..............
  33460  C                               Revision of tricuspid valve....  ..............  ..............  ..............  ..............  ..............
  33463  C                               Valvuloplasty, tricuspid.......  ..............  ..............  ..............  ..............  ..............
  33464  C                               Valvuloplasty, tricuspid.......  ..............  ..............  ..............  ..............  ..............
  33465  C                               Replace tricuspid valve........  ..............  ..............  ..............  ..............  ..............
  33468  C                               Revision of tricuspid valve....  ..............  ..............  ..............  ..............  ..............
  33470  C                               Revision of pulmonary valve....  ..............  ..............  ..............  ..............  ..............
  33471  C                               Valvotomy, pulmonary valve.....  ..............  ..............  ..............  ..............  ..............
  33472  C                               Revision of pulmonary valve....  ..............  ..............  ..............  ..............  ..............
  33474  C                               Revision of pulmonary valve....  ..............  ..............  ..............  ..............  ..............
  33475  C                               Replacement, pulmonary valve...  ..............  ..............  ..............  ..............  ..............
  33476  C                               Revision of heart chamber......  ..............  ..............  ..............  ..............  ..............
  33478  C                               Revision of heart chamber......  ..............  ..............  ..............  ..............  ..............
  33496  C                               Repair, prosth valve clot......  ..............  ..............  ..............  ..............  ..............
  33500  C                               Repair heart vessel fistula....  ..............  ..............  ..............  ..............  ..............
  33501  C                               Repair heart vessel fistula....  ..............  ..............  ..............  ..............  ..............
  33502  C                               Coronary artery correction.....  ..............  ..............  ..............  ..............  ..............
  33503  C                               Coronary artery graft..........  ..............  ..............  ..............  ..............  ..............
  33504  C                               Coronary artery graft..........  ..............  ..............  ..............  ..............  ..............
  33505  C                               Repair artery w/tunnel.........  ..............  ..............  ..............  ..............  ..............
  33506  C                               Repair artery, translocation...  ..............  ..............  ..............  ..............  ..............
  33510  C                               CABG, vein, single.............  ..............  ..............  ..............  ..............  ..............
  33511  C                               CABG, vein, two................  ..............  ..............  ..............  ..............  ..............
  33512  C                               CABG, vein, three..............  ..............  ..............  ..............  ..............  ..............
  33513  C                               CABG, vein, four...............  ..............  ..............  ..............  ..............  ..............
  33514  C                               CABG, vein, five...............  ..............  ..............  ..............  ..............  ..............
  33516  C                               Cabg, vein, six or more........  ..............  ..............  ..............  ..............  ..............
  33517  C                               CABG, artery-vein, single......  ..............  ..............  ..............  ..............  ..............
  33518  C                               CABG, artery-vein, two.........  ..............  ..............  ..............  ..............  ..............
  33519  C                               CABG, artery-vein, three.......  ..............  ..............  ..............  ..............  ..............
  33521  C                               CABG, artery-vein, four........  ..............  ..............  ..............  ..............  ..............
  33522  C                               CABG, artery-vein, five........  ..............  ..............  ..............  ..............  ..............
  33523  C                               Cabg, art-vein, six or more....  ..............  ..............  ..............  ..............  ..............
  33530  C                               Coronary artery, bypass/reop...  ..............  ..............  ..............  ..............  ..............
  33533  C                               CABG, arterial, single.........  ..............  ..............  ..............  ..............  ..............
  33534  C                               CABG, arterial, two............  ..............  ..............  ..............  ..............  ..............
  33535  C                               CABG, arterial, three..........  ..............  ..............  ..............  ..............  ..............
  33536  C                               Cabg, arterial, four or more...  ..............  ..............  ..............  ..............  ..............
  33542  C                               Removal of heart lesion........  ..............  ..............  ..............  ..............  ..............
  33545  C                               Repair of heart damage.........  ..............  ..............  ..............  ..............  ..............
  33572  C                               Open coronary endarterectomy...  ..............  ..............  ..............  ..............  ..............
  33600  C                               Closure of valve...............  ..............  ..............  ..............  ..............  ..............
  33602  C                               Closure of valve...............  ..............  ..............  ..............  ..............  ..............
  33606  C                               Anastomosis/artery-aorta.......  ..............  ..............  ..............  ..............  ..............
  33608  C                               Repair anomaly w/conduit.......  ..............  ..............  ..............  ..............  ..............
  33610  C                               Repair by enlargement..........  ..............  ..............  ..............  ..............  ..............
  33611  C                               Repair double ventricle........  ..............  ..............  ..............  ..............  ..............
  33612  C                               Repair double ventricle........  ..............  ..............  ..............  ..............  ..............
  33615  C                               Repair, simple fontan..........  ..............  ..............  ..............  ..............  ..............
  33617  C                               Repair, modified fontan........  ..............  ..............  ..............  ..............  ..............
  33619  C                               Repair single ventricle........  ..............  ..............  ..............  ..............  ..............
  33641  C                               Repair heart septum defect.....  ..............  ..............  ..............  ..............  ..............
  33645  C                               Revision of heart veins........  ..............  ..............  ..............  ..............  ..............
  33647  C                               Repair heart septum defects....  ..............  ..............  ..............  ..............  ..............
  33660  C                               Repair of heart defects........  ..............  ..............  ..............  ..............  ..............
  33665  C                               Repair of heart defects........  ..............  ..............  ..............  ..............  ..............
  33670  C                               Repair of heart chambers.......  ..............  ..............  ..............  ..............  ..............
  33681  C                               Repair heart septum defect.....  ..............  ..............  ..............  ..............  ..............

[[Page 18592]]

 
  33684  C                               Repair heart septum defect.....  ..............  ..............  ..............  ..............  ..............
  33688  C                               Repair heart septum defect.....  ..............  ..............  ..............  ..............  ..............
  33690  C                               Reinforce pulmonary artery.....  ..............  ..............  ..............  ..............  ..............
  33692  C                               Repair of heart defects........  ..............  ..............  ..............  ..............  ..............
  33694  C                               Repair of heart defects........  ..............  ..............  ..............  ..............  ..............
  33697  C                               Repair of heart defects........  ..............  ..............  ..............  ..............  ..............
  33702  C                               Repair of heart defects........  ..............  ..............  ..............  ..............  ..............
  33710  C                               Repair of heart defects........  ..............  ..............  ..............  ..............  ..............
  33720  C                               Repair of heart defect.........  ..............  ..............  ..............  ..............  ..............
  33722  C                               Repair of heart defect.........  ..............  ..............  ..............  ..............  ..............
  33730  C                               Repair heart-vein defect(s)....  ..............  ..............  ..............  ..............  ..............
  33732  C                               Repair heart-vein defect.......  ..............  ..............  ..............  ..............  ..............
  33735  C                               Revision of heart chamber......  ..............  ..............  ..............  ..............  ..............
  33736  C                               Revision of heart chamber......  ..............  ..............  ..............  ..............  ..............
  33737  C                               Revision of heart chamber......  ..............  ..............  ..............  ..............  ..............
  33750  C                               Major vessel shunt.............  ..............  ..............  ..............  ..............  ..............
  33755  C                               Major vessel shunt.............  ..............  ..............  ..............  ..............  ..............
  33762  C                               Major vessel shunt.............  ..............  ..............  ..............  ..............  ..............
  33764  C                               Major vessel shunt & graft.....  ..............  ..............  ..............  ..............  ..............
  33766  C                               Major vessel shunt.............  ..............  ..............  ..............  ..............  ..............
  33767  C                               Major vessel shunt.............  ..............  ..............  ..............  ..............  ..............
  33770  C                               Repair great vessels defect....  ..............  ..............  ..............  ..............  ..............
  33771  C                               Repair great vessels defect....  ..............  ..............  ..............  ..............  ..............
  33774  C                               Repair great vessels defect....  ..............  ..............  ..............  ..............  ..............
  33775  C                               Repair great vessels defect....  ..............  ..............  ..............  ..............  ..............
  33776  C                               Repair great vessels defect....  ..............  ..............  ..............  ..............  ..............
  33777  C                               Repair great vessels defect....  ..............  ..............  ..............  ..............  ..............
  33778  C                               Repair great vessels defect....  ..............  ..............  ..............  ..............  ..............
  33779  C                               Repair great vessels defect....  ..............  ..............  ..............  ..............  ..............
  33780  C                               Repair great vessels defect....  ..............  ..............  ..............  ..............  ..............
  33781  C                               Repair great vessels defect....  ..............  ..............  ..............  ..............  ..............
  33786  C                               Repair arterial trunk..........  ..............  ..............  ..............  ..............  ..............
  33788  C                               Revision of pulmonary artery...  ..............  ..............  ..............  ..............  ..............
  33800  C                               Aortic suspension..............  ..............  ..............  ..............  ..............  ..............
  33802  C                               Repair vessel defect...........  ..............  ..............  ..............  ..............  ..............
  33803  C                               Repair vessel defect...........  ..............  ..............  ..............  ..............  ..............
  33813  C                               Repair septal defect...........  ..............  ..............  ..............  ..............  ..............
  33814  C                               Repair septal defect...........  ..............  ..............  ..............  ..............  ..............
  33820  C                               Revise major vessel............  ..............  ..............  ..............  ..............  ..............
  33822  C                               Revise major vessel............  ..............  ..............  ..............  ..............  ..............
  33824  C                               Revise major vessel............  ..............  ..............  ..............  ..............  ..............
  33840  C                               Remove aorta constriction......  ..............  ..............  ..............  ..............  ..............
  33845  C                               Remove aorta constriction......  ..............  ..............  ..............  ..............  ..............
  33851  C                               Remove aorta constriction......  ..............  ..............  ..............  ..............  ..............
  33852  C                               Repair septal defect...........  ..............  ..............  ..............  ..............  ..............
  33853  C                               Repair septal defect...........  ..............  ..............  ..............  ..............  ..............
  33860  C                               Ascending aortic graft.........  ..............  ..............  ..............  ..............  ..............
  33861  C                               Ascending aortic graft.........  ..............  ..............  ..............  ..............  ..............
  33863  C                               Ascending aortic graft.........  ..............  ..............  ..............  ..............  ..............
  33870  C                               Transverse aortic arch graft...  ..............  ..............  ..............  ..............  ..............
  33875  C                               Thoracic aortic graft..........  ..............  ..............  ..............  ..............  ..............
  33877  C                               Thoracoabdominal graft.........  ..............  ..............  ..............  ..............  ..............
  33910  C                               Remove lung artery emboli......  ..............  ..............  ..............  ..............  ..............
  33915  C                               Remove lung artery emboli......  ..............  ..............  ..............  ..............  ..............
  33916  C                               Surgery of great vessel........  ..............  ..............  ..............  ..............  ..............
  33917  C                               Repair pulmonary artery........  ..............  ..............  ..............  ..............  ..............
  33918  C                               Repair pulmonary atresia.......  ..............  ..............  ..............  ..............  ..............
  33919  C                               Repair pulmonary atresia.......  ..............  ..............  ..............  ..............  ..............
  33920  C                               Repair pulmonary atresia.......  ..............  ..............  ..............  ..............  ..............
  33922  C                               Transect pulmonary artery......  ..............  ..............  ..............  ..............  ..............
  33924  C                               Remove pulmonary shunt.........  ..............  ..............  ..............  ..............  ..............
  33930  C                               Removal of donor heart/lung....  ..............  ..............  ..............  ..............  ..............
  33935  C                               Transplantation, heart/lung....  ..............  ..............  ..............  ..............  ..............
  33940  C                               Removal of donor heart.........  ..............  ..............  ..............  ..............  ..............
  33945  C                               Transplantation of heart.......  ..............  ..............  ..............  ..............  ..............
  33960  C                               External circulation assist....  ..............  ..............  ..............  ..............  ..............
  33961  C                               External circulation assist....  ..............  ..............  ..............  ..............  ..............
  33968  C                               Remove aortic assist device....  ..............  ..............  ..............  ..............  ..............
  33970  C                               Aortic circulation assist......  ..............  ..............  ..............  ..............  ..............
  33971  C                               Aortic circulation assist......  ..............  ..............  ..............  ..............  ..............
  33973  C                               Insert balloon device..........  ..............  ..............  ..............  ..............  ..............
  33974  C                               Remove intra-aortic balloon....  ..............  ..............  ..............  ..............  ..............
  33975  C                               Implant ventricular device.....  ..............  ..............  ..............  ..............  ..............

[[Page 18593]]

 
  33976  C                               Implant ventricular device.....  ..............  ..............  ..............  ..............  ..............
  33977  C                               Remove ventricular device......  ..............  ..............  ..............  ..............  ..............
  33978  C                               Remove ventricular device......  ..............  ..............  ..............  ..............  ..............
  33999  T                               Cardiac surgery procedure......            0070            3.64         $176.49          $79.60          $35.30
  34001  C                               Removal of artery clot.........  ..............  ..............  ..............  ..............  ..............
  34051  C                               Removal of artery clot.........  ..............  ..............  ..............  ..............  ..............
  34101  T                               Removal of artery clot.........            0088           26.49       $1,284.42         $678.68         $256.88
  34111  T                               Removal of arm artery clot.....            0088           26.49       $1,284.42         $678.68         $256.88
  34151  C                               Removal of artery clot.........  ..............  ..............  ..............  ..............  ..............
  34201  T                               Removal of artery clot.........            0088           26.49       $1,284.42         $678.68         $256.88
  34203  T                               Removal of leg artery clot.....            0088           26.49       $1,284.42         $678.68         $256.88
  34401  C                               Removal of vein clot...........  ..............  ..............  ..............  ..............  ..............
  34421  C                               Removal of vein clot...........  ..............  ..............  ..............  ..............  ..............
  34451  C                               Removal of vein clot...........  ..............  ..............  ..............  ..............  ..............
  34471  T                               Removal of vein clot...........            0088           26.49       $1,284.42         $678.68         $256.88
  34490  T                               Removal of vein clot...........            0088           26.49       $1,284.42         $678.68         $256.88
  34501  T                               Repair valve, femoral vein.....            0088           26.49       $1,284.42         $678.68         $256.88
  34502  C                               Reconstruct vena cava..........  ..............  ..............  ..............  ..............  ..............
  34510  T                               Transposition of vein valve....            0088           26.49       $1,284.42         $678.68         $256.88
  34520  T                               Cross-over vein graft..........            0088           26.49       $1,284.42         $678.68         $256.88
  34530  T                               Leg vein fusion................            0088           26.49       $1,284.42         $678.68         $256.88
  35001  C                               Repair defect of artery........  ..............  ..............  ..............  ..............  ..............
  35002  C                               Repair artery rupture, neck....  ..............  ..............  ..............  ..............  ..............
  35005  C                               Repair defect of artery........  ..............  ..............  ..............  ..............  ..............
  35011  C                               Repair defect of artery........  ..............  ..............  ..............  ..............  ..............
  35013  C                               Repair artery rupture, arm.....  ..............  ..............  ..............  ..............  ..............
  35021  C                               Repair defect of artery........  ..............  ..............  ..............  ..............  ..............
  35022  C                               Repair artery rupture, chest...  ..............  ..............  ..............  ..............  ..............
  35045  C                               Repair defect of arm artery....  ..............  ..............  ..............  ..............  ..............
  35081  C                               Repair defect of artery........  ..............  ..............  ..............  ..............  ..............
  35082  C                               Repair artery rupture, aorta...  ..............  ..............  ..............  ..............  ..............
  35091  C                               Repair defect of artery........  ..............  ..............  ..............  ..............  ..............
  35092  C                               Repair artery rupture, aorta...  ..............  ..............  ..............  ..............  ..............
  35102  C                               Repair defect of artery........  ..............  ..............  ..............  ..............  ..............
  35103  C                               Repair artery rupture, groin...  ..............  ..............  ..............  ..............  ..............
  35111  C                               Repair defect of artery........  ..............  ..............  ..............  ..............  ..............
  35112  C                               Repair artery rupture, spleen..  ..............  ..............  ..............  ..............  ..............
  35121  C                               Repair defect of artery........  ..............  ..............  ..............  ..............  ..............
  35122  C                               Repair artery rupture, belly...  ..............  ..............  ..............  ..............  ..............
  35131  C                               Repair defect of artery........  ..............  ..............  ..............  ..............  ..............
  35132  C                               Repair artery rupture, groin...  ..............  ..............  ..............  ..............  ..............
  35141  C                               Repair defect of artery........  ..............  ..............  ..............  ..............  ..............
  35142  C                               Repair artery rupture, thigh...  ..............  ..............  ..............  ..............  ..............
  35151  C                               Repair defect of artery........  ..............  ..............  ..............  ..............  ..............
  35152  C                               Repair artery rupture, knee....  ..............  ..............  ..............  ..............  ..............
  35161  C                               Repair defect of artery........  ..............  ..............  ..............  ..............  ..............
  35162  C                               Repair artery rupture..........  ..............  ..............  ..............  ..............  ..............
  35180  T                               Repair blood vessel lesion.....            0081           19.36         $938.71         $434.25         $187.74
  35182  C                               Repair blood vessel lesion.....  ..............  ..............  ..............  ..............  ..............
  35184  T                               Repair blood vessel lesion.....            0081           19.36         $938.71         $434.25         $187.74
  35188  T                               Repair blood vessel lesion.....            0088           26.49       $1,284.42         $678.68         $256.88
  35189  C                               Repair blood vessel lesion.....  ..............  ..............  ..............  ..............  ..............
  35190  T                               Repair blood vessel lesion.....            0081           19.36         $938.71         $434.25         $187.74
  35201  T                               Repair blood vessel lesion.....            0081           19.36         $938.71         $434.25         $187.74
  35206  T                               Repair blood vessel lesion.....            0081           19.36         $938.71         $434.25         $187.74
  35207  T                               Repair blood vessel lesion.....            0088           26.49       $1,284.42         $678.68         $256.88
  35211  C                               Repair blood vessel lesion.....  ..............  ..............  ..............  ..............  ..............
  35216  C                               Repair blood vessel lesion.....  ..............  ..............  ..............  ..............  ..............
  35221  C                               Repair blood vessel lesion.....  ..............  ..............  ..............  ..............  ..............
  35226  T                               Repair blood vessel lesion.....            0081           19.36         $938.71         $434.25         $187.74
  35231  T                               Repair blood vessel lesion.....            0081           19.36         $938.71         $434.25         $187.74
  35236  T                               Repair blood vessel lesion.....            0081           19.36         $938.71         $434.25         $187.74
  35241  C                               Repair blood vessel lesion.....  ..............  ..............  ..............  ..............  ..............
  35246  C                               Repair blood vessel lesion.....  ..............  ..............  ..............  ..............  ..............
  35251  C                               Repair blood vessel lesion.....  ..............  ..............  ..............  ..............  ..............
  35256  T                               Repair blood vessel lesion.....            0081           19.36         $938.71         $434.25         $187.74
  35261  T                               Repair blood vessel lesion.....            0081           19.36         $938.71         $434.25         $187.74
  35266  T                               Repair blood vessel lesion.....            0081           19.36         $938.71         $434.25         $187.74
  35271  C                               Repair blood vessel lesion.....  ..............  ..............  ..............  ..............  ..............
  35276  C                               Repair blood vessel lesion.....  ..............  ..............  ..............  ..............  ..............
  35281  C                               Repair blood vessel lesion.....  ..............  ..............  ..............  ..............  ..............
  35286  T                               Repair blood vessel lesion.....            0081           19.36         $938.71         $434.25         $187.74
  35301  C                               Rechanneling of artery.........  ..............  ..............  ..............  ..............  ..............

[[Page 18594]]

 
  35311  C                               Rechanneling of artery.........  ..............  ..............  ..............  ..............  ..............
  35321  T                               Rechanneling of artery.........            0081           19.36         $938.71         $434.25         $187.74
  35331  C                               Rechanneling of artery.........  ..............  ..............  ..............  ..............  ..............
  35341  C                               Rechanneling of artery.........  ..............  ..............  ..............  ..............  ..............
  35351  C                               Rechanneling of artery.........  ..............  ..............  ..............  ..............  ..............
  35355  C                               Rechanneling of artery.........  ..............  ..............  ..............  ..............  ..............
  35361  C                               Rechanneling of artery.........  ..............  ..............  ..............  ..............  ..............
  35363  C                               Rechanneling of artery.........  ..............  ..............  ..............  ..............  ..............
  35371  C                               Rechanneling of artery.........  ..............  ..............  ..............  ..............  ..............
  35372  C                               Rechanneling of artery.........  ..............  ..............  ..............  ..............  ..............
  35381  C                               Rechanneling of artery.........  ..............  ..............  ..............  ..............  ..............
  35390  C                               Reoperation, carotid add-on....  ..............  ..............  ..............  ..............  ..............
  35400  C                               Angioscopy.....................  ..............  ..............  ..............  ..............  ..............
  35450  C                               Repair arterial blockage.......  ..............  ..............  ..............  ..............  ..............
  35452  C                               Repair arterial blockage.......  ..............  ..............  ..............  ..............  ..............
  35454  C                               Repair arterial blockage.......  ..............  ..............  ..............  ..............  ..............
  35456  C                               Repair arterial blockage.......  ..............  ..............  ..............  ..............  ..............
  35458  C                               Repair arterial blockage.......  ..............  ..............  ..............  ..............  ..............
  35459  T                               Repair arterial blockage.......            0081           19.36         $938.71         $434.25         $187.74
  35460  T                               Repair venous blockage.........            0081           19.36         $938.71         $434.25         $187.74
  35470  T                               Repair arterial blockage.......            0081           19.36         $938.71         $434.25         $187.74
  35471  T                               Repair arterial blockage.......            0081           19.36         $938.71         $434.25         $187.74
  35472  T                               Repair arterial blockage.......            0081           19.36         $938.71         $434.25         $187.74
  35473  T                               Repair arterial blockage.......            0081           19.36         $938.71         $434.25         $187.74
  35474  T                               Repair arterial blockage.......            0081           19.36         $938.71         $434.25         $187.74
  35475  T                               Repair arterial blockage.......            0081           19.36         $938.71         $434.25         $187.74
  35476  T                               Repair venous blockage.........            0081           19.36         $938.71         $434.25         $187.74
  35480  C                               Atherectomy, open..............  ..............  ..............  ..............  ..............  ..............
  35481  C                               Atherectomy, open..............  ..............  ..............  ..............  ..............  ..............
  35482  C                               Atherectomy, open..............  ..............  ..............  ..............  ..............  ..............
  35483  C                               Atherectomy, open..............  ..............  ..............  ..............  ..............  ..............
  35484  T                               Atherectomy, open..............            0081           19.36         $938.71         $434.25         $187.74
  35485  T                               Atherectomy, open..............            0081           19.36         $938.71         $434.25         $187.74
  35490  T                               Atherectomy, percutaneous......            0081           19.36         $938.71         $434.25         $187.74
  35491  T                               Atherectomy, percutaneous......            0081           19.36         $938.71         $434.25         $187.74
  35492  T                               Atherectomy, percutaneous......            0081           19.36         $938.71         $434.25         $187.74
  35493  T                               Atherectomy, percutaneous......            0081           19.36         $938.71         $434.25         $187.74
  35494  T                               Atherectomy, percutaneous......            0081           19.36         $938.71         $434.25         $187.74
  35495  T                               Atherectomy, percutaneous......            0081           19.36         $938.71         $434.25         $187.74
  35500  T                               Harvest vein for bypass........            0081           19.36         $938.71         $434.25         $187.74
  35501  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35506  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35507  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35508  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35509  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35511  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35515  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35516  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35518  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35521  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35526  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35531  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35533  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35536  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35541  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35546  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35548  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35549  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35551  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35556  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35558  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35560  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35563  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35565  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35566  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35571  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35582  C                               Vein bypass graft..............  ..............  ..............  ..............  ..............  ..............
  35583  C                               Vein bypass graft..............  ..............  ..............  ..............  ..............  ..............
  35585  C                               Vein bypass graft..............  ..............  ..............  ..............  ..............  ..............
  35587  C                               Vein bypass graft..............  ..............  ..............  ..............  ..............  ..............
  35601  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35606  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35612  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............

[[Page 18595]]

 
  35616  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35621  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35623  C                               Bypass graft, not vein.........  ..............  ..............  ..............  ..............  ..............
  35626  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35631  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35636  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35641  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35642  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35645  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35646  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35650  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35651  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35654  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35656  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35661  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35663  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35665  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35666  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35671  C                               Artery bypass graft............  ..............  ..............  ..............  ..............  ..............
  35681  C                               Composite bypass graft.........  ..............  ..............  ..............  ..............  ..............
  35682  C                               Composite bypass graft.........  ..............  ..............  ..............  ..............  ..............
  35683  C                               Composite bypass graft.........  ..............  ..............  ..............  ..............  ..............
  35691  C                               Arterial transposition.........  ..............  ..............  ..............  ..............  ..............
  35693  C                               Arterial transposition.........  ..............  ..............  ..............  ..............  ..............
  35694  C                               Arterial transposition.........  ..............  ..............  ..............  ..............  ..............
  35695  C                               Arterial transposition.........  ..............  ..............  ..............  ..............  ..............
  35700  C                               Reoperation, bypass graft......  ..............  ..............  ..............  ..............  ..............
  35701  C                               Exploration, carotid artery....  ..............  ..............  ..............  ..............  ..............
  35721  C                               Exploration, femoral artery....  ..............  ..............  ..............  ..............  ..............
  35741  C                               Exploration popliteal artery...  ..............  ..............  ..............  ..............  ..............
  35761  C                               Exploration of artery/vein.....  ..............  ..............  ..............  ..............  ..............
  35800  C                               Explore neck vessels...........  ..............  ..............  ..............  ..............  ..............
  35820  C                               Explore chest vessels..........  ..............  ..............  ..............  ..............  ..............
  35840  C                               Explore abdominal vessels......  ..............  ..............  ..............  ..............  ..............
  35860  C                               Explore limb vessels...........  ..............  ..............  ..............  ..............  ..............
  35870  C                               Repair vessel graft defect.....  ..............  ..............  ..............  ..............  ..............
  35875  T                               Removal of clot in graft.......            0088           26.49       $1,284.42         $678.68         $256.88
  35876  T                               Removal of clot in graft.......            0088           26.49       $1,284.42         $678.68         $256.88
  35879  T                               Revise graft w/vein............            0088           26.49       $1,284.42         $678.68         $256.88
  35881  T                               Revise graft w/vein............            0088           26.49       $1,284.42         $678.68         $256.88
  35901  C                               Excision, graft, neck..........  ..............  ..............  ..............  ..............  ..............
  35903  C                               Excision, graft, extremity.....  ..............  ..............  ..............  ..............  ..............
  35905  C                               Excision, graft, thorax........  ..............  ..............  ..............  ..............  ..............
  35907  C                               Excision, graft, abdomen.......  ..............  ..............  ..............  ..............  ..............
  36000  N                               Place needle in vein...........  ..............  ..............  ..............  ..............  ..............
  36005  N                               Injection, venography..........  ..............  ..............  ..............  ..............  ..............
  36010  N                               Place catheter in vein.........  ..............  ..............  ..............  ..............  ..............
  36011  N                               Place catheter in vein.........  ..............  ..............  ..............  ..............  ..............
  36012  N                               Place catheter in vein.........  ..............  ..............  ..............  ..............  ..............
  36013  N                               Place catheter in artery.......  ..............  ..............  ..............  ..............  ..............
  36014  N                               Place catheter in artery.......  ..............  ..............  ..............  ..............  ..............
  36015  N                               Place catheter in artery.......  ..............  ..............  ..............  ..............  ..............
  36100  N                               Establish access to artery.....  ..............  ..............  ..............  ..............  ..............
  36120  N                               Establish access to artery.....  ..............  ..............  ..............  ..............  ..............
  36140  N                               Establish access to artery.....  ..............  ..............  ..............  ..............  ..............
  36145  N                               Artery to vein shunt...........  ..............  ..............  ..............  ..............  ..............
  36160  N                               Establish access to aorta......  ..............  ..............  ..............  ..............  ..............
  36200  N                               Place catheter in aorta........  ..............  ..............  ..............  ..............  ..............
  36215  N                               Place catheter in artery.......  ..............  ..............  ..............  ..............  ..............
  36216  N                               Place catheter in artery.......  ..............  ..............  ..............  ..............  ..............
  36217  N                               Place catheter in artery.......  ..............  ..............  ..............  ..............  ..............
  36218  N                               Place catheter in artery.......  ..............  ..............  ..............  ..............  ..............
  36245  N                               Place catheter in artery.......  ..............  ..............  ..............  ..............  ..............
  36246  N                               Place catheter in artery.......  ..............  ..............  ..............  ..............  ..............
  36247  N                               Place catheter in artery.......  ..............  ..............  ..............  ..............  ..............
  36248  N                               Place catheter in artery.......  ..............  ..............  ..............  ..............  ..............
  36260  T                               Insertion of infusion pump.....            0093           17.95         $870.34         $422.33         $174.07
  36261  T                               Revision of infusion pump......            0089            6.49         $314.68         $130.07          $62.94
  36262  T                               Removal of infusion pump.......            0089            6.49         $314.68         $130.07          $62.94
  36299  T                               Vessel injection procedure.....            0089            6.49         $314.68         $130.07          $62.94
  36400  N                               Drawing blood..................  ..............  ..............  ..............  ..............  ..............
  36405  N                               Drawing blood..................  ..............  ..............  ..............  ..............  ..............
  36406  N                               Drawing blood..................  ..............  ..............  ..............  ..............  ..............

[[Page 18596]]

 
  36410  N                               Drawing blood..................  ..............  ..............  ..............  ..............  ..............
  36415  E                               Drawing blood..................  ..............  ..............  ..............  ..............  ..............
  36420  T                               Establish access to vein.......            0032            5.40         $261.83         $119.52          $52.37
  36425  T                               Establish access to vein.......            0032            5.40         $261.83         $119.52          $52.37
  36430  S                               Blood transfusion service......            0110            5.83         $282.68         $122.73          $56.54
  36440  S                               Blood transfusion service......            0110            5.83         $282.68         $122.73          $56.54
  36450  S                               Exchange transfusion service...            0110            5.83         $282.68         $122.73          $56.54
  36455  S                               Exchange transfusion service...            0110            5.83         $282.68         $122.73          $56.54
  36460  S                               Transfusion service, fetal.....            0110            5.83         $282.68         $122.73          $56.54
  36468  T                               Injection(s), spider veins.....            0098            1.19          $57.70          $20.88          $11.54
  36469  T                               Injection(s), spider veins.....            0098            1.19          $57.70          $20.88          $11.54
  36470  T                               Injection therapy of vein......            0098            1.19          $57.70          $20.88          $11.54
  36471  T                               Injection therapy of veins.....            0098            1.19          $57.70          $20.88          $11.54
  36481  N                               Insertion of catheter, vein....  ..............  ..............  ..............  ..............  ..............
  36488  T                               Insertion of catheter, vein....            0032            5.40         $261.83         $119.52          $52.37
  36489  T                               Insertion of catheter, vein....            0032            5.40         $261.83         $119.52          $52.37
  36490  T                               Insertion of catheter, vein....            0032            5.40         $261.83         $119.52          $52.37
  36491  T                               Insertion of catheter, vein....            0032            5.40         $261.83         $119.52          $52.37
  36493  T                               Repositioning of cvc...........            0032            5.40         $261.83         $119.52          $52.37
  36500  N                               Insertion of catheter, vein....  ..............  ..............  ..............  ..............  ..............
  36510  C                               Insertion of catheter, vein....  ..............  ..............  ..............  ..............  ..............
  36520  S                               Plasma and/or cell exchange....            0111           14.17         $687.06         $300.74         $137.41
  36521  S                               Apheresis w/adsorp/reinfuse....            0111           14.17         $687.06         $300.74         $137.41
  36522  S                               Photopheresis..................            0112           39.60       $1,920.09         $663.65         $384.02
  36530  T                               Insertion of infusion pump.....            0093           17.95         $870.34         $422.33         $174.07
  36531  T                               Revision of infusion pump......            0089            6.49         $314.68         $130.07          $62.94
  36532  T                               Removal of infusion pump.......            0089            6.49         $314.68         $130.07          $62.94
  36533  T                               Insertion of access device.....            0093           17.95         $870.34         $422.33         $174.07
  36534  T                               Revision of access device......            0089            6.49         $314.68         $130.07          $62.94
  36535  T                               Removal of access device.......            0089            6.49         $314.68         $130.07          $62.94
  36550  C                               Declot vascular device.........  ..............  ..............  ..............  ..............  ..............
  36600  N                               Withdrawal of arterial blood...  ..............  ..............  ..............  ..............  ..............
  36620  N                               Insertion catheter, artery.....  ..............  ..............  ..............  ..............  ..............
  36625  N                               Insertion catheter, artery.....  ..............  ..............  ..............  ..............  ..............
  36640  T                               Insertion catheter, artery.....            0032            5.40         $261.83         $119.52          $52.37
  36660  C                               Insertion catheter, artery.....  ..............  ..............  ..............  ..............  ..............
  36680  S                               Insert needle, bone cavity.....            0120            1.66          $80.49          $42.67          $16.10
  36800  T                               Insertion of cannula...........            0093           17.95         $870.34         $422.33         $174.07
  36810  T                               Insertion of cannula...........            0093           17.95         $870.34         $422.33         $174.07
  36815  T                               Insertion of cannula...........            0093           17.95         $870.34         $422.33         $174.07
  36819  T                               Av fusion by basilic vein......            0093           17.95         $870.34         $422.33         $174.07
  36821  T                               Av fusion direct any site......            0088           26.49       $1,284.42         $678.68         $256.88
  36822  C                               Insertion of cannula(s)........  ..............  ..............  ..............  ..............  ..............
  36823  C                               Insertion of cannula(s)........  ..............  ..............  ..............  ..............  ..............
  36825  T                               Artery-vein graft..............            0088           26.49       $1,284.42         $678.68         $256.88
  36830  T                               Artery-vein graft..............            0088           26.49       $1,284.42         $678.68         $256.88
  36831  T                               Av fistula excision............            0088           26.49       $1,284.42         $678.68         $256.88
  36832  T                               Av fistula revision............            0088           26.49       $1,284.42         $678.68         $256.88
  36833  T                               Av fistula revision............            0088           26.49       $1,284.42         $678.68         $256.88
  36834  C                               Repair A-V aneurysm............  ..............  ..............  ..............  ..............  ..............
  36835  T                               Artery to vein shunt...........            0093           17.95         $870.34         $422.33         $174.07
  36860  T                               External cannula declotting....            0090           20.96       $1,016.29         $573.04         $203.26
  36861  T                               Cannula declotting.............            0090           20.96       $1,016.29         $573.04         $203.26
  37140  C                               Revision of circulation........  ..............  ..............  ..............  ..............  ..............
  37145  C                               Revision of circulation........  ..............  ..............  ..............  ..............  ..............
  37160  C                               Revision of circulation........  ..............  ..............  ..............  ..............  ..............
  37180  C                               Revision of circulation........  ..............  ..............  ..............  ..............  ..............
  37181  C                               Splice spleen/kidney veins.....  ..............  ..............  ..............  ..............  ..............
  37195  C                               Thrombolytic therapy, stroke...  ..............  ..............  ..............  ..............  ..............
  37200  C                               Transcatheter biopsy...........  ..............  ..............  ..............  ..............  ..............
  37201  C                               Transcatheter therapy infuse...  ..............  ..............  ..............  ..............  ..............
  37202  C                               Transcatheter therapy infuse...  ..............  ..............  ..............  ..............  ..............
  37203  T                               Transcatheter retrieval........            0089            6.49         $314.68         $130.07          $62.94
  37204  T                               Transcatheter occlusion........            0081           19.36         $938.71         $434.25         $187.74
  37205  T                               Transcatheter stent............            0081           19.36         $938.71         $434.25         $187.74
  37206  T                               Transcatheter stent add-on.....            0081           19.36         $938.71         $434.25         $187.74
  37207  T                               Transcatheter stent............            0081           19.36         $938.71         $434.25         $187.74
  37208  T                               Transcatheter stent add-on.....            0081           19.36         $938.71         $434.25         $187.74
  37209  T                               Exchange arterial catheter.....            0081           19.36         $938.71         $434.25         $187.74
  37250  T                               Iv us first vessel add-on......            0081           19.36         $938.71         $434.25         $187.74
  37251  T                               Iv us each add vessel add-on...            0081           19.36         $938.71         $434.25         $187.74
  37565  T                               Ligation of neck vein..........            0081           19.36         $938.71         $434.25         $187.74
  37600  T                               Ligation of neck artery........            0081           19.36         $938.71         $434.25         $187.74

[[Page 18597]]

 
  37605  T                               Ligation of neck artery........            0091           14.79         $717.12         $348.23         $143.42
  37606  T                               Ligation of neck artery........            0091           14.79         $717.12         $348.23         $143.42
  37607  T                               Ligation of a-v fistula........            0092           20.21         $979.92         $505.37         $195.98
  37609  T                               Temporal artery procedure......            0020            6.51         $315.65         $130.53          $63.13
  37615  T                               Ligation of neck artery........            0091           14.79         $717.12         $348.23         $143.42
  37616  C                               Ligation of chest artery.......  ..............  ..............  ..............  ..............  ..............
  37617  C                               Ligation of abdomen artery.....  ..............  ..............  ..............  ..............  ..............
  37618  E                               Ligation of extremity artery...  ..............  ..............  ..............  ..............  ..............
  37620  C                               Revision of major vein.........  ..............  ..............  ..............  ..............  ..............
  37650  T                               Revision of major vein.........            0091           14.79         $717.12         $348.23         $143.42
  37660  C                               Revision of major vein.........  ..............  ..............  ..............  ..............  ..............
  37700  T                               Revise leg vein................            0091           14.79         $717.12         $348.23         $143.42
  37720  T                               Removal of leg vein............            0092           20.21         $979.92         $505.37         $195.98
  37730  T                               Removal of leg veins...........            0092           20.21         $979.92         $505.37         $195.98
  37735  T                               Removal of leg veins/lesion....            0092           20.21         $979.92         $505.37         $195.98
  37760  T                               Revision of leg veins..........            0091           14.79         $717.12         $348.23         $143.42
  37780  T                               Revision of leg vein...........            0091           14.79         $717.12         $348.23         $143.42
  37785  T                               Revise secondary varicosity....            0091           14.79         $717.12         $348.23         $143.42
  37788  C                               Revascularization, penis.......  ..............  ..............  ..............  ..............  ..............
  37790  T                               Penile venous occlusion........            0181           32.37       $1,569.53         $906.36         $313.91
  37799  T                               Vascular surgery procedure.....            0020            6.51         $315.65         $130.53          $63.13
  38100  C                               Removal of spleen, total.......  ..............  ..............  ..............  ..............  ..............
  38101  C                               Removal of spleen, partial.....  ..............  ..............  ..............  ..............  ..............
  38102  C                               Removal of spleen, total.......  ..............  ..............  ..............  ..............  ..............
  38115  C                               Repair of ruptured spleen......  ..............  ..............  ..............  ..............  ..............
  38120  T                               Laparoscopy, splenectomy.......            0131           41.81       $2,027.24       $1,089.88         $405.45
  38129  T                               Laparoscope proc, spleen.......            0130           25.36       $1,229.63         $659.53         $245.93
  38200  N                               Injection for spleen x-ray.....  ..............  ..............  ..............  ..............  ..............
  38230  S                               Bone marrow collection.........            0109            4.13         $200.25          $40.05          $40.05
  38231  S                               Stem cell collection...........            0111           14.17         $687.06         $300.74         $137.41
  38240  S                               Bone marrow/stem transplant....            0109            4.13         $200.25          $40.05          $40.05
  38241  S                               Bone marrow/stem transplant....            0109            4.13         $200.25          $40.05          $40.05
  38300  T                               Drainage, lymph node lesion....            0008            6.15         $298.20         $113.67          $59.64
  38305  T                               Drainage, lymph node lesion....            0008            6.15         $298.20         $113.67          $59.64
  38308  T                               Incision of lymph channels.....            0113           13.89         $673.49         $326.55         $134.70
  38380  C                               Thoracic duct procedure........  ..............  ..............  ..............  ..............  ..............
  38381  C                               Thoracic duct procedure........  ..............  ..............  ..............  ..............  ..............
  38382  C                               Thoracic duct procedure........  ..............  ..............  ..............  ..............  ..............
  38500  T                               Biopsy/removal, lymph nodes....            0113           13.89         $673.49         $326.55         $134.70
  38505  T                               Needle biopsy, lymph nodes.....            0005            5.41         $262.32         $119.75          $52.46
  38510  T                               Biopsy/removal, lymph nodes....            0113           13.89         $673.49         $326.55         $134.70
  38520  T                               Biopsy/removal, lymph nodes....            0113           13.89         $673.49         $326.55         $134.70
  38525  T                               Biopsy/removal, lymph nodes....            0113           13.89         $673.49         $326.55         $134.70
  38530  T                               Biopsy/removal, lymph nodes....            0113           13.89         $673.49         $326.55         $134.70
  38542  T                               Explore deep node(s), neck.....            0114           19.56         $948.41         $493.78         $189.68
  38550  T                               Removal, neck/armpit lesion....            0113           13.89         $673.49         $326.55         $134.70
  38555  T                               Removal, neck/armpit lesion....            0114           19.56         $948.41         $493.78         $189.68
  38562  C                               Removal, pelvic lymph nodes....  ..............  ..............  ..............  ..............  ..............
  38564  C                               Removal, abdomen lymph nodes...  ..............  ..............  ..............  ..............  ..............
  38570  T                               Laparoscopy, lymph node biop...            0131           41.81       $2,027.24       $1,089.88         $405.45
  38571  T                               Laparoscopy, lymphadenectomy...            0132           48.91       $2,371.50       $1,239.22         $474.30
  38572  T                               Laparoscopy, lymphadenectomy...            0131           41.81       $2,027.24       $1,089.88         $405.45
  38589  T                               Laparoscope proc, lymphatic....            0130           25.36       $1,229.63         $659.53         $245.93
  38700  C                               Removal of lymph nodes, neck...  ..............  ..............  ..............  ..............  ..............
  38720  T                               Removal of lymph nodes, neck...            0114           19.56         $948.41         $493.78         $189.68
  38724  C                               Removal of lymph nodes, neck...  ..............  ..............  ..............  ..............  ..............
  38740  T                               Remove armpit lymph nodes......            0114           19.56         $948.41         $493.78         $189.68
  38745  T                               Remove armpit lymph nodes......            0114           19.56         $948.41         $493.78         $189.68
  38746  C                               Remove thoracic lymph nodes....  ..............  ..............  ..............  ..............  ..............
  38747  C                               Remove abdominal lymph nodes...  ..............  ..............  ..............  ..............  ..............
  38760  T                               Remove groin lymph nodes.......            0114           19.56         $948.41         $493.78         $189.68
  38765  C                               Remove groin lymph nodes.......  ..............  ..............  ..............  ..............  ..............
  38770  C                               Remove pelvis lymph nodes......  ..............  ..............  ..............  ..............  ..............
  38780  C                               Remove abdomen lymph nodes.....  ..............  ..............  ..............  ..............  ..............
  38790  N                               Inject for lymphatic x-ray.....  ..............  ..............  ..............  ..............  ..............
  38792  N                               Identify sentinel node.........  ..............  ..............  ..............  ..............  ..............
  38794  N                               Access thoracic lymph duct.....  ..............  ..............  ..............  ..............  ..............
  38999  T                               Blood/lymph system procedure...            0008            6.15         $298.20         $113.67          $59.64
  39000  C                               Exploration of chest...........  ..............  ..............  ..............  ..............  ..............
  39010  C                               Exploration of chest...........  ..............  ..............  ..............  ..............  ..............
  39200  C                               Removal chest lesion...........  ..............  ..............  ..............  ..............  ..............
  39220  C                               Removal chest lesion...........  ..............  ..............  ..............  ..............  ..............
  39400  T                               Visualization of chest.........            0076            8.06         $390.81         $197.05          $78.16

[[Page 18598]]

 
  39499  C                               Chest procedure................  ..............  ..............  ..............  ..............  ..............
  39501  C                               Repair diaphragm laceration....  ..............  ..............  ..............  ..............  ..............
  39502  C                               Repair paraesophageal hernia...  ..............  ..............  ..............  ..............  ..............
  39503  C                               Repair of diaphragm hernia.....  ..............  ..............  ..............  ..............  ..............
  39520  C                               Repair of diaphragm hernia.....  ..............  ..............  ..............  ..............  ..............
  39530  C                               Repair of diaphragm hernia.....  ..............  ..............  ..............  ..............  ..............
  39531  C                               Repair of diaphragm hernia.....  ..............  ..............  ..............  ..............  ..............
  39540  C                               Repair of diaphragm hernia.....  ..............  ..............  ..............  ..............  ..............
  39541  C                               Repair of diaphragm hernia.....  ..............  ..............  ..............  ..............  ..............
  39545  C                               Revision of diaphragm..........  ..............  ..............  ..............  ..............  ..............
  39560  C                               Resect diaphragm, simple.......  ..............  ..............  ..............  ..............  ..............
  39561  C                               Resect diaphragm, complex......  ..............  ..............  ..............  ..............  ..............
  39599  C                               Diaphragm surgery procedure....  ..............  ..............  ..............  ..............  ..............
  40490  T                               Biopsy of lip..................            0252            5.18         $251.16         $114.24          $50.23
  40500  T                               Partial excision of lip........            0253           12.02         $582.81         $284.00         $116.56
  40510  T                               Partial excision of lip........            0254           12.45         $603.66         $272.41         $120.73
  40520  T                               Partial excision of lip........            0253           12.02         $582.81         $284.00         $116.56
  40525  T                               Reconstruct lip with flap......            0254           12.45         $603.66         $272.41         $120.73
  40527  T                               Reconstruct lip with flap......            0254           12.45         $603.66         $272.41         $120.73
  40530  T                               Partial removal of lip.........            0254           12.45         $603.66         $272.41         $120.73
  40650  T                               Repair lip.....................            0253           12.02         $582.81         $284.00         $116.56
  40652  T                               Repair lip.....................            0253           12.02         $582.81         $284.00         $116.56
  40654  T                               Repair lip.....................            0254           12.45         $603.66         $272.41         $120.73
  40700  T                               Repair cleft lip/nasal.........            0256           25.40       $1,231.57         $623.05         $246.31
  40701  T                               Repair cleft lip/nasal.........            0256           25.40       $1,231.57         $623.05         $246.31
  40702  T                               Repair cleft lip/nasal.........            0256           25.40       $1,231.57         $623.05         $246.31
  40720  T                               Repair cleft lip/nasal.........            0256           25.40       $1,231.57         $623.05         $246.31
  40761  T                               Repair cleft lip/nasal.........            0256           25.40       $1,231.57         $623.05         $246.31
  40799  T                               Lip surgery procedure..........            0253           12.02         $582.81         $284.00         $116.56
  40800  T                               Drainage of mouth lesion.......            0251            1.68          $81.46          $27.99          $16.29
  40801  T                               Drainage of mouth lesion.......            0252            5.18         $251.16         $114.24          $50.23
  40804  T                               Removal, foreign body, mouth...            0251            1.68          $81.46          $27.99          $16.29
  40805  T                               Removal, foreign body, mouth...            0252            5.18         $251.16         $114.24          $50.23
  40806  T                               Incision of lip fold...........            0251            1.68          $81.46          $27.99          $16.29
  40808  T                               Biopsy of mouth lesion.........            0251            1.68          $81.46          $27.99          $16.29
  40810  T                               Excision of mouth lesion.......            0253           12.02         $582.81         $284.00         $116.56
  40812  T                               Excise/repair mouth lesion.....            0252            5.18         $251.16         $114.24          $50.23
  40814  T                               Excise/repair mouth lesion.....            0253           12.02         $582.81         $284.00         $116.56
  40816  T                               Excision of mouth lesion.......            0253           12.02         $582.81         $284.00         $116.56
  40818  T                               Excise oral mucosa for graft...            0251            1.68          $81.46          $27.99          $16.29
  40819  T                               Excise lip or cheek fold.......            0252            5.18         $251.16         $114.24          $50.23
  40820  T                               Treatment of mouth lesion......            0253           12.02         $582.81         $284.00         $116.56
  40830  T                               Repair mouth laceration........            0251            1.68          $81.46          $27.99          $16.29
  40831  T                               Repair mouth laceration........            0253           12.02         $582.81         $284.00         $116.56
  40840  T                               Reconstruction of mouth........            0254           12.45         $603.66         $272.41         $120.73
  40842  T                               Reconstruction of mouth........            0254           12.45         $603.66         $272.41         $120.73
  40843  T                               Reconstruction of mouth........            0254           12.45         $603.66         $272.41         $120.73
  40844  T                               Reconstruction of mouth........            0256           25.40       $1,231.57         $623.05         $246.31
  40845  T                               Reconstruction of mouth........            0256           25.40       $1,231.57         $623.05         $246.31
  40899  T                               Mouth surgery procedure........            0252            5.18         $251.16         $114.24          $50.23
  41000  T                               Drainage of mouth lesion.......            0253           12.02         $582.81         $284.00         $116.56
  41005  T                               Drainage of mouth lesion.......            0251            1.68          $81.46          $27.99          $16.29
  41006  T                               Drainage of mouth lesion.......            0253           12.02         $582.81         $284.00         $116.56
  41007  T                               Drainage of mouth lesion.......            0253           12.02         $582.81         $284.00         $116.56
  41008  T                               Drainage of mouth lesion.......            0253           12.02         $582.81         $284.00         $116.56
  41009  T                               Drainage of mouth lesion.......            0251            1.68          $81.46          $27.99          $16.29
  41010  T                               Incision of tongue fold........            0253           12.02         $582.81         $284.00         $116.56
  41015  T                               Drainage of mouth lesion.......            0252            5.18         $251.16         $114.24          $50.23
  41016  T                               Drainage of mouth lesion.......            0253           12.02         $582.81         $284.00         $116.56
  41017  T                               Drainage of mouth lesion.......            0253           12.02         $582.81         $284.00         $116.56
  41018  T                               Drainage of mouth lesion.......            0253           12.02         $582.81         $284.00         $116.56
  41100  T                               Biopsy of tongue...............            0252            5.18         $251.16         $114.24          $50.23
  41105  T                               Biopsy of tongue...............            0253           12.02         $582.81         $284.00         $116.56
  41108  T                               Biopsy of floor of mouth.......            0252            5.18         $251.16         $114.24          $50.23
  41110  T                               Excision of tongue lesion......            0253           12.02         $582.81         $284.00         $116.56
  41112  T                               Excision of tongue lesion......            0253           12.02         $582.81         $284.00         $116.56
  41113  T                               Excision of tongue lesion......            0253           12.02         $582.81         $284.00         $116.56
  41114  T                               Excision of tongue lesion......            0254           12.45         $603.66         $272.41         $120.73
  41115  T                               Excision of tongue fold........            0253           12.02         $582.81         $284.00         $116.56
  41116  T                               Excision of mouth lesion.......            0253           12.02         $582.81         $284.00         $116.56
  41120  T                               Partial removal of tongue......            0256           25.40       $1,231.57         $623.05         $246.31
  41130  C                               Partial removal of tongue......  ..............  ..............  ..............  ..............  ..............
  41135  C                               Tongue and neck surgery........  ..............  ..............  ..............  ..............  ..............

[[Page 18599]]

 
  41140  C                               Removal of tongue..............  ..............  ..............  ..............  ..............  ..............
  41145  C                               Tongue removal, neck surgery...  ..............  ..............  ..............  ..............  ..............
  41150  C                               Tongue, mouth, jaw surgery.....  ..............  ..............  ..............  ..............  ..............
  41153  C                               Tongue, mouth, neck surgery....  ..............  ..............  ..............  ..............  ..............
  41155  C                               Tongue, jaw, & neck surgery....  ..............  ..............  ..............  ..............  ..............
  41250  T                               Repair tongue laceration.......            0251            1.68          $81.46          $27.99          $16.29
  41251  T                               Repair tongue laceration.......            0253           12.02         $582.81         $284.00         $116.56
  41252  T                               Repair tongue laceration.......            0253           12.02         $582.81         $284.00         $116.56
  41500  T                               Fixation of tongue.............            0253           12.02         $582.81         $284.00         $116.56
  41510  T                               Tongue to lip surgery..........            0253           12.02         $582.81         $284.00         $116.56
  41520  T                               Reconstruction, tongue fold....            0253           12.02         $582.81         $284.00         $116.56
  41599  T                               Tongue and mouth surgery.......            0251            1.68          $81.46          $27.99          $16.29
  41800  T                               Drainage of gum lesion.........            0251            1.68          $81.46          $27.99          $16.29
  41805  T                               Removal foreign body, gum......            0253           12.02         $582.81         $284.00         $116.56
  41806  T                               Removal foreign body, jawbone..            0253           12.02         $582.81         $284.00         $116.56
  41820  T                               Excision, gum, each quadrant...            0252            5.18         $251.16         $114.24          $50.23
  41821  T                               Excision of gum flap...........            0252            5.18         $251.16         $114.24          $50.23
  41822  T                               Excision of gum lesion.........            0253           12.02         $582.81         $284.00         $116.56
  41823  T                               Excision of gum lesion.........            0253           12.02         $582.81         $284.00         $116.56
  41825  T                               Excision of gum lesion.........            0253           12.02         $582.81         $284.00         $116.56
  41826  T                               Excision of gum lesion.........            0253           12.02         $582.81         $284.00         $116.56
  41827  T                               Excision of gum lesion.........            0253           12.02         $582.81         $284.00         $116.56
  41828  T                               Excision of gum lesion.........            0253           12.02         $582.81         $284.00         $116.56
  41830  T                               Removal of gum tissue..........            0253           12.02         $582.81         $284.00         $116.56
  41850  T                               Treatment of gum lesion........            0253           12.02         $582.81         $284.00         $116.56
  41870  T                               Gum graft......................            0253           12.02         $582.81         $284.00         $116.56
  41872  T                               Repair gum.....................            0253           12.02         $582.81         $284.00         $116.56
  41874  T                               Repair tooth socket............            0253           12.02         $582.81         $284.00         $116.56
  41899  T                               Dental surgery procedure.......            0253           12.02         $582.81         $284.00         $116.56
  42000  T                               Drainage mouth roof lesion.....            0251            1.68          $81.46          $27.99          $16.29
  42100  T                               Biopsy roof of mouth...........            0252            5.18         $251.16         $114.24          $50.23
  42104  T                               Excision lesion, mouth roof....            0253           12.02         $582.81         $284.00         $116.56
  42106  T                               Excision lesion, mouth roof....            0253           12.02         $582.81         $284.00         $116.56
  42107  T                               Excision lesion, mouth roof....            0254           12.45         $603.66         $272.41         $120.73
  42120  T                               Remove palate/lesion...........            0256           25.40       $1,231.57         $623.05         $246.31
  42140  T                               Excision of uvula..............            0252            5.18         $251.16         $114.24          $50.23
  42145  T                               Repair palate, pharynx/uvula...            0254           12.45         $603.66         $272.41         $120.73
  42160  T                               Treatment mouth roof lesion....            0253           12.02         $582.81         $284.00         $116.56
  42180  T                               Repair palate..................            0251            1.68          $81.46          $27.99          $16.29
  42182  T                               Repair palate..................            0256           25.40       $1,231.57         $623.05         $246.31
  42200  T                               Reconstruct cleft palate.......            0256           25.40       $1,231.57         $623.05         $246.31
  42205  T                               Reconstruct cleft palate.......            0256           25.40       $1,231.57         $623.05         $246.31
  42210  T                               Reconstruct cleft palate.......            0256           25.40       $1,231.57         $623.05         $246.31
  42215  T                               Reconstruct cleft palate.......            0256           25.40       $1,231.57         $623.05         $246.31
  42220  T                               Reconstruct cleft palate.......            0256           25.40       $1,231.57         $623.05         $246.31
  42225  T                               Reconstruct cleft palate.......            0256           25.40       $1,231.57         $623.05         $246.31
  42226  T                               Lengthening of palate..........            0256           25.40       $1,231.57         $623.05         $246.31
  42227  T                               Lengthening of palate..........            0256           25.40       $1,231.57         $623.05         $246.31
  42235  T                               Repair palate..................            0254           12.45         $603.66         $272.41         $120.73
  42260  T                               Repair nose to lip fistula.....            0253           12.02         $582.81         $284.00         $116.56
  42280  T                               Preparation, palate mold.......            0251            1.68          $81.46          $27.99          $16.29
  42281  T                               Insertion, palate prosthesis...            0253           12.02         $582.81         $284.00         $116.56
  42299  T                               Palate/uvula surgery...........            0251            1.68          $81.46          $27.99          $16.29
  42300  T                               Drainage of salivary gland.....            0253           12.02         $582.81         $284.00         $116.56
  42305  T                               Drainage of salivary gland.....            0253           12.02         $582.81         $284.00         $116.56
  42310  T                               Drainage of salivary gland.....            0251            1.68          $81.46          $27.99          $16.29
  42320  T                               Drainage of salivary gland.....            0251            1.68          $81.46          $27.99          $16.29
  42325  T                               Create salivary cyst drain.....            0252            5.18         $251.16         $114.24          $50.23
  42326  T                               Create salivary cyst drain.....            0252            5.18         $251.16         $114.24          $50.23
  42330  T                               Removal of salivary stone......            0252            5.18         $251.16         $114.24          $50.23
  42335  T                               Removal of salivary stone......            0253           12.02         $582.81         $284.00         $116.56
  42340  T                               Removal of salivary stone......            0253           12.02         $582.81         $284.00         $116.56
  42400  T                               Biopsy of salivary gland.......            0004            1.84          $89.22          $32.57          $17.84
  42405  T                               Biopsy of salivary gland.......            0253           12.02         $582.81         $284.00         $116.56
  42408  T                               Excision of salivary cyst......            0253           12.02         $582.81         $284.00         $116.56
  42409  T                               Drainage of salivary cyst......            0253           12.02         $582.81         $284.00         $116.56
  42410  T                               Excise parotid gland/lesion....            0256           25.40       $1,231.57         $623.05         $246.31
  42415  T                               Excise parotid gland/lesion....            0256           25.40       $1,231.57         $623.05         $246.31
  42420  T                               Excise parotid gland/lesion....            0256           25.40       $1,231.57         $623.05         $246.31
  42425  T                               Excise parotid gland/lesion....            0256           25.40       $1,231.57         $623.05         $246.31
  42426  C                               Excise parotid gland/lesion....  ..............  ..............  ..............  ..............  ..............
  42440  T                               Excise submaxillary gland......            0256           25.40       $1,231.57         $623.05         $246.31
  42450  T                               Excise sublingual gland........            0253           12.02         $582.81         $284.00         $116.56

[[Page 18600]]

 
  42500  T                               Repair salivary duct...........            0254           12.45         $603.66         $272.41         $120.73
  42505  T                               Repair salivary duct...........            0256           25.40       $1,231.57         $623.05         $246.31
  42507  T                               Parotid duct diversion.........            0256           25.40       $1,231.57         $623.05         $246.31
  42508  T                               Parotid duct diversion.........            0256           25.40       $1,231.57         $623.05         $246.31
  42509  T                               Parotid duct diversion.........            0256           25.40       $1,231.57         $623.05         $246.31
  42510  T                               Parotid duct diversion.........            0256           25.40       $1,231.57         $623.05         $246.31
  42550  N                               Injection for salivary x-ray...  ..............  ..............  ..............  ..............  ..............
  42600  T                               Closure of salivary fistula....            0253           12.02         $582.81         $284.00         $116.56
  42650  T                               Dilation of salivary duct......            0252            5.18         $251.16         $114.24          $50.23
  42660  T                               Dilation of salivary duct......            0252            5.18         $251.16         $114.24          $50.23
  42665  T                               Ligation of salivary duct......            0253           12.02         $582.81         $284.00         $116.56
  42699  T                               Salivary surgery procedure.....            0253           12.02         $582.81         $284.00         $116.56
  42700  T                               Drainage of tonsil abscess.....            0251            1.68          $81.46          $27.99          $16.29
  42720  T                               Drainage of throat abscess.....            0253           12.02         $582.81         $284.00         $116.56
  42725  T                               Drainage of throat abscess.....            0256           25.40       $1,231.57         $623.05         $246.31
  42800  T                               Biopsy of throat...............            0252            5.18         $251.16         $114.24          $50.23
  42802  T                               Biopsy of throat...............            0253           12.02         $582.81         $284.00         $116.56
  42804  T                               Biopsy of upper nose/throat....            0253           12.02         $582.81         $284.00         $116.56
  42806  T                               Biopsy of upper nose/throat....            0253           12.02         $582.81         $284.00         $116.56
  42808  T                               Excise pharynx lesion..........            0253           12.02         $582.81         $284.00         $116.56
  42809  T                               Remove pharynx foreign body....            0251            1.68          $81.46          $27.99          $16.29
  42810  T                               Excision of neck cyst..........            0253           12.02         $582.81         $284.00         $116.56
  42815  T                               Excision of neck cyst..........            0256           25.40       $1,231.57         $623.05         $246.31
  42820  T                               Remove tonsils and adenoids....            0258           18.62         $902.83         $462.81         $180.57
  42821  T                               Remove tonsils and adenoids....            0258           18.62         $902.83         $462.81         $180.57
  42825  T                               Removal of tonsils.............            0258           18.62         $902.83         $462.81         $180.57
  42826  T                               Removal of tonsils.............            0258           18.62         $902.83         $462.81         $180.57
  42830  T                               Removal of adenoids............            0258           18.62         $902.83         $462.81         $180.57
  42831  T                               Removal of adenoids............            0258           18.62         $902.83         $462.81         $180.57
  42835  T                               Removal of adenoids............            0258           18.62         $902.83         $462.81         $180.57
  42836  T                               Removal of adenoids............            0258           18.62         $902.83         $462.81         $180.57
  42842  C                               Extensive surgery of throat....  ..............  ..............  ..............  ..............  ..............
  42844  T                               Extensive surgery of throat....            0256           25.40       $1,231.57         $623.05         $246.31
  42845  C                               Extensive surgery of throat....  ..............  ..............  ..............  ..............  ..............
  42860  T                               Excision of tonsil tags........            0258           18.62         $902.83         $462.81         $180.57
  42870  T                               Excision of lingual tonsil.....            0258           18.62         $902.83         $462.81         $180.57
  42890  T                               Partial removal of pharynx.....            0256           25.40       $1,231.57         $623.05         $246.31
  42892  T                               Revision of pharyngeal walls...            0256           25.40       $1,231.57         $623.05         $246.31
  42894  C                               Revision of pharyngeal walls...  ..............  ..............  ..............  ..............  ..............
  42900  T                               Repair throat wound............            0253           12.02         $582.81         $284.00         $116.56
  42950  T                               Reconstruction of throat.......            0254           12.45         $603.66         $272.41         $120.73
  42953  C                               Repair throat, esophagus.......  ..............  ..............  ..............  ..............  ..............
  42955  T                               Surgical opening of throat.....            0254           12.45         $603.66         $272.41         $120.73
  42960  T                               Control throat bleeding........            0250            2.21         $107.16          $38.54          $21.43
  42961  C                               Control throat bleeding........  ..............  ..............  ..............  ..............  ..............
  42962  T                               Control throat bleeding........            0256           25.40       $1,231.57         $623.05         $246.31
  42970  T                               Control nose/throat bleeding...            0250            2.21         $107.16          $38.54          $21.43
  42971  C                               Control nose/throat bleeding...  ..............  ..............  ..............  ..............  ..............
  42972  T                               Control nose/throat bleeding...            0253           12.02         $582.81         $284.00         $116.56
  42999  T                               Throat surgery procedure.......            0252            5.18         $251.16         $114.24          $50.23
  43020  T                               Incision of esophagus..........            0254           12.45         $603.66         $272.41         $120.73
  43030  C                               Throat muscle surgery..........  ..............  ..............  ..............  ..............  ..............
  43045  C                               Incision of esophagus..........  ..............  ..............  ..............  ..............  ..............
  43100  C                               Excision of esophagus lesion...  ..............  ..............  ..............  ..............  ..............
  43101  C                               Excision of esophagus lesion...  ..............  ..............  ..............  ..............  ..............
  43107  C                               Removal of esophagus...........  ..............  ..............  ..............  ..............  ..............
  43108  C                               Removal of esophagus...........  ..............  ..............  ..............  ..............  ..............
  43112  C                               Removal of esophagus...........  ..............  ..............  ..............  ..............  ..............
  43113  C                               Removal of esophagus...........  ..............  ..............  ..............  ..............  ..............
  43116  C                               Partial removal of esophagus...  ..............  ..............  ..............  ..............  ..............
  43117  C                               Partial removal of esophagus...  ..............  ..............  ..............  ..............  ..............
  43118  C                               Partial removal of esophagus...  ..............  ..............  ..............  ..............  ..............
  43121  C                               Partial removal of esophagus...  ..............  ..............  ..............  ..............  ..............
  43122  C                               Parital removal of esophagus...  ..............  ..............  ..............  ..............  ..............
  43123  C                               Partial removal of esophagus...  ..............  ..............  ..............  ..............  ..............
  43124  C                               Removal of esophagus...........  ..............  ..............  ..............  ..............  ..............
  43130  C                               Removal of esophagus pouch.....  ..............  ..............  ..............  ..............  ..............
  43135  C                               Removal of esophagus pouch.....  ..............  ..............  ..............  ..............  ..............
  43200  T                               Esophagus endoscopy............            0141            7.15         $346.68         $184.67          $69.34
  43202  T                               Esophagus endoscopy, biopsy....            0141            7.15         $346.68         $184.67          $69.34
  43204  T                               Esophagus endoscopy & inject...            0141            7.15         $346.68         $184.67          $69.34
  43205  T                               Esophagus endoscopy/ligation...            0141            7.15         $346.68         $184.67          $69.34
  43215  T                               Esophagus endoscopy............            0141            7.15         $346.68         $184.67          $69.34

[[Page 18601]]

 
  43216  T                               Esophagus endoscopy/lesion.....            0141            7.15         $346.68         $184.67          $69.34
  43217  T                               Esophagus endoscopy............            0141            7.15         $346.68         $184.67          $69.34
  43219  T                               Esophagus endoscopy............            0141            7.15         $346.68         $184.67          $69.34
  43220  T                               Esoph endoscopy, dilation......            0141            7.15         $346.68         $184.67          $69.34
  43226  T                               Esoph endoscopy, dilation......            0141            7.15         $346.68         $184.67          $69.34
  43227  T                               Esoph endoscopy, repair........            0141            7.15         $346.68         $184.67          $69.34
  43228  T                               Esoph endoscopy, ablation......            0141            7.15         $346.68         $184.67          $69.34
  43234  T                               Upper GI endoscopy, exam.......            0141            7.15         $346.68         $184.67          $69.34
  43235  T                               Uppr gi endoscopy, diagnosis...            0141            7.15         $346.68         $184.67          $69.34
  43239  T                               Upper GI endoscopy, biopsy.....            0141            7.15         $346.68         $184.67          $69.34
  43241  T                               Upper GI endoscopy with tube...            0141            7.15         $346.68         $184.67          $69.34
  43243  T                               Upper gi endoscopy & inject....            0141            7.15         $346.68         $184.67          $69.34
  43244  T                               Upper GI endoscopy/ligation....            0141            7.15         $346.68         $184.67          $69.34
  43245  T                               Operative upper GI endoscopy...            0141            7.15         $346.68         $184.67          $69.34
  43246  T                               Place gastrostomy tube.........            0141            7.15         $346.68         $184.67          $69.34
  43247  T                               Operative upper GI endoscopy...            0141            7.15         $346.68         $184.67          $69.34
  43248  T                               Uppr gi endoscopy/guide wire...            0141            7.15         $346.68         $184.67          $69.34
  43249  T                               Esoph endoscopy, dilation......            0141            7.15         $346.68         $184.67          $69.34
  43250  T                               Upper GI endoscopy/tumor.......            0141            7.15         $346.68         $184.67          $69.34
  43251  T                               Operative upper GI endoscopy...            0141            7.15         $346.68         $184.67          $69.34
  43255  T                               Operative upper GI endoscopy...            0141            7.15         $346.68         $184.67          $69.34
  43258  T                               Operative upper GI endoscopy...            0141            7.15         $346.68         $184.67          $69.34
  43259  T                               Endoscopic ultrasound exam.....            0141            7.15         $346.68         $184.67          $69.34
  43260  T                               Endo cholangiopancreatograph...            0151           10.53         $510.57         $245.46         $102.11
  43261  T                               Endo cholangiopancreatograph...            0151           10.53         $510.57         $245.46         $102.11
  43262  T                               Endo cholangiopancreatograph...            0151           10.53         $510.57         $245.46         $102.11
  43263  T                               Endo cholangiopancreatograph...            0151           10.53         $510.57         $245.46         $102.11
  43264  T                               Endo cholangiopancreatograph...            0151           10.53         $510.57         $245.46         $102.11
  43265  T                               Endo cholangiopancreatograph...            0151           10.53         $510.57         $245.46         $102.11
  43267  T                               Endo cholangiopancreatograph...            0151           10.53         $510.57         $245.46         $102.11
  43268  T                               Endo cholangiopancreatograph...            0151           10.53         $510.57         $245.46         $102.11
  43269  T                               Endo cholangiopancreatograph...            0151           10.53         $510.57         $245.46         $102.11
  43271  T                               Endo cholangiopancreatograph...            0151           10.53         $510.57         $245.46         $102.11
  43272  T                               Endo cholangiopancreatograph...            0151           10.53         $510.57         $245.46         $102.11
  43280  T                               Laparoscopy, fundoplasty.......            0132           48.91       $2,371.50       $1,239.22         $474.30
  43289  T                               Laparoscope proc, esoph........            0130           25.36       $1,229.63         $659.53         $245.93
  43300  C                               Repair of esophagus............  ..............  ..............  ..............  ..............  ..............
  43305  C                               Repair esophagus and fistula...  ..............  ..............  ..............  ..............  ..............
  43310  C                               Repair of esophagus............  ..............  ..............  ..............  ..............  ..............
  43312  C                               Repair esophagus and fistula...  ..............  ..............  ..............  ..............  ..............
  43320  C                               Fuse esophagus & stomach.......  ..............  ..............  ..............  ..............  ..............
  43324  C                               Revise esophagus & stomach.....  ..............  ..............  ..............  ..............  ..............
  43325  C                               Revise esophagus & stomach.....  ..............  ..............  ..............  ..............  ..............
  43326  C                               Revise esophagus & stomach.....  ..............  ..............  ..............  ..............  ..............
  43330  C                               Repair of esophagus............  ..............  ..............  ..............  ..............  ..............
  43331  C                               Repair of esophagus............  ..............  ..............  ..............  ..............  ..............
  43340  C                               Fuse esophagus & intestine.....  ..............  ..............  ..............  ..............  ..............
  43341  C                               Fuse esophagus & intestine.....  ..............  ..............  ..............  ..............  ..............
  43350  C                               Surgical opening, esophagus....  ..............  ..............  ..............  ..............  ..............
  43351  C                               Surgical opening, esophagus....  ..............  ..............  ..............  ..............  ..............
  43352  C                               Surgical opening, esophagus....  ..............  ..............  ..............  ..............  ..............
  43360  C                               Gastrointestinal repair........  ..............  ..............  ..............  ..............  ..............
  43361  C                               Gastrointestinal repair........  ..............  ..............  ..............  ..............  ..............
  43400  C                               Ligate esophagus veins.........  ..............  ..............  ..............  ..............  ..............
  43401  C                               Esophagus surgery for veins....  ..............  ..............  ..............  ..............  ..............
  43405  C                               Ligate/staple esophagus........  ..............  ..............  ..............  ..............  ..............
  43410  C                               Repair esophagus wound.........  ..............  ..............  ..............  ..............  ..............
  43415  C                               Repair esophagus wound.........  ..............  ..............  ..............  ..............  ..............
  43420  C                               Repair esophagus opening.......  ..............  ..............  ..............  ..............  ..............
  43425  C                               Repair esophagus opening.......  ..............  ..............  ..............  ..............  ..............
  43450  T                               Dilate esophagus...............            0140            4.74         $229.83         $107.24          $45.97
  43453  T                               Dilate esophagus...............            0140            4.74         $229.83         $107.24          $45.97
  43456  T                               Dilate esophagus...............            0140            4.74         $229.83         $107.24          $45.97
  43458  T                               Dilate esophagus...............            0140            4.74         $229.83         $107.24          $45.97
  43460  C                               Pressure treatment esophagus...  ..............  ..............  ..............  ..............  ..............
  43496  C                               Free jejunum flap, microvasc...  ..............  ..............  ..............  ..............  ..............
  43499  T                               Esophagus surgery procedure....            0140            4.74         $229.83         $107.24          $45.97
  43500  C                               Surgical opening of stomach....  ..............  ..............  ..............  ..............  ..............
  43501  C                               Surgical repair of stomach.....  ..............  ..............  ..............  ..............  ..............
  43502  C                               Surgical repair of stomach.....  ..............  ..............  ..............  ..............  ..............
  43510  C                               Surgical opening of stomach....  ..............  ..............  ..............  ..............  ..............
  43520  C                               Incision of pyloric muscle.....  ..............  ..............  ..............  ..............  ..............
  43600  T                               Biopsy of stomach..............            0141            7.15         $346.68         $184.67          $69.34

[[Page 18602]]

 
  43605  C                               Biopsy of stomach..............  ..............  ..............  ..............  ..............  ..............
  43610  C                               Excision of stomach lesion.....  ..............  ..............  ..............  ..............  ..............
  43611  C                               Excision of stomach lesion.....  ..............  ..............  ..............  ..............  ..............
  43620  C                               Removal of stomach.............  ..............  ..............  ..............  ..............  ..............
  43621  C                               Removal of stomach.............  ..............  ..............  ..............  ..............  ..............
  43622  C                               Removal of stomach.............  ..............  ..............  ..............  ..............  ..............
  43631  C                               Removal of stomach, partial....  ..............  ..............  ..............  ..............  ..............
  43632  C                               Removal of stomach, partial....  ..............  ..............  ..............  ..............  ..............
  43633  C                               Removal of stomach, partial....  ..............  ..............  ..............  ..............  ..............
  43634  C                               Removal of stomach, partial....  ..............  ..............  ..............  ..............  ..............
  43635  C                               Removal of stomach, partial....  ..............  ..............  ..............  ..............  ..............
  43638  C                               Removal of stomach, partial....  ..............  ..............  ..............  ..............  ..............
  43639  C                               Removal of stomach, partial....  ..............  ..............  ..............  ..............  ..............
  43640  C                               Vagotomy & pylorus repair......  ..............  ..............  ..............  ..............  ..............
  43641  C                               Vagotomy & pylorus repair......  ..............  ..............  ..............  ..............  ..............
  43651  T                               Laparoscopy, vagus nerve.......            0132           48.91       $2,371.50       $1,239.22         $474.30
  43652  T                               Laparoscopy, vagus nerve.......            0132           48.91       $2,371.50       $1,239.22         $474.30
  43653  T                               Laparoscopy, gastrostomy.......            0131           41.81       $2,027.24       $1,089.88         $405.45
  43659  T                               Laparoscope proc, stom.........            0130           25.36       $1,229.63         $659.53         $245.93
  43750  T                               Place gastrostomy tube.........            0141            7.15         $346.68         $184.67          $69.34
  43760  T                               Change gastrostomy tube........            0121            2.36         $114.43          $52.53          $22.89
  43761  T                               Reposition gastrostomy tube....            0121            2.36         $114.43          $52.53          $22.89
  43800  C                               Reconstruction of pylorus......  ..............  ..............  ..............  ..............  ..............
  43810  C                               Fusion of stomach and bowel....  ..............  ..............  ..............  ..............  ..............
  43820  C                               Fusion of stomach and bowel....  ..............  ..............  ..............  ..............  ..............
  43825  C                               Fusion of stomach and bowel....  ..............  ..............  ..............  ..............  ..............
  43830  T                               Place gastrostomy tube.........            0141            7.15         $346.68         $184.67          $69.34
  43831  T                               Place gastrostomy tube.........            0141            7.15         $346.68         $184.67          $69.34
  43832  C                               Place gastrostomy tube.........  ..............  ..............  ..............  ..............  ..............
  43840  C                               Repair of stomach lesion.......  ..............  ..............  ..............  ..............  ..............
  43842  C                               Gastroplasty for obesity.......  ..............  ..............  ..............  ..............  ..............
  43843  C                               Gastroplasty for obesity.......  ..............  ..............  ..............  ..............  ..............
  43846  C                               Gastric bypass for obesity.....  ..............  ..............  ..............  ..............  ..............
  43847  C                               Gastric bypass for obesity.....  ..............  ..............  ..............  ..............  ..............
  43848  C                               Revision gastroplasty..........  ..............  ..............  ..............  ..............  ..............
  43850  C                               Revise stomach-bowel fusion....  ..............  ..............  ..............  ..............  ..............
  43855  C                               Revise stomach-bowel fusion....  ..............  ..............  ..............  ..............  ..............
  43860  C                               Revise stomach-bowel fusion....  ..............  ..............  ..............  ..............  ..............
  43865  C                               Revise stomach-bowel fusion....  ..............  ..............  ..............  ..............  ..............
  43870  T                               Repair stomach opening.........            0025            3.74         $181.34          $70.66          $36.27
  43880  C                               Repair stomach-bowel fistula...  ..............  ..............  ..............  ..............  ..............
  43999  T                               Stomach surgery procedure......            0121            2.36         $114.43          $52.53          $22.89
  44005  C                               Freeing of bowel adhesion......  ..............  ..............  ..............  ..............  ..............
  44010  C                               Incision of small bowel........  ..............  ..............  ..............  ..............  ..............
  44015  C                               Insert needle cath bowel.......  ..............  ..............  ..............  ..............  ..............
  44020  C                               Exploration of small bowel.....  ..............  ..............  ..............  ..............  ..............
  44021  C                               Decompress small bowel.........  ..............  ..............  ..............  ..............  ..............
  44025  C                               Incision of large bowel........  ..............  ..............  ..............  ..............  ..............
  44050  C                               Reduce bowel obstruction.......  ..............  ..............  ..............  ..............  ..............
  44055  C                               Correct malrotation of bowel...  ..............  ..............  ..............  ..............  ..............
  44100  T                               Biopsy of bowel................            0141            7.15         $346.68         $184.67          $69.34
  44110  C                               Excision of bowel lesion(s)....  ..............  ..............  ..............  ..............  ..............
  44111  C                               Excision of bowel lesion(s)....  ..............  ..............  ..............  ..............  ..............
  44120  C                               Removal of small intestine.....  ..............  ..............  ..............  ..............  ..............
  44121  C                               Removal of small intestine.....  ..............  ..............  ..............  ..............  ..............
  44125  C                               Removal of small intestine.....  ..............  ..............  ..............  ..............  ..............
  44130  C                               Bowel to bowel fusion..........  ..............  ..............  ..............  ..............  ..............
  44139  C                               Mobilization of colon..........  ..............  ..............  ..............  ..............  ..............
  44140  C                               Partial removal of colon.......  ..............  ..............  ..............  ..............  ..............
  44141  C                               Partial removal of colon.......  ..............  ..............  ..............  ..............  ..............
  44143  C                               Partial removal of colon.......  ..............  ..............  ..............  ..............  ..............
  44144  C                               Partial removal of colon.......  ..............  ..............  ..............  ..............  ..............
  44145  C                               Partial removal of colon.......  ..............  ..............  ..............  ..............  ..............
  44146  C                               Partial removal of colon.......  ..............  ..............  ..............  ..............  ..............
  44147  C                               Partial removal of colon.......  ..............  ..............  ..............  ..............  ..............
  44150  C                               Removal of colon...............  ..............  ..............  ..............  ..............  ..............
  44151  C                               Removal of colon/ileostomy.....  ..............  ..............  ..............  ..............  ..............
  44152  C                               Removal of colon/ileostomy.....  ..............  ..............  ..............  ..............  ..............
  44153  C                               Removal of colon/ileostomy.....  ..............  ..............  ..............  ..............  ..............
  44155  C                               Removal of colon/ileostomy.....  ..............  ..............  ..............  ..............  ..............
  44156  C                               Removal of colon/ileostomy.....  ..............  ..............  ..............  ..............  ..............
  44160  C                               Removal of colon...............  ..............  ..............  ..............  ..............  ..............
  44200  T                               Laparoscopy, enterolysis.......            0131           41.81       $2,027.24       $1,089.88         $405.45

[[Page 18603]]

 
  44201  T                               Laparoscopy, jejunostomy.......            0131           41.81       $2,027.24       $1,089.88         $405.45
  44202  C                               Laparo, resect intestine.......  ..............  ..............  ..............  ..............  ..............
  44209  T                               Laparoscope proc, intestine....            0130           25.36       $1,229.63         $659.53         $245.93
  44300  C                               Open bowel to skin.............  ..............  ..............  ..............  ..............  ..............
  44310  C                               Ileostomy/jejunostomy..........  ..............  ..............  ..............  ..............  ..............
  44312  T                               Revision of ileostomy..........            0026           12.11         $587.18         $277.92         $117.44
  44314  C                               Revision of ileostomy..........  ..............  ..............  ..............  ..............  ..............
  44316  C                               Devise bowel pouch.............  ..............  ..............  ..............  ..............  ..............
  44320  C                               Colostomy......................  ..............  ..............  ..............  ..............  ..............
  44322  C                               Colostomy with biopsies........  ..............  ..............  ..............  ..............  ..............
  44340  T                               Revision of colostomy..........            0026           12.11         $587.18         $277.92         $117.44
  44345  C                               Revision of colostomy..........  ..............  ..............  ..............  ..............  ..............
  44346  C                               Revision of colostomy..........  ..............  ..............  ..............  ..............  ..............
  44360  T                               Small bowel endoscopy..........            0142            7.45         $361.23         $162.42          $72.25
  44361  T                               Small bowel endoscopy/biopsy...            0142            7.45         $361.23         $162.42          $72.25
  44363  T                               Small bowel endoscopy..........            0142            7.45         $361.23         $162.42          $72.25
  44364  T                               Small bowel endoscopy..........            0142            7.45         $361.23         $162.42          $72.25
  44365  T                               Small bowel endoscopy..........            0142            7.45         $361.23         $162.42          $72.25
  44366  T                               Small bowel endoscopy..........            0142            7.45         $361.23         $162.42          $72.25
  44369  T                               Small bowel endoscopy..........            0142            7.45         $361.23         $162.42          $72.25
  44372  T                               Small bowel endoscopy..........            0142            7.45         $361.23         $162.42          $72.25
  44373  T                               Small bowel endoscopy..........            0142            7.45         $361.23         $162.42          $72.25
  44376  T                               Small bowel endoscopy..........            0142            7.45         $361.23         $162.42          $72.25
  44377  T                               Small bowel endoscopy/biopsy...            0142            7.45         $361.23         $162.42          $72.25
  44378  T                               Small bowel endoscopy..........            0142            7.45         $361.23         $162.42          $72.25
  44380  T                               Small bowel endoscopy..........            0142            7.45         $361.23         $162.42          $72.25
  44382  T                               Small bowel endoscopy..........            0142            7.45         $361.23         $162.42          $72.25
  44385  T                               Endoscopy of bowel pouch.......            0143            7.98         $386.93         $199.12          $77.39
  44386  T                               Endoscopy, bowel pouch/biop....            0143            7.98         $386.93         $199.12          $77.39
  44388  T                               Colon endoscopy................            0143            7.98         $386.93         $199.12          $77.39
  44389  T                               Colonoscopy with biopsy........            0143            7.98         $386.93         $199.12          $77.39
  44390  T                               Colonoscopy for foreign body...            0143            7.98         $386.93         $199.12          $77.39
  44391  T                               Colonoscopy for bleeding.......            0143            7.98         $386.93         $199.12          $77.39
  44392  T                               Colonoscopy & polypectomy......            0143            7.98         $386.93         $199.12          $77.39
  44393  T                               Colonoscopy, lesion removal....            0143            7.98         $386.93         $199.12          $77.39
  44394  T                               Colonoscopy w/snare............            0143            7.98         $386.93         $199.12          $77.39
  44500  C                               Intro, gastrointestinal tube...  ..............  ..............  ..............  ..............  ..............
  44602  C                               Suture, small intestine........  ..............  ..............  ..............  ..............  ..............
  44603  C                               Suture, small intestine........  ..............  ..............  ..............  ..............  ..............
  44604  C                               Suture, large intestine........  ..............  ..............  ..............  ..............  ..............
  44605  C                               Repair of bowel lesion.........  ..............  ..............  ..............  ..............  ..............
  44615  C                               Intestinal stricturoplasty.....  ..............  ..............  ..............  ..............  ..............
  44620  C                               Repair bowel opening...........  ..............  ..............  ..............  ..............  ..............
  44625  C                               Repair bowel opening...........  ..............  ..............  ..............  ..............  ..............
  44626  C                               Repair bowel opening...........  ..............  ..............  ..............  ..............  ..............
  44640  C                               Repair bowel-skin fistula......  ..............  ..............  ..............  ..............  ..............
  44650  C                               Repair bowel fistula...........  ..............  ..............  ..............  ..............  ..............
  44660  C                               Repair bowel-bladder fistula...  ..............  ..............  ..............  ..............  ..............
  44661  C                               Repair bowel-bladder fistula...  ..............  ..............  ..............  ..............  ..............
  44680  C                               Surgical revision, intestine...  ..............  ..............  ..............  ..............  ..............
  44700  C                               Suspend bowel w/prosthesis.....  ..............  ..............  ..............  ..............  ..............
  44799  T                               Intestine surgery procedure....            0142            7.45         $361.23         $162.42          $72.25
  44800  C                               Excision of bowel pouch........  ..............  ..............  ..............  ..............  ..............
  44820  C                               Excision of mesentery lesion...  ..............  ..............  ..............  ..............  ..............
  44850  C                               Repair of mesentery............  ..............  ..............  ..............  ..............  ..............
  44899  C                               Bowel surgery procedure........  ..............  ..............  ..............  ..............  ..............
  44900  C                               Drain app abscess, open........  ..............  ..............  ..............  ..............  ..............
  44901  C                               Drain app abscess, percut......  ..............  ..............  ..............  ..............  ..............
  44950  C                               Appendectomy...................  ..............  ..............  ..............  ..............  ..............
  44955  C                               Appendectomy add-on............  ..............  ..............  ..............  ..............  ..............
  44960  C                               Appendectomy...................  ..............  ..............  ..............  ..............  ..............
  44970  T                               Laparoscopy, appendectomy......            0130           25.36       $1,229.63         $659.53         $245.93
  44979  T                               Laparoscope proc, app..........            0130           25.36       $1,229.63         $659.53         $245.93
  45000  T                               Drainage of pelvic abscess.....            0149           12.86         $623.54         $293.06         $124.71
  45005  T                               Drainage of rectal abscess.....            0148            2.34         $113.46          $43.59          $22.69
  45020  T                               Drainage of rectal abscess.....            0149           12.86         $623.54         $293.06         $124.71
  45100  T                               Biopsy of rectum...............            0149           12.86         $623.54         $293.06         $124.71
  45108  T                               Removal of anorectal lesion....            0150           17.68         $857.25         $437.12         $171.45
  45110  C                               Removal of rectum..............  ..............  ..............  ..............  ..............  ..............
  45111  C                               Partial removal of rectum......  ..............  ..............  ..............  ..............  ..............
  45112  C                               Removal of rectum..............  ..............  ..............  ..............  ..............  ..............
  45113  C                               Partial proctectomy............  ..............  ..............  ..............  ..............  ..............
  45114  C                               Partial removal of rectum......  ..............  ..............  ..............  ..............  ..............

[[Page 18604]]

 
  45116  C                               Partial removal of rectum......  ..............  ..............  ..............  ..............  ..............
  45119  C                               Remove rectum w/reservoir......  ..............  ..............  ..............  ..............  ..............
  45120  C                               Removal of rectum..............  ..............  ..............  ..............  ..............  ..............
  45121  C                               Removal of rectum and colon....  ..............  ..............  ..............  ..............  ..............
  45123  C                               Partial proctectomy............  ..............  ..............  ..............  ..............  ..............
  45126  C                               Pelvic exenteration............  ..............  ..............  ..............  ..............  ..............
  45130  C                               Excision of rectal prolapse....  ..............  ..............  ..............  ..............  ..............
  45135  C                               Excision of rectal prolapse....  ..............  ..............  ..............  ..............  ..............
  45150  T                               Excision of rectal stricture...            0150           17.68         $857.25         $437.12         $171.45
  45160  T                               Excision of rectal lesion......            0150           17.68         $857.25         $437.12         $171.45
  45170  T                               Excision of rectal lesion......            0150           17.68         $857.25         $437.12         $171.45
  45190  T                               Destruction, rectal tumor......            0150           17.68         $857.25         $437.12         $171.45
  45300  T                               Proctosigmoidoscopy............            0146            2.83         $137.22          $65.15          $27.44
  45303  T                               Proctosigmoidoscopy............            0146            2.83         $137.22          $65.15          $27.44
  45305  T                               Proctosigmoidoscopy & biopsy...            0146            2.83         $137.22          $65.15          $27.44
  45307  T                               Proctosigmoidoscopy............            0146            2.83         $137.22          $65.15          $27.44
  45308  T                               Proctosigmoidoscopy............            0147            6.26         $303.53         $149.11          $60.71
  45309  T                               Proctosigmoidoscopy............            0147            6.26         $303.53         $149.11          $60.71
  45315  T                               Proctosigmoidoscopy............            0147            6.26         $303.53         $149.11          $60.71
  45317  T                               Proctosigmoidoscopy............            0146            2.83         $137.22          $65.15          $27.44
  45320  T                               Proctosigmoidoscopy............            0147            6.26         $303.53         $149.11          $60.71
  45321  T                               Proctosigmoidoscopy............            0147            6.26         $303.53         $149.11          $60.71
  45330  T                               Diagnostic sigmoidoscopy.......            0146            2.83         $137.22          $65.15          $27.44
  45331  T                               Sigmoidoscopy and biopsy.......            0146            2.83         $137.22          $65.15          $27.44
  45332  T                               Sigmoidoscopy..................            0146            2.83         $137.22          $65.15          $27.44
  45333  T                               Sigmoidoscopy & polypectomy....            0147            6.26         $303.53         $149.11          $60.71
  45334  T                               Sigmoidoscopy for bleeding.....            0147            6.26         $303.53         $149.11          $60.71
  45337  T                               Sigmoidoscopy & decompress.....            0147            6.26         $303.53         $149.11          $60.71
  45338  T                               Sigmoidoscopy..................            0147            6.26         $303.53         $149.11          $60.71
  45339  T                               Sigmoidoscopy..................            0147            6.26         $303.53         $149.11          $60.71
  45355  T                               Surgical colonoscopy...........            0143            7.98         $386.93         $199.12          $77.39
  45378  T                               Diagnostic colonoscopy.........            0143            7.98         $386.93         $199.12          $77.39
  45379  T                               Colonoscopy....................            0143            7.98         $386.93         $199.12          $77.39
  45380  T                               Colonoscopy and biopsy.........            0143            7.98         $386.93         $199.12          $77.39
  45382  T                               Colonoscopy/control bleeding...            0143            7.98         $386.93         $199.12          $77.39
  45383  T                               Lesion removal colonoscopy.....            0143            7.98         $386.93         $199.12          $77.39
  45384  T                               Colonoscopy....................            0143            7.98         $386.93         $199.12          $77.39
  45385  T                               Lesion removal colonoscopy.....            0143            7.98         $386.93         $199.12          $77.39
  45500  T                               Repair of rectum...............            0150           17.68         $857.25         $437.12         $171.45
  45505  T                               Repair of rectum...............            0150           17.68         $857.25         $437.12         $171.45
  45520  T                               Treatment of rectal prolapse...            0098            1.19          $57.70          $20.88          $11.54
  45540  C                               Correct rectal prolapse........  ..............  ..............  ..............  ..............  ..............
  45541  C                               Correct rectal prolapse........  ..............  ..............  ..............  ..............  ..............
  45550  C                               Repair rectum/remove sigmoid...  ..............  ..............  ..............  ..............  ..............
  45560  T                               Repair of rectocele............            0150           17.68         $857.25         $437.12         $171.45
  45562  C                               Exploration/repair of rectum...  ..............  ..............  ..............  ..............  ..............
  45563  C                               Exploration/repair of rectum...  ..............  ..............  ..............  ..............  ..............
  45800  C                               Repair rect/bladder fistula....  ..............  ..............  ..............  ..............  ..............
  45805  C                               Repair fistula w/colostomy.....  ..............  ..............  ..............  ..............  ..............
  45820  C                               Repair rectourethral fistula...  ..............  ..............  ..............  ..............  ..............
  45825  C                               Repair fistula w/colostomy.....  ..............  ..............  ..............  ..............  ..............
  45900  T                               Reduction of rectal prolapse...            0148            2.34         $113.46          $43.59          $22.69
  45905  T                               Dilation of anal sphincter.....            0149           12.86         $623.54         $293.06         $124.71
  45910  T                               Dilation of rectal narrowing...            0149           12.86         $623.54         $293.06         $124.71
  45915  T                               Remove rectal obstruction......            0148            2.34         $113.46          $43.59          $22.69
  45999  T                               Rectum surgery procedure.......            0148            2.34         $113.46          $43.59          $22.69
  46030  T                               Removal of rectal marker.......            0149           12.86         $623.54         $293.06         $124.71
  46040  T                               Incision of rectal abscess.....            0148            2.34         $113.46          $43.59          $22.69
  46045  T                               Incision of rectal abscess.....            0150           17.68         $857.25         $437.12         $171.45
  46050  T                               Incision of anal abscess.......            0148            2.34         $113.46          $43.59          $22.69
  46060  T                               Incision of rectal abscess.....            0150           17.68         $857.25         $437.12         $171.45
  46070  T                               Incision of anal septum........            0148            2.34         $113.46          $43.59          $22.69
  46080  T                               Incision of anal sphincter.....            0149           12.86         $623.54         $293.06         $124.71
  46083  T                               Incise external hemorrhoid.....            0148            2.34         $113.46          $43.59          $22.69
  46200  T                               Removal of anal fissure........            0150           17.68         $857.25         $437.12         $171.45
  46210  T                               Removal of anal crypt..........            0149           12.86         $623.54         $293.06         $124.71
  46211  T                               Removal of anal crypts.........            0150           17.68         $857.25         $437.12         $171.45
  46220  T                               Removal of anal tab............            0149           12.86         $623.54         $293.06         $124.71
  46221  T                               Ligation of hemorrhoid(s)......            0148            2.34         $113.46          $43.59          $22.69
  46230  T                               Removal of anal tabs...........            0149           12.86         $623.54         $293.06         $124.71
  46250  T                               Hemorrhoidectomy...............            0150           17.68         $857.25         $437.12         $171.45
  46255  T                               Hemorrhoidectomy...............            0150           17.68         $857.25         $437.12         $171.45
  46257  T                               Remove hemorrhoids & fissure...            0150           17.68         $857.25         $437.12         $171.45

[[Page 18605]]

 
  46258  T                               Remove hemorrhoids & fistula...            0150           17.68         $857.25         $437.12         $171.45
  46260  T                               Hemorrhoidectomy...............            0150           17.68         $857.25         $437.12         $171.45
  46261  T                               Remove hemorrhoids & fissure...            0150           17.68         $857.25         $437.12         $171.45
  46262  T                               Remove hemorrhoids & fistula...            0150           17.68         $857.25         $437.12         $171.45
  46270  T                               Removal of anal fistula........            0150           17.68         $857.25         $437.12         $171.45
  46275  T                               Removal of anal fistula........            0150           17.68         $857.25         $437.12         $171.45
  46280  T                               Removal of anal fistula........            0150           17.68         $857.25         $437.12         $171.45
  46285  T                               Removal of anal fistula........            0150           17.68         $857.25         $437.12         $171.45
  46288  T                               Repair anal fistula............            0150           17.68         $857.25         $437.12         $171.45
  46320  T                               Removal of hemorrhoid clot.....            0148            2.34         $113.46          $43.59          $22.69
  46500  T                               Injection into hemorrhoids.....            0148            2.34         $113.46          $43.59          $22.69
  46600  N                               Diagnostic anoscopy............  ..............  ..............  ..............  ..............  ..............
  46604  T                               Anoscopy and dilation..........            0144            2.23         $108.13          $49.32          $21.63
  46606  T                               Anoscopy and biopsy............            0145            7.46         $361.71         $179.39          $72.34
  46608  T                               Anoscopy/remove for body.......            0144            2.23         $108.13          $49.32          $21.63
  46610  T                               Anoscopy/remove lesion.........            0145            7.46         $361.71         $179.39          $72.34
  46611  T                               Anoscopy.......................            0145            7.46         $361.71         $179.39          $72.34
  46612  T                               Anoscopy/remove lesions........            0145            7.46         $361.71         $179.39          $72.34
  46614  T                               Anoscopy/control bleeding......            0145            7.46         $361.71         $179.39          $72.34
  46615  T                               Anoscopy.......................            0145            7.46         $361.71         $179.39          $72.34
  46700  T                               Repair of anal stricture.......            0150           17.68         $857.25         $437.12         $171.45
  46705  C                               Repair of anal stricture.......  ..............  ..............  ..............  ..............  ..............
  46715  C                               Repair of anovaginal fistula...  ..............  ..............  ..............  ..............  ..............
  46716  C                               Repair of anovaginal fistula...  ..............  ..............  ..............  ..............  ..............
  46730  C                               Construction of absent anus....  ..............  ..............  ..............  ..............  ..............
  46735  C                               Construction of absent anus....  ..............  ..............  ..............  ..............  ..............
  46740  C                               Construction of absent anus....  ..............  ..............  ..............  ..............  ..............
  46742  C                               Repair of imperforated anus....  ..............  ..............  ..............  ..............  ..............
  46744  C                               Repair of cloacal anomaly......  ..............  ..............  ..............  ..............  ..............
  46746  C                               Repair of cloacal anomaly......  ..............  ..............  ..............  ..............  ..............
  46748  C                               Repair of cloacal anomaly......  ..............  ..............  ..............  ..............  ..............
  46750  T                               Repair of anal sphincter.......            0150           17.68         $857.25         $437.12         $171.45
  46751  C                               Repair of anal sphincter.......  ..............  ..............  ..............  ..............  ..............
  46753  T                               Reconstruction of anus.........            0150           17.68         $857.25         $437.12         $171.45
  46754  T                               Removal of suture from anus....            0149           12.86         $623.54         $293.06         $124.71
  46760  T                               Repair of anal sphincter.......            0150           17.68         $857.25         $437.12         $171.45
  46761  T                               Repair of anal sphincter.......            0150           17.68         $857.25         $437.12         $171.45
  46762  T                               Implant artificial sphincter...            0150           17.68         $857.25         $437.12         $171.45
  46900  T                               Destruction, anal lesion(s)....            0016            3.53         $171.16          $74.67          $34.23
  46910  T                               Destruction, anal lesion(s)....            0016            3.53         $171.16          $74.67          $34.23
  46916  T                               Cryosurgery, anal lesion(s)....            0016            3.53         $171.16          $74.67          $34.23
  46917  T                               Laser surgery, anal lesions....            0014            1.50          $72.73          $24.55          $14.55
  46922  T                               Excision of anal lesion(s).....            0017           12.45         $603.66         $289.16         $120.73
  46924  T                               Destruction, anal lesion(s)....            0017           12.45         $603.66         $289.16         $120.73
  46934  T                               Destruction of hemorrhoids.....            0148            2.34         $113.46          $43.59          $22.69
  46935  T                               Destruction of hemorrhoids.....            0148            2.34         $113.46          $43.59          $22.69
  46936  T                               Destruction of hemorrhoids.....            0149           12.86         $623.54         $293.06         $124.71
  46937  T                               Cryotherapy of rectal lesion...            0150           17.68         $857.25         $437.12         $171.45
  46938  T                               Cryotherapy of rectal lesion...            0150           17.68         $857.25         $437.12         $171.45
  46940  T                               Treatment of anal fissure......            0149           12.86         $623.54         $293.06         $124.71
  46942  T                               Treatment of anal fissure......            0149           12.86         $623.54         $293.06         $124.71
  46945  T                               Ligation of hemorrhoids........            0148            2.34         $113.46          $43.59          $22.69
  46946  T                               Ligation of hemorrhoids........            0148            2.34         $113.46          $43.59          $22.69
  46999  T                               Anus surgery procedure.........            0149           12.86         $623.54         $293.06         $124.71
  47000  T                               Needle biopsy of liver.........            0005            5.41         $262.32         $119.75          $52.46
  47001  C                               Needle biopsy, liver add-on....  ..............  ..............  ..............  ..............  ..............
  47010  C                               Open drainage, liver lesion....  ..............  ..............  ..............  ..............  ..............
  47011  C                               Percut drain, liver lesion.....  ..............  ..............  ..............  ..............  ..............
  47015  C                               Inject/aspirate liver cyst.....  ..............  ..............  ..............  ..............  ..............
  47100  C                               Wedge biopsy of liver..........  ..............  ..............  ..............  ..............  ..............
  47120  C                               Partial removal of liver.......  ..............  ..............  ..............  ..............  ..............
  47122  C                               Extensive removal of liver.....  ..............  ..............  ..............  ..............  ..............
  47125  C                               Partial removal of liver.......  ..............  ..............  ..............  ..............  ..............
  47130  C                               Partial removal of liver.......  ..............  ..............  ..............  ..............  ..............
  47133  C                               Removal of donor liver.........  ..............  ..............  ..............  ..............  ..............
  47134  C                               Partial removal, donor liver...  ..............  ..............  ..............  ..............  ..............
  47135  C                               Transplantation of liver.......  ..............  ..............  ..............  ..............  ..............
  47136  C                               Transplantation of liver.......  ..............  ..............  ..............  ..............  ..............
  47300  C                               Surgery for liver lesion.......  ..............  ..............  ..............  ..............  ..............
  47350  C                               Repair liver wound.............  ..............  ..............  ..............  ..............  ..............
  47360  C                               Repair liver wound.............  ..............  ..............  ..............  ..............  ..............
  47361  C                               Repair liver wound.............  ..............  ..............  ..............  ..............  ..............
  47362  C                               Repair liver wound.............  ..............  ..............  ..............  ..............  ..............

[[Page 18606]]

 
  47399  T                               Liver surgery procedure........            0005            5.41         $262.32         $119.75          $52.46
  47400  C                               Incision of liver duct.........  ..............  ..............  ..............  ..............  ..............
  47420  C                               Incision of bile duct..........  ..............  ..............  ..............  ..............  ..............
  47425  C                               Incision of bile duct..........  ..............  ..............  ..............  ..............  ..............
  47460  C                               Incise bile duct sphincter.....  ..............  ..............  ..............  ..............  ..............
  47480  C                               Incision of gallbladder........  ..............  ..............  ..............  ..............  ..............
  47490  C                               Incision of gallbladder........  ..............  ..............  ..............  ..............  ..............
  47500  N                               Injection for liver x-rays.....  ..............  ..............  ..............  ..............  ..............
  47505  N                               Injection for liver x-rays.....  ..............  ..............  ..............  ..............  ..............
  47510  T                               Insert catheter, bile duct.....            0152            8.22         $398.56         $207.38          $79.71
  47511  T                               Insert bile duct drain.........            0152            8.22         $398.56         $207.38          $79.71
  47525  T                               Change bile duct catheter......            0122            5.04         $244.37         $114.93          $48.88
  47530  T                               Revise/reinsert bile tube......            0121            2.36         $114.43          $52.53          $22.89
  47550  C                               Bile duct endoscopy add-on.....  ..............  ..............  ..............  ..............  ..............
  47552  T                               Biliary endoscopy thru skin....            0152            8.22         $398.56         $207.38          $79.71
  47553  T                               Biliary endoscopy thru skin....            0152            8.22         $398.56         $207.38          $79.71
  47554  T                               Biliary endoscopy thru skin....            0152            8.22         $398.56         $207.38          $79.71
  47555  T                               Biliary endoscopy thru skin....            0152            8.22         $398.56         $207.38          $79.71
  47556  T                               Biliary endoscopy thru skin....            0152            8.22         $398.56         $207.38          $79.71
  47560  T                               Laparoscopy w/cholangio........            0130           25.36       $1,229.63         $659.53         $245.93
  47561  T                               Laparo w/cholangio/biopsy......            0130           25.36       $1,229.63         $659.53         $245.93
  47562  T                               Laparoscopic cholecystectomy...            0131           41.81       $2,027.24       $1,089.88         $405.45
  47563  T                               Laparo cholecystectomy/graph...            0131           41.81       $2,027.24       $1,089.88         $405.45
  47564  T                               Laparo cholecystectomy/explr...            0131           41.81       $2,027.24       $1,089.88         $405.45
  47570  T                               Laparo cholecystoenterostomy...            0131           41.81       $2,027.24       $1,089.88         $405.45
  47579  T                               Laparoscope proc, biliary......            0130           25.36       $1,229.63         $659.53         $245.93
  47600  C                               Removal of gallbladder.........  ..............  ..............  ..............  ..............  ..............
  47605  C                               Removal of gallbladder.........  ..............  ..............  ..............  ..............  ..............
  47610  C                               Removal of gallbladder.........  ..............  ..............  ..............  ..............  ..............
  47612  C                               Removal of gallbladder.........  ..............  ..............  ..............  ..............  ..............
  47620  C                               Removal of gallbladder.........  ..............  ..............  ..............  ..............  ..............
  47630  T                               Remove bile duct stone.........            0152            8.22         $398.56         $207.38          $79.71
  47700  C                               Exploration of bile ducts......  ..............  ..............  ..............  ..............  ..............
  47701  C                               Bile duct revision.............  ..............  ..............  ..............  ..............  ..............
  47711  C                               Excision of bile duct tumor....  ..............  ..............  ..............  ..............  ..............
  47712  C                               Excision of bile duct tumor....  ..............  ..............  ..............  ..............  ..............
  47715  C                               Excision of bile duct cyst.....  ..............  ..............  ..............  ..............  ..............
  47716  C                               Fusion of bile duct cyst.......  ..............  ..............  ..............  ..............  ..............
  47720  C                               Fuse gallbladder & bowel.......  ..............  ..............  ..............  ..............  ..............
  47721  C                               Fuse upper gi structures.......  ..............  ..............  ..............  ..............  ..............
  47740  C                               Fuse gallbladder & bowel.......  ..............  ..............  ..............  ..............  ..............
  47741  C                               Fuse gallbladder & bowel.......  ..............  ..............  ..............  ..............  ..............
  47760  C                               Fuse bile ducts and bowel......  ..............  ..............  ..............  ..............  ..............
  47765  C                               Fuse liver ducts & bowel.......  ..............  ..............  ..............  ..............  ..............
  47780  C                               Fuse bile ducts and bowel......  ..............  ..............  ..............  ..............  ..............
  47785  C                               Fuse bile ducts and bowel......  ..............  ..............  ..............  ..............  ..............
  47800  C                               Reconstruction of bile ducts...  ..............  ..............  ..............  ..............  ..............
  47801  C                               Placement, bile duct support...  ..............  ..............  ..............  ..............  ..............
  47802  C                               Fuse liver duct & intestine....  ..............  ..............  ..............  ..............  ..............
  47900  C                               Suture bile duct injury........  ..............  ..............  ..............  ..............  ..............
  47999  T                               Bile tract surgery procedure...            0121            2.36         $114.43          $52.53          $22.89
  48000  C                               Drainage of abdomen............  ..............  ..............  ..............  ..............  ..............
  48001  C                               Placement of drain, pancreas...  ..............  ..............  ..............  ..............  ..............
  48005  C                               Resect/debride pancreas........  ..............  ..............  ..............  ..............  ..............
  48020  C                               Removal of pancreatic stone....  ..............  ..............  ..............  ..............  ..............
  48100  C                               Biopsy of pancreas.............  ..............  ..............  ..............  ..............  ..............
  48102  T                               Needle biopsy, pancreas........            0005            5.41         $262.32         $119.75          $52.46
  48120  C                               Removal of pancreas lesion.....  ..............  ..............  ..............  ..............  ..............
  48140  C                               Partial removal of pancreas....  ..............  ..............  ..............  ..............  ..............
  48145  C                               Partial removal of pancreas....  ..............  ..............  ..............  ..............  ..............
  48146  C                               Pancreatectomy.................  ..............  ..............  ..............  ..............  ..............
  48148  C                               Removal of pancreatic duct.....  ..............  ..............  ..............  ..............  ..............
  48150  C                               Partial removal of pancreas....  ..............  ..............  ..............  ..............  ..............
  48152  C                               Pancreatectomy.................  ..............  ..............  ..............  ..............  ..............
  48153  C                               Pancreatectomy.................  ..............  ..............  ..............  ..............  ..............
  48154  C                               Pancreatectomy.................  ..............  ..............  ..............  ..............  ..............
  48155  C                               Removal of pancreas............  ..............  ..............  ..............  ..............  ..............
  48160  E                               Pancreas removal/transplant....  ..............  ..............  ..............  ..............  ..............
  48180  C                               Fuse pancreas and bowel........  ..............  ..............  ..............  ..............  ..............
  48400  C                               Injection, intraop add-on......  ..............  ..............  ..............  ..............  ..............
  48500  C                               Surgery of pancreas cyst.......  ..............  ..............  ..............  ..............  ..............
  48510  C                               Drain pancreatic pseudocyst....  ..............  ..............  ..............  ..............  ..............
  48511  C                               Drain pancreatic pseudocyst....  ..............  ..............  ..............  ..............  ..............

[[Page 18607]]

 
  48520  C                               Fuse pancreas cyst and bowel...  ..............  ..............  ..............  ..............  ..............
  48540  C                               Fuse pancreas cyst and bowel...  ..............  ..............  ..............  ..............  ..............
  48545  C                               Pancreatorrhaphy...............  ..............  ..............  ..............  ..............  ..............
  48547  C                               Duodenal exclusion.............  ..............  ..............  ..............  ..............  ..............
  48550  E                               Donor pancreatectomy...........  ..............  ..............  ..............  ..............  ..............
  48554  E                               Transpl allograft pancreas.....  ..............  ..............  ..............  ..............  ..............
  48556  C                               Removal, allograft pancreas....  ..............  ..............  ..............  ..............  ..............
  48999  T                               Pancreas surgery procedure.....            0005            5.41         $262.32         $119.75          $52.46
  49000  C                               Exploration of abdomen.........  ..............  ..............  ..............  ..............  ..............
  49002  C                               Reopening of abdomen...........  ..............  ..............  ..............  ..............  ..............
  49010  C                               Exploration behind abdomen.....  ..............  ..............  ..............  ..............  ..............
  49020  C                               Drain abdominal abscess........  ..............  ..............  ..............  ..............  ..............
  49021  C                               Drain abdominal abscess........  ..............  ..............  ..............  ..............  ..............
  49040  C                               Drain, open, abdom abscess.....  ..............  ..............  ..............  ..............  ..............
  49041  C                               Drain, percut, abdom abscess...  ..............  ..............  ..............  ..............  ..............
  49060  C                               Drain, open, retrop abscess....  ..............  ..............  ..............  ..............  ..............
  49061  C                               Drain, percut, retroper absc...  ..............  ..............  ..............  ..............  ..............
  49062  C                               Drain to peritoneal cavity.....  ..............  ..............  ..............  ..............  ..............
  49080  T                               Puncture, peritoneal cavity....            0070            3.64         $176.49          $79.60          $35.30
  49081  T                               Removal of abdominal fluid.....            0070            3.64         $176.49          $79.60          $35.30
  49085  T                               Remove abdomen foreign body....            0153           19.62         $951.32         $496.31         $190.26
  49180  T                               Biopsy, abdominal mass.........            0005            5.41         $262.32         $119.75          $52.46
  49200  C                               Removal of abdominal lesion....  ..............  ..............  ..............  ..............  ..............
  49201  C                               Removal of abdominal lesion....  ..............  ..............  ..............  ..............  ..............
  49215  C                               Excise sacral spine tumor......  ..............  ..............  ..............  ..............  ..............
  49220  C                               Multiple surgery, abdomen......  ..............  ..............  ..............  ..............  ..............
  49250  T                               Excision of umbilicus..........            0153           19.62         $951.32         $496.31         $190.26
  49255  C                               Removal of omentum.............  ..............  ..............  ..............  ..............  ..............
  49320  T                               Diag laparo separate proc......            0130           25.36       $1,229.63         $659.53         $245.93
  49321  T                               Laparoscopy, biopsy............            0130           25.36       $1,229.63         $659.53         $245.93
  49322  T                               Laparoscopy, aspiration........            0130           25.36       $1,229.63         $659.53         $245.93
  49323  T                               Laparo drain lymphocele........            0130           25.36       $1,229.63         $659.53         $245.93
  49329  T                               Laparo proc, abdm/per/oment....            0130           25.36       $1,229.63         $659.53         $245.93
  49400  N                               Air injection into abdomen.....  ..............  ..............  ..............  ..............  ..............
  49420  T                               Insert abdominal drain.........            0153           19.62         $951.32         $496.31         $190.26
  49421  T                               Insert abdominal drain.........            0153           19.62         $951.32         $496.31         $190.26
  49422  T                               Remove perm cannula/catheter...            0123           13.89         $673.49         $350.75         $134.70
  49423  T                               Exchange drainage catheter.....            0153           19.62         $951.32         $496.31         $190.26
  49424  N                               Assess cyst, contrast inject...  ..............  ..............  ..............  ..............  ..............
  49425  C                               Insert abdomen-venous drain....  ..............  ..............  ..............  ..............  ..............
  49426  T                               Revise abdomen-venous shunt....            0153           19.62         $951.32         $496.31         $190.26
  49427  N                               Injection, abdominal shunt.....  ..............  ..............  ..............  ..............  ..............
  49428  C                               Ligation of shunt..............  ..............  ..............  ..............  ..............  ..............
  49429  T                               Removal of shunt...............            0123           13.89         $673.49         $350.75         $134.70
  49495  T                               Repair inguinal hernia, init...            0154           22.43       $1,087.57         $556.98         $217.51
  49496  T                               Repair inguinal hernia, init...            0154           22.43       $1,087.57         $556.98         $217.51
  49500  T                               Repair inguinal hernia.........            0154           22.43       $1,087.57         $556.98         $217.51
  49501  T                               Repair inguinal hernia, init...            0154           22.43       $1,087.57         $556.98         $217.51
  49505  T                               Repair inguinal hernia.........            0154           22.43       $1,087.57         $556.98         $217.51
  49507  T                               Repair inguinal hernia.........            0154           22.43       $1,087.57         $556.98         $217.51
  49520  T                               Rerepair inguinal hernia.......            0154           22.43       $1,087.57         $556.98         $217.51
  49521  T                               Repair inguinal hernia, rec....            0154           22.43       $1,087.57         $556.98         $217.51
  49525  T                               Repair inguinal hernia.........            0154           22.43       $1,087.57         $556.98         $217.51
  49540  T                               Repair lumbar hernia...........            0154           22.43       $1,087.57         $556.98         $217.51
  49550  T                               Repair femoral hernia..........            0154           22.43       $1,087.57         $556.98         $217.51
  49553  T                               Repair femoral hernia, init....            0154           22.43       $1,087.57         $556.98         $217.51
  49555  T                               Repair femoral hernia..........            0154           22.43       $1,087.57         $556.98         $217.51
  49557  T                               Repair femoral hernia, recur...            0154           22.43       $1,087.57         $556.98         $217.51
  49560  T                               Repair abdominal hernia........            0154           22.43       $1,087.57         $556.98         $217.51
  49561  T                               Repair incisional hernia.......            0154           22.43       $1,087.57         $556.98         $217.51
  49565  T                               Rerepair abdominal hernia......            0154           22.43       $1,087.57         $556.98         $217.51
  49566  T                               Repair incisional hernia.......            0154           22.43       $1,087.57         $556.98         $217.51
  49568  T                               Hernia repair w/mesh...........            0154           22.43       $1,087.57         $556.98         $217.51
  49570  T                               Repair epigastric hernia.......            0154           22.43       $1,087.57         $556.98         $217.51
  49572  T                               Repair epigastric hernia.......            0154           22.43       $1,087.57         $556.98         $217.51
  49580  T                               Repair umbilical hernia........            0154           22.43       $1,087.57         $556.98         $217.51
  49582  T                               Repair umbilical hernia........            0154           22.43       $1,087.57         $556.98         $217.51
  49585  T                               Repair umbilical hernia........            0154           22.43       $1,087.57         $556.98         $217.51
  49587  T                               Repair umbilical hernia........            0154           22.43       $1,087.57         $556.98         $217.51
  49590  T                               Repair abdominal hernia........            0154           22.43       $1,087.57         $556.98         $217.51
  49600  T                               Repair umbilical lesion........            0154           22.43       $1,087.57         $556.98         $217.51
  49605  C                               Repair umbilical lesion........  ..............  ..............  ..............  ..............  ..............
  49606  C                               Repair umbilical lesion........  ..............  ..............  ..............  ..............  ..............

[[Page 18608]]

 
  49610  C                               Repair umbilical lesion........  ..............  ..............  ..............  ..............  ..............
  49611  C                               Repair umbilical lesion........  ..............  ..............  ..............  ..............  ..............
  49650  T                               Laparo hernia repair initial...            0131           41.81       $2,027.24       $1,089.88         $405.45
  49651  T                               Laparo hernia repair recur.....            0131           41.81       $2,027.24       $1,089.88         $405.45
  49659  T                               Laparo proc, hernia repair.....            0131           41.81       $2,027.24       $1,089.88         $405.45
  49900  C                               Repair of abdominal wall.......  ..............  ..............  ..............  ..............  ..............
  49905  C                               Omental flap...................  ..............  ..............  ..............  ..............  ..............
  49906  C                               Free omental flap, microvasc...  ..............  ..............  ..............  ..............  ..............
  49999  T                               Abdomen surgery procedure......            0121            2.36         $114.43          $52.53          $22.89
  50010  C                               Exploration of kidney..........  ..............  ..............  ..............  ..............  ..............
  50020  C                               Renal abscess, open drain......  ..............  ..............  ..............  ..............  ..............
  50021  C                               Renal abscess, percut drain....  ..............  ..............  ..............  ..............  ..............
  50040  C                               Drainage of kidney.............  ..............  ..............  ..............  ..............  ..............
  50045  C                               Exploration of kidney..........  ..............  ..............  ..............  ..............  ..............
  50060  C                               Removal of kidney stone........  ..............  ..............  ..............  ..............  ..............
  50065  C                               Incision of kidney.............  ..............  ..............  ..............  ..............  ..............
  50070  C                               Incision of kidney.............  ..............  ..............  ..............  ..............  ..............
  50075  C                               Removal of kidney stone........  ..............  ..............  ..............  ..............  ..............
  50080  T                               Removal of kidney stone........            0163           28.98       $1,405.16         $792.58         $281.03
  50081  T                               Removal of kidney stone........            0163           28.98       $1,405.16         $792.58         $281.03
  50100  C                               Revise kidney blood vessels....  ..............  ..............  ..............  ..............  ..............
  50120  C                               Exploration of kidney..........  ..............  ..............  ..............  ..............  ..............
  50125  C                               Explore and drain kidney.......  ..............  ..............  ..............  ..............  ..............
  50130  C                               Removal of kidney stone........  ..............  ..............  ..............  ..............  ..............
  50135  C                               Exploration of kidney..........  ..............  ..............  ..............  ..............  ..............
  50200  T                               Biopsy of kidney...............            0005            5.41         $262.32         $119.75          $52.46
  50205  C                               Biopsy of kidney...............  ..............  ..............  ..............  ..............  ..............
  50220  C                               Removal of kidney..............  ..............  ..............  ..............  ..............  ..............
  50225  C                               Removal of kidney..............  ..............  ..............  ..............  ..............  ..............
  50230  C                               Removal of kidney..............  ..............  ..............  ..............  ..............  ..............
  50234  C                               Removal of kidney & ureter.....  ..............  ..............  ..............  ..............  ..............
  50236  C                               Removal of kidney & ureter.....  ..............  ..............  ..............  ..............  ..............
  50240  C                               Partial removal of kidney......  ..............  ..............  ..............  ..............  ..............
  50280  C                               Removal of kidney lesion.......  ..............  ..............  ..............  ..............  ..............
  50290  C                               Removal of kidney lesion.......  ..............  ..............  ..............  ..............  ..............
  50300  C                               Removal of donor kidney........  ..............  ..............  ..............  ..............  ..............
  50320  C                               Removal of donor kidney........  ..............  ..............  ..............  ..............  ..............
  50340  C                               Removal of kidney..............  ..............  ..............  ..............  ..............  ..............
  50360  C                               Transplantation of kidney......  ..............  ..............  ..............  ..............  ..............
  50365  C                               Transplantation of kidney......  ..............  ..............  ..............  ..............  ..............
  50370  C                               Remove transplanted kidney.....  ..............  ..............  ..............  ..............  ..............
  50380  C                               Reimplantation of kidney.......  ..............  ..............  ..............  ..............  ..............
  50390  T                               Drainage of kidney lesion......            0005            5.41         $262.32         $119.75          $52.46
  50392  T                               Insert kidney drain............            0160            5.43         $263.28         $110.11          $52.66
  50393  T                               Insert ureteral tube...........            0160            5.43         $263.28         $110.11          $52.66
  50394  N                               Injection for kidney x-ray.....  ..............  ..............  ..............  ..............  ..............
  50395  T                               Create passage to kidney.......            0160            5.43         $263.28         $110.11          $52.66
  50396  T                               Measure kidney pressure........            0165            3.89         $188.61          $91.76          $37.72
  50398  T                               Change kidney tube.............            0122            5.04         $244.37         $114.93          $48.88
  50400  C                               Revision of kidney/ureter......  ..............  ..............  ..............  ..............  ..............
  50405  C                               Revision of kidney/ureter......  ..............  ..............  ..............  ..............  ..............
  50500  C                               Repair of kidney wound.........  ..............  ..............  ..............  ..............  ..............
  50520  C                               Close kidney-skin fistula......  ..............  ..............  ..............  ..............  ..............
  50525  C                               Repair renal-abdomen fistula...  ..............  ..............  ..............  ..............  ..............
  50526  C                               Repair renal-abdomen fistula...  ..............  ..............  ..............  ..............  ..............
  50540  C                               Revision of horseshoe kidney...  ..............  ..............  ..............  ..............  ..............
  50541  T                               Laparo ablate renal cyst.......            0131           41.81       $2,027.24       $1,089.88         $405.45
  50544  T                               Laparoscopy, pyeloplasty.......            0131           41.81       $2,027.24       $1,089.88         $405.45
  50546  C                               Laparoscopic nephrectomy.......  ..............  ..............  ..............  ..............  ..............
  50547  C                               Laparo removal donor kidney....  ..............  ..............  ..............  ..............  ..............
  50548  T                               Laparo-asst remove k/ureter....            0132           48.91       $2,371.50       $1,239.22         $474.30
  50549  T                               Laparoscope proc, renal........            0130           25.36       $1,229.63         $659.53         $245.93
  50551  T                               Kidney endoscopy...............            0161           10.94         $530.45         $249.36         $106.09
  50553  T                               Kidney endoscopy...............            0161           10.94         $530.45         $249.36         $106.09
  50555  T                               Kidney endoscopy & biopsy......            0161           10.94         $530.45         $249.36         $106.09
  50557  T                               Kidney endoscopy & treatment...            0161           10.94         $530.45         $249.36         $106.09
  50559  T                               Renal endoscopy/radiotracer....            0161           10.94         $530.45         $249.36         $106.09
  50561  T                               Kidney endoscopy & treatment...            0161           10.94         $530.45         $249.36         $106.09
  50570  C                               Kidney endoscopy...............  ..............  ..............  ..............  ..............  ..............
  50572  C                               Kidney endoscopy...............  ..............  ..............  ..............  ..............  ..............
  50574  C                               Kidney endoscopy & biopsy......  ..............  ..............  ..............  ..............  ..............
  50575  C                               Kidney endoscopy...............  ..............  ..............  ..............  ..............  ..............
  50576  C                               Kidney endoscopy & treatment...  ..............  ..............  ..............  ..............  ..............

[[Page 18609]]

 
  50578  C                               Renal endoscopy/radiotracer....  ..............  ..............  ..............  ..............  ..............
  50580  C                               Kidney endoscopy & treatment...  ..............  ..............  ..............  ..............  ..............
  50590  T                               Fragmenting of kidney stone....            0169           46.72       $2,265.32       $1,384.20         $453.06
  50600  C                               Exploration of ureter..........  ..............  ..............  ..............  ..............  ..............
  50605  C                               Insert ureteral support........  ..............  ..............  ..............  ..............  ..............
  50610  C                               Removal of ureter stone........  ..............  ..............  ..............  ..............  ..............
  50620  C                               Removal of ureter stone........  ..............  ..............  ..............  ..............  ..............
  50630  C                               Removal of ureter stone........  ..............  ..............  ..............  ..............  ..............
  50650  C                               Removal of ureter..............  ..............  ..............  ..............  ..............  ..............
  50660  C                               Removal of ureter..............  ..............  ..............  ..............  ..............  ..............
  50684  N                               Injection for ureter x-ray.....  ..............  ..............  ..............  ..............  ..............
  50686  T                               Measure ureter pressure........            0165            3.89         $188.61          $91.76          $37.72
  50688  T                               Change of ureter tube..........            0121            2.36         $114.43          $52.53          $22.89
  50690  N                               Injection for ureter x-ray.....  ..............  ..............  ..............  ..............  ..............
  50700  C                               Revision of ureter.............  ..............  ..............  ..............  ..............  ..............
  50715  C                               Release of ureter..............  ..............  ..............  ..............  ..............  ..............
  50722  C                               Release of ureter..............  ..............  ..............  ..............  ..............  ..............
  50725  C                               Release/revise ureter..........  ..............  ..............  ..............  ..............  ..............
  50727  C                               Revise ureter..................  ..............  ..............  ..............  ..............  ..............
  50728  C                               Revise ureter..................  ..............  ..............  ..............  ..............  ..............
  50740  C                               Fusion of ureter & kidney......  ..............  ..............  ..............  ..............  ..............
  50750  C                               Fusion of ureter & kidney......  ..............  ..............  ..............  ..............  ..............
  50760  C                               Fusion of ureters..............  ..............  ..............  ..............  ..............  ..............
  50770  C                               Splicing of ureters............  ..............  ..............  ..............  ..............  ..............
  50780  C                               Reimplant ureter in bladder....  ..............  ..............  ..............  ..............  ..............
  50782  C                               Reimplant ureter in bladder....  ..............  ..............  ..............  ..............  ..............
  50783  C                               Reimplant ureter in bladder....  ..............  ..............  ..............  ..............  ..............
  50785  C                               Reimplant ureter in bladder....  ..............  ..............  ..............  ..............  ..............
  50800  C                               Implant ureter in bowel........  ..............  ..............  ..............  ..............  ..............
  50810  C                               Fusion of ureter & bowel.......  ..............  ..............  ..............  ..............  ..............
  50815  C                               Urine shunt to bowel...........  ..............  ..............  ..............  ..............  ..............
  50820  C                               Construct bowel bladder........  ..............  ..............  ..............  ..............  ..............
  50825  C                               Construct bowel bladder........  ..............  ..............  ..............  ..............  ..............
  50830  C                               Revise urine flow..............  ..............  ..............  ..............  ..............  ..............
  50840  C                               Replace ureter by bowel........  ..............  ..............  ..............  ..............  ..............
  50845  C                               Appendico-vesicostomy..........  ..............  ..............  ..............  ..............  ..............
  50860  C                               Transplant ureter to skin......  ..............  ..............  ..............  ..............  ..............
  50900  C                               Repair of ureter...............  ..............  ..............  ..............  ..............  ..............
  50920  C                               Closure ureter/skin fistula....  ..............  ..............  ..............  ..............  ..............
  50930  C                               Closure ureter/bowel fistula...  ..............  ..............  ..............  ..............  ..............
  50940  C                               Release of ureter..............  ..............  ..............  ..............  ..............  ..............
  50945  T                               Laparoscopy ureterolithotomy...            0131           41.81       $2,027.24       $1,089.88         $405.45
  50951  T                               Endoscopy of ureter............            0162           17.49         $848.04         $427.49         $169.61
  50953  T                               Endoscopy of ureter............            0162           17.49         $848.04         $427.49         $169.61
  50955  T                               Ureter endoscopy & biopsy......            0162           17.49         $848.04         $427.49         $169.61
  50957  T                               Ureter endoscopy & treatment...            0162           17.49         $848.04         $427.49         $169.61
  50959  T                               Ureter endoscopy & tracer......            0162           17.49         $848.04         $427.49         $169.61
  50961  T                               Ureter endoscopy & treatment...            0162           17.49         $848.04         $427.49         $169.61
  50970  C                               Ureter endoscopy...............  ..............  ..............  ..............  ..............  ..............
  50972  C                               Ureter endoscopy & catheter....  ..............  ..............  ..............  ..............  ..............
  50974  C                               Ureter endoscopy & biopsy......  ..............  ..............  ..............  ..............  ..............
  50976  C                               Ureter endoscopy & treatment...  ..............  ..............  ..............  ..............  ..............
  50978  C                               Ureter endoscopy & tracer......  ..............  ..............  ..............  ..............  ..............
  50980  C                               Ureter endoscopy & treatment...  ..............  ..............  ..............  ..............  ..............
  51000  T                               Drainage of bladder............            0165            3.89         $188.61          $91.76          $37.72
  51005  T                               Drainage of bladder............            0164            2.17         $105.23          $33.03          $21.05
  51010  T                               Drainage of bladder............            0165            3.89         $188.61          $91.76          $37.72
  51020  T                               Incise & treat bladder.........            0162           17.49         $848.04         $427.49         $169.61
  51030  T                               Incise & treat bladder.........            0162           17.49         $848.04         $427.49         $169.61
  51040  T                               Incise & drain bladder.........            0162           17.49         $848.04         $427.49         $169.61
  51045  T                               Incise bladder/drain ureter....            0162           17.49         $848.04         $427.49         $169.61
  51050  T                               Removal of bladder stone.......            0162           17.49         $848.04         $427.49         $169.61
  51060  C                               Removal of ureter stone........  ..............  ..............  ..............  ..............  ..............
  51065  T                               Removal of ureter stone........            0162           17.49         $848.04         $427.49         $169.61
  51080  T                               Drainage of bladder abscess....            0008            6.15         $298.20         $113.67          $59.64
  51500  T                               Removal of bladder cyst........            0154           22.43       $1,087.57         $556.98         $217.51
  51520  T                               Removal of bladder lesion......            0162           17.49         $848.04         $427.49         $169.61
  51525  C                               Removal of bladder lesion......  ..............  ..............  ..............  ..............  ..............
  51530  C                               Removal of bladder lesion......  ..............  ..............  ..............  ..............  ..............
  51535  C                               Repair of ureter lesion........  ..............  ..............  ..............  ..............  ..............
  51550  C                               Partial removal of bladder.....  ..............  ..............  ..............  ..............  ..............
  51555  C                               Partial removal of bladder.....  ..............  ..............  ..............  ..............  ..............
  51565  C                               Revise bladder & ureter(s).....  ..............  ..............  ..............  ..............  ..............

[[Page 18610]]

 
  51570  C                               Removal of bladder.............  ..............  ..............  ..............  ..............  ..............
  51575  C                               Removal of bladder & nodes.....  ..............  ..............  ..............  ..............  ..............
  51580  C                               Remove bladder/revise tract....  ..............  ..............  ..............  ..............  ..............
  51585  C                               Removal of bladder & nodes.....  ..............  ..............  ..............  ..............  ..............
  51590  C                               Remove bladder/revise tract....  ..............  ..............  ..............  ..............  ..............
  51595  C                               Remove bladder/revise tract....  ..............  ..............  ..............  ..............  ..............
  51596  C                               Remove bladder/create pouch....  ..............  ..............  ..............  ..............  ..............
  51597  C                               Removal of pelvic structures...  ..............  ..............  ..............  ..............  ..............
  51600  N                               Injection for bladder x-ray....  ..............  ..............  ..............  ..............  ..............
  51605  N                               Preparation for bladder x-ray..  ..............  ..............  ..............  ..............  ..............
  51610  N                               Injection for bladder x-ray....  ..............  ..............  ..............  ..............  ..............
  51700  T                               Irrigation of bladder..........            0164            2.17         $105.23          $33.03          $21.05
  51705  T                               Change of bladder tube.........            0121            2.36         $114.43          $52.53          $22.89
  51710  T                               Change of bladder tube.........            0121            2.36         $114.43          $52.53          $22.89
  51715  T                               Endoscopic injection/implant...            0167           21.06       $1,021.14         $555.84         $204.23
  51720  T                               Treatment of bladder lesion....            0165            3.89         $188.61          $91.76          $37.72
  51725  T                               Simple cystometrogram..........            0165            3.89         $188.61          $91.76          $37.72
  51726  T                               Complex cystometrogram.........            0165            3.89         $188.61          $91.76          $37.72
  51736  T                               Urine flow measurement.........            0164            2.17         $105.23          $33.03          $21.05
  51741  T                               Electro-uroflowmetry, first....            0164            2.17         $105.23          $33.03          $21.05
  51772  T                               Urethra pressure profile.......            0165            3.89         $188.61          $91.76          $37.72
  51784  T                               Anal/urinary muscle study......            0164            2.17         $105.23          $33.03          $21.05
  51785  T                               Anal/urinary muscle study......            0164            2.17         $105.23          $33.03          $21.05
  51792  T                               Urinary reflex study...........            0165            3.89         $188.61          $91.76          $37.72
  51795  T                               Urine voiding pressure study...            0164            2.17         $105.23          $33.03          $21.05
  51797  T                               Intraabdominal pressure test...            0164            2.17         $105.23          $33.03          $21.05
  51800  C                               Revision of bladder/urethra....  ..............  ..............  ..............  ..............  ..............
  51820  C                               Revision of urinary tract......  ..............  ..............  ..............  ..............  ..............
  51840  C                               Attach bladder/urethra.........  ..............  ..............  ..............  ..............  ..............
  51841  C                               Attach bladder/urethra.........  ..............  ..............  ..............  ..............  ..............
  51845  C                               Repair bladder neck............  ..............  ..............  ..............  ..............  ..............
  51860  C                               Repair of bladder wound........  ..............  ..............  ..............  ..............  ..............
  51865  C                               Repair of bladder wound........  ..............  ..............  ..............  ..............  ..............
  51880  T                               Repair of bladder opening......            0162           17.49         $848.04         $427.49         $169.61
  51900  C                               Repair bladder/vagina lesion...  ..............  ..............  ..............  ..............  ..............
  51920  C                               Close bladder-uterus fistula...  ..............  ..............  ..............  ..............  ..............
  51925  C                               Hysterectomy/bladder repair....  ..............  ..............  ..............  ..............  ..............
  51940  C                               Correction of bladder defect...  ..............  ..............  ..............  ..............  ..............
  51960  C                               Revision of bladder & bowel....  ..............  ..............  ..............  ..............  ..............
  51980  C                               Construct bladder opening......  ..............  ..............  ..............  ..............  ..............
  51990  T                               Laparo urethral suspension.....            0131           41.81       $2,027.24       $1,089.88         $405.45
  51992  T                               Laparo sling operation.........            0132           48.91       $2,371.50       $1,239.22         $474.30
  52000  T                               Cystoscopy.....................            0160            5.43         $263.28         $110.11          $52.66
  52005  T                               Cystoscopy & ureter catheter...            0161           10.94         $530.45         $249.36         $106.09
  52007  T                               Cystoscopy and biopsy..........            0161           10.94         $530.45         $249.36         $106.09
  52010  T                               Cystoscopy & duct catheter.....            0161           10.94         $530.45         $249.36         $106.09
  52204  T                               Cystoscopy.....................            0161           10.94         $530.45         $249.36         $106.09
  52214  T                               Cystoscopy and treatment.......            0161           10.94         $530.45         $249.36         $106.09
  52224  T                               Cystoscopy and treatment.......            0161           10.94         $530.45         $249.36         $106.09
  52234  T                               Cystoscopy and treatment.......            0162           17.49         $848.04         $427.49         $169.61
  52235  T                               Cystoscopy and treatment.......            0162           17.49         $848.04         $427.49         $169.61
  52240  T                               Cystoscopy and treatment.......            0163           28.98       $1,405.16         $792.58         $281.03
  52250  T                               Cystoscopy and radiotracer.....            0162           17.49         $848.04         $427.49         $169.61
  52260  T                               Cystoscopy and treatment.......            0161           10.94         $530.45         $249.36         $106.09
  52265  T                               Cystoscopy and treatment.......            0160            5.43         $263.28         $110.11          $52.66
  52270  T                               Cystoscopy & revise urethra....            0161           10.94         $530.45         $249.36         $106.09
  52275  T                               Cystoscopy & revise urethra....            0161           10.94         $530.45         $249.36         $106.09
  52276  T                               Cystoscopy and treatment.......            0161           10.94         $530.45         $249.36         $106.09
  52277  T                               Cystoscopy and treatment.......            0162           17.49         $848.04         $427.49         $169.61
  52281  T                               Cystoscopy and treatment.......            0161           10.94         $530.45         $249.36         $106.09
  52282  T                               Cystoscopy, implant stent......            0162           17.49         $848.04         $427.49         $169.61
  52283  T                               Cystoscopy and treatment.......            0161           10.94         $530.45         $249.36         $106.09
  52285  T                               Cystoscopy and treatment.......            0161           10.94         $530.45         $249.36         $106.09
  52290  T                               Cystoscopy and treatment.......            0161           10.94         $530.45         $249.36         $106.09
  52300  T                               Cystoscopy and treatment.......            0161           10.94         $530.45         $249.36         $106.09
  52301  T                               Cystoscopy and treatment.......            0161           10.94         $530.45         $249.36         $106.09
  52305  T                               Cystoscopy and treatment.......            0161           10.94         $530.45         $249.36         $106.09
  52310  T                               Cystoscopy and treatment.......            0161           10.94         $530.45         $249.36         $106.09
  52315  T                               Cystoscopy and treatment.......            0161           10.94         $530.45         $249.36         $106.09
  52317  T                               Remove bladder stone...........            0162           17.49         $848.04         $427.49         $169.61
  52318  T                               Remove bladder stone...........            0162           17.49         $848.04         $427.49         $169.61
  52320  T                               Cystoscopy and treatment.......            0162           17.49         $848.04         $427.49         $169.61
  52325  T                               Cystoscopy, stone removal......            0162           17.49         $848.04         $427.49         $169.61

[[Page 18611]]

 
  52327  T                               Cystoscopy, inject material....            0161           10.94         $530.45         $249.36         $106.09
  52330  T                               Cystoscopy and treatment.......            0162           17.49         $848.04         $427.49         $169.61
  52332  T                               Cystoscopy and treatment.......            0162           17.49         $848.04         $427.49         $169.61
  52334  T                               Create passage to kidney.......            0162           17.49         $848.04         $427.49         $169.61
  52335  T                               Endoscopy of urinary tract.....            0162           17.49         $848.04         $427.49         $169.61
  52336  T                               Cystoscopy, stone removal......            0162           17.49         $848.04         $427.49         $169.61
  52337  T                               Cystoscopy, stone removal......            0162           17.49         $848.04         $427.49         $169.61
  52338  T                               Cystoscopy and treatment.......            0162           17.49         $848.04         $427.49         $169.61
  52339  T                               Cystoscopy and treatment.......            0162           17.49         $848.04         $427.49         $169.61
  52340  T                               Cystoscopy and treatment.......            0162           17.49         $848.04         $427.49         $169.61
  52450  T                               Incision of prostate...........            0162           17.49         $848.04         $427.49         $169.61
  52500  T                               Revision of bladder neck.......            0162           17.49         $848.04         $427.49         $169.61
  52510  T                               Dilation prostatic urethra.....            0161           10.94         $530.45         $249.36         $106.09
  52601  T                               Prostatectomy (TURP)...........            0163           28.98       $1,405.16         $792.58         $281.03
  52606  T                               Control postop bleeding........            0162           17.49         $848.04         $427.49         $169.61
  52612  T                               Prostatectomy, first stage.....            0163           28.98       $1,405.16         $792.58         $281.03
  52614  T                               Prostatectomy, second stage....            0163           28.98       $1,405.16         $792.58         $281.03
  52620  T                               Remove residual prostate.......            0163           28.98       $1,405.16         $792.58         $281.03
  52630  T                               Remove prostate regrowth.......            0163           28.98       $1,405.16         $792.58         $281.03
  52640  T                               Relieve bladder contracture....            0162           17.49         $848.04         $427.49         $169.61
  52647  T                               Laser surgery of prostate......            0163           28.98       $1,405.16         $792.58         $281.03
  52648  T                               Laser surgery of prostate......            0163           28.98       $1,405.16         $792.58         $281.03
  52700  T                               Drainage of prostate abscess...            0162           17.49         $848.04         $427.49         $169.61
  53000  T                               Incision of urethra............            0166           10.17         $493.11         $218.73          $98.62
  53010  T                               Incision of urethra............            0166           10.17         $493.11         $218.73          $98.62
  53020  T                               Incision of urethra............            0166           10.17         $493.11         $218.73          $98.62
  53025  T                               Incision of urethra............            0166           10.17         $493.11         $218.73          $98.62
  53040  T                               Drainage of urethra abscess....            0166           10.17         $493.11         $218.73          $98.62
  53060  T                               Drainage of urethra abscess....            0166           10.17         $493.11         $218.73          $98.62
  53080  T                               Drainage of urinary leakage....            0166           10.17         $493.11         $218.73          $98.62
  53085  C                               Drainage of urinary leakage....  ..............  ..............  ..............  ..............  ..............
  53200  T                               Biopsy of urethra..............            0166           10.17         $493.11         $218.73          $98.62
  53210  T                               Removal of urethra.............            0168           24.94       $1,209.27         $536.11         $241.85
  53215  T                               Removal of urethra.............            0168           24.94       $1,209.27         $536.11         $241.85
  53220  T                               Treatment of urethra lesion....            0168           24.94       $1,209.27         $536.11         $241.85
  53230  T                               Removal of urethra lesion......            0168           24.94       $1,209.27         $536.11         $241.85
  53235  T                               Removal of urethra lesion......            0168           24.94       $1,209.27         $536.11         $241.85
  53240  T                               Surgery for urethra pouch......            0168           24.94       $1,209.27         $536.11         $241.85
  53250  T                               Removal of urethra gland.......            0166           10.17         $493.11         $218.73          $98.62
  53260  T                               Treatment of urethra lesion....            0166           10.17         $493.11         $218.73          $98.62
  53265  T                               Treatment of urethra lesion....            0166           10.17         $493.11         $218.73          $98.62
  53270  T                               Removal of urethra gland.......            0167           21.06       $1,021.14         $555.84         $204.23
  53275  T                               Repair of urethra defect.......            0166           10.17         $493.11         $218.73          $98.62
  53400  T                               Revise urethra, stage 1........            0168           24.94       $1,209.27         $536.11         $241.85
  53405  T                               Revise urethra, stage 2........            0168           24.94       $1,209.27         $536.11         $241.85
  53410  T                               Reconstruction of urethra......            0168           24.94       $1,209.27         $536.11         $241.85
  53415  C                               Reconstruction of urethra......  ..............  ..............  ..............  ..............  ..............
  53420  T                               Reconstruct urethra, stage 1...            0168           24.94       $1,209.27         $536.11         $241.85
  53425  T                               Reconstruct urethra, stage 2...            0168           24.94       $1,209.27         $536.11         $241.85
  53430  T                               Reconstruction of urethra......            0168           24.94       $1,209.27         $536.11         $241.85
  53440  T                               Correct bladder function.......            0182           52.11       $2,526.66       $1,525.05         $505.33
  53442  T                               Remove perineal prosthesis.....            0166           10.17         $493.11         $218.73          $98.62
  53443  C                               Reconstruction of urethra......  ..............  ..............  ..............  ..............  ..............
  53445  T                               Correct urine flow control.....            0182           52.11       $2,526.66       $1,525.05         $505.33
  53447  T                               Remove artificial sphincter....            0168           24.94       $1,209.27         $536.11         $241.85
  53449  T                               Correct artificial sphincter...            0168           24.94       $1,209.27         $536.11         $241.85
  53450  T                               Revision of urethra............            0168           24.94       $1,209.27         $536.11         $241.85
  53460  T                               Revision of urethra............            0168           24.94       $1,209.27         $536.11         $241.85
  53502  T                               Repair of urethra injury.......            0166           10.17         $493.11         $218.73          $98.62
  53505  T                               Repair of urethra injury.......            0167           21.06       $1,021.14         $555.84         $204.23
  53510  T                               Repair of urethra injury.......            0166           10.17         $493.11         $218.73          $98.62
  53515  T                               Repair of urethra injury.......            0168           24.94       $1,209.27         $536.11         $241.85
  53520  T                               Repair of urethra defect.......            0168           24.94       $1,209.27         $536.11         $241.85
  53600  T                               Dilate urethra stricture.......            0164            2.17         $105.23          $33.03          $21.05
  53601  T                               Dilate urethra stricture.......            0164            2.17         $105.23          $33.03          $21.05
  53605  T                               Dilate urethra stricture.......            0161           10.94         $530.45         $249.36         $106.09
  53620  T                               Dilate urethra stricture.......            0165            3.89         $188.61          $91.76          $37.72
  53621  T                               Dilate urethra stricture.......            0164            2.17         $105.23          $33.03          $21.05
  53660  T                               Dilation of urethra............            0164            2.17         $105.23          $33.03          $21.05
  53661  T                               Dilation of urethra............            0164            2.17         $105.23          $33.03          $21.05
  53665  T                               Dilation of urethra............            0166           10.17         $493.11         $218.73          $98.62
  53670  N                               Insert urinary catheter........  ..............  ..............  ..............  ..............  ..............
  53675  T                               Insert urinary catheter........            0164            2.17         $105.23          $33.03          $21.05

[[Page 18612]]

 
2 53850  T                               Prostatic microwave thermotx...            0980           38.67       $1,875.00  ..............         $375.00
2 53852  T                               Prostatic rf thermotx..........            0980           38.67       $1,875.00  ..............         $375.00
  53899  T                               Urology surgery procedure......            0165            3.89         $188.61          $91.76          $37.72
  54000  T                               Slitting of prepuce............            0166           10.17         $493.11         $218.73          $98.62
  54001  T                               Slitting of prepuce............            0166           10.17         $493.11         $218.73          $98.62
  54015  T                               Drain penis lesion.............            0008            6.15         $298.20         $113.67          $59.64
  54050  T                               Destruction, penis lesion(s)...            0013            0.91          $44.12          $17.66           $8.82
  54055  T                               Destruction, penis lesion(s)...            0016            3.53         $171.16          $74.67          $34.23
  54056  T                               Cryosurgery, penis lesion(s)...            0013            0.91          $44.12          $17.66           $8.82
  54057  T                               Laser surg, penis lesion(s)....            0017           12.45         $603.66         $289.16         $120.73
  54060  T                               Excision of penis lesion(s)....            0017           12.45         $603.66         $289.16         $120.73
  54065  T                               Destruction, penis lesion(s)...            0017           12.45         $603.66         $289.16         $120.73
  54100  T                               Biopsy of penis................            0020            6.51         $315.65         $130.53          $63.13
  54105  T                               Biopsy of penis................            0021           10.49         $508.63         $236.51         $101.73
  54110  T                               Treatment of penis lesion......            0181           32.37       $1,569.53         $906.36         $313.91
  54111  T                               Treat penis lesion, graft......            0181           32.37       $1,569.53         $906.36         $313.91
  54112  T                               Treat penis lesion, graft......            0181           32.37       $1,569.53         $906.36         $313.91
  54115  T                               Treatment of penis lesion......            0008            6.15         $298.20         $113.67          $59.64
  54120  T                               Partial removal of penis.......            0181           32.37       $1,569.53         $906.36         $313.91
  54125  C                               Removal of penis...............  ..............  ..............  ..............  ..............  ..............
  54130  C                               Remove penis & nodes...........  ..............  ..............  ..............  ..............  ..............
  54135  C                               Remove penis & nodes...........  ..............  ..............  ..............  ..............  ..............
  54150  T                               Circumcision...................            0180           13.62         $660.39         $304.87         $132.08
  54152  T                               Circumcision...................            0180           13.62         $660.39         $304.87         $132.08
  54160  T                               Circumcision...................            0180           13.62         $660.39         $304.87         $132.08
  54161  T                               Circumcision...................            0180           13.62         $660.39         $304.87         $132.08
  54200  T                               Treatment of penis lesion......            0165            3.89         $188.61          $91.76          $37.72
  54205  T                               Treatment of penis lesion......            0181           32.37       $1,569.53         $906.36         $313.91
  54220  T                               Treatment of penis lesion......            0165            3.89         $188.61          $91.76          $37.72
  54230  N                               Prepare penis study............  ..............  ..............  ..............  ..............  ..............
  54231  T                               Dynamic cavernosometry.........            0165            3.89         $188.61          $91.76          $37.72
  54235  T                               Penile injection...............            0164            2.17         $105.23          $33.03          $21.05
  54240  T                               Penis study....................            0164            2.17         $105.23          $33.03          $21.05
  54250  T                               Penis study....................            0165            3.89         $188.61          $91.76          $37.72
  54300  T                               Revision of penis..............            0181           32.37       $1,569.53         $906.36         $313.91
  54304  T                               Revision of penis..............            0181           32.37       $1,569.53         $906.36         $313.91
  54308  T                               Reconstruction of urethra......            0181           32.37       $1,569.53         $906.36         $313.91
  54312  T                               Reconstruction of urethra......            0181           32.37       $1,569.53         $906.36         $313.91
  54316  T                               Reconstruction of urethra......            0181           32.37       $1,569.53         $906.36         $313.91
  54318  T                               Reconstruction of urethra......            0181           32.37       $1,569.53         $906.36         $313.91
  54322  T                               Reconstruction of urethra......            0181           32.37       $1,569.53         $906.36         $313.91
  54324  T                               Reconstruction of urethra......            0181           32.37       $1,569.53         $906.36         $313.91
  54326  T                               Reconstruction of urethra......            0181           32.37       $1,569.53         $906.36         $313.91
  54328  T                               Revise penis/urethra...........            0181           32.37       $1,569.53         $906.36         $313.91
  54332  C                               Revise penis/urethra...........  ..............  ..............  ..............  ..............  ..............
  54336  C                               Revise penis/urethra...........  ..............  ..............  ..............  ..............  ..............
  54340  T                               Secondary urethral surgery.....            0181           32.37       $1,569.53         $906.36         $313.91
  54344  T                               Secondary urethral surgery.....            0181           32.37       $1,569.53         $906.36         $313.91
  54348  T                               Secondary urethral surgery.....            0181           32.37       $1,569.53         $906.36         $313.91
  54352  T                               Reconstruct urethra/penis......            0181           32.37       $1,569.53         $906.36         $313.91
  54360  T                               Penis plastic surgery..........            0181           32.37       $1,569.53         $906.36         $313.91
  54380  T                               Repair penis...................            0181           32.37       $1,569.53         $906.36         $313.91
  54385  T                               Repair penis...................            0181           32.37       $1,569.53         $906.36         $313.91
  54390  C                               Repair penis and bladder.......  ..............  ..............  ..............  ..............  ..............
  54400  T                               Insert semi-rigid prosthesis...            0182           52.11       $2,526.66       $1,525.05         $505.33
  54401  T                               Insert self-contd prosthesis...            0182           52.11       $2,526.66       $1,525.05         $505.33
  54402  T                               Remove penis prosthesis........            0181           32.37       $1,569.53         $906.36         $313.91
  54405  T                               Insert multi-comp prosthesis...            0182           52.11       $2,526.66       $1,525.05         $505.33
  54407  T                               Remove multi-comp prosthesis...            0181           32.37       $1,569.53         $906.36         $313.91
  54409  T                               Revise penis prosthesis........            0181           32.37       $1,569.53         $906.36         $313.91
  54420  T                               Revision of penis..............            0181           32.37       $1,569.53         $906.36         $313.91
  54430  C                               Revision of penis..............  ..............  ..............  ..............  ..............  ..............
  54435  T                               Revision of penis..............            0181           32.37       $1,569.53         $906.36         $313.91
  54440  T                               Repair of penis................            0181           32.37       $1,569.53         $906.36         $313.91
  54450  T                               Preputial stretching...........            0165            3.89         $188.61          $91.76          $37.72
  54500  T                               Biopsy of testis...............            0005            5.41         $262.32         $119.75          $52.46
  54505  T                               Biopsy of testis...............            0183           18.26         $885.37         $448.94         $177.07
  54510  T                               Removal of testis lesion.......            0183           18.26         $885.37         $448.94         $177.07
  54520  T                               Removal of testis..............            0183           18.26         $885.37         $448.94         $177.07
  54530  T                               Removal of testis..............            0154           22.43       $1,087.57         $556.98         $217.51
  54535  C                               Extensive testis surgery.......  ..............  ..............  ..............  ..............  ..............
  54550  T                               Exploration for testis.........            0154           22.43       $1,087.57         $556.98         $217.51
  54560  C                               Exploration for testis.........  ..............  ..............  ..............  ..............  ..............

[[Page 18613]]

 
  54600  T                               Reduce testis torsion..........            0183           18.26         $885.37         $448.94         $177.07
  54620  T                               Suspension of testis...........            0183           18.26         $885.37         $448.94         $177.07
  54640  T                               Suspension of testis...........            0154           22.43       $1,087.57         $556.98         $217.51
  54650  C                               Orchiopexy (Fowler-Stephens)...  ..............  ..............  ..............  ..............  ..............
  54660  T                               Revision of testis.............            0183           18.26         $885.37         $448.94         $177.07
  54670  T                               Repair testis injury...........            0183           18.26         $885.37         $448.94         $177.07
  54680  T                               Relocation of testis(es).......            0183           18.26         $885.37         $448.94         $177.07
  54690  T                               Laparoscopy, orchiectomy.......            0131           41.81       $2,027.24       $1,089.88         $405.45
  54692  T                               Laparoscopy, orchiopexy........            0132           48.91       $2,371.50       $1,239.22         $474.30
  54699  T                               Laparoscope proc, testis.......            0130           25.36       $1,229.63         $659.53         $245.93
  54700  T                               Drainage of scrotum............            0183           18.26         $885.37         $448.94         $177.07
  54800  T                               Biopsy of epididymis...........            0004            1.84          $89.22          $32.57          $17.84
  54820  T                               Exploration of epididymis......            0183           18.26         $885.37         $448.94         $177.07
  54830  T                               Remove epididymis lesion.......            0183           18.26         $885.37         $448.94         $177.07
  54840  T                               Remove epididymis lesion.......            0183           18.26         $885.37         $448.94         $177.07
  54860  T                               Removal of epididymis..........            0183           18.26         $885.37         $448.94         $177.07
  54861  T                               Removal of epididymis..........            0183           18.26         $885.37         $448.94         $177.07
  54900  T                               Fusion of spermatic ducts......            0183           18.26         $885.37         $448.94         $177.07
  54901  T                               Fusion of spermatic ducts......            0183           18.26         $885.37         $448.94         $177.07
  55000  T                               Drainage of hydrocele..........            0004            1.84          $89.22          $32.57          $17.84
  55040  T                               Removal of hydrocele...........            0154           22.43       $1,087.57         $556.98         $217.51
  55041  T                               Removal of hydroceles..........            0154           22.43       $1,087.57         $556.98         $217.51
  55060  T                               Repair of hydrocele............            0183           18.26         $885.37         $448.94         $177.07
  55100  T                               Drainage of scrotum abscess....            0008            6.15         $298.20         $113.67          $59.64
  55110  T                               Explore scrotum................            0183           18.26         $885.37         $448.94         $177.07
  55120  T                               Removal of scrotum lesion......            0183           18.26         $885.37         $448.94         $177.07
  55150  T                               Removal of scrotum.............            0183           18.26         $885.37         $448.94         $177.07
  55175  T                               Revision of scrotum............            0183           18.26         $885.37         $448.94         $177.07
  55180  T                               Revision of scrotum............            0183           18.26         $885.37         $448.94         $177.07
  55200  T                               Incision of sperm duct.........            0183           18.26         $885.37         $448.94         $177.07
  55250  T                               Removal of sperm duct(s).......            0183           18.26         $885.37         $448.94         $177.07
  55300  N                               Prepare, sperm duct x-ray......  ..............  ..............  ..............  ..............  ..............
  55400  T                               Repair of sperm duct...........            0183           18.26         $885.37         $448.94         $177.07
  55450  T                               Ligation of sperm duct.........            0183           18.26         $885.37         $448.94         $177.07
  55500  T                               Removal of hydrocele...........            0183           18.26         $885.37         $448.94         $177.07
  55520  T                               Removal of sperm cord lesion...            0183           18.26         $885.37         $448.94         $177.07
  55530  T                               Revise spermatic cord veins....            0183           18.26         $885.37         $448.94         $177.07
  55535  T                               Revise spermatic cord veins....            0154           22.43       $1,087.57         $556.98         $217.51
  55540  T                               Revise hernia & sperm veins....            0154           22.43       $1,087.57         $556.98         $217.51
  55550  T                               Laparo ligate spermatic vein...            0131           41.81       $2,027.24       $1,089.88         $405.45
  55559  T                               Laparo proc, spermatic cord....            0130           25.36       $1,229.63         $659.53         $245.93
  55600  C                               Incise sperm duct pouch........  ..............  ..............  ..............  ..............  ..............
  55605  C                               Incise sperm duct pouch........  ..............  ..............  ..............  ..............  ..............
  55650  C                               Remove sperm duct pouch........  ..............  ..............  ..............  ..............  ..............
  55680  T                               Remove sperm pouch lesion......            0183           18.26         $885.37         $448.94         $177.07
  55700  T                               Biopsy of prostate.............            0184            4.94         $239.53         $122.96          $47.91
  55705  T                               Biopsy of prostate.............            0184            4.94         $239.53         $122.96          $47.91
  55720  T                               Drainage of prostate abscess...            0162           17.49         $848.04         $427.49         $169.61
  55725  T                               Drainage of prostate abscess...            0162           17.49         $848.04         $427.49         $169.61
  55801  C                               Removal of prostate............  ..............  ..............  ..............  ..............  ..............
  55810  C                               Extensive prostate surgery.....  ..............  ..............  ..............  ..............  ..............
  55812  C                               Extensive prostate surgery.....  ..............  ..............  ..............  ..............  ..............
  55815  C                               Extensive prostate surgery.....  ..............  ..............  ..............  ..............  ..............
  55821  C                               Removal of prostate............  ..............  ..............  ..............  ..............  ..............
  55831  C                               Removal of prostate............  ..............  ..............  ..............  ..............  ..............
  55840  C                               Extensive prostate surgery.....  ..............  ..............  ..............  ..............  ..............
  55842  C                               Extensive prostate surgery.....  ..............  ..............  ..............  ..............  ..............
  55845  C                               Extensive prostate surgery.....  ..............  ..............  ..............  ..............  ..............
  55859  T                               Percut/needle insert, pros.....            0162           17.49         $848.04         $427.49         $169.61
  55860  C                               Surgical exposure, prostate....  ..............  ..............  ..............  ..............  ..............
  55862  C                               Extensive prostate surgery.....  ..............  ..............  ..............  ..............  ..............
  55865  C                               Extensive prostate surgery.....  ..............  ..............  ..............  ..............  ..............
  55870  T                               Electroejaculation.............            0197            2.40         $116.37          $49.55          $23.27
  55899  T                               Genital surgery procedure......            0164            2.17         $105.23          $33.03          $21.05
  55970  E                               Sex transformation, M to F.....  ..............  ..............  ..............  ..............  ..............
  55980  E                               Sex transformation, F to M.....  ..............  ..............  ..............  ..............  ..............
  56405  T                               I & D of vulva/perineum........            0192            2.38         $115.40          $35.33          $23.08
  56420  T                               Drainage of gland abscess......            0192            2.38         $115.40          $35.33          $23.08
  56440  T                               Surgery for vulva lesion.......            0194           16.21         $785.98         $395.94         $157.20
  56441  T                               Lysis of labial lesion(s)......            0193            8.93         $432.99         $171.13          $86.60
  56501  T                               Destruction, vulva lesion(s)...            0016            3.53         $171.16          $74.67          $34.23
  56515  T                               Destruction, vulva lesion(s)...            0017           12.45         $603.66         $289.16         $120.73
  56605  T                               Biopsy of vulva/perineum.......            0019            4.00         $193.95          $78.91          $38.79

[[Page 18614]]

 
  56606  T                               Biopsy of vulva/perineum.......            0019            4.00         $193.95          $78.91          $38.79
  56620  T                               Partial removal of vulva.......            0195           18.68         $905.74         $483.80         $181.15
  56625  T                               Complete removal of vulva......            0195           18.68         $905.74         $483.80         $181.15
  56630  C                               Extensive vulva surgery........  ..............  ..............  ..............  ..............  ..............
  56631  C                               Extensive vulva surgery........  ..............  ..............  ..............  ..............  ..............
  56632  C                               Extensive vulva surgery........  ..............  ..............  ..............  ..............  ..............
  56633  C                               Extensive vulva surgery........  ..............  ..............  ..............  ..............  ..............
  56634  C                               Extensive vulva surgery........  ..............  ..............  ..............  ..............  ..............
  56637  C                               Extensive vulva surgery........  ..............  ..............  ..............  ..............  ..............
  56640  C                               Extensive vulva surgery........  ..............  ..............  ..............  ..............  ..............
  56700  T                               Partial removal of hymen.......            0194           16.21         $785.98         $395.94         $157.20
  56720  T                               Incision of hymen..............            0193            8.93         $432.99         $171.13          $86.60
  56740  T                               Remove vagina gland lesion.....            0194           16.21         $785.98         $395.94         $157.20
  56800  T                               Repair of vagina...............            0194           16.21         $785.98         $395.94         $157.20
  56805  C                               Repair clitoris................  ..............  ..............  ..............  ..............  ..............
  56810  T                               Repair of perineum.............            0194           16.21         $785.98         $395.94         $157.20
  57000  T                               Exploration of vagina..........            0194           16.21         $785.98         $395.94         $157.20
  57010  T                               Drainage of pelvic abscess.....            0194           16.21         $785.98         $395.94         $157.20
  57020  T                               Drainage of pelvic fluid.......            0193            8.93         $432.99         $171.13          $86.60
  57061  T                               Destruction vagina lesion(s)...            0194           16.21         $785.98         $395.94         $157.20
  57065  T                               Destruction vagina lesion(s)...            0194           16.21         $785.98         $395.94         $157.20
  57100  T                               Biopsy of vagina...............            0192            2.38         $115.40          $35.33          $23.08
  57105  T                               Biopsy of vagina...............            0194           16.21         $785.98         $395.94         $157.20
  57106  T                               Remove vagina wall, partial....            0194           16.21         $785.98         $395.94         $157.20
  57107  T                               Remove vagina tissue, part.....            0194           16.21         $785.98         $395.94         $157.20
  57109  T                               Vaginectomy partial w/nodes....            0194           16.21         $785.98         $395.94         $157.20
  57110  C                               Remove vagina wall, complete...  ..............  ..............  ..............  ..............  ..............
  57111  C                               Remove vagina tissue, compl....  ..............  ..............  ..............  ..............  ..............
  57112  C                               Vaginectomy w/nodes, compl.....  ..............  ..............  ..............  ..............  ..............
  57120  C                               Closure of vagina..............  ..............  ..............  ..............  ..............  ..............
  57130  T                               Remove vagina lesion...........            0194           16.21         $785.98         $395.94         $157.20
  57135  T                               Remove vagina lesion...........            0194           16.21         $785.98         $395.94         $157.20
  57150  T                               Treat vagina infection.........            0192            2.38         $115.40          $35.33          $23.08
  57160  T                               Insert pessary/other device....            0191            1.19          $57.70          $17.43          $11.54
  57170  T                               Fitting of diaphragm/cap.......            0191            1.19          $57.70          $17.43          $11.54
  57180  T                               Treat vaginal bleeding.........            0192            2.38         $115.40          $35.33          $23.08
  57200  T                               Repair of vagina...............            0194           16.21         $785.98         $395.94         $157.20
  57210  T                               Repair vagina/perineum.........            0194           16.21         $785.98         $395.94         $157.20
  57220  T                               Revision of urethra............            0195           18.68         $905.74         $483.80         $181.15
  57230  T                               Repair of urethral lesion......            0194           16.21         $785.98         $395.94         $157.20
  57240  T                               Repair bladder & vagina........            0195           18.68         $905.74         $483.80         $181.15
  57250  T                               Repair rectum & vagina.........            0195           18.68         $905.74         $483.80         $181.15
  57260  T                               Repair of vagina...............            0195           18.68         $905.74         $483.80         $181.15
  57265  T                               Extensive repair of vagina.....            0195           18.68         $905.74         $483.80         $181.15
  57268  T                               Repair of bowel bulge..........            0195           18.68         $905.74         $483.80         $181.15
  57270  C                               Repair of bowel pouch..........  ..............  ..............  ..............  ..............  ..............
  57280  C                               Suspension of vagina...........  ..............  ..............  ..............  ..............  ..............
  57282  C                               Repair of vaginal prolapse.....  ..............  ..............  ..............  ..............  ..............
  57284  T                               Repair paravaginal defect......            0195           18.68         $905.74         $483.80         $181.15
  57288  T                               Repair bladder defect..........            0195           18.68         $905.74         $483.80         $181.15
  57289  T                               Repair bladder & vagina........            0195           18.68         $905.74         $483.80         $181.15
  57291  T                               Construction of vagina.........            0195           18.68         $905.74         $483.80         $181.15
  57292  C                               Construct vagina with graft....  ..............  ..............  ..............  ..............  ..............
  57300  T                               Repair rectum-vagina fistula...            0195           18.68         $905.74         $483.80         $181.15
  57305  C                               Repair rectum-vagina fistula...  ..............  ..............  ..............  ..............  ..............
  57307  C                               Fistula repair & colostomy.....  ..............  ..............  ..............  ..............  ..............
  57308  C                               Fistula repair, transperine....  ..............  ..............  ..............  ..............  ..............
  57310  C                               Repair urethrovaginal lesion...  ..............  ..............  ..............  ..............  ..............
  57311  C                               Repair urethrovaginal lesion...  ..............  ..............  ..............  ..............  ..............
  57320  C                               Repair bladder-vagina lesion...  ..............  ..............  ..............  ..............  ..............
  57330  C                               Repair bladder-vagina lesion...  ..............  ..............  ..............  ..............  ..............
  57335  C                               Repair vagina..................  ..............  ..............  ..............  ..............  ..............
  57400  T                               Dilation of vagina.............            0194           16.21         $785.98         $395.94         $157.20
  57410  T                               Pelvic examination.............            0194           16.21         $785.98         $395.94         $157.20
  57415  T                               Remove vaginal foreign body....            0194           16.21         $785.98         $395.94         $157.20
  57452  T                               Examination of vagina..........            0191            1.19          $57.70          $17.43          $11.54
  57454  T                               Vagina examination & biopsy....            0192            2.38         $115.40          $35.33          $23.08
  57460  T                               Cervix excision................            0193            8.93         $432.99         $171.13          $86.60
  57500  T                               Biopsy of cervix...............            0193            8.93         $432.99         $171.13          $86.60
  57505  T                               Endocervical curettage.........            0192            2.38         $115.40          $35.33          $23.08
  57510  T                               Cauterization of cervix........            0193            8.93         $432.99         $171.13          $86.60
  57511  T                               Cryocautery of cervix..........            0192            2.38         $115.40          $35.33          $23.08
  57513  T                               Laser surgery of cervix........            0193            8.93         $432.99         $171.13          $86.60

[[Page 18615]]

 
  57520  T                               Conization of cervix...........            0194           16.21         $785.98         $395.94         $157.20
  57522  T                               Conization of cervix...........            0195           18.68         $905.74         $483.80         $181.15
  57530  T                               Removal of cervix..............            0195           18.68         $905.74         $483.80         $181.15
  57531  C                               Removal of cervix, radical.....  ..............  ..............  ..............  ..............  ..............
  57540  C                               Removal of residual cervix.....  ..............  ..............  ..............  ..............  ..............
  57545  C                               Remove cervix/repair pelvis....  ..............  ..............  ..............  ..............  ..............
  57550  T                               Removal of residual cervix.....            0195           18.68         $905.74         $483.80         $181.15
  57555  T                               Remove cervix/repair vagina....            0195           18.68         $905.74         $483.80         $181.15
  57556  T                               Remove cervix, repair bowel....            0195           18.68         $905.74         $483.80         $181.15
  57700  T                               Revision of cervix.............            0194           16.21         $785.98         $395.94         $157.20
  57720  T                               Revision of cervix.............            0194           16.21         $785.98         $395.94         $157.20
  57800  T                               Dilation of cervical canal.....            0193            8.93         $432.99         $171.13          $86.60
  57820  T                               D & c of residual cervix.......            0196           14.47         $701.61         $357.98         $140.32
  58100  T                               Biopsy of uterus lining........            0191            1.19          $57.70          $17.43          $11.54
  58120  T                               Dilation and curettage.........            0196           14.47         $701.61         $357.98         $140.32
  58140  C                               Removal of uterus lesion.......  ..............  ..............  ..............  ..............  ..............
  58145  T                               Removal of uterus lesion.......            0195           18.68         $905.74         $483.80         $181.15
  58150  C                               Total hysterectomy.............  ..............  ..............  ..............  ..............  ..............
  58152  C                               Total hysterectomy.............  ..............  ..............  ..............  ..............  ..............
  58180  C                               Partial hysterectomy...........  ..............  ..............  ..............  ..............  ..............
  58200  C                               Extensive hysterectomy.........  ..............  ..............  ..............  ..............  ..............
  58210  C                               Extensive hysterectomy.........  ..............  ..............  ..............  ..............  ..............
  58240  C                               Removal of pelvis contents.....  ..............  ..............  ..............  ..............  ..............
  58260  C                               Vaginal hysterectomy...........  ..............  ..............  ..............  ..............  ..............
  58262  C                               Vaginal hysterectomy...........  ..............  ..............  ..............  ..............  ..............
  58263  C                               Vaginal hysterectomy...........  ..............  ..............  ..............  ..............  ..............
  58267  C                               Hysterectomy & vagina repair...  ..............  ..............  ..............  ..............  ..............
  58270  C                               Hysterectomy & vagina repair...  ..............  ..............  ..............  ..............  ..............
  58275  C                               Hysterectomy/revise vagina.....  ..............  ..............  ..............  ..............  ..............
  58280  C                               Hysterectomy/revise vagina.....  ..............  ..............  ..............  ..............  ..............
  58285  C                               Extensive hysterectomy.........  ..............  ..............  ..............  ..............  ..............
  58300  E                               Insert intrauterine device.....  ..............  ..............  ..............  ..............  ..............
  58301  T                               Remove intrauterine device.....            0191            1.19          $57.70          $17.43          $11.54
  58321  T                               Artificial insemination........            0197            2.40         $116.37          $49.55          $23.27
  58322  T                               Artificial insemination........            0197            2.40         $116.37          $49.55          $23.27
  58323  T                               Sperm washing..................            0197            2.40         $116.37          $49.55          $23.27
  58340  N                               Catheter for hysterography.....  ..............  ..............  ..............  ..............  ..............
  58345  T                               Reopen fallopian tube..........            0194           16.21         $785.98         $395.94         $157.20
  58350  T                               Reopen fallopian tube..........            0194           16.21         $785.98         $395.94         $157.20
  58400  C                               Suspension of uterus...........  ..............  ..............  ..............  ..............  ..............
  58410  C                               Suspension of uterus...........  ..............  ..............  ..............  ..............  ..............
  58520  C                               Repair of ruptured uterus......  ..............  ..............  ..............  ..............  ..............
  58540  C                               Revision of uterus.............  ..............  ..............  ..............  ..............  ..............
  58550  T                               Laparo-asst vag hysterectomy...            0132           48.91       $2,371.50       $1,239.22         $474.30
  58551  T                               Laparoscopy, remove myoma......            0131           41.81       $2,027.24       $1,089.88         $405.45
  58555  T                               Hysteroscopy, dx, sep proc.....            0191            1.19          $57.70          $17.43          $11.54
  58558  T                               Hysteroscopy, biopsy...........            0190           17.85         $865.49         $443.89         $173.10
  58559  T                               Hysteroscopy, lysis............            0190           17.85         $865.49         $443.89         $173.10
  58560  T                               Hysteroscopy, resect septum....            0190           17.85         $865.49         $443.89         $173.10
  58561  T                               Hysteroscopy, remove myoma.....            0190           17.85         $865.49         $443.89         $173.10
  58562  T                               Hysteroscopy, remove fb........            0190           17.85         $865.49         $443.89         $173.10
  58563  T                               Hysteroscopy, ablation.........            0190           17.85         $865.49         $443.89         $173.10
  58578  T                               Laparo proc, uterus............            0190           17.85         $865.49         $443.89         $173.10
  58579  T                               Hysteroscope procedure.........            0190           17.85         $865.49         $443.89         $173.10
  58600  C                               Division of fallopian tube.....  ..............  ..............  ..............  ..............  ..............
  58605  C                               Division of fallopian tube.....  ..............  ..............  ..............  ..............  ..............
  58611  C                               Ligate oviduct(s) add-on.......  ..............  ..............  ..............  ..............  ..............
  58615  C                               Occlude fallopian tube(s)......  ..............  ..............  ..............  ..............  ..............
  58660  T                               Laparoscopy, lysis.............            0131           41.81       $2,027.24       $1,089.88         $405.45
  58661  T                               Laparoscopy, remove adnexa.....            0131           41.81       $2,027.24       $1,089.88         $405.45
  58662  T                               Laparoscopy, excise lesions....            0131           41.81       $2,027.24       $1,089.88         $405.45
  58670  T                               Laparoscopy, tubal cautery.....            0131           41.81       $2,027.24       $1,089.88         $405.45
  58671  T                               Laparoscopy, tubal block.......            0131           41.81       $2,027.24       $1,089.88         $405.45
  58672  T                               Laparoscopy, fimbrioplasty.....            0131           41.81       $2,027.24       $1,089.88         $405.45
  58673  T                               Laparoscopy, salpingostomy.....            0131           41.81       $2,027.24       $1,089.88         $405.45
  58679  T                               Laparo proc, oviduct-ovary.....            0130           25.36       $1,229.63         $659.53         $245.93
  58700  C                               Removal of fallopian tube......  ..............  ..............  ..............  ..............  ..............
  58720  C                               Removal of ovary/tube(s).......  ..............  ..............  ..............  ..............  ..............
  58740  C                               Revise fallopian tube(s).......  ..............  ..............  ..............  ..............  ..............
  58750  C                               Repair oviduct.................  ..............  ..............  ..............  ..............  ..............
  58752  C                               Revise ovarian tube(s).........  ..............  ..............  ..............  ..............  ..............
  58760  C                               Remove tubal obstruction.......  ..............  ..............  ..............  ..............  ..............
  58770  C                               Create new tubal opening.......  ..............  ..............  ..............  ..............  ..............

[[Page 18616]]

 
  58800  T                               Drainage of ovarian cyst(s)....            0195           18.68         $905.74         $483.80         $181.15
  58805  C                               Drainage of ovarian cyst(s)....  ..............  ..............  ..............  ..............  ..............
  58820  T                               Drain ovary abscess, open......            0195           18.68         $905.74         $483.80         $181.15
  58822  C                               Drain ovary abscess, percut....  ..............  ..............  ..............  ..............  ..............
  58823  C                               Drain pelvic abscess, percut...  ..............  ..............  ..............  ..............  ..............
  58825  C                               Transposition, ovary(s)........  ..............  ..............  ..............  ..............  ..............
  58900  T                               Biopsy of ovary(s).............            0195           18.68         $905.74         $483.80         $181.15
  58920  T                               Partial removal of ovary(s)....            0195           18.68         $905.74         $483.80         $181.15
  58925  T                               Removal of ovarian cyst(s).....            0195           18.68         $905.74         $483.80         $181.15
  58940  C                               Removal of ovary(s)............  ..............  ..............  ..............  ..............  ..............
  58943  C                               Removal of ovary(s)............  ..............  ..............  ..............  ..............  ..............
  58950  C                               Resect ovarian malignancy......  ..............  ..............  ..............  ..............  ..............
  58951  C                               Resect ovarian malignancy......  ..............  ..............  ..............  ..............  ..............
  58952  C                               Resect ovarian malignancy......  ..............  ..............  ..............  ..............  ..............
  58960  C                               Exploration of abdomen.........  ..............  ..............  ..............  ..............  ..............
  58970  T                               Retrieval of oocyte............            0194           16.21         $785.98         $395.94         $157.20
  58974  T                               Transfer of embryo.............            0197            2.40         $116.37          $49.55          $23.27
  58976  T                               Transfer of embryo.............            0197            2.40         $116.37          $49.55          $23.27
  58999  T                               Genital surgery procedure......            0019            4.00         $193.95          $78.91          $38.79
  59000  T                               Amniocentesis..................            0198            1.34          $64.97          $33.03          $12.99
  59012  T                               Fetal cord puncture, prenatal..            0198            1.34          $64.97          $33.03          $12.99
  59015  T                               Chorion biopsy.................            0198            1.34          $64.97          $33.03          $12.99
  59020  T                               Fetal contract stress test.....            0198            1.34          $64.97          $33.03          $12.99
  59025  T                               Fetal non-stress test..........            0198            1.34          $64.97          $33.03          $12.99
  59030  T                               Fetal scalp blood sample.......            0198            1.34          $64.97          $33.03          $12.99
  59050  T                               Fetal monitor w/report.........            0198            1.34          $64.97          $33.03          $12.99
  59051  E                               Fetal monitor/interpret only...  ..............  ..............  ..............  ..............  ..............
  59100  C                               Remove uterus lesion...........  ..............  ..............  ..............  ..............  ..............
  59120  C                               Treat ectopic pregnancy........  ..............  ..............  ..............  ..............  ..............
  59121  C                               Treat ectopic pregnancy........  ..............  ..............  ..............  ..............  ..............
  59130  C                               Treat ectopic pregnancy........  ..............  ..............  ..............  ..............  ..............
  59135  C                               Treat ectopic pregnancy........  ..............  ..............  ..............  ..............  ..............
  59136  C                               Treat ectopic pregnancy........  ..............  ..............  ..............  ..............  ..............
  59140  C                               Treat ectopic pregnancy........  ..............  ..............  ..............  ..............  ..............
  59150  T                               Treat ectopic pregnancy........            0131           41.81       $2,027.24       $1,089.88         $405.45
  59151  T                               Treat ectopic pregnancy........            0131           41.81       $2,027.24       $1,089.88         $405.45
  59160  T                               D & c after delivery...........            0196           14.47         $701.61         $357.98         $140.32
  59200  T                               Insert cervical dilator........            0191            1.19          $57.70          $17.43          $11.54
  59300  T                               Episiotomy or vaginal repair...            0194           16.21         $785.98         $395.94         $157.20
  59320  T                               Revision of cervix.............            0194           16.21         $785.98         $395.94         $157.20
  59325  C                               Revision of cervix.............  ..............  ..............  ..............  ..............  ..............
  59350  C                               Repair of uterus...............  ..............  ..............  ..............  ..............  ..............
  59400  E                               Obstetrical care...............  ..............  ..............  ..............  ..............  ..............
  59409  T                               Obstetrical care...............            0199           11.20         $543.06         $157.83         $108.61
  59410  E                               Obstetrical care...............  ..............  ..............  ..............  ..............  ..............
  59412  T                               Antepartum manipulation........            0199           11.20         $543.06         $157.83         $108.61
  59414  T                               Deliver placenta...............            0199           11.20         $543.06         $157.83         $108.61
  59425  E                               Antepartum care only...........  ..............  ..............  ..............  ..............  ..............
  59426  E                               Antepartum care only...........  ..............  ..............  ..............  ..............  ..............
  59430  E                               Care after delivery............  ..............  ..............  ..............  ..............  ..............
  59510  E                               Cesarean delivery..............  ..............  ..............  ..............  ..............  ..............
  59514  C                               Cesarean delivery only.........  ..............  ..............  ..............  ..............  ..............
  59515  E                               Cesarean delivery..............  ..............  ..............  ..............  ..............  ..............
  59525  C                               Remove uterus after cesarean...  ..............  ..............  ..............  ..............  ..............
  59610  E                               Vbac delivery..................  ..............  ..............  ..............  ..............  ..............
  59612  T                               Vbac delivery only.............            0199           11.20         $543.06         $157.83         $108.61
  59614  E                               Vbac care after delivery.......  ..............  ..............  ..............  ..............  ..............
  59618  E                               Attempted vbac delivery........  ..............  ..............  ..............  ..............  ..............
  59620  C                               Attempted vbac delivery only...  ..............  ..............  ..............  ..............  ..............
  59622  E                               Attempted vbac after care......  ..............  ..............  ..............  ..............  ..............
  59812  T                               Treatment of miscarriage.......            0201           13.00         $630.33         $329.65         $126.07
  59820  T                               Care of miscarriage............            0201           13.00         $630.33         $329.65         $126.07
  59821  T                               Treatment of miscarriage.......            0201           13.00         $630.33         $329.65         $126.07
  59830  C                               Treat uterus infection.........  ..............  ..............  ..............  ..............  ..............
  59840  T                               Abortion.......................            0200           13.89         $673.49         $373.23         $134.70
  59841  T                               Abortion.......................            0200           13.89         $673.49         $373.23         $134.70
  59850  C                               Abortion.......................  ..............  ..............  ..............  ..............  ..............
  59851  C                               Abortion.......................  ..............  ..............  ..............  ..............  ..............
  59852  C                               Abortion.......................  ..............  ..............  ..............  ..............  ..............
  59855  C                               Abortion.......................  ..............  ..............  ..............  ..............  ..............
  59856  C                               Abortion.......................  ..............  ..............  ..............  ..............  ..............
  59857  C                               Abortion.......................  ..............  ..............  ..............  ..............  ..............
  59866  C                               Abortion (mpr).................  ..............  ..............  ..............  ..............  ..............

[[Page 18617]]

 
  59870  T                               Evacuate mole of uterus........            0201           13.00         $630.33         $329.65         $126.07
  59871  T                               Remove cerclage suture.........            0194           16.21         $785.98         $395.94         $157.20
  59898  T                               Laparo proc, ob care/deliver...            0130           25.36       $1,229.63         $659.53         $245.93
  59899  T                               Maternity care procedure.......            0198            1.34          $64.97          $33.03          $12.99
  60000  T                               Drain thyroid/tongue cyst......            0253           12.02         $582.81         $284.00         $116.56
  60001  T                               Aspirate/inject thyriod cyst...            0002            0.62          $30.06          $17.66           $6.01
  60100  T                               Biopsy of thyroid..............            0004            1.84          $89.22          $32.57          $17.84
  60200  T                               Remove thyroid lesion..........            0114           19.56         $948.41         $493.78         $189.68
  60210  T                               Partial thyroid excision.......            0114           19.56         $948.41         $493.78         $189.68
  60212  C                               Parital thyroid excision.......  ..............  ..............  ..............  ..............  ..............
  60220  T                               Partial removal of thyroid.....            0114           19.56         $948.41         $493.78         $189.68
  60225  T                               Partial removal of thyroid.....            0114           19.56         $948.41         $493.78         $189.68
  60240  T                               Removal of thyroid.............            0114           19.56         $948.41         $493.78         $189.68
  60252  C                               Removal of thyroid.............  ..............  ..............  ..............  ..............  ..............
  60254  C                               Extensive thyroid surgery......  ..............  ..............  ..............  ..............  ..............
  60260  C                               Repeat thyroid surgery.........  ..............  ..............  ..............  ..............  ..............
  60270  C                               Removal of thyroid.............  ..............  ..............  ..............  ..............  ..............
  60271  C                               Removal of thyroid.............  ..............  ..............  ..............  ..............  ..............
  60280  T                               Remove thyroid duct lesion.....            0114           19.56         $948.41         $493.78         $189.68
  60281  T                               Remove thyroid duct lesion.....            0114           19.56         $948.41         $493.78         $189.68
  60500  T                               Explore parathyroid glands.....            0256           25.40       $1,231.57         $623.05         $246.31
  60502  C                               Re-explore parathyroids........  ..............  ..............  ..............  ..............  ..............
  60505  C                               Explore parathyroid glands.....  ..............  ..............  ..............  ..............  ..............
  60512  C                               Autotransplant parathyroid.....  ..............  ..............  ..............  ..............  ..............
  60520  C                               Removal of thymus gland........  ..............  ..............  ..............  ..............  ..............
  60521  C                               Removal of thymus gland........  ..............  ..............  ..............  ..............  ..............
  60522  C                               Removal of thymus gland........  ..............  ..............  ..............  ..............  ..............
  60540  C                               Explore adrenal gland..........  ..............  ..............  ..............  ..............  ..............
  60545  C                               Explore adrenal gland..........  ..............  ..............  ..............  ..............  ..............
  60600  C                               Remove carotid body lesion.....  ..............  ..............  ..............  ..............  ..............
  60605  C                               Remove carotid body lesion.....  ..............  ..............  ..............  ..............  ..............
  60650  C                               Laparoscopy adrenalectomy......  ..............  ..............  ..............  ..............  ..............
  60659  T                               Laparo proc, endocrine.........            0130           25.36       $1,229.63         $659.53         $245.93
  60699  T                               Endocrine surgery procedure....            0004            1.84          $89.22          $32.57          $17.84
  61000  T                               Remove cranial cavity fluid....            0212            3.64         $176.49          $88.78          $35.30
  61001  T                               Remove cranial cavity fluid....            0212            3.64         $176.49          $88.78          $35.30
  61020  T                               Remove brain cavity fluid......            0212            3.64         $176.49          $88.78          $35.30
  61026  T                               Injection into brain canal.....            0212            3.64         $176.49          $88.78          $35.30
  61050  T                               Remove brain canal fluid.......            0212            3.64         $176.49          $88.78          $35.30
  61055  T                               Injection into brain canal.....            0212            3.64         $176.49          $88.78          $35.30
  61070  T                               Brain canal shunt procedure....            0212            3.64         $176.49          $88.78          $35.30
  61105  C                               Twist drill hole...............  ..............  ..............  ..............  ..............  ..............
  61107  C                               Drill skull for implantation...  ..............  ..............  ..............  ..............  ..............
  61108  C                               Drill skull for drainage.......  ..............  ..............  ..............  ..............  ..............
  61120  C                               Burr hole for puncture.........  ..............  ..............  ..............  ..............  ..............
  61140  C                               Pierce skull for biopsy........  ..............  ..............  ..............  ..............  ..............
  61150  C                               Pierce skull for drainage......  ..............  ..............  ..............  ..............  ..............
  61151  C                               Pierce skull for drainage......  ..............  ..............  ..............  ..............  ..............
  61154  C                               Pierce skull & remove clot.....  ..............  ..............  ..............  ..............  ..............
  61156  C                               Pierce skull for drainage......  ..............  ..............  ..............  ..............  ..............
  61210  C                               Pierce skull, implant device...  ..............  ..............  ..............  ..............  ..............
  61215  T                               Insert brain-fluid device......            0222           25.48       $1,235.45         $780.07         $247.09
  61250  C                               Pierce skull & explore.........  ..............  ..............  ..............  ..............  ..............
  61253  C                               Pierce skull & explore.........  ..............  ..............  ..............  ..............  ..............
  61304  C                               Open skull for exploration.....  ..............  ..............  ..............  ..............  ..............
  61305  C                               Open skull for exploration.....  ..............  ..............  ..............  ..............  ..............
  61312  C                               Open skull for drainage........  ..............  ..............  ..............  ..............  ..............
  61313  C                               Open skull for drainage........  ..............  ..............  ..............  ..............  ..............
  61314  C                               Open skull for drainage........  ..............  ..............  ..............  ..............  ..............
  61315  C                               Open skull for drainage........  ..............  ..............  ..............  ..............  ..............
  61320  C                               Open skull for drainage........  ..............  ..............  ..............  ..............  ..............
  61321  C                               Open skull for drainage........  ..............  ..............  ..............  ..............  ..............
  61330  T                               Decompress eye socket..........            0256           25.40       $1,231.57         $623.05         $246.31
  61332  C                               Explore/biopsy eye socket......  ..............  ..............  ..............  ..............  ..............
  61333  C                               Explore orbit/remove lesion....  ..............  ..............  ..............  ..............  ..............
  61334  C                               Explore orbit/remove object....  ..............  ..............  ..............  ..............  ..............
  61340  C                               Relieve cranial pressure.......  ..............  ..............  ..............  ..............  ..............
  61343  C                               Incise skull (press relief)....  ..............  ..............  ..............  ..............  ..............
  61345  C                               Relieve cranial pressure.......  ..............  ..............  ..............  ..............  ..............
  61440  C                               Incise skull for surgery.......  ..............  ..............  ..............  ..............  ..............
  61450  C                               Incise skull for surgery.......  ..............  ..............  ..............  ..............  ..............
  61458  C                               Incise skull for brain wound...  ..............  ..............  ..............  ..............  ..............
  61460  C                               Incise skull for surgery.......  ..............  ..............  ..............  ..............  ..............

[[Page 18618]]

 
  61470  C                               Incise skull for surgery.......  ..............  ..............  ..............  ..............  ..............
  61480  C                               Incise skull for surgery.......  ..............  ..............  ..............  ..............  ..............
  61490  C                               Incise skull for surgery.......  ..............  ..............  ..............  ..............  ..............
  61500  C                               Removal of skull lesion........  ..............  ..............  ..............  ..............  ..............
  61501  C                               Remove infected skull bone.....  ..............  ..............  ..............  ..............  ..............
  61510  C                               Removal of brain lesion........  ..............  ..............  ..............  ..............  ..............
  61512  C                               Remove brain lining lesion.....  ..............  ..............  ..............  ..............  ..............
  61514  C                               Removal of brain abscess.......  ..............  ..............  ..............  ..............  ..............
  61516  C                               Removal of brain lesion........  ..............  ..............  ..............  ..............  ..............
  61518  C                               Removal of brain lesion........  ..............  ..............  ..............  ..............  ..............
  61519  C                               Remove brain lining lesion.....  ..............  ..............  ..............  ..............  ..............
  61520  C                               Removal of brain lesion........  ..............  ..............  ..............  ..............  ..............
  61521  C                               Removal of brain lesion........  ..............  ..............  ..............  ..............  ..............
  61522  C                               Removal of brain abscess.......  ..............  ..............  ..............  ..............  ..............
  61524  C                               Removal of brain lesion........  ..............  ..............  ..............  ..............  ..............
  61526  C                               Removal of brain lesion........  ..............  ..............  ..............  ..............  ..............
  61530  C                               Removal of brain lesion........  ..............  ..............  ..............  ..............  ..............
  61531  C                               Implant brain electrodes.......  ..............  ..............  ..............  ..............  ..............
  61533  C                               Implant brain electrodes.......  ..............  ..............  ..............  ..............  ..............
  61534  C                               Removal of brain lesion........  ..............  ..............  ..............  ..............  ..............
  61535  C                               Remove brain electrodes........  ..............  ..............  ..............  ..............  ..............
  61536  C                               Removal of brain lesion........  ..............  ..............  ..............  ..............  ..............
  61538  C                               Removal of brain tissue........  ..............  ..............  ..............  ..............  ..............
  61539  C                               Removal of brain tissue........  ..............  ..............  ..............  ..............  ..............
  61541  C                               Incision of brain tissue.......  ..............  ..............  ..............  ..............  ..............
  61542  C                               Removal of brain tissue........  ..............  ..............  ..............  ..............  ..............
  61543  C                               Removal of brain tissue........  ..............  ..............  ..............  ..............  ..............
  61544  C                               Remove & treat brain lesion....  ..............  ..............  ..............  ..............  ..............
  61545  C                               Excision of brain tumor........  ..............  ..............  ..............  ..............  ..............
  61546  C                               Removal of pituitary gland.....  ..............  ..............  ..............  ..............  ..............
  61548  C                               Removal of pituitary gland.....  ..............  ..............  ..............  ..............  ..............
  61550  C                               Release of skull seams.........  ..............  ..............  ..............  ..............  ..............
  61552  C                               Release of skull seams.........  ..............  ..............  ..............  ..............  ..............
  61556  C                               Incise skull/sutures...........  ..............  ..............  ..............  ..............  ..............
  61557  C                               Incise skull/sutures...........  ..............  ..............  ..............  ..............  ..............
  61558  C                               Excision of skull/sutures......  ..............  ..............  ..............  ..............  ..............
  61559  C                               Excision of skull/sutures......  ..............  ..............  ..............  ..............  ..............
  61563  C                               Excision of skull tumor........  ..............  ..............  ..............  ..............  ..............
  61564  C                               Excision of skull tumor........  ..............  ..............  ..............  ..............  ..............
  61570  C                               Remove foreign body, brain.....  ..............  ..............  ..............  ..............  ..............
  61571  C                               Incise skull for brain wound...  ..............  ..............  ..............  ..............  ..............
  61575  C                               Skull base/brainstem surgery...  ..............  ..............  ..............  ..............  ..............
  61576  C                               Skull base/brainstem surgery...  ..............  ..............  ..............  ..............  ..............
  61580  C                               Craniofacial approach, skull...  ..............  ..............  ..............  ..............  ..............
  61581  C                               Craniofacial approach, skull...  ..............  ..............  ..............  ..............  ..............
  61582  C                               Craniofacial approach, skull...  ..............  ..............  ..............  ..............  ..............
  61583  C                               Craniofacial approach, skull...  ..............  ..............  ..............  ..............  ..............
  61584  C                               Orbitocranial approach/skull...  ..............  ..............  ..............  ..............  ..............
  61585  C                               Orbitocranial approach/skull...  ..............  ..............  ..............  ..............  ..............
  61586  C                               Resect nasopharynx, skull......  ..............  ..............  ..............  ..............  ..............
  61590  C                               Infratemporal approach/skull...  ..............  ..............  ..............  ..............  ..............
  61591  C                               Infratemporal approach/skull...  ..............  ..............  ..............  ..............  ..............
  61592  C                               Orbitocranial approach/skull...  ..............  ..............  ..............  ..............  ..............
  61595  C                               Transtemporal approach/skull...  ..............  ..............  ..............  ..............  ..............
  61596  C                               Transcochlear approach/skull...  ..............  ..............  ..............  ..............  ..............
  61597  C                               Transcondylar approach/skull...  ..............  ..............  ..............  ..............  ..............
  61598  C                               Transpetrosal approach/skull...  ..............  ..............  ..............  ..............  ..............
  61600  C                               Resect/excise cranial lesion...  ..............  ..............  ..............  ..............  ..............
  61601  C                               Resect/excise cranial lesion...  ..............  ..............  ..............  ..............  ..............
  61605  C                               Resect/excise cranial lesion...  ..............  ..............  ..............  ..............  ..............
  61606  C                               Resect/excise cranial lesion...  ..............  ..............  ..............  ..............  ..............
  61607  C                               Resect/excise cranial lesion...  ..............  ..............  ..............  ..............  ..............
  61608  C                               Resect/excise cranial lesion...  ..............  ..............  ..............  ..............  ..............
  61609  C                               Transect artery, sinus.........  ..............  ..............  ..............  ..............  ..............
  61610  C                               Transect artery, sinus.........  ..............  ..............  ..............  ..............  ..............
  61611  C                               Transect artery, sinus.........  ..............  ..............  ..............  ..............  ..............
  61612  C                               Transect artery, sinus.........  ..............  ..............  ..............  ..............  ..............
  61613  C                               Remove aneurysm, sinus.........  ..............  ..............  ..............  ..............  ..............
  61615  C                               Resect/excise lesion, skull....  ..............  ..............  ..............  ..............  ..............
  61616  C                               Resect/excise lesion, skull....  ..............  ..............  ..............  ..............  ..............
  61618  C                               Repair dura....................  ..............  ..............  ..............  ..............  ..............
  61619  C                               Repair dura....................  ..............  ..............  ..............  ..............  ..............
  61624  C                               Occlusion/embolization cath....  ..............  ..............  ..............  ..............  ..............

[[Page 18619]]

 
  61626  C                               Occlusion/embolization cath....  ..............  ..............  ..............  ..............  ..............
  61680  C                               Intracranial vessel surgery....  ..............  ..............  ..............  ..............  ..............
  61682  C                               Intracranial vessel surgery....  ..............  ..............  ..............  ..............  ..............
  61684  C                               Intracranial vessel surgery....  ..............  ..............  ..............  ..............  ..............
  61686  C                               Intracranial vessel surgery....  ..............  ..............  ..............  ..............  ..............
  61690  C                               Intracranial vessel surgery....  ..............  ..............  ..............  ..............  ..............
  61692  C                               Intracranial vessel surgery....  ..............  ..............  ..............  ..............  ..............
  61700  C                               Inner skull vessel surgery.....  ..............  ..............  ..............  ..............  ..............
  61702  C                               Inner skull vessel surgery.....  ..............  ..............  ..............  ..............  ..............
  61703  C                               Clamp neck artery..............  ..............  ..............  ..............  ..............  ..............
  61705  C                               Revise circulation to head.....  ..............  ..............  ..............  ..............  ..............
  61708  C                               Revise circulation to head.....  ..............  ..............  ..............  ..............  ..............
  61710  C                               Revise circulation to head.....  ..............  ..............  ..............  ..............  ..............
  61711  C                               Fusion of skull arteries.......  ..............  ..............  ..............  ..............  ..............
  61720  C                               Incise skull/brain surgery.....  ..............  ..............  ..............  ..............  ..............
  61735  C                               Incise skull/brain surgery.....  ..............  ..............  ..............  ..............  ..............
  61750  C                               Incise skull/brain biopsy......  ..............  ..............  ..............  ..............  ..............
  61751  C                               Brain biopsy w/ct/mr guide.....  ..............  ..............  ..............  ..............  ..............
  61760  C                               Implant brain electrodes.......  ..............  ..............  ..............  ..............  ..............
  61770  C                               Incise skull for treatment.....  ..............  ..............  ..............  ..............  ..............
  61790  T                               Treat trigeminal nerve.........            0220           13.96         $676.88         $326.21         $135.38
  61791  C                               Treat trigeminal tract.........  ..............  ..............  ..............  ..............  ..............
  61793  E                               Focus radiation beam...........  ..............  ..............  ..............  ..............  ..............
  61795  C                               Brain surgery using computer...  ..............  ..............  ..............  ..............  ..............
  61850  C                               Implant neuroelectrodes........  ..............  ..............  ..............  ..............  ..............
  61860  C                               Implant neuroelectrodes........  ..............  ..............  ..............  ..............  ..............
  61862  C                               Implant neurostimul, subcort...  ..............  ..............  ..............  ..............  ..............
  61870  C                               Implant neuroelectrodes........  ..............  ..............  ..............  ..............  ..............
  61875  C                               Implant neuroelectrodes........  ..............  ..............  ..............  ..............  ..............
  61880  C                               Revise/remove neuroelectrode...  ..............  ..............  ..............  ..............  ..............
  61885  T                               Implant neurostim one array....            0222           25.48       $1,235.45         $780.07         $247.09
  61886  C                               Implant neurostim arrays.......  ..............  ..............  ..............  ..............  ..............
  61888  C                               Revise/remove neuroreceiver....  ..............  ..............  ..............  ..............  ..............
  62000  C                               Treat skull fracture...........  ..............  ..............  ..............  ..............  ..............
  62005  C                               Treat skull fracture...........  ..............  ..............  ..............  ..............  ..............
  62010  C                               Treatment of head injury.......  ..............  ..............  ..............  ..............  ..............
  62100  C                               Repair brain fluid leakage.....  ..............  ..............  ..............  ..............  ..............
  62115  C                               Reduction of skull defect......  ..............  ..............  ..............  ..............  ..............
  62116  C                               Reduction of skull defect......  ..............  ..............  ..............  ..............  ..............
  62117  C                               Reduction of skull defect......  ..............  ..............  ..............  ..............  ..............
  62120  C                               Repair skull cavity lesion.....  ..............  ..............  ..............  ..............  ..............
  62121  C                               Incise skull repair............  ..............  ..............  ..............  ..............  ..............
  62140  C                               Repair of skull defect.........  ..............  ..............  ..............  ..............  ..............
  62141  C                               Repair of skull defect.........  ..............  ..............  ..............  ..............  ..............
  62142  C                               Remove skull plate/flap........  ..............  ..............  ..............  ..............  ..............
  62143  C                               Replace skull plate/flap.......  ..............  ..............  ..............  ..............  ..............
  62145  C                               Repair of skull & brain........  ..............  ..............  ..............  ..............  ..............
  62146  C                               Repair of skull with graft.....  ..............  ..............  ..............  ..............  ..............
  62147  C                               Repair of skull with graft.....  ..............  ..............  ..............  ..............  ..............
  62180  C                               Establish brain cavity shunt...  ..............  ..............  ..............  ..............  ..............
  62190  C                               Establish brain cavity shunt...  ..............  ..............  ..............  ..............  ..............
  62192  C                               Establish brain cavity shunt...  ..............  ..............  ..............  ..............  ..............
  62194  T                               Replace/irrigate catheter......            0121            2.36         $114.43          $52.53          $22.89
  62200  C                               Establish brain cavity shunt...  ..............  ..............  ..............  ..............  ..............
  62201  C                               Establish brain cavity shunt...  ..............  ..............  ..............  ..............  ..............
  62220  C                               Establish brain cavity shunt...  ..............  ..............  ..............  ..............  ..............
  62223  C                               Establish brain cavity shunt...  ..............  ..............  ..............  ..............  ..............
  62225  T                               Replace/irrigate catheter......            0121            2.36         $114.43          $52.53          $22.89
  62230  T                               Replace/revise brain shunt.....            0224           15.94         $772.88         $374.61         $154.58
  62256  C                               Remove brain cavity shunt......  ..............  ..............  ..............  ..............  ..............
  62258  C                               Replace brain cavity shunt.....  ..............  ..............  ..............  ..............  ..............
  62263  T                               Lysis epidural adhesions.......            0212            3.64         $176.49          $88.78          $35.30
  62268  T                               Drain spinal cord cyst.........            0212            3.64         $176.49          $88.78          $35.30
  62269  T                               Needle biopsy, spinal cord.....            0005            5.41         $262.32         $119.75          $52.46
  62270  T                               Spinal fluid tap, diagnostic...            0210            3.00         $145.46          $62.40          $29.09
  62272  T                               Drain spinal fluid.............            0210            3.00         $145.46          $62.40          $29.09
  62273  T                               Treat epidural spine lesion....            0212            3.64         $176.49          $88.78          $35.30
  62280  T                               Treat spinal cord lesion.......            0212            3.64         $176.49          $88.78          $35.30
  62281  T                               Treat spinal cord lesion.......            0212            3.64         $176.49          $88.78          $35.30
  62282  T                               Treat spinal canal lesion......            0212            3.64         $176.49          $88.78          $35.30
  62284  N                               Injection for myelogram........  ..............  ..............  ..............  ..............  ..............
  62287  T                               Percutaneous diskectomy........            0220           13.96         $676.88         $326.21         $135.38
  62290  N                               Inject for spine disk x-ray....  ..............  ..............  ..............  ..............  ..............

[[Page 18620]]

 
  62291  N                               Inject for spine disk x-ray....  ..............  ..............  ..............  ..............  ..............
  62292  T                               Injection into disk lesion.....            0212            3.64         $176.49          $88.78          $35.30
  62294  T                               Injection into spinal artery...            0212            3.64         $176.49          $88.78          $35.30
  62310  T                               Inject spine c/t...............            0212            3.64         $176.49          $88.78          $35.30
  62311  T                               Inject spine l/s (cd)..........            0212            3.64         $176.49          $88.78          $35.30
  62318  T                               Inject spine w/cath, c/t.......            0212            3.64         $176.49          $88.78          $35.30
  62319  T                               Inject spine w/cath l/s (cd)...            0212            3.64         $176.49          $88.78          $35.30
  62350  T                               Implant spinal canal cath......            0223            6.34         $307.41         $153.24          $61.48
  62351  C                               Implant spinal canal cath......  ..............  ..............  ..............  ..............  ..............
  62355  T                               Remove spinal canal catheter...            0223            6.34         $307.41         $153.24          $61.48
  62360  T                               Insert spine infusion device...            0222           25.48       $1,235.45         $780.07         $247.09
  62361  T                               Implant spine infusion pump....            0222           25.48       $1,235.45         $780.07         $247.09
  62362  T                               Implant spine infusion pump....            0222           25.48       $1,235.45         $780.07         $247.09
  62365  T                               Remove spine infusion device...            0224           15.94         $772.88         $374.61         $154.58
  62367  S                               Analyze spine infusion pump....            0102            0.45          $21.82          $12.62           $4.36
  62368  S                               Analyze spine infusion pump....            0102            0.45          $21.82          $12.62           $4.36
  63001  C                               Removal of spinal lamina.......  ..............  ..............  ..............  ..............  ..............
  63003  C                               Removal of spinal lamina.......  ..............  ..............  ..............  ..............  ..............
  63005  C                               Removal of spinal lamina.......  ..............  ..............  ..............  ..............  ..............
  63011  C                               Removal of spinal lamina.......  ..............  ..............  ..............  ..............  ..............
  63012  C                               Removal of spinal lamina.......  ..............  ..............  ..............  ..............  ..............
  63015  C                               Removal of spinal lamina.......  ..............  ..............  ..............  ..............  ..............
  63016  C                               Removal of spinal lamina.......  ..............  ..............  ..............  ..............  ..............
  63017  C                               Removal of spinal lamina.......  ..............  ..............  ..............  ..............  ..............
  63020  C                               Neck spine disk surgery........  ..............  ..............  ..............  ..............  ..............
  63030  C                               Low back disk surgery..........  ..............  ..............  ..............  ..............  ..............
  63035  C                               Spinal disk surgery add-on.....  ..............  ..............  ..............  ..............  ..............
  63040  C                               Neck spine disk surgery........  ..............  ..............  ..............  ..............  ..............
  63042  C                               Low back disk surgery..........  ..............  ..............  ..............  ..............  ..............
  63045  C                               Removal of spinal lamina.......  ..............  ..............  ..............  ..............  ..............
  63046  C                               Removal of spinal lamina.......  ..............  ..............  ..............  ..............  ..............
  63047  C                               Removal of spinal lamina.......  ..............  ..............  ..............  ..............  ..............
  63048  C                               Remove spinal lamina add-on....  ..............  ..............  ..............  ..............  ..............
  63055  C                               Decompress spinal cord.........  ..............  ..............  ..............  ..............  ..............
  63056  C                               Decompress spinal cord.........  ..............  ..............  ..............  ..............  ..............
  63057  C                               Decompress spine cord add-on...  ..............  ..............  ..............  ..............  ..............
  63064  C                               Decompress spinal cord.........  ..............  ..............  ..............  ..............  ..............
  63066  C                               Decompress spine cord add-on...  ..............  ..............  ..............  ..............  ..............
  63075  C                               Neck spine disk surgery........  ..............  ..............  ..............  ..............  ..............
  63076  C                               Neck spine disk surgery........  ..............  ..............  ..............  ..............  ..............
  63077  C                               Spine disk surgery, thorax.....  ..............  ..............  ..............  ..............  ..............
  63078  C                               Spine disk surgery, thorax.....  ..............  ..............  ..............  ..............  ..............
  63081  C                               Removal of vertebral body......  ..............  ..............  ..............  ..............  ..............
  63082  C                               Remove vertebral body add-on...  ..............  ..............  ..............  ..............  ..............
  63085  C                               Removal of vertebral body......  ..............  ..............  ..............  ..............  ..............
  63086  C                               Remove vertebral body add-on...  ..............  ..............  ..............  ..............  ..............
  63087  C                               Removal of vertebral body......  ..............  ..............  ..............  ..............  ..............
  63088  C                               Remove vertebral body add-on...  ..............  ..............  ..............  ..............  ..............
  63090  C                               Removal of vertebral body......  ..............  ..............  ..............  ..............  ..............
  63091  C                               Remove vertebral body add-on...  ..............  ..............  ..............  ..............  ..............
  63170  C                               Incise spinal cord tract(s)....  ..............  ..............  ..............  ..............  ..............
  63172  C                               Drainage of spinal cyst........  ..............  ..............  ..............  ..............  ..............
  63173  C                               Drainage of spinal cyst........  ..............  ..............  ..............  ..............  ..............
  63180  C                               Revise spinal cord ligaments...  ..............  ..............  ..............  ..............  ..............
  63182  C                               Revise spinal cord ligaments...  ..............  ..............  ..............  ..............  ..............
  63185  C                               Incise spinal column/nerves....  ..............  ..............  ..............  ..............  ..............
  63190  C                               Incise spinal column/nerves....  ..............  ..............  ..............  ..............  ..............
  63191  C                               Incise spinal column/nerves....  ..............  ..............  ..............  ..............  ..............
  63194  C                               Incise spinal column & cord....  ..............  ..............  ..............  ..............  ..............
  63195  C                               Incise spinal column & cord....  ..............  ..............  ..............  ..............  ..............
  63196  C                               Incise spinal column & cord....  ..............  ..............  ..............  ..............  ..............
  63197  C                               Incise spinal column & cord....  ..............  ..............  ..............  ..............  ..............
  63198  C                               Incise spinal column & cord....  ..............  ..............  ..............  ..............  ..............
  63199  C                               Incise spinal column & cord....  ..............  ..............  ..............  ..............  ..............
  63200  C                               Release of spinal cord.........  ..............  ..............  ..............  ..............  ..............
  63250  C                               Revise spinal cord vessels.....  ..............  ..............  ..............  ..............  ..............
  63251  C                               Revise spinal cord vessels.....  ..............  ..............  ..............  ..............  ..............
  63252  C                               Revise spinal cord vessels.....  ..............  ..............  ..............  ..............  ..............
  63265  C                               Excise intraspinal lesion......  ..............  ..............  ..............  ..............  ..............
  63266  C                               Excise intraspinal lesion......  ..............  ..............  ..............  ..............  ..............
  63267  C                               Excise intraspinal lesion......  ..............  ..............  ..............  ..............  ..............
  63268  C                               Excise intraspinal lesion......  ..............  ..............  ..............  ..............  ..............
  63270  C                               Excise intraspinal lesion......  ..............  ..............  ..............  ..............  ..............

[[Page 18621]]

 
  63271  C                               Excise intraspinal lesion......  ..............  ..............  ..............  ..............  ..............
  63272  C                               Excise intraspinal lesion......  ..............  ..............  ..............  ..............  ..............
  63273  C                               Excise intraspinal lesion......  ..............  ..............  ..............  ..............  ..............
  63275  C                               Biopsy/excise spinal tumor.....  ..............  ..............  ..............  ..............  ..............
  63276  C                               Biopsy/excise spinal tumor.....  ..............  ..............  ..............  ..............  ..............
  63277  C                               Biopsy/excise spinal tumor.....  ..............  ..............  ..............  ..............  ..............
  63278  C                               Biopsy/excise spinal tumor.....  ..............  ..............  ..............  ..............  ..............
  63280  C                               Biopsy/excise spinal tumor.....  ..............  ..............  ..............  ..............  ..............
  63281  C                               Biopsy/excise spinal tumor.....  ..............  ..............  ..............  ..............  ..............
  63282  C                               Biopsy/excise spinal tumor.....  ..............  ..............  ..............  ..............  ..............
  63283  C                               Biopsy/excise spinal tumor.....  ..............  ..............  ..............  ..............  ..............
  63285  C                               Biopsy/excise spinal tumor.....  ..............  ..............  ..............  ..............  ..............
  63286  C                               Biopsy/excise spinal tumor.....  ..............  ..............  ..............  ..............  ..............
  63287  C                               Biopsy/excise spinal tumor.....  ..............  ..............  ..............  ..............  ..............
  63290  C                               Biopsy/excise spinal tumor.....  ..............  ..............  ..............  ..............  ..............
  63300  C                               Removal of vertebral body......  ..............  ..............  ..............  ..............  ..............
  63301  C                               Removal of vertebral body......  ..............  ..............  ..............  ..............  ..............
  63302  C                               Removal of vertebral body......  ..............  ..............  ..............  ..............  ..............
  63303  C                               Removal of vertebral body......  ..............  ..............  ..............  ..............  ..............
  63304  C                               Removal of vertebral body......  ..............  ..............  ..............  ..............  ..............
  63305  C                               Removal of vertebral body......  ..............  ..............  ..............  ..............  ..............
  63306  C                               Removal of vertebral body......  ..............  ..............  ..............  ..............  ..............
  63307  C                               Removal of vertebral body......  ..............  ..............  ..............  ..............  ..............
  63308  C                               Remove vertebral body add-on...  ..............  ..............  ..............  ..............  ..............
  63600  T                               Remove spinal cord lesion......            0220           13.96         $676.88         $326.21         $135.38
  63610  T                               Stimulation of spinal cord.....            0220           13.96         $676.88         $326.21         $135.38
  63615  T                               Remove lesion of spinal cord...            0220           13.96         $676.88         $326.21         $135.38
  63650  T                               Implant neuroelectrodes........            0224           15.94         $772.88         $374.61         $154.58
  63655  C                               Implant neuroelectrodes........  ..............  ..............  ..............  ..............  ..............
  63660  T                               Revise/remove neuroelectrode...            0224           15.94         $772.88         $374.61         $154.58
  63685  T                               Implant neuroreceiver..........            0222           25.48       $1,235.45         $780.07         $247.09
  63688  T                               Revise/remove neuroreceiver....            0224           15.94         $772.88         $374.61         $154.58
  63700  C                               Repair of spinal herniation....  ..............  ..............  ..............  ..............  ..............
  63702  C                               Repair of spinal herniation....  ..............  ..............  ..............  ..............  ..............
  63704  C                               Repair of spinal herniation....  ..............  ..............  ..............  ..............  ..............
  63706  C                               Repair of spinal herniation....  ..............  ..............  ..............  ..............  ..............
  63707  C                               Repair spinal fluid leakage....  ..............  ..............  ..............  ..............  ..............
  63709  C                               Repair spinal fluid leakage....  ..............  ..............  ..............  ..............  ..............
  63710  C                               Graft repair of spine defect...  ..............  ..............  ..............  ..............  ..............
  63740  C                               Install spinal shunt...........  ..............  ..............  ..............  ..............  ..............
  63741  C                               Install spinal shunt...........  ..............  ..............  ..............  ..............  ..............
  63744  T                               Revision of spinal shunt.......            0224           15.94         $772.88         $374.61         $154.58
  63746  T                               Removal of spinal shunt........            0223            6.34         $307.41         $153.24          $61.48
  64400  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64402  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64405  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64408  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64410  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64412  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64413  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64415  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64417  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64418  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64420  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64421  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64425  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64430  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64435  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64445  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64450  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64470  T                               Inj paravertebral c/t..........            0211            3.32         $160.98          $74.78          $32.20
  64472  T                               Inj paravertebral c/t add-on...            0211            3.32         $160.98          $74.78          $32.20
  64475  T                               Inj paravertebral l/s..........            0211            3.32         $160.98          $74.78          $32.20
  64476  T                               Inj paravertebral l/s add-on...            0211            3.32         $160.98          $74.78          $32.20
  64479  T                               Inj foramen epidural c/t.......            0211            3.32         $160.98          $74.78          $32.20
  64480  T                               Inj foramen epidural add-on....            0211            3.32         $160.98          $74.78          $32.20
  64483  T                               Inj foramen epidural l/s.......            0211            3.32         $160.98          $74.78          $32.20
  64484  T                               Inj foramen epidural add-on....            0211            3.32         $160.98          $74.78          $32.20
  64505  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64508  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64510  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64520  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20
  64530  T                               Injection for nerve block......            0211            3.32         $160.98          $74.78          $32.20

[[Page 18622]]

 
  64550  A                               Apply neurostimulator..........  ..............  ..............  ..............  ..............  ..............
  64553  T                               Implant neuroelectrodes........            0225            3.43         $166.31          $64.46          $33.26
  64555  T                               Implant neuroelectrodes........            0225            3.43         $166.31          $64.46          $33.26
  64560  T                               Implant neuroelectrodes........            0225            3.43         $166.31          $64.46          $33.26
  64565  T                               Implant neuroelectrodes........            0225            3.43         $166.31          $64.46          $33.26
  64573  T                               Implant neuroelectrodes........            0225            3.43         $166.31          $64.46          $33.26
  64575  T                               Implant neuroelectrodes........            0225            3.43         $166.31          $64.46          $33.26
  64577  T                               Implant neuroelectrodes........            0225            3.43         $166.31          $64.46          $33.26
  64580  T                               Implant neuroelectrodes........            0225            3.43         $166.31          $64.46          $33.26
  64585  T                               Revise/remove neuroelectrode...            0225            3.43         $166.31          $64.46          $33.26
  64590  T                               Implant neuroreceiver..........            0222           25.48       $1,235.45         $780.07         $247.09
  64595  T                               Revise/remove neuroreceiver....            0225            3.43         $166.31          $64.46          $33.26
  64600  T                               Injection treatment of nerve...            0211            3.32         $160.98          $74.78          $32.20
  64605  T                               Injection treatment of nerve...            0211            3.32         $160.98          $74.78          $32.20
  64610  T                               Injection treatment of nerve...            0211            3.32         $160.98          $74.78          $32.20
  64612  T                               Destroy nerve, face muscle.....            0211            3.32         $160.98          $74.78          $32.20
  64613  T                               Destroy nerve, spine muscle....            0211            3.32         $160.98          $74.78          $32.20
  64620  T                               Injection treatment of nerve...            0211            3.32         $160.98          $74.78          $32.20
  64622  T                               Destr paravertebrl nerve l/s...            0211            3.32         $160.98          $74.78          $32.20
  64623  T                               Destr paravertebral n add-on...            0211            3.32         $160.98          $74.78          $32.20
  64626  T                               Destr paravertebrl nerve c/t...            0211            3.32         $160.98          $74.78          $32.20
  64627  T                               Destr paravertebral n add-on...            0211            3.32         $160.98          $74.78          $32.20
  64630  T                               Injection treatment of nerve...            0211            3.32         $160.98          $74.78          $32.20
  64640  T                               Injection treatment of nerve...            0211            3.32         $160.98          $74.78          $32.20
  64680  T                               Injection treatment of nerve...            0211            3.32         $160.98          $74.78          $32.20
  64702  T                               Revise finger/toe nerve........            0220           13.96         $676.88         $326.21         $135.38
  64704  T                               Revise hand/foot nerve.........            0220           13.96         $676.88         $326.21         $135.38
  64708  T                               Revise arm/leg nerve...........            0220           13.96         $676.88         $326.21         $135.38
  64712  T                               Revision of sciatic nerve......            0220           13.96         $676.88         $326.21         $135.38
  64713  T                               Revision of arm nerve(s).......            0220           13.96         $676.88         $326.21         $135.38
  64714  T                               Revise low back nerve(s).......            0220           13.96         $676.88         $326.21         $135.38
  64716  T                               Revision of cranial nerve......            0220           13.96         $676.88         $326.21         $135.38
  64718  T                               Revise ulnar nerve at elbow....            0220           13.96         $676.88         $326.21         $135.38
  64719  T                               Revise ulnar nerve at wrist....            0220           13.96         $676.88         $326.21         $135.38
  64721  T                               Carpal tunnel surgery..........            0220           13.96         $676.88         $326.21         $135.38
  64722  T                               Relieve pressure on nerve(s)...            0220           13.96         $676.88         $326.21         $135.38
  64726  T                               Release foot/toe nerve.........            0220           13.96         $676.88         $326.21         $135.38
  64727  T                               Internal nerve revision........            0220           13.96         $676.88         $326.21         $135.38
  64732  T                               Incision of brow nerve.........            0220           13.96         $676.88         $326.21         $135.38
  64734  T                               Incision of cheek nerve........            0220           13.96         $676.88         $326.21         $135.38
  64736  T                               Incision of chin nerve.........            0220           13.96         $676.88         $326.21         $135.38
  64738  T                               Incision of jaw nerve..........            0220           13.96         $676.88         $326.21         $135.38
  64740  T                               Incision of tongue nerve.......            0220           13.96         $676.88         $326.21         $135.38
  64742  T                               Incision of facial nerve.......            0220           13.96         $676.88         $326.21         $135.38
  64744  T                               Incise nerve, back of head.....            0220           13.96         $676.88         $326.21         $135.38
  64746  T                               Incise diaphragm nerve.........            0220           13.96         $676.88         $326.21         $135.38
  64752  C                               Incision of vagus nerve........  ..............  ..............  ..............  ..............  ..............
  64755  C                               Incision of stomach nerves.....  ..............  ..............  ..............  ..............  ..............
  64760  C                               Incision of vagus nerve........  ..............  ..............  ..............  ..............  ..............
  64761  T                               Incision of pelvis nerve.......            0220           13.96         $676.88         $326.21         $135.38
  64763  C                               Incise hip/thigh nerve.........  ..............  ..............  ..............  ..............  ..............
  64766  C                               Incise hip/thigh nerve.........  ..............  ..............  ..............  ..............  ..............
  64771  T                               Sever cranial nerve............            0220           13.96         $676.88         $326.21         $135.38
  64772  T                               Incision of spinal nerve.......            0220           13.96         $676.88         $326.21         $135.38
  64774  T                               Remove skin nerve lesion.......            0220           13.96         $676.88         $326.21         $135.38
  64776  T                               Remove digit nerve lesion......            0220           13.96         $676.88         $326.21         $135.38
  64778  T                               Digit nerve surgery add-on.....            0220           13.96         $676.88         $326.21         $135.38
  64782  T                               Remove limb nerve lesion.......            0220           13.96         $676.88         $326.21         $135.38
  64783  T                               Limb nerve surgery add-on......            0220           13.96         $676.88         $326.21         $135.38
  64784  T                               Remove nerve lesion............            0220           13.96         $676.88         $326.21         $135.38
  64786  T                               Remove sciatic nerve lesion....            0221           18.36         $890.22         $463.62         $178.04
  64787  T                               Implant nerve end..............            0220           13.96         $676.88         $326.21         $135.38
  64788  T                               Remove skin nerve lesion.......            0220           13.96         $676.88         $326.21         $135.38
  64790  T                               Removal of nerve lesion........            0220           13.96         $676.88         $326.21         $135.38
  64792  T                               Removal of nerve lesion........            0221           18.36         $890.22         $463.62         $178.04
  64795  T                               Biopsy of nerve................            0220           13.96         $676.88         $326.21         $135.38
  64802  C                               Remove sympathetic nerves......  ..............  ..............  ..............  ..............  ..............
  64804  C                               Remove sympathetic nerves......  ..............  ..............  ..............  ..............  ..............
  64809  C                               Remove sympathetic nerves......  ..............  ..............  ..............  ..............  ..............
  64818  C                               Remove sympathetic nerves......  ..............  ..............  ..............  ..............  ..............
  64820  C                               Remove sympathetic nerves......  ..............  ..............  ..............  ..............  ..............
  64831  T                               Repair of digit nerve..........            0221           18.36         $890.22         $463.62         $178.04
  64832  T                               Repair nerve add-on............            0221           18.36         $890.22         $463.62         $178.04

[[Page 18623]]

 
  64834  T                               Repair of hand or foot nerve...            0221           18.36         $890.22         $463.62         $178.04
  64835  T                               Repair of hand or foot nerve...            0221           18.36         $890.22         $463.62         $178.04
  64836  T                               Repair of hand or foot nerve...            0221           18.36         $890.22         $463.62         $178.04
  64837  T                               Repair nerve add-on............            0221           18.36         $890.22         $463.62         $178.04
  64840  T                               Repair of leg nerve............            0221           18.36         $890.22         $463.62         $178.04
  64856  T                               Repair/transpose nerve.........            0221           18.36         $890.22         $463.62         $178.04
  64857  T                               Repair arm/leg nerve...........            0221           18.36         $890.22         $463.62         $178.04
  64858  T                               Repair sciatic nerve...........            0221           18.36         $890.22         $463.62         $178.04
  64859  T                               Nerve surgery..................            0221           18.36         $890.22         $463.62         $178.04
  64861  T                               Repair of arm nerves...........            0221           18.36         $890.22         $463.62         $178.04
  64862  T                               Repair of low back nerves......            0221           18.36         $890.22         $463.62         $178.04
  64864  T                               Repair of facial nerve.........            0221           18.36         $890.22         $463.62         $178.04
  64865  T                               Repair of facial nerve.........            0221           18.36         $890.22         $463.62         $178.04
  64866  C                               Fusion of facial/other nerve...  ..............  ..............  ..............  ..............  ..............
  64868  C                               Fusion of facial/other nerve...  ..............  ..............  ..............  ..............  ..............
  64870  T                               Fusion of facial/other nerve...            0221           18.36         $890.22         $463.62         $178.04
  64872  T                               Subsequent repair of nerve.....            0221           18.36         $890.22         $463.62         $178.04
  64874  T                               Repair & revise nerve add-on...            0221           18.36         $890.22         $463.62         $178.04
  64876  T                               Repair nerve/shorten bone......            0221           18.36         $890.22         $463.62         $178.04
  64885  T                               Nerve graft, head or neck......            0221           18.36         $890.22         $463.62         $178.04
  64886  T                               Nerve graft, head or neck......            0221           18.36         $890.22         $463.62         $178.04
  64890  T                               Nerve graft, hand or foot......            0221           18.36         $890.22         $463.62         $178.04
  64891  T                               Nerve graft, hand or foot......            0221           18.36         $890.22         $463.62         $178.04
  64892  T                               Nerve graft, arm or leg........            0221           18.36         $890.22         $463.62         $178.04
  64893  T                               Nerve graft, arm or leg........            0221           18.36         $890.22         $463.62         $178.04
  64895  T                               Nerve graft, hand or foot......            0221           18.36         $890.22         $463.62         $178.04
  64896  T                               Nerve graft, hand or foot......            0221           18.36         $890.22         $463.62         $178.04
  64897  T                               Nerve graft, arm or leg........            0221           18.36         $890.22         $463.62         $178.04
  64898  T                               Nerve graft, arm or leg........            0221           18.36         $890.22         $463.62         $178.04
  64901  T                               Nerve graft add-on.............            0221           18.36         $890.22         $463.62         $178.04
  64902  T                               Nerve graft add-on.............            0221           18.36         $890.22         $463.62         $178.04
  64905  T                               Nerve pedicle transfer.........            0221           18.36         $890.22         $463.62         $178.04
  64907  T                               Nerve pedicle transfer.........            0221           18.36         $890.22         $463.62         $178.04
  64999  T                               Nervous system surgery.........            0211            3.32         $160.98          $74.78          $32.20
  65091  T                               Revise eye.....................            0242           23.70       $1,149.14         $597.36         $229.83
  65093  T                               Revise eye with implant........            0241           16.60         $804.89         $384.47         $160.98
  65101  T                               Removal of eye.................            0242           23.70       $1,149.14         $597.36         $229.83
  65103  T                               Remove eye/insert implant......            0242           23.70       $1,149.14         $597.36         $229.83
  65105  T                               Remove eye/attach implant......            0242           23.70       $1,149.14         $597.36         $229.83
  65110  T                               Removal of eye.................            0242           23.70       $1,149.14         $597.36         $229.83
  65112  T                               Remove eye/revise socket.......            0242           23.70       $1,149.14         $597.36         $229.83
  65114  T                               Remove eye/revise socket.......            0242           23.70       $1,149.14         $597.36         $229.83
  65125  T                               Revise ocular implant..........            0240           13.47         $653.12         $315.31         $130.62
  65130  T                               Insert ocular implant..........            0241           16.60         $804.89         $384.47         $160.98
  65135  T                               Insert ocular implant..........            0241           16.60         $804.89         $384.47         $160.98
  65140  T                               Attach ocular implant..........            0242           23.70       $1,149.14         $597.36         $229.83
  65150  T                               Revise ocular implant..........            0241           16.60         $804.89         $384.47         $160.98
  65155  T                               Reinsert ocular implant........            0242           23.70       $1,149.14         $597.36         $229.83
  65175  T                               Removal of ocular implant......            0240           13.47         $653.12         $315.31         $130.62
  65205  S                               Remove foreign body from eye...            0231            2.64         $128.01          $59.87          $25.60
  65210  S                               Remove foreign body from eye...            0231            2.64         $128.01          $59.87          $25.60
  65220  S                               Remove foreign body from eye...            0231            2.64         $128.01          $59.87          $25.60
  65222  S                               Remove foreign body from eye...            0231            2.64         $128.01          $59.87          $25.60
  65235  T                               Remove foreign body from eye...            0232            6.04         $292.86         $134.66          $58.57
  65260  T                               Remove foreign body from eye...            0237           33.96       $1,646.62         $852.68         $329.32
  65265  T                               Remove foreign body from eye...            0237           33.96       $1,646.62         $852.68         $329.32
  65270  T                               Repair of eye wound............            0240           13.47         $653.12         $315.31         $130.62
  65272  T                               Repair of eye wound............            0232            6.04         $292.86         $134.66          $58.57
  65273  C                               Repair of eye wound............  ..............  ..............  ..............  ..............  ..............
  65275  T                               Repair of eye wound............            0233           13.79         $668.64         $331.60         $133.73
  65280  T                               Repair of eye wound............            0233           13.79         $668.64         $331.60         $133.73
  65285  T                               Repair of eye wound............            0234           20.64       $1,000.77         $502.16         $200.15
  65286  T                               Repair of eye wound............            0232            6.04         $292.86         $134.66          $58.57
  65290  T                               Repair of eye socket wound.....            0243           17.99         $872.28         $431.39         $174.46
  65400  T                               Removal of eye lesion..........            0232            6.04         $292.86         $134.66          $58.57
  65410  T                               Biopsy of cornea...............            0233           13.79         $668.64         $331.60         $133.73
  65420  T                               Removal of eye lesion..........            0233           13.79         $668.64         $331.60         $133.73
  65426  T                               Removal of eye lesion..........            0233           13.79         $668.64         $331.60         $133.73
  65430  S                               Corneal smear..................            0231            2.64         $128.01          $59.87          $25.60
  65435  T                               Curette/treat cornea...........            0239            6.26         $303.53         $123.42          $60.71
  65436  T                               Curette/treat cornea...........            0232            6.04         $292.86         $134.66          $58.57
  65450  T                               Treatment of corneal lesion....            0232            6.04         $292.86         $134.66          $58.57
  65600  T                               Revision of cornea.............            0240           13.47         $653.12         $315.31         $130.62

[[Page 18624]]

 
  65710  T                               Corneal transplant.............            0244           32.88       $1,594.26         $851.42         $318.85
  65730  T                               Corneal transplant.............            0244           32.88       $1,594.26         $851.42         $318.85
  65750  T                               Corneal transplant.............            0244           32.88       $1,594.26         $851.42         $318.85
  65755  T                               Corneal transplant.............            0244           32.88       $1,594.26         $851.42         $318.85
  65760  E                               Revision of cornea.............  ..............  ..............  ..............  ..............  ..............
  65765  E                               Revision of cornea.............  ..............  ..............  ..............  ..............  ..............
  65767  E                               Corneal tissue transplant......  ..............  ..............  ..............  ..............  ..............
  65770  T                               Revise cornea with implant.....            0244           32.88       $1,594.26         $851.42         $318.85
  65771  E                               Radial keratotomy..............  ..............  ..............  ..............  ..............  ..............
  65772  T                               Correction of astigmatism......            0232            6.04         $292.86         $134.66          $58.57
  65775  T                               Correction of astigmatism......            0233           13.79         $668.64         $331.60         $133.73
  65800  T                               Drainage of eye................            0232            6.04         $292.86         $134.66          $58.57
  65805  T                               Drainage of eye................            0233           13.79         $668.64         $331.60         $133.73
  65810  T                               Drainage of eye................            0233           13.79         $668.64         $331.60         $133.73
  65815  T                               Drainage of eye................            0233           13.79         $668.64         $331.60         $133.73
  65820  T                               Relieve inner eye pressure.....            0232            6.04         $292.86         $134.66          $58.57
  65850  T                               Incision of eye................            0234           20.64       $1,000.77         $502.16         $200.15
  65855  T                               Laser surgery of eye...........            0247            4.89         $237.10         $112.86          $47.42
  65860  T                               Incise inner eye adhesions.....            0247            4.89         $237.10         $112.86          $47.42
  65865  T                               Incise inner eye adhesions.....            0233           13.79         $668.64         $331.60         $133.73
  65870  T                               Incise inner eye adhesions.....            0233           13.79         $668.64         $331.60         $133.73
  65875  T                               Incise inner eye adhesions.....            0233           13.79         $668.64         $331.60         $133.73
  65880  T                               Incise inner eye adhesions.....            0232            6.04         $292.86         $134.66          $58.57
  65900  T                               Remove eye lesion..............            0232            6.04         $292.86         $134.66          $58.57
  65920  T                               Remove implant from eye........            0233           13.79         $668.64         $331.60         $133.73
  65930  T                               Remove blood clot from eye.....            0233           13.79         $668.64         $331.60         $133.73
  66020  T                               Injection treatment of eye.....            0232            6.04         $292.86         $134.66          $58.57
  66030  T                               Injection treatment of eye.....            0232            6.04         $292.86         $134.66          $58.57
  66130  T                               Remove eye lesion..............            0233           13.79         $668.64         $331.60         $133.73
  66150  T                               Glaucoma surgery...............            0233           13.79         $668.64         $331.60         $133.73
  66155  T                               Glaucoma surgery...............            0234           20.64       $1,000.77         $502.16         $200.15
  66160  T                               Glaucoma surgery...............            0234           20.64       $1,000.77         $502.16         $200.15
  66165  T                               Glaucoma surgery...............            0234           20.64       $1,000.77         $502.16         $200.15
  66170  T                               Glaucoma surgery...............            0234           20.64       $1,000.77         $502.16         $200.15
  66172  T                               Incision of eye................            0234           20.64       $1,000.77         $502.16         $200.15
  66180  T                               Implant eye shunt..............            0234           20.64       $1,000.77         $502.16         $200.15
  66185  T                               Revise eye shunt...............            0234           20.64       $1,000.77         $502.16         $200.15
  66220  T                               Repair eye lesion..............            0236            6.70         $324.86         $147.96          $64.97
  66225  T                               Repair/graft eye lesion........            0234           20.64       $1,000.77         $502.16         $200.15
  66250  T                               Follow-up surgery of eye.......            0233           13.79         $668.64         $331.60         $133.73
  66500  T                               Incision of iris...............            0232            6.04         $292.86         $134.66          $58.57
  66505  T                               Incision of iris...............            0232            6.04         $292.86         $134.66          $58.57
  66600  T                               Remove iris and lesion.........            0233           13.79         $668.64         $331.60         $133.73
  66605  T                               Removal of iris................            0233           13.79         $668.64         $331.60         $133.73
  66625  T                               Removal of iris................            0232            6.04         $292.86         $134.66          $58.57
  66630  T                               Removal of iris................            0233           13.79         $668.64         $331.60         $133.73
  66635  T                               Removal of iris................            0233           13.79         $668.64         $331.60         $133.73
  66680  T                               Repair iris & ciliary body.....            0233           13.79         $668.64         $331.60         $133.73
  66682  T                               Repair iris & ciliary body.....            0233           13.79         $668.64         $331.60         $133.73
  66700  T                               Destruction, ciliary body......            0232            6.04         $292.86         $134.66          $58.57
  66710  T                               Destruction, ciliary body......            0232            6.04         $292.86         $134.66          $58.57
  66720  T                               Destruction, ciliary body......            0232            6.04         $292.86         $134.66          $58.57
  66740  T                               Destruction, ciliary body......            0233           13.79         $668.64         $331.60         $133.73
  66761  T                               Revision of iris...............            0247            4.89         $237.10         $112.86          $47.42
  66762  T                               Revision of iris...............            0247            4.89         $237.10         $112.86          $47.42
  66770  T                               Removal of inner eye lesion....            0247            4.89         $237.10         $112.86          $47.42
  66820  T                               Incision, secondary cataract...            0232            6.04         $292.86         $134.66          $58.57
  66821  T                               After cataract laser surgery...            0247            4.89         $237.10         $112.86          $47.42
  66825  T                               Reposition intraocular lens....            0233           13.79         $668.64         $331.60         $133.73
  66830  T                               Removal of lens lesion.........            0232            6.04         $292.86         $134.66          $58.57
  66840  T                               Removal of lens material.......            0245           26.55       $1,287.33         $623.85         $257.47
  66850  T                               Removal of lens material.......            0245           26.55       $1,287.33         $623.85         $257.47
  66852  T                               Removal of lens material.......            0245           26.55       $1,287.33         $623.85         $257.47
  66920  T                               Extraction of lens.............            0245           26.55       $1,287.33         $623.85         $257.47
  66930  T                               Extraction of lens.............            0245           26.55       $1,287.33         $623.85         $257.47
  66940  T                               Extraction of lens.............            0245           26.55       $1,287.33         $623.85         $257.47
  66983  T                               Remove cataract/insert lens....            0246           26.55       $1,287.33         $623.85         $257.47
  66984  T                               Remove cataract/insert lens....            0246           26.55       $1,287.33         $623.85         $257.47
  66985  T                               Insert lens prosthesis.........            0246           26.55       $1,287.33         $623.85         $257.47
  66986  T                               Exchange lens prosthesis.......            0246           26.55       $1,287.33         $623.85         $257.47
  66999  T                               Eye surgery procedure..........            0247            4.89         $237.10         $112.86          $47.42
  67005  T                               Partial removal of eye fluid...            0237           33.96       $1,646.62         $852.68         $329.32
  67010  T                               Partial removal of eye fluid...            0237           33.96       $1,646.62         $852.68         $329.32

[[Page 18625]]

 
  67015  T                               Release of eye fluid...........            0237           33.96       $1,646.62         $852.68         $329.32
  67025  T                               Replace eye fluid..............            0237           33.96       $1,646.62         $852.68         $329.32
  67027  T                               Implant eye drug system........            0237           33.96       $1,646.62         $852.68         $329.32
  67028  T                               Injection eye drug.............            0236            6.70         $324.86         $147.96          $64.97
  67030  T                               Incise inner eye strands.......            0236            6.70         $324.86         $147.96          $64.97
  67031  T                               Laser surgery, eye strands.....            0247            4.89         $237.10         $112.86          $47.42
  67036  T                               Removal of inner eye fluid.....            0237           33.96       $1,646.62         $852.68         $329.32
  67038  T                               Strip retinal membrane.........            0237           33.96       $1,646.62         $852.68         $329.32
  67039  T                               Laser treatment of retina......            0237           33.96       $1,646.62         $852.68         $329.32
  67040  T                               Laser treatment of retina......            0237           33.96       $1,646.62         $852.68         $329.32
  67101  T                               Repair detached retina.........            0236            6.70         $324.86         $147.96          $64.97
  67105  T                               Repair detached retina.........            0248            4.19         $203.16          $94.05          $40.63
  67107  T                               Repair detached retina.........            0237           33.96       $1,646.62         $852.68         $329.32
  67108  T                               Repair detached retina.........            0237           33.96       $1,646.62         $852.68         $329.32
  67110  T                               Repair detached retina.........            0236            6.70         $324.86         $147.96          $64.97
  67112  T                               Rerepair detached retina.......            0237           33.96       $1,646.62         $852.68         $329.32
  67115  T                               Release encircling material....            0236            6.70         $324.86         $147.96          $64.97
  67120  T                               Remove eye implant material....            0236            6.70         $324.86         $147.96          $64.97
  67121  T                               Remove eye implant material....            0237           33.96       $1,646.62         $852.68         $329.32
  67141  T                               Treatment of retina............            0235            2.94         $142.55          $78.91          $28.51
  67145  T                               Treatment of retina............            0248            4.19         $203.16          $94.05          $40.63
  67208  T                               Treatment of retinal lesion....            0235            2.94         $142.55          $78.91          $28.51
  67210  T                               Treatment of retinal lesion....            0248            4.19         $203.16          $94.05          $40.63
  67218  T                               Treatment of retinal lesion....            0237           33.96       $1,646.62         $852.68         $329.32
  67220  T                               Treatment of choroid lesion....            0237           33.96       $1,646.62         $852.68         $329.32
  67227  T                               Treatment of retinal lesion....            0235            2.94         $142.55          $78.91          $28.51
  67228  T                               Treatment of retinal lesion....            0248            4.19         $203.16          $94.05          $40.63
  67250  T                               Reinforce eye wall.............            0240           13.47         $653.12         $315.31         $130.62
  67255  T                               Reinforce/graft eye wall.......            0237           33.96       $1,646.62         $852.68         $329.32
  67299  T                               Eye surgery procedure..........            0248            4.19         $203.16          $94.05          $40.63
  67311  T                               Revise eye muscle..............            0243           17.99         $872.28         $431.39         $174.46
  67312  T                               Revise two eye muscles.........            0243           17.99         $872.28         $431.39         $174.46
  67314  T                               Revise eye muscle..............            0243           17.99         $872.28         $431.39         $174.46
  67316  T                               Revise two eye muscles.........            0243           17.99         $872.28         $431.39         $174.46
  67318  T                               Revise eye muscle(s)...........            0243           17.99         $872.28         $431.39         $174.46
  67320  T                               Revise eye muscle(s) add-on....            0243           17.99         $872.28         $431.39         $174.46
  67331  T                               Eye surgery follow-up add-on...            0243           17.99         $872.28         $431.39         $174.46
  67332  T                               Rerevise eye muscles add-on....            0243           17.99         $872.28         $431.39         $174.46
  67334  T                               Revise eye muscle w/suture.....            0243           17.99         $872.28         $431.39         $174.46
  67335  T                               Eye suture during surgery......            0243           17.99         $872.28         $431.39         $174.46
  67340  T                               Revise eye muscle add-on.......            0243           17.99         $872.28         $431.39         $174.46
  67343  T                               Release eye tissue.............            0243           17.99         $872.28         $431.39         $174.46
  67345  T                               Destroy nerve of eye muscle....            0238            2.80         $135.76          $58.96          $27.15
  67350  S                               Biopsy eye muscle..............            0231            2.64         $128.01          $59.87          $25.60
  67399  T                               Eye muscle surgery procedure...            0243           17.99         $872.28         $431.39         $174.46
  67400  T                               Explore/biopsy eye socket......            0241           16.60         $804.89         $384.47         $160.98
  67405  T                               Explore/drain eye socket.......            0241           16.60         $804.89         $384.47         $160.98
  67412  T                               Explore/treat eye socket.......            0241           16.60         $804.89         $384.47         $160.98
  67413  T                               Explore/treat eye socket.......            0241           16.60         $804.89         $384.47         $160.98
  67414  T                               Explr/decompress eye socket....            0242           23.70       $1,149.14         $597.36         $229.83
  67415  T                               Aspiration, orbital contents...            0239            6.26         $303.53         $123.42          $60.71
  67420  T                               Explore/treat eye socket.......            0242           23.70       $1,149.14         $597.36         $229.83
  67430  T                               Explore/treat eye socket.......            0242           23.70       $1,149.14         $597.36         $229.83
  67440  T                               Explore/drain eye socket.......            0242           23.70       $1,149.14         $597.36         $229.83
  67445  T                               Explr/decompress eye socket....            0242           23.70       $1,149.14         $597.36         $229.83
  67450  T                               Explore/biopsy eye socket......            0242           23.70       $1,149.14         $597.36         $229.83
  67500  S                               Inject/treat eye socket........            0231            2.64         $128.01          $59.87          $25.60
  67505  T                               Inject/treat eye socket........            0238            2.80         $135.76          $58.96          $27.15
  67515  T                               Inject/treat eye socket........            0239            6.26         $303.53         $123.42          $60.71
  67550  T                               Insert eye socket implant......            0242           23.70       $1,149.14         $597.36         $229.83
  67560  T                               Revise eye socket implant......            0241           16.60         $804.89         $384.47         $160.98
  67570  T                               Decompress optic nerve.........            0242           23.70       $1,149.14         $597.36         $229.83
  67599  T                               Orbit surgery procedure........            0239            6.26         $303.53         $123.42          $60.71
  67700  T                               Drainage of eyelid abscess.....            0238            2.80         $135.76          $58.96          $27.15
  67710  T                               Incision of eyelid.............            0239            6.26         $303.53         $123.42          $60.71
  67715  T                               Incision of eyelid fold........            0240           13.47         $653.12         $315.31         $130.62
  67800  T                               Remove eyelid lesion...........            0238            2.80         $135.76          $58.96          $27.15
  67801  T                               Remove eyelid lesions..........            0239            6.26         $303.53         $123.42          $60.71
  67805  T                               Remove eyelid lesions..........            0238            2.80         $135.76          $58.96          $27.15
  67808  T                               Remove eyelid lesion(s)........            0240           13.47         $653.12         $315.31         $130.62
  67810  T                               Biopsy of eyelid...............            0238            2.80         $135.76          $58.96          $27.15
  67820  T                               Revise eyelashes...............            0238            2.80         $135.76          $58.96          $27.15
  67825  T                               Revise eyelashes...............            0238            2.80         $135.76          $58.96          $27.15

[[Page 18626]]

 
  67830  T                               Revise eyelashes...............            0239            6.26         $303.53         $123.42          $60.71
  67835  T                               Revise eyelashes...............            0240           13.47         $653.12         $315.31         $130.62
  67840  T                               Remove eyelid lesion...........            0239            6.26         $303.53         $123.42          $60.71
  67850  T                               Treat eyelid lesion............            0239            6.26         $303.53         $123.42          $60.71
  67875  T                               Closure of eyelid by suture....            0239            6.26         $303.53         $123.42          $60.71
  67880  T                               Revision of eyelid.............            0232            6.04         $292.86         $134.66          $58.57
  67882  T                               Revision of eyelid.............            0240           13.47         $653.12         $315.31         $130.62
  67900  T                               Repair brow defect.............            0240           13.47         $653.12         $315.31         $130.62
  67901  T                               Repair eyelid defect...........            0240           13.47         $653.12         $315.31         $130.62
  67902  T                               Repair eyelid defect...........            0240           13.47         $653.12         $315.31         $130.62
  67903  T                               Repair eyelid defect...........            0240           13.47         $653.12         $315.31         $130.62
  67904  T                               Repair eyelid defect...........            0240           13.47         $653.12         $315.31         $130.62
  67906  T                               Repair eyelid defect...........            0240           13.47         $653.12         $315.31         $130.62
  67908  T                               Repair eyelid defect...........            0240           13.47         $653.12         $315.31         $130.62
  67909  T                               Revise eyelid defect...........            0240           13.47         $653.12         $315.31         $130.62
  67911  T                               Revise eyelid defect...........            0240           13.47         $653.12         $315.31         $130.62
  67914  T                               Repair eyelid defect...........            0240           13.47         $653.12         $315.31         $130.62
  67915  T                               Repair eyelid defect...........            0239            6.26         $303.53         $123.42          $60.71
  67916  T                               Repair eyelid defect...........            0240           13.47         $653.12         $315.31         $130.62
  67917  T                               Repair eyelid defect...........            0240           13.47         $653.12         $315.31         $130.62
  67921  T                               Repair eyelid defect...........            0240           13.47         $653.12         $315.31         $130.62
  67922  T                               Repair eyelid defect...........            0239            6.26         $303.53         $123.42          $60.71
  67923  T                               Repair eyelid defect...........            0240           13.47         $653.12         $315.31         $130.62
  67924  T                               Repair eyelid defect...........            0240           13.47         $653.12         $315.31         $130.62
  67930  T                               Repair eyelid wound............            0240           13.47         $653.12         $315.31         $130.62
  67935  T                               Repair eyelid wound............            0240           13.47         $653.12         $315.31         $130.62
  67938  T                               Remove eyelid foreign body.....            0238            2.80         $135.76          $58.96          $27.15
  67950  T                               Revision of eyelid.............            0240           13.47         $653.12         $315.31         $130.62
  67961  T                               Revision of eyelid.............            0240           13.47         $653.12         $315.31         $130.62
  67966  T                               Revision of eyelid.............            0240           13.47         $653.12         $315.31         $130.62
  67971  T                               Reconstruction of eyelid.......            0241           16.60         $804.89         $384.47         $160.98
  67973  T                               Reconstruction of eyelid.......            0241           16.60         $804.89         $384.47         $160.98
  67974  T                               Reconstruction of eyelid.......            0241           16.60         $804.89         $384.47         $160.98
  67975  T                               Reconstruction of eyelid.......            0240           13.47         $653.12         $315.31         $130.62
  67999  T                               Revision of eyelid.............            0240           13.47         $653.12         $315.31         $130.62
  68020  T                               Incise/drain eyelid lining.....            0240           13.47         $653.12         $315.31         $130.62
  68040  T                               Treatment of eyelid lesions....            0239            6.26         $303.53         $123.42          $60.71
  68100  T                               Biopsy of eyelid lining........            0232            6.04         $292.86         $134.66          $58.57
  68110  S                               Remove eyelid lining lesion....            0231            2.64         $128.01          $59.87          $25.60
  68115  T                               Remove eyelid lining lesion....            0239            6.26         $303.53         $123.42          $60.71
  68130  T                               Remove eyelid lining lesion....            0233           13.79         $668.64         $331.60         $133.73
  68135  T                               Remove eyelid lining lesion....            0239            6.26         $303.53         $123.42          $60.71
  68200  S                               Treat eyelid by injection......            0230            0.98          $47.52          $22.48           $9.50
  68320  T                               Revise/graft eyelid lining.....            0240           13.47         $653.12         $315.31         $130.62
  68325  T                               Revise/graft eyelid lining.....            0242           23.70       $1,149.14         $597.36         $229.83
  68326  T                               Revise/graft eyelid lining.....            0241           16.60         $804.89         $384.47         $160.98
  68328  T                               Revise/graft eyelid lining.....            0241           16.60         $804.89         $384.47         $160.98
  68330  T                               Revise eyelid lining...........            0233           13.79         $668.64         $331.60         $133.73
  68335  T                               Revise/graft eyelid lining.....            0241           16.60         $804.89         $384.47         $160.98
  68340  T                               Separate eyelid adhesions......            0240           13.47         $653.12         $315.31         $130.62
  68360  T                               Revise eyelid lining...........            0234           20.64       $1,000.77         $502.16         $200.15
  68362  T                               Revise eyelid lining...........            0234           20.64       $1,000.77         $502.16         $200.15
  68399  T                               Eyelid lining surgery..........            0239            6.26         $303.53         $123.42          $60.71
  68400  T                               Incise/drain tear gland........            0238            2.80         $135.76          $58.96          $27.15
  68420  T                               Incise/drain tear sac..........            0240           13.47         $653.12         $315.31         $130.62
  68440  T                               Incise tear duct opening.......            0238            2.80         $135.76          $58.96          $27.15
  68500  T                               Removal of tear gland..........            0241           16.60         $804.89         $384.47         $160.98
  68505  T                               Partial removal, tear gland....            0241           16.60         $804.89         $384.47         $160.98
  68510  T                               Biopsy of tear gland...........            0240           13.47         $653.12         $315.31         $130.62
  68520  T                               Removal of tear sac............            0241           16.60         $804.89         $384.47         $160.98
  68525  T                               Biopsy of tear sac.............            0240           13.47         $653.12         $315.31         $130.62
  68530  T                               Clearance of tear duct.........            0240           13.47         $653.12         $315.31         $130.62
  68540  T                               Remove tear gland lesion.......            0241           16.60         $804.89         $384.47         $160.98
  68550  T                               Remove tear gland lesion.......            0242           23.70       $1,149.14         $597.36         $229.83
  68700  T                               Repair tear ducts..............            0241           16.60         $804.89         $384.47         $160.98
  68705  T                               Revise tear duct opening.......            0238            2.80         $135.76          $58.96          $27.15
  68720  T                               Create tear sac drain..........            0242           23.70       $1,149.14         $597.36         $229.83
  68745  T                               Create tear duct drain.........            0241           16.60         $804.89         $384.47         $160.98
  68750  T                               Create tear duct drain.........            0242           23.70       $1,149.14         $597.36         $229.83
  68760  T                               Close tear duct opening........            0238            2.80         $135.76          $58.96          $27.15
  68761  S                               Close tear duct opening........            0231            2.64         $128.01          $59.87          $25.60
  68770  T                               Close tear system fistula......            0240           13.47         $653.12         $315.31         $130.62
  68801  S                               Dilate tear duct opening.......            0231            2.64         $128.01          $59.87          $25.60

[[Page 18627]]

 
  68810  S                               Probe nasolacrimal duct........            0231            2.64         $128.01          $59.87          $25.60
  68811  T                               Probe nasolacrimal duct........            0240           13.47         $653.12         $315.31         $130.62
  68815  T                               Probe nasolacrimal duct........            0240           13.47         $653.12         $315.31         $130.62
  68840  S                               Explore/irrigate tear ducts....            0231            2.64         $128.01          $59.87          $25.60
  68850  N                               Injection for tear sac x-ray...  ..............  ..............  ..............  ..............  ..............
  68899  S                               Tear duct system surgery.......            0231            2.64         $128.01          $59.87          $25.60
  69000  T                               Drain external ear lesion......            0006            2.00          $96.97          $33.95          $19.39
  69005  T                               Drain external ear lesion......            0007            3.68         $178.43          $72.03          $35.69
  69020  T                               Drain outer ear canal lesion...            0006            2.00          $96.97          $33.95          $19.39
  69090  E                               Pierce earlobes................  ..............  ..............  ..............  ..............  ..............
  69100  T                               Biopsy of external ear.........            0019            4.00         $193.95          $78.91          $38.79
  69105  T                               Biopsy of external ear canal...            0253           12.02         $582.81         $284.00         $116.56
  69110  T                               Remove external ear, partial...            0020            6.51         $315.65         $130.53          $63.13
  69120  T                               Removal of external ear........            0253           12.02         $582.81         $284.00         $116.56
  69140  T                               Remove ear canal lesion(s).....            0254           12.45         $603.66         $272.41         $120.73
  69145  T                               Remove ear canal lesion(s).....            0020            6.51         $315.65         $130.53          $63.13
  69150  C                               Extensive ear canal surgery....  ..............  ..............  ..............  ..............  ..............
  69155  C                               Extensive ear/neck surgery.....  ..............  ..............  ..............  ..............  ..............
  69200  X                               Clear outer ear canal..........            0340            1.04          $50.43          $12.85          $10.09
  69205  T                               Clear outer ear canal..........            0022           12.49         $605.60         $292.94         $121.12
  69210  X                               Remove impacted ear wax........            0340            1.04          $50.43          $12.85          $10.09
  69220  T                               Clean out mastoid cavity.......            0012            0.53          $25.70           $9.18           $5.14
  69222  T                               Clean out mastoid cavity.......            0253           12.02         $582.81         $284.00         $116.56
  69300  T                               Revise external ear............            0254           12.45         $603.66         $272.41         $120.73
  69310  T                               Rebuild outer ear canal........            0256           25.40       $1,231.57         $623.05         $246.31
  69320  T                               Rebuild outer ear canal........            0256           25.40       $1,231.57         $623.05         $246.31
  69399  T                               Outer ear surgery procedure....            0252            5.18         $251.16         $114.24          $50.23
  69400  T                               Inflate middle ear canal.......            0251            1.68          $81.46          $27.99          $16.29
  69401  N                               Inflate middle ear canal.......  ..............  ..............  ..............  ..............  ..............
  69405  T                               Catheterize middle ear canal...            0252            5.18         $251.16         $114.24          $50.23
  69410  T                               Inset middle ear (baffle)......            0252            5.18         $251.16         $114.24          $50.23
  69420  T                               Incision of eardrum............            0252            5.18         $251.16         $114.24          $50.23
  69421  T                               Incision of eardrum............            0253           12.02         $582.81         $284.00         $116.56
  69424  T                               Remove ventilating tube........            0252            5.18         $251.16         $114.24          $50.23
  69433  T                               Create eardrum opening.........            0252            5.18         $251.16         $114.24          $50.23
  69436  T                               Create eardrum opening.........            0253           12.02         $582.81         $284.00         $116.56
  69440  T                               Exploration of middle ear......            0253           12.02         $582.81         $284.00         $116.56
  69450  T                               Eardrum revision...............            0256           25.40       $1,231.57         $623.05         $246.31
  69501  T                               Mastoidectomy..................            0256           25.40       $1,231.57         $623.05         $246.31
  69502  C                               Mastoidectomy..................  ..............  ..............  ..............  ..............  ..............
  69505  T                               Remove mastoid structures......            0256           25.40       $1,231.57         $623.05         $246.31
  69511  T                               Extensive mastoid surgery......            0256           25.40       $1,231.57         $623.05         $246.31
  69530  T                               Extensive mastoid surgery......            0256           25.40       $1,231.57         $623.05         $246.31
  69535  C                               Remove part of temporal bone...  ..............  ..............  ..............  ..............  ..............
  69540  T                               Remove ear lesion..............            0253           12.02         $582.81         $284.00         $116.56
  69550  T                               Remove ear lesion..............            0256           25.40       $1,231.57         $623.05         $246.31
  69552  T                               Remove ear lesion..............            0256           25.40       $1,231.57         $623.05         $246.31
  69554  C                               Remove ear lesion..............  ..............  ..............  ..............  ..............  ..............
  69601  T                               Mastoid surgery revision.......            0256           25.40       $1,231.57         $623.05         $246.31
  69602  T                               Mastoid surgery revision.......            0256           25.40       $1,231.57         $623.05         $246.31
  69603  T                               Mastoid surgery revision.......            0256           25.40       $1,231.57         $623.05         $246.31
  69604  T                               Mastoid surgery revision.......            0256           25.40       $1,231.57         $623.05         $246.31
  69605  T                               Mastoid surgery revision.......            0256           25.40       $1,231.57         $623.05         $246.31
  69610  T                               Repair of eardrum..............            0253           12.02         $582.81         $284.00         $116.56
  69620  T                               Repair of eardrum..............            0253           12.02         $582.81         $284.00         $116.56
  69631  T                               Repair eardrum structures......            0256           25.40       $1,231.57         $623.05         $246.31
  69632  T                               Rebuild eardrum structures.....            0256           25.40       $1,231.57         $623.05         $246.31
  69633  T                               Rebuild eardrum structures.....            0256           25.40       $1,231.57         $623.05         $246.31
  69635  T                               Repair eardrum structures......            0256           25.40       $1,231.57         $623.05         $246.31
  69636  T                               Rebuild eardrum structures.....            0256           25.40       $1,231.57         $623.05         $246.31
  69637  T                               Rebuild eardrum structures.....            0256           25.40       $1,231.57         $623.05         $246.31
  69641  T                               Revise middle ear & mastoid....            0256           25.40       $1,231.57         $623.05         $246.31
  69642  T                               Revise middle ear & mastoid....            0256           25.40       $1,231.57         $623.05         $246.31
  69643  T                               Revise middle ear & mastoid....            0256           25.40       $1,231.57         $623.05         $246.31
  69644  T                               Revise middle ear & mastoid....            0256           25.40       $1,231.57         $623.05         $246.31
  69645  T                               Revise middle ear & mastoid....            0256           25.40       $1,231.57         $623.05         $246.31
  69646  T                               Revise middle ear & mastoid....            0256           25.40       $1,231.57         $623.05         $246.31
  69650  T                               Release middle ear bone........            0254           12.45         $603.66         $272.41         $120.73
  69660  T                               Revise middle ear bone.........            0256           25.40       $1,231.57         $623.05         $246.31
  69661  T                               Revise middle ear bone.........            0256           25.40       $1,231.57         $623.05         $246.31
  69662  T                               Revise middle ear bone.........            0256           25.40       $1,231.57         $623.05         $246.31
  69666  T                               Repair middle ear structures...            0256           25.40       $1,231.57         $623.05         $246.31
  69667  T                               Repair middle ear structures...            0256           25.40       $1,231.57         $623.05         $246.31

[[Page 18628]]

 
  69670  T                               Remove mastoid air cells.......            0256           25.40       $1,231.57         $623.05         $246.31
  69676  T                               Remove middle ear nerve........            0256           25.40       $1,231.57         $623.05         $246.31
  69700  T                               Close mastoid fistula..........            0256           25.40       $1,231.57         $623.05         $246.31
  69710  E                               Implant/replace hearing aid....  ..............  ..............  ..............  ..............  ..............
  69711  T                               Remove/repair hearing aid......            0256           25.40       $1,231.57         $623.05         $246.31
  69720  T                               Release facial nerve...........            0256           25.40       $1,231.57         $623.05         $246.31
  69725  T                               Release facial nerve...........            0256           25.40       $1,231.57         $623.05         $246.31
  69740  T                               Repair facial nerve............            0256           25.40       $1,231.57         $623.05         $246.31
  69745  T                               Repair facial nerve............            0256           25.40       $1,231.57         $623.05         $246.31
  69799  T                               Middle ear surgery procedure...            0253           12.02         $582.81         $284.00         $116.56
  69801  T                               Incise inner ear...............            0256           25.40       $1,231.57         $623.05         $246.31
  69802  T                               Incise inner ear...............            0256           25.40       $1,231.57         $623.05         $246.31
  69805  T                               Explore inner ear..............            0256           25.40       $1,231.57         $623.05         $246.31
  69806  T                               Explore inner ear..............            0256           25.40       $1,231.57         $623.05         $246.31
  69820  T                               Establish inner ear window.....            0256           25.40       $1,231.57         $623.05         $246.31
  69840  T                               Revise inner ear window........            0256           25.40       $1,231.57         $623.05         $246.31
  69905  T                               Remove inner ear...............            0256           25.40       $1,231.57         $623.05         $246.31
  69910  T                               Remove inner ear & mastoid.....            0256           25.40       $1,231.57         $623.05         $246.31
  69915  T                               Incise inner ear nerve.........            0256           25.40       $1,231.57         $623.05         $246.31
  69930  T                               Implant cochlear device........            0257          115.31       $5,591.04       $3,498.58       $1,118.21
  69949  T                               Inner ear surgery procedure....            0253           12.02         $582.81         $284.00         $116.56
  69950  C                               Incise inner ear nerve.........  ..............  ..............  ..............  ..............  ..............
  69955  T                               Release facial nerve...........            0256           25.40       $1,231.57         $623.05         $246.31
  69960  T                               Release inner ear canal........            0256           25.40       $1,231.57         $623.05         $246.31
  69970  C                               Remove inner ear lesion........  ..............  ..............  ..............  ..............  ..............
  69979  T                               Temporal bone surgery..........            0252            5.18         $251.16         $114.24          $50.23
  69990  N                               Microsurgery add-on............  ..............  ..............  ..............  ..............  ..............
  70010  S                               Contrast x-ray of brain........            0274            4.83         $234.19         $128.12          $46.84
  70015  S                               Contrast x-ray of brain........            0274            4.83         $234.19         $128.12          $46.84
  70030  X                               X-ray eye for foreign body.....            0260            0.79          $38.30          $22.02           $7.66
  70100  X                               X-ray exam of jaw..............            0260            0.79          $38.30          $22.02           $7.66
  70110  X                               X-ray exam of jaw..............            0260            0.79          $38.30          $22.02           $7.66
  70120  X                               X-ray exam of mastoids.........            0260            0.79          $38.30          $22.02           $7.66
  70130  X                               X-ray exam of mastoids.........            0260            0.79          $38.30          $22.02           $7.66
  70134  X                               X-ray exam of middle ear.......            0261            1.38          $66.91          $38.77          $13.38
  70140  X                               X-ray exam of facial bones.....            0260            0.79          $38.30          $22.02           $7.66
  70150  X                               X-ray exam of facial bones.....            0260            0.79          $38.30          $22.02           $7.66
  70160  X                               X-ray exam of nasal bones......            0260            0.79          $38.30          $22.02           $7.66
  70170  X                               X-ray exam of tear duct........            0263            1.68          $81.46          $45.88          $16.29
  70190  X                               X-ray exam of eye sockets......            0260            0.79          $38.30          $22.02           $7.66
  70200  X                               X-ray exam of eye sockets......            0260            0.79          $38.30          $22.02           $7.66
  70210  X                               X-ray exam of sinuses..........            0260            0.79          $38.30          $22.02           $7.66
  70220  X                               X-ray exam of sinuses..........            0260            0.79          $38.30          $22.02           $7.66
  70240  X                               X-ray exam, pituitary saddle...            0260            0.79          $38.30          $22.02           $7.66
  70250  X                               X-ray exam of skull............            0260            0.79          $38.30          $22.02           $7.66
  70260  X                               X-ray exam of skull............            0261            1.38          $66.91          $38.77          $13.38
  70300  X                               X-ray exam of teeth............            0262            0.40          $19.39          $10.90           $3.88
  70310  X                               X-ray exam of teeth............            0262            0.40          $19.39          $10.90           $3.88
  70320  X                               Full mouth x-ray of teeth......            0262            0.40          $19.39          $10.90           $3.88
  70328  X                               X-ray exam of jaw joint........            0260            0.79          $38.30          $22.02           $7.66
  70330  X                               X-ray exam of jaw joints.......            0260            0.79          $38.30          $22.02           $7.66
  70332  S                               X-ray exam of jaw joint........            0275            2.74         $132.85          $72.26          $26.57
  70336  S                               Magnetic image, jaw joint......            0284            8.02         $388.87         $257.39          $77.77
  70350  X                               X-ray head for orthodontia.....            0260            0.79          $38.30          $22.02           $7.66
  70355  X                               Panoramic x-ray of jaws........            0260            0.79          $38.30          $22.02           $7.66
  70360  X                               X-ray exam of neck.............            0260            0.79          $38.30          $22.02           $7.66
  70370  X                               Throat x-ray & fluoroscopy.....            0273            2.49         $120.73          $61.02          $24.15
  70371  X                               Speech evaluation, complex.....            0272            1.40          $67.88          $39.00          $13.58
  70373  X                               Contrast x-ray of larynx.......            0263            1.68          $81.46          $45.88          $16.29
  70380  X                               X-ray exam of salivary gland...            0260            0.79          $38.30          $22.02           $7.66
  70390  X                               X-ray exam of salivary duct....            0263            1.68          $81.46          $45.88          $16.29
  70450  S                               CAT scan of head or brain......            0283            4.89         $237.10         $179.39          $47.42
  70460  S                               Contrast CAT scan of head......            0283            4.89         $237.10         $179.39          $47.42
  70470  S                               Contrast CAT scans of head.....            0283            4.89         $237.10         $179.39          $47.42
  70480  S                               CAT scan of skull..............            0283            4.89         $237.10         $179.39          $47.42
  70481  S                               Contrast CAT scan of skull.....            0283            4.89         $237.10         $179.39          $47.42
  70482  S                               Contrast CAT scans of skull....            0283            4.89         $237.10         $179.39          $47.42
  70486  S                               Cat scan of face/jaw...........            0282            2.38         $115.40          $94.51          $23.08
  70487  S                               Contrast CAT scan, face/jaw....            0283            4.89         $237.10         $179.39          $47.42
  70488  S                               Contrast cat scans, face/jaw...            0283            4.89         $237.10         $179.39          $47.42
  70490  S                               CAT scan of neck tissue........            0283            4.89         $237.10         $179.39          $47.42
  70491  S                               Contrast CAT of neck tissue....            0283            4.89         $237.10         $179.39          $47.42
  70492  S                               Contrast CAT of neck tissue....            0283            4.89         $237.10         $179.39          $47.42

[[Page 18629]]

 
  70540  S                               Magnetic image, face/neck......            0284            8.02         $388.87         $257.39          $77.77
  70541  S                               Magnetic image, head (MRA).....            0284            8.02         $388.87         $257.39          $77.77
  70551  S                               Magnetic image, brain (MRI)....            0284            8.02         $388.87         $257.39          $77.77
  70552  S                               Magnetic image, brain (MRI)....            0284            8.02         $388.87         $257.39          $77.77
  70553  S                               Magnetic image, brain (mri)....            0284            8.02         $388.87         $257.39          $77.77
  71010  X                               Chest x-ray....................            0260            0.79          $38.30          $22.02           $7.66
  71015  X                               Chest x-ray....................            0260            0.79          $38.30          $22.02           $7.66
  71020  X                               Chest x-ray....................            0260            0.79          $38.30          $22.02           $7.66
  71021  X                               Chest x-ray....................            0260            0.79          $38.30          $22.02           $7.66
  71022  X                               Chest x-ray....................            0260            0.79          $38.30          $22.02           $7.66
  71023  X                               Chest x-ray and fluoroscopy....            0272            1.40          $67.88          $39.00          $13.58
  71030  X                               Chest x-ray....................            0260            0.79          $38.30          $22.02           $7.66
  71034  X                               Chest x-ray and fluoroscopy....            0272            1.40          $67.88          $39.00          $13.58
  71035  X                               Chest x-ray....................            0260            0.79          $38.30          $22.02           $7.66
  71036  X                               X-ray guidance for biopsy......            0273            2.49         $120.73          $61.02          $24.15
  71040  X                               Contrast x-ray of bronchi......            0263            1.68          $81.46          $45.88          $16.29
  71060  X                               Contrast x-ray of bronchi......            0263            1.68          $81.46          $45.88          $16.29
  71090  X                               X-ray & pacemaker insertion....            0273            2.49         $120.73          $61.02          $24.15
  71100  X                               X-ray exam of ribs.............            0260            0.79          $38.30          $22.02           $7.66
  71101  X                               X-ray exam of ribs/chest.......            0260            0.79          $38.30          $22.02           $7.66
  71110  X                               X-ray exam of ribs.............            0260            0.79          $38.30          $22.02           $7.66
  71111  X                               X-ray exam of ribs/chest.......            0261            1.38          $66.91          $38.77          $13.38
  71120  X                               X-ray exam of breastbone.......            0260            0.79          $38.30          $22.02           $7.66
  71130  X                               X-ray exam of breastbone.......            0260            0.79          $38.30          $22.02           $7.66
  71250  S                               Cat scan of chest..............            0283            4.89         $237.10         $179.39          $47.42
  71260  S                               Contrast CAT scan of chest.....            0283            4.89         $237.10         $179.39          $47.42
  71270  S                               Contrast CAT scans of chest....            0283            4.89         $237.10         $179.39          $47.42
  71550  S                               Magnetic image, chest (mri)....            0284            8.02         $388.87         $257.39          $77.77
  71555  E                               Magnetic image, chest (mra)....  ..............  ..............  ..............  ..............  ..............
  72010  X                               X-ray exam of spine............            0261            1.38          $66.91          $38.77          $13.38
  72020  X                               X-ray exam of spine............            0260            0.79          $38.30          $22.02           $7.66
  72040  X                               X-ray exam of neck spine.......            0260            0.79          $38.30          $22.02           $7.66
  72050  X                               X-ray exam of neck spine.......            0261            1.38          $66.91          $38.77          $13.38
  72052  X                               X-ray exam of neck spine.......            0261            1.38          $66.91          $38.77          $13.38
  72069  X                               X-ray exam of trunk spine......            0260            0.79          $38.30          $22.02           $7.66
  72070  X                               X-ray exam of thoracic spine...            0260            0.79          $38.30          $22.02           $7.66
  72072  X                               X-ray exam of thoracic spine...            0260            0.79          $38.30          $22.02           $7.66
  72074  X                               X-ray exam of thoracic spine...            0260            0.79          $38.30          $22.02           $7.66
  72080  X                               X-ray exam of trunk spine......            0260            0.79          $38.30          $22.02           $7.66
  72090  X                               X-ray exam of trunk spine......            0260            0.79          $38.30          $22.02           $7.66
  72100  X                               X-ray exam of lower spine......            0260            0.79          $38.30          $22.02           $7.66
  72110  X                               X-ray exam of lower spine......            0261            1.38          $66.91          $38.77          $13.38
  72114  X                               X-ray exam of lower spine......            0261            1.38          $66.91          $38.77          $13.38
  72120  X                               X-ray exam of lower spine......            0260            0.79          $38.30          $22.02           $7.66
  72125  S                               CAT scan of neck spine.........            0283            4.89         $237.10         $179.39          $47.42
  72126  S                               Contrast CAT scan of neck......            0283            4.89         $237.10         $179.39          $47.42
  72127  S                               Contrast CAT scans of neck.....            0283            4.89         $237.10         $179.39          $47.42
  72128  S                               CAT scan of thorax spine.......            0283            4.89         $237.10         $179.39          $47.42
  72129  S                               Contrast CAT scan of thorax....            0283            4.89         $237.10         $179.39          $47.42
  72130  S                               Contrast CAT scans of thorax...            0283            4.89         $237.10         $179.39          $47.42
  72131  S                               CAT scan of lower spine........            0283            4.89         $237.10         $179.39          $47.42
  72132  S                               Contrast CAT of lower spine....            0283            4.89         $237.10         $179.39          $47.42
  72133  S                               Contrast cat scans, low spine..            0283            4.89         $237.10         $179.39          $47.42
  72141  S                               Magnetic image, neck spine.....            0284            8.02         $388.87         $257.39          $77.77
  72142  S                               Magnetic image, neck spine.....            0284            8.02         $388.87         $257.39          $77.77
  72146  S                               Magnetic image, chest spine....            0284            8.02         $388.87         $257.39          $77.77
  72147  S                               Magnetic image, chest spine....            0284            8.02         $388.87         $257.39          $77.77
  72148  S                               Magnetic image, lumbar spine...            0284            8.02         $388.87         $257.39          $77.77
  72149  S                               Magnetic image, lumbar spine...            0284            8.02         $388.87         $257.39          $77.77
  72156  S                               Magnetic image, neck spine.....            0284            8.02         $388.87         $257.39          $77.77
  72157  S                               Magnetic image, chest spine....            0284            8.02         $388.87         $257.39          $77.77
  72158  S                               Magnetic image, lumbar spine...            0284            8.02         $388.87         $257.39          $77.77
  72159  E                               Magnetic image, spine (mra)....  ..............  ..............  ..............  ..............  ..............
  72170  X                               X-ray exam of pelvis...........            0260            0.79          $38.30          $22.02           $7.66
  72190  X                               X-ray exam of pelvis...........            0260            0.79          $38.30          $22.02           $7.66
  72192  S                               CAT scan of pelvis.............            0283            4.89         $237.10         $179.39          $47.42
  72193  S                               Contrast CAT scan of pelvis....            0283            4.89         $237.10         $179.39          $47.42
  72194  S                               Contrast CAT scans of pelvis...            0283            4.89         $237.10         $179.39          $47.42
  72196  S                               Magnetic image, pelvis.........            0284            8.02         $388.87         $257.39          $77.77
  72198  E                               Magnetic image, pelvis (mra)...  ..............  ..............  ..............  ..............  ..............
  72200  X                               X-ray exam sacroiliac joints...            0260            0.79          $38.30          $22.02           $7.66
  72202  X                               X-ray exam sacroiliac joints...            0260            0.79          $38.30          $22.02           $7.66
  72220  X                               X-ray exam of tailbone.........            0260            0.79          $38.30          $22.02           $7.66

[[Page 18630]]

 
  72240  S                               Contrast x-ray of neck spine...            0274            4.83         $234.19         $128.12          $46.84
  72255  S                               Contrast x-ray, thorax spine...            0274            4.83         $234.19         $128.12          $46.84
  72265  S                               Contrast x-ray, lower spine....            0274            4.83         $234.19         $128.12          $46.84
  72270  S                               Contrast x-ray of spine........            0274            4.83         $234.19         $128.12          $46.84
  72275  S                               Epidurography..................            0274            4.83         $234.19         $128.12          $46.84
  72285  S                               X-ray c/t spine disk...........            0274            4.83         $234.19         $128.12          $46.84
  72295  S                               X-ray of lower spine disk......            0274            4.83         $234.19         $128.12          $46.84
  73000  X                               X-ray exam of collar bone......            0260            0.79          $38.30          $22.02           $7.66
  73010  X                               X-ray exam of shoulder blade...            0260            0.79          $38.30          $22.02           $7.66
  73020  X                               X-ray exam of shoulder.........            0260            0.79          $38.30          $22.02           $7.66
  73030  X                               X-ray exam of shoulder.........            0260            0.79          $38.30          $22.02           $7.66
  73040  S                               Contrast x-ray of shoulder.....            0275            2.74         $132.85          $72.26          $26.57
  73050  X                               X-ray exam of shoulders........            0260            0.79          $38.30          $22.02           $7.66
  73060  X                               X-ray exam of humerus..........            0260            0.79          $38.30          $22.02           $7.66
  73070  X                               X-ray exam of elbow............            0260            0.79          $38.30          $22.02           $7.66
  73080  X                               X-ray exam of elbow............            0260            0.79          $38.30          $22.02           $7.66
  73085  S                               Contrast x-ray of elbow........            0275            2.74         $132.85          $72.26          $26.57
  73090  X                               X-ray exam of forearm..........            0260            0.79          $38.30          $22.02           $7.66
  73092  X                               X-ray exam of arm, infant......            0260            0.79          $38.30          $22.02           $7.66
  73100  X                               X-ray exam of wrist............            0260            0.79          $38.30          $22.02           $7.66
  73110  X                               X-ray exam of wrist............            0260            0.79          $38.30          $22.02           $7.66
  73115  S                               Contrast x-ray of wrist........            0275            2.74         $132.85          $72.26          $26.57
  73120  X                               X-ray exam of hand.............            0260            0.79          $38.30          $22.02           $7.66
  73130  X                               X-ray exam of hand.............            0260            0.79          $38.30          $22.02           $7.66
  73140  X                               X-ray exam of finger(s)........            0260            0.79          $38.30          $22.02           $7.66
  73200  S                               CAT scan of arm................            0283            4.89         $237.10         $179.39          $47.42
  73201  S                               Contrast CAT scan of arm.......            0283            4.89         $237.10         $179.39          $47.42
  73202  S                               Contrast CAT scans of arm......            0283            4.89         $237.10         $179.39          $47.42
  73220  S                               Magnetic image, arm/hand.......            0284            8.02         $388.87         $257.39          $77.77
  73221  S                               Magnetic image, joint of arm...            0284            8.02         $388.87         $257.39          $77.77
  73225  E                               Magnetic image, upper (mra)....  ..............  ..............  ..............  ..............  ..............
  73500  X                               X-ray exam of hip..............            0260            0.79          $38.30          $22.02           $7.66
  73510  X                               X-ray exam of hip..............            0260            0.79          $38.30          $22.02           $7.66
  73520  X                               X-ray exam of hips.............            0260            0.79          $38.30          $22.02           $7.66
  73525  S                               Contrast x-ray of hip..........            0275            2.74         $132.85          $72.26          $26.57
  73530  X                               X-ray exam of hip..............            0261            1.38          $66.91          $38.77          $13.38
  73540  X                               X-ray exam of pelvis & hips....            0260            0.79          $38.30          $22.02           $7.66
  73542  S                               X-ray exam, sacroiliac joint...            0275            2.74         $132.85          $72.26          $26.57
  73550  X                               X-ray exam of thigh............            0260            0.79          $38.30          $22.02           $7.66
  73560  X                               X-ray exam of knee, 1 or 2.....            0260            0.79          $38.30          $22.02           $7.66
  73562  X                               X-ray exam of knee, 3..........            0260            0.79          $38.30          $22.02           $7.66
  73564  X                               X-ray exam, knee, 4 or more....            0260            0.79          $38.30          $22.02           $7.66
  73565  X                               X-ray exam of knees............            0260            0.79          $38.30          $22.02           $7.66
  73580  S                               Contrast x-ray of knee joint...            0275            2.74         $132.85          $72.26          $26.57
  73590  X                               X-ray exam of lower leg........            0260            0.79          $38.30          $22.02           $7.66
  73592  X                               X-ray exam of leg, infant......            0261            1.38          $66.91          $38.77          $13.38
  73600  X                               X-ray exam of ankle............            0260            0.79          $38.30          $22.02           $7.66
  73610  X                               X-ray exam of ankle............            0260            0.79          $38.30          $22.02           $7.66
  73615  S                               Contrast x-ray of ankle........            0275            2.74         $132.85          $72.26          $26.57
  73620  X                               X-ray exam of foot.............            0260            0.79          $38.30          $22.02           $7.66
  73630  X                               X-ray exam of foot.............            0260            0.79          $38.30          $22.02           $7.66
  73650  X                               X-ray exam of heel.............            0260            0.79          $38.30          $22.02           $7.66
  73660  X                               X-ray exam of toe(s)...........            0260            0.79          $38.30          $22.02           $7.66
  73700  S                               CAT scan of leg................            0283            4.89         $237.10         $179.39          $47.42
  73701  S                               Contrast CAT scan of leg.......            0283            4.89         $237.10         $179.39          $47.42
  73702  S                               Contrast CAT scans of leg......            0283            4.89         $237.10         $179.39          $47.42
  73720  S                               Magnetic image, leg/foot.......            0284            8.02         $388.87         $257.39          $77.77
  73721  S                               Magnetic image, joint of leg...            0284            8.02         $388.87         $257.39          $77.77
  73725  E                               Magnetic image/lower (mra).....  ..............  ..............  ..............  ..............  ..............
  74000  X                               X-ray exam of abdomen..........            0260            0.79          $38.30          $22.02           $7.66
  74010  X                               X-ray exam of abdomen..........            0260            0.79          $38.30          $22.02           $7.66
  74020  X                               X-ray exam of abdomen..........            0260            0.79          $38.30          $22.02           $7.66
  74022  X                               X-ray exam series, abdomen.....            0261            1.38          $66.91          $38.77          $13.38
  74150  S                               CAT scan of abdomen............            0283            4.89         $237.10         $179.39          $47.42
  74160  S                               Contrast CAT scan of abdomen...            0283            4.89         $237.10         $179.39          $47.42
  74170  S                               Contrast CAT scans, abdomen....            0283            4.89         $237.10         $179.39          $47.42
  74181  S                               Magnetic image/abdomen (mri)...            0284            8.02         $388.87         $257.39          $77.77
  74185  E                               Magnetic image/abdomen (MRA)...  ..............  ..............  ..............  ..............  ..............
  74190  X                               X-ray exam of peritoneum.......            0263            1.68          $81.46          $45.88          $16.29
  74210  S                               Contrast x-ray exam of throat..            0276            1.79          $86.79          $49.78          $17.36
  74220  S                               Contrast x-ray, esophagus......            0276            1.79          $86.79          $49.78          $17.36
  74230  S                               Cinema x-ray, throat/esoph.....            0276            1.79          $86.79          $49.78          $17.36
  74235  S                               Remove esophagus obstruction...            0296            3.57         $173.10         $100.25          $34.62

[[Page 18631]]

 
  74240  S                               X-ray exam, upper gi tract.....            0276            1.79          $86.79          $49.78          $17.36
  74241  S                               X-ray exam, upper gi tract.....            0276            1.79          $86.79          $49.78          $17.36
  74245  S                               X-ray exam, upper gi tract.....            0277            2.47         $119.76          $69.28          $23.95
  74246  S                               Contrast x-ray uppr gi tract...            0276            1.79          $86.79          $49.78          $17.36
  74247  S                               Contrast x-ray uppr gi tract...            0276            1.79          $86.79          $49.78          $17.36
  74249  S                               Contrast x-ray uppr gi tract...            0277            2.47         $119.76          $69.28          $23.95
  74250  S                               X-ray exam of small bowel......            0276            1.79          $86.79          $49.78          $17.36
  74251  S                               X-ray exam of small bowel......            0277            2.47         $119.76          $69.28          $23.95
  74260  S                               X-ray exam of small bowel......            0277            2.47         $119.76          $69.28          $23.95
  74270  S                               Contrast x-ray exam of colon...            0276            1.79          $86.79          $49.78          $17.36
  74280  S                               Contrast x-ray exam of colon...            0277            2.47         $119.76          $69.28          $23.95
  74283  S                               Contrast x-ray exam of colon...            0276            1.79          $86.79          $49.78          $17.36
  74290  S                               Contrast x-ray, gallbladder....            0276            1.79          $86.79          $49.78          $17.36
  74291  S                               Contrast x-rays, gallbladder...            0276            1.79          $86.79          $49.78          $17.36
  74300  C                               X-ray bile ducts/pancreas......  ..............  ..............  ..............  ..............  ..............
  74301  C                               X-rays at surgery add-on.......  ..............  ..............  ..............  ..............  ..............
  74305  X                               X-ray bile ducts/pancreas......            0263            1.68          $81.46          $45.88          $16.29
  74320  X                               Contrast x-ray of bile ducts...            0264            3.83         $185.71         $108.97          $37.14
  74327  S                               X-ray bile stone removal.......            0296            3.57         $173.10         $100.25          $34.62
  74328  X                               X-ray bile duct endoscopy......            0264            3.83         $185.71         $108.97          $37.14
  74329  X                               X-ray for pancreas endoscopy...            0264            3.83         $185.71         $108.97          $37.14
  74330  X                               X-ray bile/panc endoscopy......            0264            3.83         $185.71         $108.97          $37.14
  74340  X                               X-ray guide for GI tube........            0272            1.40          $67.88          $39.00          $13.58
  74350  X                               X-ray guide, stomach tube......            0264            3.83         $185.71         $108.97          $37.14
  74355  X                               X-ray guide, intestinal tube...            0264            3.83         $185.71         $108.97          $37.14
  74360  S                               X-ray guide, GI dilation.......            0296            3.57         $173.10         $100.25          $34.62
  74363  S                               X-ray, bile duct dilation......            0297            6.13         $297.23         $172.51          $59.45
  74400  S                               Contrast x-ray, urinary tract..            0278            2.85         $138.19          $81.67          $27.64
  74410  S                               Contrast x-ray, urinary tract..            0278            2.85         $138.19          $81.67          $27.64
  74415  S                               Contrast x-ray, urinary tract..            0278            2.85         $138.19          $81.67          $27.64
  74420  S                               Contrast x-ray, urinary tract..            0278            2.85         $138.19          $81.67          $27.64
  74425  S                               Contrast x-ray, urinary tract..            0278            2.85         $138.19          $81.67          $27.64
  74430  S                               Contrast x-ray, bladder........            0278            2.85         $138.19          $81.67          $27.64
  74440  S                               X-ray, male genital tract......            0278            2.85         $138.19          $81.67          $27.64
  74445  S                               X-ray exam of penis............            0278            2.85         $138.19          $81.67          $27.64
  74450  S                               X-ray, urethra/bladder.........            0278            2.85         $138.19          $81.67          $27.64
  74455  S                               X-ray, urethra/bladder.........            0278            2.85         $138.19          $81.67          $27.64
  74470  X                               X-ray exam of kidney lesion....            0264            3.83         $185.71         $108.97          $37.14
  74475  S                               X-ray control, cath insert.....            0297            6.13         $297.23         $172.51          $59.45
  74480  S                               X-ray control, cath insert.....            0297            6.13         $297.23         $172.51          $59.45
  74485  S                               X-ray guide, GU dilation.......            0296            3.57         $173.10         $100.25          $34.62
  74710  X                               X-ray measurement of pelvis....            0260            0.79          $38.30          $22.02           $7.66
  74740  X                               X-ray, female genital tract....            0264            3.83         $185.71         $108.97          $37.14
  74742  X                               X-ray, fallopian tube..........            0264            3.83         $185.71         $108.97          $37.14
  74775  S                               X-ray exam of perineum.........            0278            2.85         $138.19          $81.67          $27.64
  75552  S                               Magnetic image, myocardium.....            0284            8.02         $388.87         $257.39          $77.77
  75553  S                               Magnetic image, myocardium.....            0284            8.02         $388.87         $257.39          $77.77
  75554  S                               Cardiac MRI/function...........            0284            8.02         $388.87         $257.39          $77.77
  75555  S                               Cardiac MRI/limited study......            0284            8.02         $388.87         $257.39          $77.77
  75556  E                               Cardiac MRI/flow mapping.......  ..............  ..............  ..............  ..............  ..............
  75600  S                               Contrast x-ray exam of aorta...            0280           14.98         $726.34         $380.12         $145.27
  75605  S                               Contrast x-ray exam of aorta...            0280           14.98         $726.34         $380.12         $145.27
  75625  S                               Contrast x-ray exam of aorta...            0280           14.98         $726.34         $380.12         $145.27
  75630  S                               X-ray aorta, leg arteries......            0280           14.98         $726.34         $380.12         $145.27
  75650  S                               Artery x-rays, head & neck.....            0280           14.98         $726.34         $380.12         $145.27
  75658  S                               Artery x-rays, arm.............            0280           14.98         $726.34         $380.12         $145.27
  75660  S                               Artery x-rays, head & neck.....            0279            6.30         $305.47         $174.57          $61.09
  75662  S                               Artery x-rays, head & neck.....            0279            6.30         $305.47         $174.57          $61.09
  75665  S                               Artery x-rays, head & neck.....            0280           14.98         $726.34         $380.12         $145.27
  75671  S                               Artery x-rays, head & neck.....            0280           14.98         $726.34         $380.12         $145.27
  75676  S                               Artery x-rays, neck............            0280           14.98         $726.34         $380.12         $145.27
  75680  S                               Artery x-rays, neck............            0280           14.98         $726.34         $380.12         $145.27
  75685  S                               Artery x-rays, spine...........            0279            6.30         $305.47         $174.57          $61.09
  75705  S                               Artery x-rays, spine...........            0279            6.30         $305.47         $174.57          $61.09
  75710  S                               Artery x-rays, arm/leg.........            0280           14.98         $726.34         $380.12         $145.27
  75716  S                               Artery x-rays, arms/legs.......            0280           14.98         $726.34         $380.12         $145.27
  75722  S                               Artery x-rays, kidney..........            0280           14.98         $726.34         $380.12         $145.27
  75724  S                               Artery x-rays, kidneys.........            0280           14.98         $726.34         $380.12         $145.27
  75726  S                               Artery x-rays, abdomen.........            0280           14.98         $726.34         $380.12         $145.27
  75731  S                               Artery x-rays, adrenal gland...            0280           14.98         $726.34         $380.12         $145.27
  75733  S                               Artery x-rays, adrenals........            0280           14.98         $726.34         $380.12         $145.27
  75736  S                               Artery x-rays, pelvis..........            0280           14.98         $726.34         $380.12         $145.27
  75741  S                               Artery x-rays, lung............            0279            6.30         $305.47         $174.57          $61.09

[[Page 18632]]

 
  75743  S                               Artery x-rays, lungs...........            0280           14.98         $726.34         $380.12         $145.27
  75746  S                               Artery x-rays, lung............            0279            6.30         $305.47         $174.57          $61.09
  75756  S                               Artery x-rays, chest...........            0279            6.30         $305.47         $174.57          $61.09
  75774  S                               Artery x-ray, each vessel......            0280           14.98         $726.34         $380.12         $145.27
  75790  S                               Visualize A-V shunt............            0281            4.40         $213.34         $115.16          $42.67
  75801  X                               Lymph vessel x-ray, arm/leg....            0264            3.83         $185.71         $108.97          $37.14
  75803  X                               Lymph vessel x-ray, arms/legs..            0264            3.83         $185.71         $108.97          $37.14
  75805  X                               Lymph vessel x-ray, trunk......            0264            3.83         $185.71         $108.97          $37.14
  75807  X                               Lymph vessel x-ray, trunk......            0264            3.83         $185.71         $108.97          $37.14
  75809  X                               Nonvascular shunt, x-ray.......            0264            3.83         $185.71         $108.97          $37.14
  75810  S                               Vein x-ray, spleen/liver.......            0279            6.30         $305.47         $174.57          $61.09
  75820  S                               Vein x-ray, arm/leg............            0281            4.40         $213.34         $115.16          $42.67
  75822  S                               Vein x-ray, arms/legs..........            0281            4.40         $213.34         $115.16          $42.67
  75825  S                               Vein x-ray, trunk..............            0279            6.30         $305.47         $174.57          $61.09
  75827  S                               Vein x-ray, chest..............            0279            6.30         $305.47         $174.57          $61.09
  75831  S                               Vein x-ray, kidney.............            0279            6.30         $305.47         $174.57          $61.09
  75833  S                               Vein x-ray, kidneys............            0279            6.30         $305.47         $174.57          $61.09
  75840  S                               Vein x-ray, adrenal gland......            0279            6.30         $305.47         $174.57          $61.09
  75842  S                               Vein x-ray, adrenal glands.....            0279            6.30         $305.47         $174.57          $61.09
  75860  S                               Vein x-ray, neck...............            0279            6.30         $305.47         $174.57          $61.09
  75870  S                               Vein x-ray, skull..............            0279            6.30         $305.47         $174.57          $61.09
  75872  S                               Vein x-ray, skull..............            0279            6.30         $305.47         $174.57          $61.09
  75880  S                               Vein x-ray, eye socket.........            0279            6.30         $305.47         $174.57          $61.09
  75885  S                               Vein x-ray, liver..............            0279            6.30         $305.47         $174.57          $61.09
  75887  S                               Vein x-ray, liver..............            0280           14.98         $726.34         $380.12         $145.27
  75889  S                               Vein x-ray, liver..............            0279            6.30         $305.47         $174.57          $61.09
  75891  S                               Vein x-ray, liver..............            0279            6.30         $305.47         $174.57          $61.09
  75893  N                               Venous sampling by catheter....  ..............  ..............  ..............  ..............  ..............
  75894  S                               X-rays, transcath therapy......            0297            6.13         $297.23         $172.51          $59.45
  75896  S                               X-rays, transcath therapy......            0297            6.13         $297.23         $172.51          $59.45
  75898  X                               Follow-up angiogram............            0264            3.83         $185.71         $108.97          $37.14
  75900  C                               Arterial catheter exchange.....  ..............  ..............  ..............  ..............  ..............
  75940  C                               X-ray placement, vein filter...  ..............  ..............  ..............  ..............  ..............
  75945  C                               Intravascular us...............  ..............  ..............  ..............  ..............  ..............
  75946  C                               Intravascular us add-on........  ..............  ..............  ..............  ..............  ..............
  75960  C                               Transcatheter intro, stent.....  ..............  ..............  ..............  ..............  ..............
  75961  C                               Retrieval, broken catheter.....  ..............  ..............  ..............  ..............  ..............
  75962  C                               Repair arterial blockage.......  ..............  ..............  ..............  ..............  ..............
  75964  C                               Repair artery blockage, each...  ..............  ..............  ..............  ..............  ..............
  75966  C                               Repair arterial blockage.......  ..............  ..............  ..............  ..............  ..............
  75968  C                               Repair artery blockage, each...  ..............  ..............  ..............  ..............  ..............
  75970  C                               Vascular biopsy................  ..............  ..............  ..............  ..............  ..............
  75978  C                               Repair venous blockage.........  ..............  ..............  ..............  ..............  ..............
  75980  S                               Contrast x-ray exam bile duct..            0297            6.13         $297.23         $172.51          $59.45
  75982  S                               Contrast x-ray exam bile duct..            0297            6.13         $297.23         $172.51          $59.45
  75984  S                               X-ray control catheter change..            0296            3.57         $173.10         $100.25          $34.62
  75989  X                               Abscess drainage under x-ray...            0273            2.49         $120.73          $61.02          $24.15
  75992  C                               Atherectomy, x-ray exam........  ..............  ..............  ..............  ..............  ..............
  75993  C                               Atherectomy, x-ray exam........  ..............  ..............  ..............  ..............  ..............
  75994  C                               Atherectomy, x-ray exam........  ..............  ..............  ..............  ..............  ..............
  75995  C                               Atherectomy, x-ray exam........  ..............  ..............  ..............  ..............  ..............
  75996  C                               Atherectomy, x-ray exam........  ..............  ..............  ..............  ..............  ..............
  76000  X                               Fluoroscope examination........            0272            1.40          $67.88          $39.00          $13.58
  76001  X                               Fluoroscope exam, extensive....            0273            2.49         $120.73          $61.02          $24.15
  76003  X                               Needle localization by x-ray...            0272            1.40          $67.88          $39.00          $13.58
  76005  X                               Fluoroguide for spine inject...            0273            2.49         $120.73          $61.02          $24.15
  76006  X                               X-ray stress view..............            0261            1.38          $66.91          $38.77          $13.38
  76010  X                               X-ray, nose to rectum..........            0260            0.79          $38.30          $22.02           $7.66
  76020  X                               X-rays for bone age............            0261            1.38          $66.91          $38.77          $13.38
  76040  X                               X-rays, bone evaluation........            0260            0.79          $38.30          $22.02           $7.66
  76061  X                               X-rays, bone survey............            0261            1.38          $66.91          $38.77          $13.38
  76062  X                               X-rays, bone survey............            0261            1.38          $66.91          $38.77          $13.38
  76065  X                               X-rays, bone evaluation........            0261            1.38          $66.91          $38.77          $13.38
  76066  X                               Joint(s) survey, single film...            0260            0.79          $38.30          $22.02           $7.66
  76070  E                               CT scan, bone density study....  ..............  ..............  ..............  ..............  ..............
  76075  X                               Dual energy x-ray study........            0261            1.38          $66.91          $38.77          $13.38
  76076  X                               Dual energy x-ray study........            0261            1.38          $66.91          $38.77          $13.38
  76078  X                               Photodensitometry..............            0261            1.38          $66.91          $38.77          $13.38
  76080  X                               X-ray exam of fistula..........            0263            1.68          $81.46          $45.88          $16.29
  76086  X                               X-ray of mammary duct..........            0263            1.68          $81.46          $45.88          $16.29
  76088  X                               X-ray of mammary ducts.........            0263            1.68          $81.46          $45.88          $16.29
  76090  S                               Mammogram, one breast..........            0271            0.70          $33.94          $19.50           $6.79
  76091  S                               Mammogram, both breasts........            0271            0.70          $33.94          $19.50           $6.79

[[Page 18633]]

 
  76092  A                               Mammogram, screening...........  ..............  ..............  ..............  ..............  ..............
  76093  S                               Magnetic image, breast.........            0284            8.02         $388.87         $257.39          $77.77
  76094  S                               Magnetic image, both breasts...            0284            8.02         $388.87         $257.39          $77.77
  76095  X                               Stereotactic breast biopsy.....            0264            3.83         $185.71         $108.97          $37.14
  76096  X                               X-ray of needle wire, breast...            0263            1.68          $81.46          $45.88          $16.29
  76098  X                               X-ray exam, breast specimen....            0260            0.79          $38.30          $22.02           $7.66
  76100  X                               X-ray exam of body section.....            0261            1.38          $66.91          $38.77          $13.38
  76101  X                               Complex body section x-ray.....            0263            1.68          $81.46          $45.88          $16.29
  76102  X                               Complex body section x-rays....            0264            3.83         $185.71         $108.97          $37.14
  76120  X                               Cinematic x-rays...............            0261            1.38          $66.91          $38.77          $13.38
  76125  X                               Cinematic x-rays add-on........            0261            1.38          $66.91          $38.77          $13.38
  76140  E                               X-ray consultation.............  ..............  ..............  ..............  ..............  ..............
  76150  X                               X-ray exam, dry process........            0260            0.79          $38.30          $22.02           $7.66
  76350  N                               Special x-ray contrast study...  ..............  ..............  ..............  ..............  ..............
  76355  S                               CAT scan for localization......            0283            4.89         $237.10         $179.39          $47.42
  76360  S                               CAT scan for needle biopsy.....            0283            4.89         $237.10         $179.39          $47.42
  76365  S                               CAT scan for cyst aspiration...            0283            4.89         $237.10         $179.39          $47.42
  76370  S                               CAT scan for therapy guide.....            0282            2.38         $115.40          $94.51          $23.08
  76375  S                               3D/holograph reconstr add-on...            0282            2.38         $115.40          $94.51          $23.08
  76380  S                               CAT scan follow-up study.......            0282            2.38         $115.40          $94.51          $23.08
  76390  S                               Mr spectroscopy................            0284            8.02         $388.87         $257.39          $77.77
  76400  S                               Magnetic image, bone marrow....            0284            8.02         $388.87         $257.39          $77.77
  76499  X                               Radiographic procedure.........            0260            0.79          $38.30          $22.02           $7.66
  76506  S                               Echo exam of head..............            0266            1.79          $86.79          $57.35          $17.36
  76511  S                               Echo exam of eye...............            0266            1.79          $86.79          $57.35          $17.36
  76512  S                               Echo exam of eye...............            0266            1.79          $86.79          $57.35          $17.36
  76513  S                               Echo exam of eye, water bath...            0265            1.17          $56.73          $38.08          $11.35
  76516  S                               Echo exam of eye...............            0266            1.79          $86.79          $57.35          $17.36
  76519  S                               Echo exam of eye...............            0266            1.79          $86.79          $57.35          $17.36
  76529  S                               Echo exam of eye...............            0265            1.17          $56.73          $38.08          $11.35
  76536  S                               Echo exam of head and neck.....            0265            1.17          $56.73          $38.08          $11.35
  76604  S                               Echo exam of chest.............            0266            1.79          $86.79          $57.35          $17.36
  76645  S                               Echo exam of breast(s).........            0265            1.17          $56.73          $38.08          $11.35
  76700  S                               Echo exam of abdomen...........            0266            1.79          $86.79          $57.35          $17.36
  76705  S                               Echo exam of abdomen...........            0266            1.79          $86.79          $57.35          $17.36
  76770  S                               Echo exam abdomen back wall....            0266            1.79          $86.79          $57.35          $17.36
  76775  S                               Echo exam abdomen back wall....            0266            1.79          $86.79          $57.35          $17.36
  76778  S                               Echo exam kidney transplant....            0266            1.79          $86.79          $57.35          $17.36
  76800  S                               Echo exam spinal canal.........            0266            1.79          $86.79          $57.35          $17.36
  76805  S                               Echo exam of pregnant uterus...            0266            1.79          $86.79          $57.35          $17.36
  76810  S                               Echo exam of pregnant uterus...            0265            1.17          $56.73          $38.08          $11.35
  76815  S                               Echo exam of pregnant uterus...            0265            1.17          $56.73          $38.08          $11.35
  76816  S                               Echo exam follow-up/repeat.....            0265            1.17          $56.73          $38.08          $11.35
  76818  S                               Fetal biophysical profile......            0266            1.79          $86.79          $57.35          $17.36
  76825  S                               Echo exam of fetal heart.......            0269            4.40         $213.34         $114.01          $42.67
  76826  S                               Echo exam of fetal heart.......            0269            4.40         $213.34         $114.01          $42.67
  76827  S                               Echo exam of fetal heart.......            0269            4.40         $213.34         $114.01          $42.67
  76828  S                               Echo exam of fetal heart.......            0269            4.40         $213.34         $114.01          $42.67
  76830  S                               Echo exam, transvaginal........            0266            1.79          $86.79          $57.35          $17.36
  76831  S                               Echo exam, uterus..............            0266            1.79          $86.79          $57.35          $17.36
  76856  S                               Echo exam of pelvis............            0266            1.79          $86.79          $57.35          $17.36
  76857  S                               Echo exam of pelvis............            0265            1.17          $56.73          $38.08          $11.35
  76870  S                               Echo exam of scrotum...........            0266            1.79          $86.79          $57.35          $17.36
  76872  S                               Echo exam, transrectal.........            0266            1.79          $86.79          $57.35          $17.36
  76873  S                               Echograp trans r, pros study...            0266            1.79          $86.79          $57.35          $17.36
  76880  S                               Echo exam of extremity.........            0266            1.79          $86.79          $57.35          $17.36
  76885  S                               Echo exam, infant hips.........            0266            1.79          $86.79          $57.35          $17.36
  76886  S                               Echo exam, infant hips.........            0266            1.79          $86.79          $57.35          $17.36
  76930  X                               Echo guide for heart sac tap...            0268            2.23         $108.13          $69.51          $21.63
  76932  X                               Echo guide for heart biopsy....            0268            2.23         $108.13          $69.51          $21.63
  76934  X                               Echo guide for chest tap.......            0268            2.23         $108.13          $69.51          $21.63
  76936  X                               Echo guide for artery repair...            0268            2.23         $108.13          $69.51          $21.63
  76938  X                               Echo exam for drainage.........            0268            2.23         $108.13          $69.51          $21.63
  76941  X                               Echo guide for transfusion.....            0268            2.23         $108.13          $69.51          $21.63
  76942  X                               Echo guide for biopsy..........            0268            2.23         $108.13          $69.51          $21.63
  76945  X                               Echo guide, villus sampling....            0268            2.23         $108.13          $69.51          $21.63
  76946  X                               Echo guide for amniocentesis...            0268            2.23         $108.13          $69.51          $21.63
  76948  X                               Echo guide, ova aspiration.....            0268            2.23         $108.13          $69.51          $21.63
  76950  X                               Echo guidance radiotherapy.....            0268            2.23         $108.13          $69.51          $21.63
  76960  X                               Echo guidance radiotherapy.....            0268            2.23         $108.13          $69.51          $21.63
  76965  X                               Echo guidance radiotherapy.....            0268            2.23         $108.13          $69.51          $21.63
  76970  S                               Ultrasound exam follow-up......            0265            1.17          $56.73          $38.08          $11.35
  76975  S                               GI endoscopic ultrasound.......            0266            1.79          $86.79          $57.35          $17.36

[[Page 18634]]

 
  76977  S                               Us bone density measure........            0265            1.17          $56.73          $38.08          $11.35
  76986  S                               Echo exam at surgery...........            0266            1.79          $86.79          $57.35          $17.36
  76999  S                               Echo examination procedure.....            0266            1.79          $86.79          $57.35          $17.36
  77261  E                               Radiation therapy planning.....  ..............  ..............  ..............  ..............  ..............
  77262  E                               Radiation therapy planning.....  ..............  ..............  ..............  ..............  ..............
  77263  E                               Radiation therapy planning.....  ..............  ..............  ..............  ..............  ..............
  77280  X                               Set radiation therapy field....            0304            1.49          $72.25          $41.52          $14.45
  77285  X                               Set radiation therapy field....            0305            4.06         $196.86          $97.50          $39.37
  77290  X                               Set radiation therapy field....            0305            4.06         $196.86          $97.50          $39.37
  77295  X                               Set radiation therapy field....            0310           13.98         $677.85         $339.05         $135.57
  77299  E                               Radiation therapy planning.....  ..............  ..............  ..............  ..............  ..............
  77300  X                               Radiation therapy dose plan....            0304            1.49          $72.25          $41.52          $14.45
  77305  X                               Radiation therapy dose plan....            0304            1.49          $72.25          $41.52          $14.45
  77310  X                               Radiation therapy dose plan....            0304            1.49          $72.25          $41.52          $14.45
  77315  X                               Radiation therapy dose plan....            0305            4.06         $196.86          $97.50          $39.37
  77321  X                               Radiation therapy port plan....            0305            4.06         $196.86          $97.50          $39.37
  77326  X                               Radiation therapy dose plan....            0305            4.06         $196.86          $97.50          $39.37
  77327  X                               Radiation therapy dose plan....            0305            4.06         $196.86          $97.50          $39.37
  77328  X                               Radiation therapy dose plan....            0305            4.06         $196.86          $97.50          $39.37
  77331  X                               Special radiation dosimetry....            0304            1.49          $72.25          $41.52          $14.45
  77332  X                               Radiation treatment aid(s).....            0303            2.83         $137.22          $69.28          $27.44
  77333  X                               Radiation treatment aid(s).....            0303            2.83         $137.22          $69.28          $27.44
  77334  X                               Radiation treatment aid(s).....            0303            2.83         $137.22          $69.28          $27.44
  77336  X                               Radiation physics consult......            0311            1.32          $64.00          $31.66          $12.80
  77370  X                               Radiation physics consult......            0311            1.32          $64.00          $31.66          $12.80
  77399  X                               External radiation dosimetry...            0311            1.32          $64.00          $31.66          $12.80
  77401  S                               Radiation treatment delivery...            0300            1.98          $96.00          $47.72          $19.20
  77402  S                               Radiation treatment delivery...            0300            1.98          $96.00          $47.72          $19.20
  77403  S                               Radiation treatment delivery...            0300            1.98          $96.00          $47.72          $19.20
  77404  S                               Radiation treatment delivery...            0300            1.98          $96.00          $47.72          $19.20
  77406  S                               Radiation treatment delivery...            0300            1.98          $96.00          $47.72          $19.20
  77407  S                               Radiation treatment delivery...            0300            1.98          $96.00          $47.72          $19.20
  77408  S                               Radiation treatment delivery...            0300            1.98          $96.00          $47.72          $19.20
  77409  S                               Radiation treatment delivery...            0300            1.98          $96.00          $47.72          $19.20
  77411  S                               Radiation treatment delivery...            0301            2.21         $107.16          $52.53          $21.43
  77412  S                               Radiation treatment delivery...            0301            2.21         $107.16          $52.53          $21.43
  77413  S                               Radiation treatment delivery...            0301            2.21         $107.16          $52.53          $21.43
  77414  S                               Radiation treatment delivery...            0300            1.98          $96.00          $47.72          $19.20
  77416  S                               Radiation treatment delivery...            0301            2.21         $107.16          $52.53          $21.43
  77417  X                               Radiology port film(s).........            0260            0.79          $38.30          $22.02           $7.66
  77427  E                               Radiation tx management, x5....  ..............  ..............  ..............  ..............  ..............
  77431  E                               Radiation therapy management...  ..............  ..............  ..............  ..............  ..............
  77432  E                               Stereotactic radiation trmt....  ..............  ..............  ..............  ..............  ..............
  77470  S                               Special radiation treatment....            0302            8.21         $398.08         $216.55          $79.62
  77499  E                               Radiation therapy management...  ..............  ..............  ..............  ..............  ..............
  77520  S                               Proton beam delivery...........            0301            2.21         $107.16          $52.53          $21.43
  77523  S                               Proton beam delivery...........            0301            2.21         $107.16          $52.53          $21.43
  77600  S                               Hyperthermia treatment.........            0314            5.88         $285.10         $150.95          $57.02
  77605  S                               Hyperthermia treatment.........            0314            5.88         $285.10         $150.95          $57.02
  77610  S                               Hyperthermia treatment.........            0314            5.88         $285.10         $150.95          $57.02
  77615  S                               Hyperthermia treatment.........            0314            5.88         $285.10         $150.95          $57.02
  77620  S                               Hyperthermia treatment.........            0314            5.88         $285.10         $150.95          $57.02
  77750  S                               Infuse radioactive materials...            0301            2.21         $107.16          $52.53          $21.43
  77761  S                               Radioelement application.......            0312            4.09         $198.31         $109.65          $39.66
  77762  S                               Radioelement application.......            0312            4.09         $198.31         $109.65          $39.66
  77763  S                               Radioelement application.......            0312            4.09         $198.31         $109.65          $39.66
  77776  S                               Radioelement application.......            0312            4.09         $198.31         $109.65          $39.66
  77777  S                               Radioelement application.......            0312            4.09         $198.31         $109.65          $39.66
  77778  S                               Radioelement application.......            0312            4.09         $198.31         $109.65          $39.66
  77781  S                               High intensity brachytherapy...            0313            7.89         $382.56         $164.02          $76.51
  77782  S                               High intensity brachytherapy...            0313            7.89         $382.56         $164.02          $76.51
  77783  S                               High intensity brachytherapy...            0313            7.89         $382.56         $164.02          $76.51
  77784  S                               High intensity brachytherapy...            0313            7.89         $382.56         $164.02          $76.51
  77789  S                               Radioelement application.......            0300            1.98          $96.00          $47.72          $19.20
  77790  N                               Radioelement handling..........  ..............  ..............  ..............  ..............  ..............
  77799  S                               Radium/radioisotope therapy....            0313            7.89         $382.56         $164.02          $76.51
  78000  S                               Thyroid, single uptake.........            0290            1.94          $94.06          $55.51          $18.81
  78001  S                               Thyroid, multiple uptakes......            0290            1.94          $94.06          $55.51          $18.81
  78003  S                               Thyroid suppress/stimul........            0290            1.94          $94.06          $55.51          $18.81
  78006  S                               Thyroid imaging with uptake....            0291            3.15         $152.73          $93.14          $30.55
  78007  S                               Thyroid image, mult uptakes....            0291            3.15         $152.73          $93.14          $30.55
  78010  S                               Thyroid imaging................            0290            1.94          $94.06          $55.51          $18.81
  78011  S                               Thyroid imaging with flow......            0290            1.94          $94.06          $55.51          $18.81

[[Page 18635]]

 
  78015  S                               Thyroid met imaging............            0291            3.15         $152.73          $93.14          $30.55
  78016  S                               Thyroid met imaging/studies....            0292            4.36         $211.40         $126.63          $42.28
  78018  S                               Thyroid met imaging, body......            0292            4.36         $211.40         $126.63          $42.28
  78020  S                               Thyroid met uptake.............            0292            4.36         $211.40         $126.63          $42.28
  78070  S                               Parathyroid nuclear imaging....            0292            4.36         $211.40         $126.63          $42.28
  78075  S                               Adrenal nuclear imaging........            0292            4.36         $211.40         $126.63          $42.28
  78099  S                               Endocrine nuclear procedure....            0290            1.94          $94.06          $55.51          $18.81
  78102  S                               Bone marrow imaging, ltd.......            0291            3.15         $152.73          $93.14          $30.55
  78103  S                               Bone marrow imaging, mult......            0292            4.36         $211.40         $126.63          $42.28
  78104  S                               Bone marrow imaging, body......            0292            4.36         $211.40         $126.63          $42.28
  78110  S                               Plasma volume, single..........            0291            3.15         $152.73          $93.14          $30.55
  78111  S                               Plasma volume, multiple........            0291            3.15         $152.73          $93.14          $30.55
  78120  S                               Red cell mass, single..........            0291            3.15         $152.73          $93.14          $30.55
  78121  S                               Red cell mass, multiple........            0291            3.15         $152.73          $93.14          $30.55
  78122  S                               Blood volume...................            0292            4.36         $211.40         $126.63          $42.28
  78130  S                               Red cell survival study........            0292            4.36         $211.40         $126.63          $42.28
  78135  S                               Red cell survival kinetics.....            0292            4.36         $211.40         $126.63          $42.28
  78140  S                               Red cell sequestration.........            0292            4.36         $211.40         $126.63          $42.28
  78160  S                               Plasma iron turnover...........            0292            4.36         $211.40         $126.63          $42.28
  78162  S                               Iron absorption exam...........            0292            4.36         $211.40         $126.63          $42.28
  78170  S                               Red cell iron utilization......            0292            4.36         $211.40         $126.63          $42.28
  78172  S                               Total body iron estimation.....            0292            4.36         $211.40         $126.63          $42.28
  78185  S                               Spleen imaging.................            0291            3.15         $152.73          $93.14          $30.55
  78190  S                               Platelet survival, kinetics....            0291            3.15         $152.73          $93.14          $30.55
  78191  S                               Platelet survival..............            0291            3.15         $152.73          $93.14          $30.55
  78195  S                               Lymph system imaging...........            0292            4.36         $211.40         $126.63          $42.28
  78199  S                               Blood/lymph nuclear exam.......            0290            1.94          $94.06          $55.51          $18.81
  78201  S                               Liver imaging..................            0291            3.15         $152.73          $93.14          $30.55
  78202  S                               Liver imaging with flow........            0291            3.15         $152.73          $93.14          $30.55
  78205  S                               Liver imaging (3D).............            0292            4.36         $211.40         $126.63          $42.28
  78206  S                               Liver image (3D) w/flow........            0292            4.36         $211.40         $126.63          $42.28
  78215  S                               Liver and spleen imaging.......            0291            3.15         $152.73          $93.14          $30.55
  78216  S                               Liver & spleen image/flow......            0291            3.15         $152.73          $93.14          $30.55
  78220  S                               Liver function study...........            0292            4.36         $211.40         $126.63          $42.28
  78223  S                               Hepatobiliary imaging..........            0292            4.36         $211.40         $126.63          $42.28
  78230  S                               Salivary gland imaging.........            0291            3.15         $152.73          $93.14          $30.55
  78231  S                               Serial salivary imaging........            0291            3.15         $152.73          $93.14          $30.55
  78232  S                               Salivary gland function exam...            0291            3.15         $152.73          $93.14          $30.55
  78258  S                               Esophageal motility study......            0291            3.15         $152.73          $93.14          $30.55
  78261  S                               Gastric mucosa imaging.........            0291            3.15         $152.73          $93.14          $30.55
  78262  S                               Gastroesophageal reflux exam...            0291            3.15         $152.73          $93.14          $30.55
  78264  S                               Gastric emptying study.........            0292            4.36         $211.40         $126.63          $42.28
2 78267  T                               Breath tst attain/anal c-14....            0971            1.55          $75.16  ..............          $15.03
2 78268  T                               Breath test analysis, c-14.....            0970            0.52          $25.21  ..............           $5.04
  78270  S                               Vit B-12 absorption exam.......            0290            1.94          $94.06          $55.51          $18.81
  78271  S                               Vit B-12 absorp exam, IF.......            0290            1.94          $94.06          $55.51          $18.81
  78272  S                               Vit B-12 absorp, combined......            0291            3.15         $152.73          $93.14          $30.55
  78278  S                               Acute GI blood loss imaging....            0292            4.36         $211.40         $126.63          $42.28
  78282  S                               GI protein loss exam...........            0290            1.94          $94.06          $55.51          $18.81
  78290  S                               Meckel's divert exam...........            0291            3.15         $152.73          $93.14          $30.55
  78291  S                               Leveen/shunt patency exam......            0292            4.36         $211.40         $126.63          $42.28
  78299  S                               GI nuclear procedure...........            0290            1.94          $94.06          $55.51          $18.81
  78300  S                               Bone imaging, limited area.....            0291            3.15         $152.73          $93.14          $30.55
  78305  S                               Bone imaging, multiple areas...            0292            4.36         $211.40         $126.63          $42.28
  78306  S                               Bone imaging, whole body.......            0292            4.36         $211.40         $126.63          $42.28
  78315  S                               Bone imaging, 3 phase..........            0292            4.36         $211.40         $126.63          $42.28
  78320  S                               Bone imaging (3D)..............            0292            4.36         $211.40         $126.63          $42.28
  78350  X                               Bone mineral, single photon....            0261            1.38          $66.91          $38.77          $13.38
  78351  E                               Bone mineral, dual photon......  ..............  ..............  ..............  ..............  ..............
  78399  S                               Musculoskeletal nuclear exam...            0290            1.94          $94.06          $55.51          $18.81
  78414  S                               Non-imaging heart function.....            0292            4.36         $211.40         $126.63          $42.28
  78428  S                               Cardiac shunt imaging..........            0292            4.36         $211.40         $126.63          $42.28
  78445  S                               Vascular flow imaging..........            0291            3.15         $152.73          $93.14          $30.55
  78455  S                               Venous thrombosis study........            0291            3.15         $152.73          $93.14          $30.55
  78456  S                               Acute venous thrombus image....            0291            3.15         $152.73          $93.14          $30.55
  78457  S                               Venous thrombosis imaging......            0291            3.15         $152.73          $93.14          $30.55
  78458  S                               Ven thrombosis images, bilat...            0291            3.15         $152.73          $93.14          $30.55
  78459  E                               Heart muscle imaging (PET).....  ..............  ..............  ..............  ..............  ..............
  78460  S                               Heart muscle blood, single.....            0286            7.28         $352.99         $200.04          $70.60
  78461  S                               Heart muscle blood, multiple...            0286            7.28         $352.99         $200.04          $70.60
  78464  S                               Heart image (3D), single.......            0286            7.28         $352.99         $200.04          $70.60
  78465  S                               Heart image (3D), multiple.....            0286            7.28         $352.99         $200.04          $70.60
  78466  S                               Heart infarct image............            0292            4.36         $211.40         $126.63          $42.28

[[Page 18636]]

 
  78468  S                               Heart infarct image (ef).......            0292            4.36         $211.40         $126.63          $42.28
  78469  S                               Heart infarct image (3D).......            0292            4.36         $211.40         $126.63          $42.28
  78472  S                               Gated heart, planar, single....            0286            7.28         $352.99         $200.04          $70.60
  78473  S                               Gated heart, multiple..........            0286            7.28         $352.99         $200.04          $70.60
  78478  S                               Heart wall motion add-on.......            0286            7.28         $352.99         $200.04          $70.60
  78480  S                               Heart function add-on..........            0286            7.28         $352.99         $200.04          $70.60
  78481  S                               Heart first pass, single.......            0286            7.28         $352.99         $200.04          $70.60
  78483  S                               Heart first pass, multiple.....            0286            7.28         $352.99         $200.04          $70.60
  78491  E                               Heart image (pet), single......  ..............  ..............  ..............  ..............  ..............
  78492  E                               Heart image (pet), multiple....  ..............  ..............  ..............  ..............  ..............
  78494  S                               Heart image, spect.............            0296            3.57         $173.10         $100.25          $34.62
  78496  S                               Heart first pass add-on........            0296            3.57         $173.10         $100.25          $34.62
  78499  S                               Cardiovascular nuclear exam....            0292            4.36         $211.40         $126.63          $42.28
  78580  S                               Lung perfusion imaging.........            0291            3.15         $152.73          $93.14          $30.55
  78584  S                               Lung V/Q image single breath...            0292            4.36         $211.40         $126.63          $42.28
  78585  S                               Lung V/Q imaging...............            0292            4.36         $211.40         $126.63          $42.28
  78586  S                               Aerosol lung image, single.....            0292            4.36         $211.40         $126.63          $42.28
  78587  S                               Aerosol lung image, multiple...            0292            4.36         $211.40         $126.63          $42.28
  78588  S                               Perfusion lung image...........            0292            4.36         $211.40         $126.63          $42.28
  78591  S                               Vent image, 1 breath, 1 proj...            0291            3.15         $152.73          $93.14          $30.55
  78593  S                               Vent image, 1 proj, gas........            0292            4.36         $211.40         $126.63          $42.28
  78594  S                               Vent image, mult proj, gas.....            0292            4.36         $211.40         $126.63          $42.28
  78596  S                               Lung differential function.....            0292            4.36         $211.40         $126.63          $42.28
  78599  S                               Respiratory nuclear exam.......            0291            3.15         $152.73          $93.14          $30.55
  78600  S                               Brain imaging, ltd static......            0292            4.36         $211.40         $126.63          $42.28
  78601  S                               Brain imaging, ltd w/flow......            0292            4.36         $211.40         $126.63          $42.28
  78605  S                               Brain imaging, complete........            0291            3.15         $152.73          $93.14          $30.55
  78606  S                               Brain imaging, compl w/flow....            0292            4.36         $211.40         $126.63          $42.28
  78607  S                               Brain imaging (3D).............            0292            4.36         $211.40         $126.63          $42.28
  78608  E                               Brain imaging (PET)............  ..............  ..............  ..............  ..............  ..............
  78609  E                               Brain imaging (PET)............  ..............  ..............  ..............  ..............  ..............
  78610  S                               Brain flow imaging only........            0291            3.15         $152.73          $93.14          $30.55
  78615  S                               Cerebral blood flow imaging....            0292            4.36         $211.40         $126.63          $42.28
  78630  S                               Cerebrospinal fluid scan.......            0292            4.36         $211.40         $126.63          $42.28
  78635  S                               CSF ventriculography...........            0292            4.36         $211.40         $126.63          $42.28
  78645  S                               CSF shunt evaluation...........            0292            4.36         $211.40         $126.63          $42.28
  78647  S                               Cerebrospinal fluid scan.......            0292            4.36         $211.40         $126.63          $42.28
  78650  S                               CSF leakage imaging............            0292            4.36         $211.40         $126.63          $42.28
  78655  S                               ...............................            0292            4.36         $211.40         $126.63          $42.28
  78660  S                               Nuclear exam of tear flow......            0291            3.15         $152.73          $93.14          $30.55
  78699  S                               Nervous system nuclear exam....            0292            4.36         $211.40         $126.63          $42.28
  78700  S                               Kidney imaging, static.........            0291            3.15         $152.73          $93.14          $30.55
  78701  S                               Kidney imaging with flow.......            0291            3.15         $152.73          $93.14          $30.55
  78704  S                               Imaging renogram...............            0292            4.36         $211.40         $126.63          $42.28
  78707  S                               Kidney flow/function image.....            0292            4.36         $211.40         $126.63          $42.28
  78708  S                               Kidney flow/function image.....            0292            4.36         $211.40         $126.63          $42.28
  78709  S                               Kidney flow/function image.....            0292            4.36         $211.40         $126.63          $42.28
  78710  S                               Kidney imaging (3D)............            0292            4.36         $211.40         $126.63          $42.28
  78715  S                               Renal vascular flow exam.......            0291            3.15         $152.73          $93.14          $30.55
  78725  S                               Kidney function study..........            0291            3.15         $152.73          $93.14          $30.55
  78730  S                               Urinary bladder retention......            0291            3.15         $152.73          $93.14          $30.55
  78740  S                               Ureteral reflux study..........            0291            3.15         $152.73          $93.14          $30.55
  78760  S                               Testicular imaging.............            0291            3.15         $152.73          $93.14          $30.55
  78761  S                               Testicular imaging/flow........            0291            3.15         $152.73          $93.14          $30.55
  78799  S                               Genitourinary nuclear exam.....            0292            4.36         $211.40         $126.63          $42.28
  78800  S                               Tumor imaging, limited area....            0292            4.36         $211.40         $126.63          $42.28
  78801  S                               Tumor imaging, mult areas......            0292            4.36         $211.40         $126.63          $42.28
  78802  S                               Tumor imaging, whole body......            0292            4.36         $211.40         $126.63          $42.28
  78803  S                               Tumor imaging (3D).............            0292            4.36         $211.40         $126.63          $42.28
  78805  S                               Abscess imaging, ltd area......            0292            4.36         $211.40         $126.63          $42.28
  78806  S                               Abscess imaging, whole body....            0292            4.36         $211.40         $126.63          $42.28
  78807  S                               Nuclear localization/abscess...            0292            4.36         $211.40         $126.63          $42.28
  78810  E                               Tumor imaging (PET)............  ..............  ..............  ..............  ..............  ..............
  78890  N                               Nuclear medicine data proc.....  ..............  ..............  ..............  ..............  ..............
  78891  N                               Nuclear med data proc..........  ..............  ..............  ..............  ..............  ..............
  78990  N                               Provide diag radionuclide(s)...  ..............  ..............  ..............  ..............  ..............
  78999  S                               Nuclear diagnostic exam........            0291            3.15         $152.73          $93.14          $30.55
  79000  S                               Init hyperthyroid therapy......            0294            5.13         $248.74         $144.06          $49.75
  79001  S                               Repeat hyperthyroid therapy....            0294            5.13         $248.74         $144.06          $49.75
  79020  S                               Thyroid ablation...............            0294            5.13         $248.74         $144.06          $49.75
  79030  S                               Thyroid ablation, carcinoma....            0294            5.13         $248.74         $144.06          $49.75
  79035  S                               Thyroid metastatic therapy.....            0294            5.13         $248.74         $144.06          $49.75
  79100  S                               Hematopoetic nuclear therapy...            0294            5.13         $248.74         $144.06          $49.75

[[Page 18637]]

 
  79200  S                               Intracavitary nuclear trmt.....            0295           19.85         $962.47         $609.17         $192.49
  79300  S                               Interstitial nuclear therapy...            0294            5.13         $248.74         $144.06          $49.75
  79400  S                               Nonhemato nuclear therapy......            0295           19.85         $962.47         $609.17         $192.49
  79420  S                               Intravascular nuclear ther.....            0295           19.85         $962.47         $609.17         $192.49
  79440  S                               Nuclear joint therapy..........            0294            5.13         $248.74         $144.06          $49.75
  79900  N                               Provide ther radiopharm(s).....  ..............  ..............  ..............  ..............  ..............
  79999  S                               Nuclear medicine therapy.......            0294            5.13         $248.74         $144.06          $49.75
  80048  A                               Basic metabolic panel..........  ..............  ..............  ..............  ..............  ..............
  80050  A                               General health panel...........  ..............  ..............  ..............  ..............  ..............
  80051  A                               Electrolyte panel..............  ..............  ..............  ..............  ..............  ..............
  80053  A                               Comprehen metabolic panel......  ..............  ..............  ..............  ..............  ..............
  80055  A                               Obstetric panel................  ..............  ..............  ..............  ..............  ..............
  80061  A                               Lipid panel....................  ..............  ..............  ..............  ..............  ..............
  80069  A                               Renal function panel...........  ..............  ..............  ..............  ..............  ..............
  80072  A                               Arthritis panel................  ..............  ..............  ..............  ..............  ..............
  80074  A                               Acute hepatitis panel..........  ..............  ..............  ..............  ..............  ..............
  80076  A                               Hepatic function panel.........  ..............  ..............  ..............  ..............  ..............
  80090  A                               Torch antibody panel...........  ..............  ..............  ..............  ..............  ..............
  80100  A                               Drug screen....................  ..............  ..............  ..............  ..............  ..............
  80101  A                               Drug screen....................  ..............  ..............  ..............  ..............  ..............
  80102  A                               Drug confirmation..............  ..............  ..............  ..............  ..............  ..............
  80103  N                               Drug analysis, tissue prep.....  ..............  ..............  ..............  ..............  ..............
  80150  A                               Assay of amikacin..............  ..............  ..............  ..............  ..............  ..............
  80152  A                               Assay of amitriptyline.........  ..............  ..............  ..............  ..............  ..............
  80154  A                               Assay of benzodiazepines.......  ..............  ..............  ..............  ..............  ..............
  80156  A                               Assay of carbamazepine.........  ..............  ..............  ..............  ..............  ..............
  80158  A                               Assay of cyclosporine..........  ..............  ..............  ..............  ..............  ..............
  80160  A                               Assay of desipramine...........  ..............  ..............  ..............  ..............  ..............
  80162  A                               Assay of digoxin...............  ..............  ..............  ..............  ..............  ..............
  80164  A                               Assay, dipropylacetic acid.....  ..............  ..............  ..............  ..............  ..............
  80166  A                               Assay of doxepin...............  ..............  ..............  ..............  ..............  ..............
  80168  A                               Assay of ethosuximide..........  ..............  ..............  ..............  ..............  ..............
  80170  A                               Assay of gentamicin............  ..............  ..............  ..............  ..............  ..............
  80172  A                               Assay of gold..................  ..............  ..............  ..............  ..............  ..............
  80174  A                               Assay of imipramine............  ..............  ..............  ..............  ..............  ..............
  80176  A                               Assay of lidocaine.............  ..............  ..............  ..............  ..............  ..............
  80178  A                               Assay of lithium...............  ..............  ..............  ..............  ..............  ..............
  80182  A                               Assay of nortriptyline.........  ..............  ..............  ..............  ..............  ..............
  80184  A                               Assay of phenobarbital.........  ..............  ..............  ..............  ..............  ..............
  80185  A                               Assay of phenytoin, total......  ..............  ..............  ..............  ..............  ..............
  80186  A                               Assay of phenytoin, free.......  ..............  ..............  ..............  ..............  ..............
  80188  A                               Assay of primidone.............  ..............  ..............  ..............  ..............  ..............
  80190  A                               Assay of procainamide..........  ..............  ..............  ..............  ..............  ..............
  80192  A                               Assay of procainamide..........  ..............  ..............  ..............  ..............  ..............
  80194  A                               Assay of quinidine.............  ..............  ..............  ..............  ..............  ..............
  80196  A                               Assay of salicylate............  ..............  ..............  ..............  ..............  ..............
  80197  A                               Assay of tacrolimus............  ..............  ..............  ..............  ..............  ..............
  80198  A                               Assay of theophylline..........  ..............  ..............  ..............  ..............  ..............
  80200  A                               Assay of tobramycin............  ..............  ..............  ..............  ..............  ..............
  80201  A                               Assay of topiramate............  ..............  ..............  ..............  ..............  ..............
  80202  A                               Assay of vancomycin............  ..............  ..............  ..............  ..............  ..............
  80299  A                               Quantitative assay, drug.......  ..............  ..............  ..............  ..............  ..............
  80400  A                               Acth stimulation panel.........  ..............  ..............  ..............  ..............  ..............
  80402  A                               Acth stimulation panel.........  ..............  ..............  ..............  ..............  ..............
  80406  A                               Acth stimulation panel.........  ..............  ..............  ..............  ..............  ..............
  80408  A                               Aldosterone suppression eval...  ..............  ..............  ..............  ..............  ..............
  80410  A                               Calcitonin stimul panel........  ..............  ..............  ..............  ..............  ..............
  80412  A                               CRH stimulation panel..........  ..............  ..............  ..............  ..............  ..............
  80414  A                               Testosterone response..........  ..............  ..............  ..............  ..............  ..............
  80415  A                               Estradiol response panel.......  ..............  ..............  ..............  ..............  ..............
  80416  A                               Renin stimulation panel........  ..............  ..............  ..............  ..............  ..............
  80417  A                               Renin stimulation panel........  ..............  ..............  ..............  ..............  ..............
  80418  A                               Pituitary evaluation panel.....  ..............  ..............  ..............  ..............  ..............
  80420  A                               Dexamethasone panel............  ..............  ..............  ..............  ..............  ..............
  80422  A                               Glucagon tolerance panel.......  ..............  ..............  ..............  ..............  ..............
  80424  A                               Glucagon tolerance panel.......  ..............  ..............  ..............  ..............  ..............
  80426  A                               Gonadotropin hormone panel.....  ..............  ..............  ..............  ..............  ..............
  80428  A                               Growth hormone panel...........  ..............  ..............  ..............  ..............  ..............
  80430  A                               Growth hormone panel...........  ..............  ..............  ..............  ..............  ..............
  80432  A                               Insulin suppression panel......  ..............  ..............  ..............  ..............  ..............
  80434  A                               Insulin tolerance panel........  ..............  ..............  ..............  ..............  ..............
  80435  A                               Insulin tolerance panel........  ..............  ..............  ..............  ..............  ..............
  80436  A                               Metyrapone panel...............  ..............  ..............  ..............  ..............  ..............

[[Page 18638]]

 
  80438  A                               TRH stimulation panel..........  ..............  ..............  ..............  ..............  ..............
  80439  A                               TRH stimulation panel..........  ..............  ..............  ..............  ..............  ..............
  80440  A                               TRH stimulation panel..........  ..............  ..............  ..............  ..............  ..............
  80500  X                               Lab pathology consultation.....            0343            0.45          $21.82          $12.16           $4.36
  80502  X                               Lab pathology consultation.....            0343            0.45          $21.82          $12.16           $4.36
  81000  A                               Urinalysis, nonauto w/scope....  ..............  ..............  ..............  ..............  ..............
  81001  A                               Urinalysis, auto w/scope.......  ..............  ..............  ..............  ..............  ..............
  81002  A                               Urinalysis nonauto w/o scope...  ..............  ..............  ..............  ..............  ..............
  81003  A                               Urinalysis, auto, w/o scope....  ..............  ..............  ..............  ..............  ..............
  81005  A                               Urinalysis.....................  ..............  ..............  ..............  ..............  ..............
  81007  A                               Urine screen for bacteria......  ..............  ..............  ..............  ..............  ..............
  81015  A                               Microscopic exam of urine......  ..............  ..............  ..............  ..............  ..............
  81020  A                               Urinalysis, glass test.........  ..............  ..............  ..............  ..............  ..............
  81025  A                               Urine pregnancy test...........  ..............  ..............  ..............  ..............  ..............
  81050  A                               Urinalysis, volume measure.....  ..............  ..............  ..............  ..............  ..............
  81099  A                               Urinalysis test procedure......  ..............  ..............  ..............  ..............  ..............
  82000  A                               Assay of blood acetaldehyde....  ..............  ..............  ..............  ..............  ..............
  82003  A                               Assay of acetaminophen.........  ..............  ..............  ..............  ..............  ..............
  82009  A                               Test for acetone/ketones.......  ..............  ..............  ..............  ..............  ..............
  82010  A                               Acetone assay..................  ..............  ..............  ..............  ..............  ..............
  82013  A                               Acetylcholinesterase assay.....  ..............  ..............  ..............  ..............  ..............
  82016  A                               Acylcarnitines, qual...........  ..............  ..............  ..............  ..............  ..............
  82017  A                               Acylcarnitines, quant..........  ..............  ..............  ..............  ..............  ..............
  82024  A                               Assay of acth..................  ..............  ..............  ..............  ..............  ..............
  82030  A                               Assay of adp & amp.............  ..............  ..............  ..............  ..............  ..............
  82040  A                               Assay of serum albumin.........  ..............  ..............  ..............  ..............  ..............
  82042  A                               Assay of urine albumin.........  ..............  ..............  ..............  ..............  ..............
  82043  A                               Microalbumin, quantitative.....  ..............  ..............  ..............  ..............  ..............
  82044  A                               Microalbumin, semiquant........  ..............  ..............  ..............  ..............  ..............
  82055  A                               Assay of ethanol...............  ..............  ..............  ..............  ..............  ..............
  82075  A                               Assay of breath ethanol........  ..............  ..............  ..............  ..............  ..............
  82085  A                               Assay of aldolase..............  ..............  ..............  ..............  ..............  ..............
  82088  A                               Assay of aldosterone...........  ..............  ..............  ..............  ..............  ..............
  82101  A                               Assay of urine alkaloids.......  ..............  ..............  ..............  ..............  ..............
  82103  A                               Alpha-1-antitrypsin, total.....  ..............  ..............  ..............  ..............  ..............
  82104  A                               Alpha-1-antitrypsin, pheno.....  ..............  ..............  ..............  ..............  ..............
  82105  A                               Alpha-fetoprotein, serum.......  ..............  ..............  ..............  ..............  ..............
  82106  A                               Alpha-fetoprotein, amniotic....  ..............  ..............  ..............  ..............  ..............
  82108  A                               Assay of aluminum..............  ..............  ..............  ..............  ..............  ..............
  82120  A                               Amines, vaginal fluid qual.....  ..............  ..............  ..............  ..............  ..............
  82127  A                               Amino acid, single qual........  ..............  ..............  ..............  ..............  ..............
  82128  A                               Amino acids, mult qual.........  ..............  ..............  ..............  ..............  ..............
  82131  A                               Amino acids, single quant......  ..............  ..............  ..............  ..............  ..............
  82135  A                               Assay, aminolevulinic acid.....  ..............  ..............  ..............  ..............  ..............
  82136  A                               Amino acids, quant, 2-5........  ..............  ..............  ..............  ..............  ..............
  82139  A                               Amino acids, quan, 6 or more...  ..............  ..............  ..............  ..............  ..............
  82140  A                               Assay of ammonia...............  ..............  ..............  ..............  ..............  ..............
  82143  A                               Amniotic fluid scan............  ..............  ..............  ..............  ..............  ..............
  82145  A                               Assay of amphetamines..........  ..............  ..............  ..............  ..............  ..............
  82150  A                               Assay of amylase...............  ..............  ..............  ..............  ..............  ..............
  82154  A                               Androstanediol glucuronide.....  ..............  ..............  ..............  ..............  ..............
  82157  A                               Assay of androstenedione.......  ..............  ..............  ..............  ..............  ..............
  82160  A                               Assay of androsterone..........  ..............  ..............  ..............  ..............  ..............
  82163  A                               Assay of angiotensin II........  ..............  ..............  ..............  ..............  ..............
  82164  A                               Angiotensin I enzyme test......  ..............  ..............  ..............  ..............  ..............
  82172  A                               Assay of apolipoprotein........  ..............  ..............  ..............  ..............  ..............
  82175  A                               Assay of arsenic...............  ..............  ..............  ..............  ..............  ..............
  82180  A                               Assay of ascorbic acid.........  ..............  ..............  ..............  ..............  ..............
  82190  A                               Atomic absorption..............  ..............  ..............  ..............  ..............  ..............
  82205  A                               Assay of barbiturates..........  ..............  ..............  ..............  ..............  ..............
  82232  A                               Assay of beta-2 protein........  ..............  ..............  ..............  ..............  ..............
  82239  A                               Bile acids, total..............  ..............  ..............  ..............  ..............  ..............
  82240  A                               Bile acids, cholylglycine......  ..............  ..............  ..............  ..............  ..............
  82247  A                               Bilirubin, total...............  ..............  ..............  ..............  ..............  ..............
  82248  A                               Bilirubin, direct..............  ..............  ..............  ..............  ..............  ..............
  82251  A                               Assay of bilirubin.............  ..............  ..............  ..............  ..............  ..............
  82252  A                               Fecal bilirubin test...........  ..............  ..............  ..............  ..............  ..............
  82261  A                               Assay of biotinidase...........  ..............  ..............  ..............  ..............  ..............
  82270  A                               Test for blood, feces..........  ..............  ..............  ..............  ..............  ..............
  82273  A                               Test for blood, other source...  ..............  ..............  ..............  ..............  ..............
  82286  A                               Assay of bradykinin............  ..............  ..............  ..............  ..............  ..............
  82300  A                               Assay of cadmium...............  ..............  ..............  ..............  ..............  ..............
  82306  A                               Assay of vitamin D.............  ..............  ..............  ..............  ..............  ..............

[[Page 18639]]

 
  82307  A                               Assay of vitamin D.............  ..............  ..............  ..............  ..............  ..............
  82308  A                               Assay of calcitonin............  ..............  ..............  ..............  ..............  ..............
  82310  A                               Assay of calcium...............  ..............  ..............  ..............  ..............  ..............
  82330  A                               Assay of calcium...............  ..............  ..............  ..............  ..............  ..............
  82331  A                               Calcium infusion test..........  ..............  ..............  ..............  ..............  ..............
  82340  A                               Assay of calcium in urine......  ..............  ..............  ..............  ..............  ..............
  82355  A                               Calculus (stone) analysis......  ..............  ..............  ..............  ..............  ..............
  82360  A                               Calculus (stone) assay.........  ..............  ..............  ..............  ..............  ..............
  82365  A                               Calculus (stone) assay.........  ..............  ..............  ..............  ..............  ..............
  82370  A                               X-ray assay, calculus..........  ..............  ..............  ..............  ..............  ..............
  82374  A                               Assay, blood carbon dioxide....  ..............  ..............  ..............  ..............  ..............
  82375  A                               Assay, blood carbon monoxide...  ..............  ..............  ..............  ..............  ..............
  82376  A                               Test for carbon monoxide.......  ..............  ..............  ..............  ..............  ..............
  82378  A                               Carcinoembryonic antigen.......  ..............  ..............  ..............  ..............  ..............
  82379  A                               Assay of carnitine.............  ..............  ..............  ..............  ..............  ..............
  82380  A                               Assay of carotene..............  ..............  ..............  ..............  ..............  ..............
  82382  A                               Assay, urine catecholamines....  ..............  ..............  ..............  ..............  ..............
  82383  A                               Assay, blood catecholamines....  ..............  ..............  ..............  ..............  ..............
  82384  A                               Assay, three catecholamines....  ..............  ..............  ..............  ..............  ..............
  82387  A                               Assay of cathepsin-d...........  ..............  ..............  ..............  ..............  ..............
  82390  A                               Assay of ceruloplasmin.........  ..............  ..............  ..............  ..............  ..............
  82397  A                               Chemiluminescent assay.........  ..............  ..............  ..............  ..............  ..............
  82415  A                               Assay of chloramphenicol.......  ..............  ..............  ..............  ..............  ..............
  82435  A                               Assay of blood chloride........  ..............  ..............  ..............  ..............  ..............
  82436  A                               Assay of urine chloride........  ..............  ..............  ..............  ..............  ..............
  82438  A                               Assay, other fluid chlorides...  ..............  ..............  ..............  ..............  ..............
  82441  A                               Test for chlorohydrocarbons....  ..............  ..............  ..............  ..............  ..............
  82465  A                               Assay of serum cholesterol.....  ..............  ..............  ..............  ..............  ..............
  82480  A                               Assay, serum cholinesterase....  ..............  ..............  ..............  ..............  ..............
  82482  A                               Assay, rbc cholinesterase......  ..............  ..............  ..............  ..............  ..............
  82485  A                               Assay, chondroitin sulfate.....  ..............  ..............  ..............  ..............  ..............
  82486  A                               Gas/liquid chromatography......  ..............  ..............  ..............  ..............  ..............
  82487  A                               Paper chromatography...........  ..............  ..............  ..............  ..............  ..............
  82488  A                               Paper chromatography...........  ..............  ..............  ..............  ..............  ..............
  82489  A                               Thin layer chromatography......  ..............  ..............  ..............  ..............  ..............
  82491  A                               Chromotography, quant, sing....  ..............  ..............  ..............  ..............  ..............
  82492  A                               Chromotography, quant, mult....  ..............  ..............  ..............  ..............  ..............
  82495  A                               Assay of chromium..............  ..............  ..............  ..............  ..............  ..............
  82507  A                               Assay of citrate...............  ..............  ..............  ..............  ..............  ..............
  82520  A                               Assay of cocaine...............  ..............  ..............  ..............  ..............  ..............
  82523  A                               Collagen crosslinks............  ..............  ..............  ..............  ..............  ..............
  82525  A                               Assay of copper................  ..............  ..............  ..............  ..............  ..............
  82528  A                               Assay of corticosterone........  ..............  ..............  ..............  ..............  ..............
  82530  A                               Cortisol, free.................  ..............  ..............  ..............  ..............  ..............
  82533  A                               Total cortisol.................  ..............  ..............  ..............  ..............  ..............
  82540  A                               Assay of creatine..............  ..............  ..............  ..............  ..............  ..............
  82541  A                               Column chromotography, qual....  ..............  ..............  ..............  ..............  ..............
  82542  A                               Column chromotography, quant...  ..............  ..............  ..............  ..............  ..............
  82543  A                               Column chromotograph/isotope...  ..............  ..............  ..............  ..............  ..............
  82544  A                               Column chromotograph/isotope...  ..............  ..............  ..............  ..............  ..............
  82550  A                               Assay of ck (cpk)..............  ..............  ..............  ..............  ..............  ..............
  82552  A                               Assay of cpk in blood..........  ..............  ..............  ..............  ..............  ..............
  82553  A                               Creatine, MB fraction..........  ..............  ..............  ..............  ..............  ..............
  82554  A                               Creatine, isoforms.............  ..............  ..............  ..............  ..............  ..............
  82565  A                               Assay of creatinine............  ..............  ..............  ..............  ..............  ..............
  82570  A                               Assay of urine creatinine......  ..............  ..............  ..............  ..............  ..............
  82575  A                               Creatinine clearance test......  ..............  ..............  ..............  ..............  ..............
  82585  A                               Assay of cryofibrinogen........  ..............  ..............  ..............  ..............  ..............
  82595  A                               Assay of cryoglobulin..........  ..............  ..............  ..............  ..............  ..............
  82600  A                               Assay of cyanide...............  ..............  ..............  ..............  ..............  ..............
  82607  A                               Vitamin B-12...................  ..............  ..............  ..............  ..............  ..............
  82608  A                               B-12 binding capacity..........  ..............  ..............  ..............  ..............  ..............
  82615  A                               Test for urine cystines........  ..............  ..............  ..............  ..............  ..............
  82626  A                               Dehydroepiandrosterone.........  ..............  ..............  ..............  ..............  ..............
  82627  A                               Dehydroepiandrosterone.........  ..............  ..............  ..............  ..............  ..............
  82633  A                               Desoxycorticosterone...........  ..............  ..............  ..............  ..............  ..............
  82634  A                               Deoxycortisol..................  ..............  ..............  ..............  ..............  ..............
  82638  A                               Assay of dibucaine number......  ..............  ..............  ..............  ..............  ..............
  82646  A                               Assay of dihydrocodeinone......  ..............  ..............  ..............  ..............  ..............
  82649  A                               Assay of dihydromorphinone.....  ..............  ..............  ..............  ..............  ..............
  82651  A                               Assay of dihydrotestosterone...  ..............  ..............  ..............  ..............  ..............
  82652  A                               Assay of dihydroxyvitamin d....  ..............  ..............  ..............  ..............  ..............
  82654  A                               Assay of dimethadione..........  ..............  ..............  ..............  ..............  ..............

[[Page 18640]]

 
  82657  A                               Enzyme cell activity...........  ..............  ..............  ..............  ..............  ..............
  82658  A                               Enzyme cell activity, ra.......  ..............  ..............  ..............  ..............  ..............
  82664  A                               Electrophoretic test...........  ..............  ..............  ..............  ..............  ..............
  82666  A                               Assay of epiandrosterone.......  ..............  ..............  ..............  ..............  ..............
  82668  A                               Assay of erythropoietin........  ..............  ..............  ..............  ..............  ..............
  82670  A                               Assay of estradiol.............  ..............  ..............  ..............  ..............  ..............
  82671  A                               Assay of estrogens.............  ..............  ..............  ..............  ..............  ..............
  82672  A                               Assay of estrogen..............  ..............  ..............  ..............  ..............  ..............
  82677  A                               Assay of estriol...............  ..............  ..............  ..............  ..............  ..............
  82679  A                               Assay of estrone...............  ..............  ..............  ..............  ..............  ..............
  82690  A                               Assay of ethchlorvynol.........  ..............  ..............  ..............  ..............  ..............
  82693  A                               Assay of ethylene glycol.......  ..............  ..............  ..............  ..............  ..............
  82696  A                               Assay of etiocholanolone.......  ..............  ..............  ..............  ..............  ..............
  82705  A                               Fats/lipids, feces, qual.......  ..............  ..............  ..............  ..............  ..............
  82710  A                               Fats/lipids, feces, quant......  ..............  ..............  ..............  ..............  ..............
  82715  A                               Assay of fecal fat.............  ..............  ..............  ..............  ..............  ..............
  82725  A                               Assay of blood fatty acids.....  ..............  ..............  ..............  ..............  ..............
  82726  A                               Long chain fatty acids.........  ..............  ..............  ..............  ..............  ..............
  82728  A                               Assay of ferritin..............  ..............  ..............  ..............  ..............  ..............
  82731  A                               Assay of fetal fibronectin.....  ..............  ..............  ..............  ..............  ..............
  82735  A                               Assay of fluoride..............  ..............  ..............  ..............  ..............  ..............
  82742  A                               Assay of flurazepam............  ..............  ..............  ..............  ..............  ..............
  82746  A                               Blood folic acid serum.........  ..............  ..............  ..............  ..............  ..............
  82747  A                               Assay of folic acid, rbc.......  ..............  ..............  ..............  ..............  ..............
  82757  A                               Assay of semen fructose........  ..............  ..............  ..............  ..............  ..............
  82759  A                               Assay of rbc galactokinase.....  ..............  ..............  ..............  ..............  ..............
  82760  A                               Assay of galactose.............  ..............  ..............  ..............  ..............  ..............
  82775  A                               Assay galactose transferase....  ..............  ..............  ..............  ..............  ..............
  82776  A                               Galactose transferase test.....  ..............  ..............  ..............  ..............  ..............
  82784  A                               Assay of gammaglobulin igm.....  ..............  ..............  ..............  ..............  ..............
  82785  A                               Assay of gammaglobulin ige.....  ..............  ..............  ..............  ..............  ..............
  82787  A                               Igg 1, 2, 3 and 4..............  ..............  ..............  ..............  ..............  ..............
  82800  A                               Blood pH.......................  ..............  ..............  ..............  ..............  ..............
  82803  A                               Blood gases: pH, pO2 & pCO2....  ..............  ..............  ..............  ..............  ..............
  82805  A                               Blood gases W/02 saturation....  ..............  ..............  ..............  ..............  ..............
  82810  A                               Blood gases, O2 sat only.......  ..............  ..............  ..............  ..............  ..............
  82820  A                               Hemoglobin-oxygen affinity.....  ..............  ..............  ..............  ..............  ..............
  82926  A                               Assay of gastric acid..........  ..............  ..............  ..............  ..............  ..............
  82928  A                               Assay of gastric acid..........  ..............  ..............  ..............  ..............  ..............
  82938  A                               Gastrin test...................  ..............  ..............  ..............  ..............  ..............
  82941  A                               Assay of gastrin...............  ..............  ..............  ..............  ..............  ..............
  82943  A                               Assay of glucagon..............  ..............  ..............  ..............  ..............  ..............
  82946  A                               Glucagon tolerance test........  ..............  ..............  ..............  ..............  ..............
  82947  A                               Assay of glucose, quant........  ..............  ..............  ..............  ..............  ..............
  82948  A                               Reagent strip/blood glucose....  ..............  ..............  ..............  ..............  ..............
  82950  A                               Glucose test...................  ..............  ..............  ..............  ..............  ..............
  82951  A                               Glucose tolerance test (GTT)...  ..............  ..............  ..............  ..............  ..............
  82952  A                               GTT-added samples..............  ..............  ..............  ..............  ..............  ..............
  82953  A                               Glucose-tolbutamide test.......  ..............  ..............  ..............  ..............  ..............
  82955  A                               Assay of g6pd enzyme...........  ..............  ..............  ..............  ..............  ..............
  82960  A                               Test for G6PD enzyme...........  ..............  ..............  ..............  ..............  ..............
  82962  A                               Glucose blood test.............  ..............  ..............  ..............  ..............  ..............
  82963  A                               Assay of glucosidase...........  ..............  ..............  ..............  ..............  ..............
  82965  A                               Assay of gdh enzyme............  ..............  ..............  ..............  ..............  ..............
  82975  A                               Assay of glutamine.............  ..............  ..............  ..............  ..............  ..............
  82977  A                               Assay of GGT...................  ..............  ..............  ..............  ..............  ..............
  82978  A                               Assay of glutathione...........  ..............  ..............  ..............  ..............  ..............
  82979  A                               Assay, rbc glutathione.........  ..............  ..............  ..............  ..............  ..............
  82980  A                               Assay of glutethimide..........  ..............  ..............  ..............  ..............  ..............
  82985  A                               Glycated protein...............  ..............  ..............  ..............  ..............  ..............
  83001  A                               Gonadotropin (FSH).............  ..............  ..............  ..............  ..............  ..............
  83002  A                               Gonadotropin (LH)..............  ..............  ..............  ..............  ..............  ..............
  83003  A                               Assay, growth hormone (hgh)....  ..............  ..............  ..............  ..............  ..............
  83008  A                               Assay of guanosine.............  ..............  ..............  ..............  ..............  ..............
  83010  A                               Assay of haptoglobin, quant....  ..............  ..............  ..............  ..............  ..............
  83012  A                               Assay of haptoglobins..........  ..............  ..............  ..............  ..............  ..............
  83013  A                               H pylori breath tst analysis...  ..............  ..............  ..............  ..............  ..............
  83014  A                               H pylori drug admin/collect....  ..............  ..............  ..............  ..............  ..............
  83015  A                               Heavy metal screen.............  ..............  ..............  ..............  ..............  ..............
  83018  A                               Quantitative screen, metals....  ..............  ..............  ..............  ..............  ..............
  83020  A                               Hemoglobin electrophoresis.....  ..............  ..............  ..............  ..............  ..............
  83021  A                               Hemoglobin chromotography......  ..............  ..............  ..............  ..............  ..............
  83026  A                               Hemoglobin, copper sulfate.....  ..............  ..............  ..............  ..............  ..............

[[Page 18641]]

 
  83030  A                               Fetal hemoglobin assay.........  ..............  ..............  ..............  ..............  ..............
  83033  A                               Fetal fecal hemoglobin assay...  ..............  ..............  ..............  ..............  ..............
  83036  A                               Glycated hemoglobin test.......  ..............  ..............  ..............  ..............  ..............
  83045  A                               Blood methemoglobin test.......  ..............  ..............  ..............  ..............  ..............
  83050  A                               Blood methemoglobin assay......  ..............  ..............  ..............  ..............  ..............
  83051  A                               Assay of plasma hemoglobin.....  ..............  ..............  ..............  ..............  ..............
  83055  A                               Blood sulfhemoglobin test......  ..............  ..............  ..............  ..............  ..............
  83060  A                               Blood sulfhemoglobin assay.....  ..............  ..............  ..............  ..............  ..............
  83065  A                               Assay of hemoglobin heat.......  ..............  ..............  ..............  ..............  ..............
  83068  A                               Hemoglobin stability screen....  ..............  ..............  ..............  ..............  ..............
  83069  A                               Assay of urine hemoglobin......  ..............  ..............  ..............  ..............  ..............
  83070  A                               Assay of hemosiderin, qual.....  ..............  ..............  ..............  ..............  ..............
  83071  A                               Assay of hemosiderin, quant....  ..............  ..............  ..............  ..............  ..............
  83080  A                               Assay of b hexosaminidase......  ..............  ..............  ..............  ..............  ..............
  83088  A                               Assay of histamine.............  ..............  ..............  ..............  ..............  ..............
  83150  A                               Assay of for hva...............  ..............  ..............  ..............  ..............  ..............
  83491  A                               Assay of corticosteroids.......  ..............  ..............  ..............  ..............  ..............
  83497  A                               Assay of 5-hiaa................  ..............  ..............  ..............  ..............  ..............
  83498  A                               Assay of progesterone..........  ..............  ..............  ..............  ..............  ..............
  83499  A                               Assay of progesterone..........  ..............  ..............  ..............  ..............  ..............
  83500  A                               Assay, free hydroxyproline.....  ..............  ..............  ..............  ..............  ..............
  83505  A                               Assay, total hydroxyproline....  ..............  ..............  ..............  ..............  ..............
  83516  A                               Immunoassay, nonantibody.......  ..............  ..............  ..............  ..............  ..............
  83518  A                               Immunoassay, dipstick..........  ..............  ..............  ..............  ..............  ..............
  83519  A                               Immunoassay, nonantibody.......  ..............  ..............  ..............  ..............  ..............
  83520  A                               Immunoassay, RIA...............  ..............  ..............  ..............  ..............  ..............
  83525  A                               Assay of insulin...............  ..............  ..............  ..............  ..............  ..............
  83527  A                               Assay of insulin...............  ..............  ..............  ..............  ..............  ..............
  83528  A                               Assay of intrinsic factor......  ..............  ..............  ..............  ..............  ..............
  83540  A                               Assay of iron..................  ..............  ..............  ..............  ..............  ..............
  83550  A                               Iron binding test..............  ..............  ..............  ..............  ..............  ..............
  83570  A                               Assay of idh enzyme............  ..............  ..............  ..............  ..............  ..............
  83582  A                               Assay of ketogenic steroids....  ..............  ..............  ..............  ..............  ..............
  83586  A                               Assay 17-ketosteroids..........  ..............  ..............  ..............  ..............  ..............
  83593  A                               Fractionation, ketosteroids....  ..............  ..............  ..............  ..............  ..............
  83605  A                               Assay of lactic acid...........  ..............  ..............  ..............  ..............  ..............
  83615  A                               Lactate (LD) (LDH) enzyme......  ..............  ..............  ..............  ..............  ..............
  83625  A                               Assay of ldh enzymes...........  ..............  ..............  ..............  ..............  ..............
  83632  A                               Placental lactogen.............  ..............  ..............  ..............  ..............  ..............
  83633  A                               Test urine for lactose.........  ..............  ..............  ..............  ..............  ..............
  83634  A                               Assay of urine for lactose.....  ..............  ..............  ..............  ..............  ..............
  83655  A                               Assay of lead..................  ..............  ..............  ..............  ..............  ..............
  83661  A                               Assay of l/s ratio.............  ..............  ..............  ..............  ..............  ..............
  83662  A                               L/S ratio, foam stability......  ..............  ..............  ..............  ..............  ..............
  83670  A                               Assay of lap enzyme............  ..............  ..............  ..............  ..............  ..............
  83690  A                               Assay of lipase................  ..............  ..............  ..............  ..............  ..............
  83715  A                               Assay of blood lipoproteins....  ..............  ..............  ..............  ..............  ..............
  83716  A                               Assay of blood lipoproteins....  ..............  ..............  ..............  ..............  ..............
  83718  A                               Assay of lipoprotein...........  ..............  ..............  ..............  ..............  ..............
  83719  A                               Assay of blood lipoprotein.....  ..............  ..............  ..............  ..............  ..............
  83721  A                               Assay of blood lipoprotein.....  ..............  ..............  ..............  ..............  ..............
  83727  A                               Assay of lrh hormone...........  ..............  ..............  ..............  ..............  ..............
  83735  A                               Assay of magnesium.............  ..............  ..............  ..............  ..............  ..............
  83775  A                               Assay of md enzyme.............  ..............  ..............  ..............  ..............  ..............
  83785  A                               Assay of manganese.............  ..............  ..............  ..............  ..............  ..............
  83788  A                               Mass spectrometry qual.........  ..............  ..............  ..............  ..............  ..............
  83789  A                               Mass spectrometry quant........  ..............  ..............  ..............  ..............  ..............
  83805  A                               Assay of meprobamate...........  ..............  ..............  ..............  ..............  ..............
  83825  A                               Assay of mercury...............  ..............  ..............  ..............  ..............  ..............
  83835  A                               Assay of metanephrines.........  ..............  ..............  ..............  ..............  ..............
  83840  A                               Assay of methadone.............  ..............  ..............  ..............  ..............  ..............
  83857  A                               Assay of methemalbumin.........  ..............  ..............  ..............  ..............  ..............
  83858  A                               Assay of methsuximide..........  ..............  ..............  ..............  ..............  ..............
  83864  A                               Mucopolysaccharides............  ..............  ..............  ..............  ..............  ..............
  83866  A                               Mucopolysaccharides screen.....  ..............  ..............  ..............  ..............  ..............
  83872  A                               Assay synovial fluid mucin.....  ..............  ..............  ..............  ..............  ..............
  83873  A                               Assay of csf protein...........  ..............  ..............  ..............  ..............  ..............
  83874  A                               Assay of myoglobin.............  ..............  ..............  ..............  ..............  ..............
  83883  A                               Assay, nephelometry not spec...  ..............  ..............  ..............  ..............  ..............
  83885  A                               Assay of nickel................  ..............  ..............  ..............  ..............  ..............
  83887  A                               Assay of nicotine..............  ..............  ..............  ..............  ..............  ..............
  83890  A                               Molecule isolate...............  ..............  ..............  ..............  ..............  ..............
  83891  A                               Molecule isolate nucleic.......  ..............  ..............  ..............  ..............  ..............

[[Page 18642]]

 
  83892  A                               Molecular diagnostics..........  ..............  ..............  ..............  ..............  ..............
  83893  A                               Molecule dot/slot/blot.........  ..............  ..............  ..............  ..............  ..............
  83894  A                               Molecule gel electrophor.......  ..............  ..............  ..............  ..............  ..............
  83896  A                               Molecular diagnostics..........  ..............  ..............  ..............  ..............  ..............
  83897  A                               Molecule nucleic transfer......  ..............  ..............  ..............  ..............  ..............
  83898  A                               Molecule nucleic ampli.........  ..............  ..............  ..............  ..............  ..............
  83901  A                               Molecule nucleic ampli.........  ..............  ..............  ..............  ..............  ..............
  83902  A                               Molecular diagnostics..........  ..............  ..............  ..............  ..............  ..............
  83903  A                               Molecule mutation scan.........  ..............  ..............  ..............  ..............  ..............
  83904  A                               Molecule mutation identify.....  ..............  ..............  ..............  ..............  ..............
  83905  A                               Molecule mutation identify.....  ..............  ..............  ..............  ..............  ..............
  83906  A                               Molecule mutation identify.....  ..............  ..............  ..............  ..............  ..............
  83912  A                               Genetic examination............  ..............  ..............  ..............  ..............  ..............
  83915  A                               Assay of nucleotidase..........  ..............  ..............  ..............  ..............  ..............
  83916  A                               Oligoclonal bands..............  ..............  ..............  ..............  ..............  ..............
  83918  A                               Assay, organic acids quant.....  ..............  ..............  ..............  ..............  ..............
  83919  A                               Assay, organic acids qual......  ..............  ..............  ..............  ..............  ..............
  83925  A                               Assay of opiates...............  ..............  ..............  ..............  ..............  ..............
  83930  A                               Assay of blood osmolality......  ..............  ..............  ..............  ..............  ..............
  83935  A                               Assay of urine osmolality......  ..............  ..............  ..............  ..............  ..............
  83937  A                               Assay of osteocalcin...........  ..............  ..............  ..............  ..............  ..............
  83945  A                               Assay of oxalate...............  ..............  ..............  ..............  ..............  ..............
  83970  A                               Assay of parathormone..........  ..............  ..............  ..............  ..............  ..............
  83986  A                               Assay of body fluid acidity....  ..............  ..............  ..............  ..............  ..............
  83992  A                               Assay for phencyclidine........  ..............  ..............  ..............  ..............  ..............
  84022  A                               Assay of phenothiazine.........  ..............  ..............  ..............  ..............  ..............
  84030  A                               Assay of blood pku.............  ..............  ..............  ..............  ..............  ..............
  84035  A                               Assay of phenylketones.........  ..............  ..............  ..............  ..............  ..............
  84060  A                               Assay acid phosphatase.........  ..............  ..............  ..............  ..............  ..............
  84061  A                               Phosphatase, forensic exam.....  ..............  ..............  ..............  ..............  ..............
  84066  A                               Assay prostate phosphatase.....  ..............  ..............  ..............  ..............  ..............
  84075  A                               Assay alkaline phosphatase.....  ..............  ..............  ..............  ..............  ..............
  84078  A                               Assay alkaline phosphatase.....  ..............  ..............  ..............  ..............  ..............
  84080  A                               Assay alkaline phosphatases....  ..............  ..............  ..............  ..............  ..............
  84081  A                               Amniotic fluid enzyme test.....  ..............  ..............  ..............  ..............  ..............
  84085  A                               Assay of rbc pg6d enzyme.......  ..............  ..............  ..............  ..............  ..............
  84087  A                               Assay phosphohexose enzymes....  ..............  ..............  ..............  ..............  ..............
  84100  A                               Assay of phosphorus............  ..............  ..............  ..............  ..............  ..............
  84105  A                               Assay of urine phosphorus......  ..............  ..............  ..............  ..............  ..............
  84106  A                               Test for porphobilinogen.......  ..............  ..............  ..............  ..............  ..............
  84110  A                               Assay of porphobilinogen.......  ..............  ..............  ..............  ..............  ..............
  84119  A                               Test urine for porphyrins......  ..............  ..............  ..............  ..............  ..............
  84120  A                               Assay of urine porphyrins......  ..............  ..............  ..............  ..............  ..............
  84126  A                               Assay of feces porphyrins......  ..............  ..............  ..............  ..............  ..............
  84127  A                               Assay of feces porphyrins......  ..............  ..............  ..............  ..............  ..............
  84132  A                               Assay of serum potassium.......  ..............  ..............  ..............  ..............  ..............
  84133  A                               Assay of urine potassium.......  ..............  ..............  ..............  ..............  ..............
  84134  A                               Assay of prealbumin............  ..............  ..............  ..............  ..............  ..............
  84135  A                               Assay of pregnanediol..........  ..............  ..............  ..............  ..............  ..............
  84138  A                               Assay of pregnanetriol.........  ..............  ..............  ..............  ..............  ..............
  84140  A                               Assay of pregnenolone..........  ..............  ..............  ..............  ..............  ..............
  84143  A                               Assay of 17-hydroxypregneno....  ..............  ..............  ..............  ..............  ..............
  84144  A                               Assay of progesterone..........  ..............  ..............  ..............  ..............  ..............
  84146  A                               Assay of prolactin.............  ..............  ..............  ..............  ..............  ..............
  84150  A                               Assay of prostaglandin.........  ..............  ..............  ..............  ..............  ..............
  84153  A                               Assay of psa, total............  ..............  ..............  ..............  ..............  ..............
  84154  A                               Assay of psa, free.............  ..............  ..............  ..............  ..............  ..............
  84155  A                               Assay of protein...............  ..............  ..............  ..............  ..............  ..............
  84160  A                               Assay of serum protein.........  ..............  ..............  ..............  ..............  ..............
  84165  A                               Assay of serum proteins........  ..............  ..............  ..............  ..............  ..............
  84181  A                               Western blot test..............  ..............  ..............  ..............  ..............  ..............
  84182  A                               Protein, western blot test.....  ..............  ..............  ..............  ..............  ..............
  84202  A                               Assay RBC protoporphyrin.......  ..............  ..............  ..............  ..............  ..............
  84203  A                               Test RBC protoporphyrin........  ..............  ..............  ..............  ..............  ..............
  84206  A                               Assay of proinsulin............  ..............  ..............  ..............  ..............  ..............
  84207  A                               Assay of vitamin b-6...........  ..............  ..............  ..............  ..............  ..............
  84210  A                               Assay of pyruvate..............  ..............  ..............  ..............  ..............  ..............
  84220  A                               Assay of pyruvate kinase.......  ..............  ..............  ..............  ..............  ..............
  84228  A                               Assay of quinine...............  ..............  ..............  ..............  ..............  ..............
  84233  A                               Assay of estrogen..............  ..............  ..............  ..............  ..............  ..............
  84234  A                               Assay of progesterone..........  ..............  ..............  ..............  ..............  ..............
  84235  A                               Assay of endocrine hormone.....  ..............  ..............  ..............  ..............  ..............
  84238  A                               Assay, nonendocrine receptor...  ..............  ..............  ..............  ..............  ..............

[[Page 18643]]

 
  84244  A                               Assay of renin.................  ..............  ..............  ..............  ..............  ..............
  84252  A                               Assay of vitamin b-2...........  ..............  ..............  ..............  ..............  ..............
  84255  A                               Assay of selenium..............  ..............  ..............  ..............  ..............  ..............
  84260  A                               Assay of serotonin.............  ..............  ..............  ..............  ..............  ..............
  84270  A                               Assay of sex hormone globul....  ..............  ..............  ..............  ..............  ..............
  84275  A                               Assay of sialic acid...........  ..............  ..............  ..............  ..............  ..............
  84285  A                               Assay of silica................  ..............  ..............  ..............  ..............  ..............
  84295  A                               Assay of serum sodium..........  ..............  ..............  ..............  ..............  ..............
  84300  A                               Assay of urine sodium..........  ..............  ..............  ..............  ..............  ..............
  84305  A                               Assay of somatomedin...........  ..............  ..............  ..............  ..............  ..............
  84307  A                               Assay of somatostatin..........  ..............  ..............  ..............  ..............  ..............
  84311  A                               Spectrophotometry..............  ..............  ..............  ..............  ..............  ..............
  84315  A                               Body fluid specific gravity....  ..............  ..............  ..............  ..............  ..............
  84375  A                               Chromatogram assay, sugars.....  ..............  ..............  ..............  ..............  ..............
  84376  A                               Sugars, single, qual...........  ..............  ..............  ..............  ..............  ..............
  84377  A                               Sugars, multiple, qual.........  ..............  ..............  ..............  ..............  ..............
  84378  A                               Sugars single quant............  ..............  ..............  ..............  ..............  ..............
  84379  A                               Sugars multiple quant..........  ..............  ..............  ..............  ..............  ..............
  84392  A                               Assay of urine sulfate.........  ..............  ..............  ..............  ..............  ..............
  84402  A                               Assay of testosterone..........  ..............  ..............  ..............  ..............  ..............
  84403  A                               Assay of total testosterone....  ..............  ..............  ..............  ..............  ..............
  84425  A                               Assay of vitamin b-1...........  ..............  ..............  ..............  ..............  ..............
  84430  A                               Assay of thiocyanate...........  ..............  ..............  ..............  ..............  ..............
  84432  A                               Assay of thyroglobulin.........  ..............  ..............  ..............  ..............  ..............
  84436  A                               Assay of total thyroxine.......  ..............  ..............  ..............  ..............  ..............
  84437  A                               Assay of neonatal thyroxine....  ..............  ..............  ..............  ..............  ..............
  84439  A                               Assay of free thyroxine........  ..............  ..............  ..............  ..............  ..............
  84442  A                               Assay of thyroid activity......  ..............  ..............  ..............  ..............  ..............
  84443  A                               Assay thyroid stim hormone.....  ..............  ..............  ..............  ..............  ..............
  84445  A                               Assay of tsi...................  ..............  ..............  ..............  ..............  ..............
  84446  A                               Assay of vitamin e.............  ..............  ..............  ..............  ..............  ..............
  84449  A                               Assay of transcortin...........  ..............  ..............  ..............  ..............  ..............
  84450  A                               Transferase (AST) (SGOT).......  ..............  ..............  ..............  ..............  ..............
  84460  A                               Alanine amino (ALT) (SGPT).....  ..............  ..............  ..............  ..............  ..............
  84466  A                               Assay of transferrin...........  ..............  ..............  ..............  ..............  ..............
  84478  A                               Assay of triglycerides.........  ..............  ..............  ..............  ..............  ..............
  84479  A                               Assay of thyroid (t3 or t4)....  ..............  ..............  ..............  ..............  ..............
  84480  A                               Assay, triiodothyronine (t3)...  ..............  ..............  ..............  ..............  ..............
  84481  A                               Free assay (FT-3)..............  ..............  ..............  ..............  ..............  ..............
  84482  A                               T3 reverse.....................  ..............  ..............  ..............  ..............  ..............
  84484  A                               Assay of troponin, quant.......  ..............  ..............  ..............  ..............  ..............
  84485  A                               Assay duodenal fluid trypsin...  ..............  ..............  ..............  ..............  ..............
  84488  A                               Test feces for trypsin.........  ..............  ..............  ..............  ..............  ..............
  84490  A                               Assay of feces for trypsin.....  ..............  ..............  ..............  ..............  ..............
  84510  A                               Assay of tyrosine..............  ..............  ..............  ..............  ..............  ..............
  84512  A                               Assay of troponin, qual........  ..............  ..............  ..............  ..............  ..............
  84520  A                               Assay of urea nitrogen.........  ..............  ..............  ..............  ..............  ..............
  84525  A                               Urea nitrogen semi-quant.......  ..............  ..............  ..............  ..............  ..............
  84540  A                               Assay of urine/urea-n..........  ..............  ..............  ..............  ..............  ..............
  84545  A                               Urea-N clearance test..........  ..............  ..............  ..............  ..............  ..............
  84550  A                               Assay of blood/uric acid.......  ..............  ..............  ..............  ..............  ..............
  84560  A                               Assay of urine/uric acid.......  ..............  ..............  ..............  ..............  ..............
  84577  A                               Assay of feces/urobilinogen....  ..............  ..............  ..............  ..............  ..............
  84578  A                               Test urine urobilinogen........  ..............  ..............  ..............  ..............  ..............
  84580  A                               Assay of urine urobilinogen....  ..............  ..............  ..............  ..............  ..............
  84583  A                               Assay of urine urobilinogen....  ..............  ..............  ..............  ..............  ..............
  84585  A                               Assay of urine vma.............  ..............  ..............  ..............  ..............  ..............
  84586  A                               Assay of vip...................  ..............  ..............  ..............  ..............  ..............
  84588  A                               Assay of vasopressin...........  ..............  ..............  ..............  ..............  ..............
  84590  A                               Assay of vitamin a.............  ..............  ..............  ..............  ..............  ..............
  84597  A                               Assay of vitamin k.............  ..............  ..............  ..............  ..............  ..............
  84600  A                               Assay of volatiles.............  ..............  ..............  ..............  ..............  ..............
  84620  A                               Xylose tolerance test..........  ..............  ..............  ..............  ..............  ..............
  84630  A                               Assay of zinc..................  ..............  ..............  ..............  ..............  ..............
  84681  A                               Assay of c-peptide.............  ..............  ..............  ..............  ..............  ..............
  84702  A                               Chorionic gonadotropin test....  ..............  ..............  ..............  ..............  ..............
  84703  A                               Chorionic gonadotropin assay...  ..............  ..............  ..............  ..............  ..............
  84830  A                               Ovulation tests................  ..............  ..............  ..............  ..............  ..............
  84999  A                               Clinical chemistry test........  ..............  ..............  ..............  ..............  ..............
  85002  A                               Bleeding time test.............  ..............  ..............  ..............  ..............  ..............
  85007  A                               Differential WBC count.........  ..............  ..............  ..............  ..............  ..............
  85008  A                               Nondifferential WBC count......  ..............  ..............  ..............  ..............  ..............
  85009  A                               Differential WBC count.........  ..............  ..............  ..............  ..............  ..............

[[Page 18644]]

 
  85013  A                               Hematocrit.....................  ..............  ..............  ..............  ..............  ..............
  85014  A                               Hematocrit.....................  ..............  ..............  ..............  ..............  ..............
  85018  A                               Hemoglobin.....................  ..............  ..............  ..............  ..............  ..............
  85021  A                               Automated hemogram.............  ..............  ..............  ..............  ..............  ..............
  85022  A                               Automated hemogram.............  ..............  ..............  ..............  ..............  ..............
  85023  A                               Automated hemogram.............  ..............  ..............  ..............  ..............  ..............
  85024  A                               Automated hemogram.............  ..............  ..............  ..............  ..............  ..............
  85025  A                               Automated hemogram.............  ..............  ..............  ..............  ..............  ..............
  85027  A                               Automated hemogram.............  ..............  ..............  ..............  ..............  ..............
  85031  A                               Manual hemogram, cbc...........  ..............  ..............  ..............  ..............  ..............
  85041  A                               Red blood cell (RBC) count.....  ..............  ..............  ..............  ..............  ..............
  85044  A                               Reticulocyte count.............  ..............  ..............  ..............  ..............  ..............
  85045  A                               Reticulocyte count.............  ..............  ..............  ..............  ..............  ..............
  85046  A                               Reticyte/hgb concentrate.......  ..............  ..............  ..............  ..............  ..............
  85048  A                               White blood cell (WBC) count...  ..............  ..............  ..............  ..............  ..............
  85060  X                               Blood smear interpretation.....            0342            0.26          $12.61           $8.03           $2.52
  85095  T                               Bone marrow aspiration.........            0003            0.98          $47.52          $27.99           $9.50
  85097  X                               Bone marrow interpretation.....            0344            0.79          $38.30          $23.63           $7.66
  85102  T                               Bone marrow biopsy.............            0003            0.98          $47.52          $27.99           $9.50
  85130  A                               Chromogenic substrate assay....  ..............  ..............  ..............  ..............  ..............
  85170  A                               Blood clot retraction..........  ..............  ..............  ..............  ..............  ..............
  85175  A                               Blood clot lysis time..........  ..............  ..............  ..............  ..............  ..............
  85210  A                               Blood clot factor II test......  ..............  ..............  ..............  ..............  ..............
  85220  A                               Blood clot factor V test.......  ..............  ..............  ..............  ..............  ..............
  85230  A                               Blood clot factor VII test.....  ..............  ..............  ..............  ..............  ..............
  85240  A                               Blood clot factor VIII test....  ..............  ..............  ..............  ..............  ..............
  85244  A                               Blood clot factor VIII test....  ..............  ..............  ..............  ..............  ..............
  85245  A                               Blood clot factor VIII test....  ..............  ..............  ..............  ..............  ..............
  85246  A                               Blood clot factor VIII test....  ..............  ..............  ..............  ..............  ..............
  85247  A                               Blood clot factor VIII test....  ..............  ..............  ..............  ..............  ..............
  85250  A                               Blood clot factor IX test......  ..............  ..............  ..............  ..............  ..............
  85260  A                               Blood clot factor X test.......  ..............  ..............  ..............  ..............  ..............
  85270  A                               Blood clot factor XI test......  ..............  ..............  ..............  ..............  ..............
  85280  A                               Blood clot factor XII test.....  ..............  ..............  ..............  ..............  ..............
  85290  A                               Blood clot factor XIII test....  ..............  ..............  ..............  ..............  ..............
  85291  A                               Blood clot factor XIII test....  ..............  ..............  ..............  ..............  ..............
  85292  A                               Blood clot factor assay........  ..............  ..............  ..............  ..............  ..............
  85293  A                               Blood clot factor assay........  ..............  ..............  ..............  ..............  ..............
  85300  A                               Antithrombin III test..........  ..............  ..............  ..............  ..............  ..............
  85301  A                               Antithrombin III test..........  ..............  ..............  ..............  ..............  ..............
  85302  A                               Blood clot inhibitor antigen...  ..............  ..............  ..............  ..............  ..............
  85303  A                               Blood clot inhibitor test......  ..............  ..............  ..............  ..............  ..............
  85305  A                               Blood clot inhibitor assay.....  ..............  ..............  ..............  ..............  ..............
  85306  A                               Blood clot inhibitor test......  ..............  ..............  ..............  ..............  ..............
  85335  A                               Factor inhibitor test..........  ..............  ..............  ..............  ..............  ..............
  85337  A                               Thrombomodulin.................  ..............  ..............  ..............  ..............  ..............
  85345  A                               Coagulation time...............  ..............  ..............  ..............  ..............  ..............
  85347  A                               Coagulation time...............  ..............  ..............  ..............  ..............  ..............
  85348  A                               Coagulation time...............  ..............  ..............  ..............  ..............  ..............
  85360  A                               Euglobulin lysis...............  ..............  ..............  ..............  ..............  ..............
  85362  A                               Fibrin degradation products....  ..............  ..............  ..............  ..............  ..............
  85366  A                               Fibrinogen test................  ..............  ..............  ..............  ..............  ..............
  85370  A                               Fibrinogen test................  ..............  ..............  ..............  ..............  ..............
  85378  A                               Fibrin degradation.............  ..............  ..............  ..............  ..............  ..............
  85379  A                               Fibrin degradation.............  ..............  ..............  ..............  ..............  ..............
  85384  A                               Fibrinogen.....................  ..............  ..............  ..............  ..............  ..............
  85385  A                               Fibrinogen.....................  ..............  ..............  ..............  ..............  ..............
  85390  A                               Fibrinolysins screen...........  ..............  ..............  ..............  ..............  ..............
  85400  A                               Fibrinolytic plasmin...........  ..............  ..............  ..............  ..............  ..............
  85410  A                               Fibrinolytic antiplasmin.......  ..............  ..............  ..............  ..............  ..............
  85415  A                               Fibrinolytic plasminogen.......  ..............  ..............  ..............  ..............  ..............
  85420  A                               Fibrinolytic plasminogen.......  ..............  ..............  ..............  ..............  ..............
  85421  A                               Fibrinolytic plasminogen.......  ..............  ..............  ..............  ..............  ..............
  85441  A                               Heinz bodies, direct...........  ..............  ..............  ..............  ..............  ..............
  85445  A                               Heinz bodies, induced..........  ..............  ..............  ..............  ..............  ..............
  85460  A                               Hemoglobin, fetal..............  ..............  ..............  ..............  ..............  ..............
  85461  A                               Hemoglobin, fetal..............  ..............  ..............  ..............  ..............  ..............
  85475  A                               Hemolysin......................  ..............  ..............  ..............  ..............  ..............
  85520  A                               Heparin assay..................  ..............  ..............  ..............  ..............  ..............
  85525  A                               Heparin........................  ..............  ..............  ..............  ..............  ..............
  85530  A                               Heparin-protamine tolerance....  ..............  ..............  ..............  ..............  ..............
  85535  A                               Iron stain, blood cells........  ..............  ..............  ..............  ..............  ..............
  85540  A                               Wbc alkaline phosphatase.......  ..............  ..............  ..............  ..............  ..............

[[Page 18645]]

 
  85547  A                               RBC mechanical fragility.......  ..............  ..............  ..............  ..............  ..............
  85549  A                               Muramidase.....................  ..............  ..............  ..............  ..............  ..............
  85555  A                               RBC osmotic fragility..........  ..............  ..............  ..............  ..............  ..............
  85557  A                               RBC osmotic fragility..........  ..............  ..............  ..............  ..............  ..............
  85576  A                               Blood platelet aggregation.....  ..............  ..............  ..............  ..............  ..............
  85585  A                               Blood platelet estimation......  ..............  ..............  ..............  ..............  ..............
  85590  A                               Platelet count, manual.........  ..............  ..............  ..............  ..............  ..............
  85595  A                               Platelet count, automated......  ..............  ..............  ..............  ..............  ..............
  85597  A                               Platelet neutralization........  ..............  ..............  ..............  ..............  ..............
  85610  A                               Prothrombin time...............  ..............  ..............  ..............  ..............  ..............
  85611  A                               Prothrombin test...............  ..............  ..............  ..............  ..............  ..............
  85612  A                               Viper venom prothrombin time...  ..............  ..............  ..............  ..............  ..............
  85613  A                               Russell viper venom, diluted...  ..............  ..............  ..............  ..............  ..............
  85635  A                               Reptilase test.................  ..............  ..............  ..............  ..............  ..............
  85651  A                               Rbc sed rate, nonautomated.....  ..............  ..............  ..............  ..............  ..............
  85652  A                               Rbc sed rate, automated........  ..............  ..............  ..............  ..............  ..............
  85660  A                               RBC sickle cell test...........  ..............  ..............  ..............  ..............  ..............
  85670  A                               Thrombin time, plasma..........  ..............  ..............  ..............  ..............  ..............
  85675  A                               Thrombin time, titer...........  ..............  ..............  ..............  ..............  ..............
  85705  A                               Thromboplastin inhibition......  ..............  ..............  ..............  ..............  ..............
  85730  A                               Thromboplastin time, partial...  ..............  ..............  ..............  ..............  ..............
  85732  A                               Thromboplastin time, partial...  ..............  ..............  ..............  ..............  ..............
  85810  A                               Blood viscosity examination....  ..............  ..............  ..............  ..............  ..............
  85999  A                               Hematology procedure...........  ..............  ..............  ..............  ..............  ..............
  86000  A                               Agglutinins, febrile...........  ..............  ..............  ..............  ..............  ..............
  86003  A                               Allergen specific IgE..........  ..............  ..............  ..............  ..............  ..............
  86005  A                               Allergen specific IgE..........  ..............  ..............  ..............  ..............  ..............
  86021  A                               WBC antibody identification....  ..............  ..............  ..............  ..............  ..............
  86022  A                               Platelet antibodies............  ..............  ..............  ..............  ..............  ..............
  86023  A                               Immunoglobulin assay...........  ..............  ..............  ..............  ..............  ..............
  86038  A                               Antinuclear antibodies.........  ..............  ..............  ..............  ..............  ..............
  86039  A                               Antinuclear antibodies (ANA)...  ..............  ..............  ..............  ..............  ..............
  86060  A                               Antistreptolysin o, titer......  ..............  ..............  ..............  ..............  ..............
  86063  A                               Antistreptolysin o, screen.....  ..............  ..............  ..............  ..............  ..............
  86077  X                               Physician blood bank service...            0343            0.45          $21.82          $12.16           $4.36
  86078  X                               Physician blood bank service...            0344            0.79          $38.30          $23.63           $7.66
  86079  X                               Physician blood bank service...            0344            0.79          $38.30          $23.63           $7.66
  86140  A                               C-reactive protein.............  ..............  ..............  ..............  ..............  ..............
  86147  A                               Cardiolipin antibody...........  ..............  ..............  ..............  ..............  ..............
  86148  A                               Phospholipid antibody..........  ..............  ..............  ..............  ..............  ..............
  86155  A                               Chemotaxis assay...............  ..............  ..............  ..............  ..............  ..............
  86156  A                               Cold agglutinin, screen........  ..............  ..............  ..............  ..............  ..............
  86157  A                               Cold agglutinin, titer.........  ..............  ..............  ..............  ..............  ..............
  86160  A                               Complement, antigen............  ..............  ..............  ..............  ..............  ..............
  86161  A                               Complement/function activity...  ..............  ..............  ..............  ..............  ..............
  86162  A                               Complement, total (CH50).......  ..............  ..............  ..............  ..............  ..............
  86171  A                               Complement fixation, each......  ..............  ..............  ..............  ..............  ..............
  86185  A                               Counterimmunoelectrophoresis...  ..............  ..............  ..............  ..............  ..............
  86215  A                               Deoxyribonuclease, antibody....  ..............  ..............  ..............  ..............  ..............
  86225  A                               DNA antibody...................  ..............  ..............  ..............  ..............  ..............
  86226  A                               DNA antibody, single strand....  ..............  ..............  ..............  ..............  ..............
  86235  A                               Nuclear antigen antibody.......  ..............  ..............  ..............  ..............  ..............
  86243  A                               Fc receptor....................  ..............  ..............  ..............  ..............  ..............
  86255  A                               Fluorescent antibody, screen...  ..............  ..............  ..............  ..............  ..............
  86256  A                               Fluorescent antibody, titer....  ..............  ..............  ..............  ..............  ..............
  86277  A                               Growth hormone antibody........  ..............  ..............  ..............  ..............  ..............
  86280  A                               Hemagglutination inhibition....  ..............  ..............  ..............  ..............  ..............
  86308  A                               Heterophile antibodies.........  ..............  ..............  ..............  ..............  ..............
  86309  A                               Heterophile antibodies.........  ..............  ..............  ..............  ..............  ..............
  86310  A                               Heterophile antibodies.........  ..............  ..............  ..............  ..............  ..............
  86316  A                               Immunoassay, tumor antigen.....  ..............  ..............  ..............  ..............  ..............
  86317  A                               Immunoassay, infectious agent..  ..............  ..............  ..............  ..............  ..............
  86318  A                               Immunoassay, infectious agent..  ..............  ..............  ..............  ..............  ..............
  86320  A                               Serum immunoelectrophoresis....  ..............  ..............  ..............  ..............  ..............
  86325  A                               Other immunoelectrophoresis....  ..............  ..............  ..............  ..............  ..............
  86327  A                               Immunoelectrophoresis assay....  ..............  ..............  ..............  ..............  ..............
  86329  A                               Immunodiffusion................  ..............  ..............  ..............  ..............  ..............
  86331  A                               Immunodiffusion ouchterlony....  ..............  ..............  ..............  ..............  ..............
  86332  A                               Immune complex assay...........  ..............  ..............  ..............  ..............  ..............
  86334  A                               Immunofixation procedure.......  ..............  ..............  ..............  ..............  ..............
  86337  A                               Insulin antibodies.............  ..............  ..............  ..............  ..............  ..............
  86340  A                               Intrinsic factor antibody......  ..............  ..............  ..............  ..............  ..............
  86341  A                               Islet cell antibody............  ..............  ..............  ..............  ..............  ..............

[[Page 18646]]

 
  86343  A                               Leukocyte histamine release....  ..............  ..............  ..............  ..............  ..............
  86344  A                               Leukocyte phagocytosis.........  ..............  ..............  ..............  ..............  ..............
  86353  A                               Lymphocyte transformation......  ..............  ..............  ..............  ..............  ..............
  86359  A                               T cells, total count...........  ..............  ..............  ..............  ..............  ..............
  86360  A                               T cell, absolute count/ratio...  ..............  ..............  ..............  ..............  ..............
  86361  A                               T cell, absolute count.........  ..............  ..............  ..............  ..............  ..............
  86376  A                               Microsomal antibody............  ..............  ..............  ..............  ..............  ..............
  86378  A                               Migration inhibitory factor....  ..............  ..............  ..............  ..............  ..............
  86382  A                               Neutralization test, viral.....  ..............  ..............  ..............  ..............  ..............
  86384  A                               Nitroblue tetrazolium dye......  ..............  ..............  ..............  ..............  ..............
  86403  A                               Particle agglutination test....  ..............  ..............  ..............  ..............  ..............
  86406  A                               Particle agglutination test....  ..............  ..............  ..............  ..............  ..............
  86430  A                               Rheumatoid factor test.........  ..............  ..............  ..............  ..............  ..............
  86431  A                               Rheumatoid factor, quant.......  ..............  ..............  ..............  ..............  ..............
  86485  X                               Skin test, candida.............            0341            0.13           $6.30           $3.67           $1.26
  86490  X                               Coccidioidomycosis skin test...            0341            0.13           $6.30           $3.67           $1.26
  86510  X                               Histoplasmosis skin test.......            0341            0.13           $6.30           $3.67           $1.26
  86580  X                               TB intradermal test............            0341            0.13           $6.30           $3.67           $1.26
  86585  X                               TB tine test...................            0341            0.13           $6.30           $3.67           $1.26
  86586  X                               Skin test, unlisted............            0341            0.13           $6.30           $3.67           $1.26
  86590  A                               Streptokinase, antibody........  ..............  ..............  ..............  ..............  ..............
  86592  A                               Blood serology, qualitative....  ..............  ..............  ..............  ..............  ..............
  86593  A                               Blood serology, quantitative...  ..............  ..............  ..............  ..............  ..............
  86602  A                               Antinomyces antibody...........  ..............  ..............  ..............  ..............  ..............
  86603  A                               Adenovirus antibody............  ..............  ..............  ..............  ..............  ..............
  86606  A                               Aspergillus antibody...........  ..............  ..............  ..............  ..............  ..............
  86609  A                               Bacterium antibody.............  ..............  ..............  ..............  ..............  ..............
  86612  A                               Blastomyces antibody...........  ..............  ..............  ..............  ..............  ..............
  86615  A                               Bordetella antibody............  ..............  ..............  ..............  ..............  ..............
  86617  A                               Lyme disease antibody..........  ..............  ..............  ..............  ..............  ..............
  86618  A                               Lyme disease antibody..........  ..............  ..............  ..............  ..............  ..............
  86619  A                               Borrelia antibody..............  ..............  ..............  ..............  ..............  ..............
  86622  A                               Brucella antibody..............  ..............  ..............  ..............  ..............  ..............
  86625  A                               Campylobacter antibody.........  ..............  ..............  ..............  ..............  ..............
  86628  A                               Candida antibody...............  ..............  ..............  ..............  ..............  ..............
  86631  A                               Chlamydia antibody.............  ..............  ..............  ..............  ..............  ..............
  86632  A                               Chlamydia igm antibody.........  ..............  ..............  ..............  ..............  ..............
  86635  A                               Coccidioides antibody..........  ..............  ..............  ..............  ..............  ..............
  86638  A                               Q fever antibody...............  ..............  ..............  ..............  ..............  ..............
  86641  A                               Cryptococcus antibody..........  ..............  ..............  ..............  ..............  ..............
  86644  A                               CMV antibody...................  ..............  ..............  ..............  ..............  ..............
  86645  A                               CMV antibody, IgM..............  ..............  ..............  ..............  ..............  ..............
  86648  A                               Diphtheria antibody............  ..............  ..............  ..............  ..............  ..............
  86651  A                               Encephalitis antibody..........  ..............  ..............  ..............  ..............  ..............
  86652  A                               Encephalitis antibody..........  ..............  ..............  ..............  ..............  ..............
  86653  A                               Encephalitis antibody..........  ..............  ..............  ..............  ..............  ..............
  86654  A                               Encephalitis antibody..........  ..............  ..............  ..............  ..............  ..............
  86658  A                               Enterovirus antibody...........  ..............  ..............  ..............  ..............  ..............
  86663  A                               Epstein-barr antibody..........  ..............  ..............  ..............  ..............  ..............
  86664  A                               Epstein-barr antibody..........  ..............  ..............  ..............  ..............  ..............
  86665  A                               Epstein-barr antibody..........  ..............  ..............  ..............  ..............  ..............
  86668  A                               Francisella tularensis.........  ..............  ..............  ..............  ..............  ..............
  86671  A                               Fungus antibody................  ..............  ..............  ..............  ..............  ..............
  86674  A                               Giardia lamblia antibody.......  ..............  ..............  ..............  ..............  ..............
  86677  A                               Helicobacter pylori............  ..............  ..............  ..............  ..............  ..............
  86682  A                               Helminth antibody..............  ..............  ..............  ..............  ..............  ..............
  86684  A                               Hemophilus influenza...........  ..............  ..............  ..............  ..............  ..............
  86687  A                               Htlv-i antibody................  ..............  ..............  ..............  ..............  ..............
  86688  A                               Htlv-ii antibody...............  ..............  ..............  ..............  ..............  ..............
  86689  A                               HTLV/HIV confirmatory test.....  ..............  ..............  ..............  ..............  ..............
  86692  A                               Hepatitis, delta agent.........  ..............  ..............  ..............  ..............  ..............
  86694  A                               Herpes simplex test............  ..............  ..............  ..............  ..............  ..............
  86695  A                               Herpes simplex test............  ..............  ..............  ..............  ..............  ..............
  86698  A                               Histoplasma....................  ..............  ..............  ..............  ..............  ..............
  86701  A                               HIV-1..........................  ..............  ..............  ..............  ..............  ..............
  86702  A                               HIV-2..........................  ..............  ..............  ..............  ..............  ..............
  86703  A                               HIV-1/HIV-2, single assay......  ..............  ..............  ..............  ..............  ..............
  86704  A                               Hep b core antibody, igg/igm...  ..............  ..............  ..............  ..............  ..............
  86705  A                               Hep b core antibody, igm.......  ..............  ..............  ..............  ..............  ..............
  86706  A                               Hep b surface antibody.........  ..............  ..............  ..............  ..............  ..............
  86707  A                               Hep be antibody................  ..............  ..............  ..............  ..............  ..............
  86708  A                               Hep a antibody, igg/igm........  ..............  ..............  ..............  ..............  ..............
  86709  A                               Hep a antibody, igm............  ..............  ..............  ..............  ..............  ..............

[[Page 18647]]

 
  86710  A                               Influenza virus antibody.......  ..............  ..............  ..............  ..............  ..............
  86713  A                               Legionella antibody............  ..............  ..............  ..............  ..............  ..............
  86717  A                               Leishmania antibody............  ..............  ..............  ..............  ..............  ..............
  86720  A                               Leptospira antibody............  ..............  ..............  ..............  ..............  ..............
  86723  A                               Listeria monocytogenes ab......  ..............  ..............  ..............  ..............  ..............
  86727  A                               Lymph choriomeningitis ab......  ..............  ..............  ..............  ..............  ..............
  86729  A                               Lympho venereum antibody.......  ..............  ..............  ..............  ..............  ..............
  86732  A                               Mucormycosis antibody..........  ..............  ..............  ..............  ..............  ..............
  86735  A                               Mumps antibody.................  ..............  ..............  ..............  ..............  ..............
  86738  A                               Mycoplasma antibody............  ..............  ..............  ..............  ..............  ..............
  86741  A                               Neisseria meningitidis.........  ..............  ..............  ..............  ..............  ..............
  86744  A                               Nocardia antibody..............  ..............  ..............  ..............  ..............  ..............
  86747  A                               Parvovirus antibody............  ..............  ..............  ..............  ..............  ..............
  86750  A                               Malaria antibody...............  ..............  ..............  ..............  ..............  ..............
  86753  A                               Protozoa antibody nos..........  ..............  ..............  ..............  ..............  ..............
  86756  A                               Respiratory virus antibody.....  ..............  ..............  ..............  ..............  ..............
  86759  A                               Rotavirus antibody.............  ..............  ..............  ..............  ..............  ..............
  86762  A                               Rubella antibody...............  ..............  ..............  ..............  ..............  ..............
  86765  A                               Rubeola antibody...............  ..............  ..............  ..............  ..............  ..............
  86768  A                               Salmonella antibody............  ..............  ..............  ..............  ..............  ..............
  86771  A                               Shigella antibody..............  ..............  ..............  ..............  ..............  ..............
  86774  A                               Tetanus antibody...............  ..............  ..............  ..............  ..............  ..............
  86777  A                               Toxoplasma antibody............  ..............  ..............  ..............  ..............  ..............
  86778  A                               Toxoplasma antibody, igm.......  ..............  ..............  ..............  ..............  ..............
  86781  A                               Treponema pallidum, confirm....  ..............  ..............  ..............  ..............  ..............
  86784  A                               Trichinella antibody...........  ..............  ..............  ..............  ..............  ..............
  86787  A                               Varicella-zoster antibody......  ..............  ..............  ..............  ..............  ..............
  86790  A                               Virus antibody nos.............  ..............  ..............  ..............  ..............  ..............
  86793  A                               Yersinia antibody..............  ..............  ..............  ..............  ..............  ..............
  86800  A                               Thyroglobulin antibody.........  ..............  ..............  ..............  ..............  ..............
  86803  A                               Hepatitis c ab test............  ..............  ..............  ..............  ..............  ..............
  86804  A                               Hep c ab test, confirm.........  ..............  ..............  ..............  ..............  ..............
  86805  A                               Lymphocytotoxicity assay.......  ..............  ..............  ..............  ..............  ..............
  86806  A                               Lymphocytotoxicity assay.......  ..............  ..............  ..............  ..............  ..............
  86807  A                               Cytotoxic antibody screening...  ..............  ..............  ..............  ..............  ..............
  86808  A                               Cytotoxic antibody screening...  ..............  ..............  ..............  ..............  ..............
  86812  A                               HLA typing, A, B, or C.........  ..............  ..............  ..............  ..............  ..............
  86813  A                               HLA typing, A, B, or C.........  ..............  ..............  ..............  ..............  ..............
  86816  A                               HLA typing, DR/DQ..............  ..............  ..............  ..............  ..............  ..............
  86817  A                               HLA typing, DR/DQ..............  ..............  ..............  ..............  ..............  ..............
  86821  A                               Lymphocyte culture, mixed......  ..............  ..............  ..............  ..............  ..............
  86822  A                               Lymphocyte culture, primed.....  ..............  ..............  ..............  ..............  ..............
  86849  A                               Immunology procedure...........  ..............  ..............  ..............  ..............  ..............
  86850  A                               RBC antibody screen............  ..............  ..............  ..............  ..............  ..............
  86860  A                               RBC antibody elution...........  ..............  ..............  ..............  ..............  ..............
  86870  A                               RBC antibody identification....  ..............  ..............  ..............  ..............  ..............
  86880  A                               Coombs test....................  ..............  ..............  ..............  ..............  ..............
  86885  A                               Coombs test....................  ..............  ..............  ..............  ..............  ..............
  86886  A                               Coombs test....................  ..............  ..............  ..............  ..............  ..............
  86890  A                               Autologous blood process.......  ..............  ..............  ..............  ..............  ..............
  86891  A                               Autologous blood, op salvage...  ..............  ..............  ..............  ..............  ..............
  86900  A                               Blood typing, ABO..............  ..............  ..............  ..............  ..............  ..............
  86901  A                               Blood typing, Rh (D)...........  ..............  ..............  ..............  ..............  ..............
  86903  A                               Blood typing, antigen screen...  ..............  ..............  ..............  ..............  ..............
  86904  A                               Blood typing, patient serum....  ..............  ..............  ..............  ..............  ..............
  86905  A                               Blood typing, RBC antigens.....  ..............  ..............  ..............  ..............  ..............
  86906  A                               Blood typing, Rh phenotype.....  ..............  ..............  ..............  ..............  ..............
  86910  E                               Blood typing, paternity test...  ..............  ..............  ..............  ..............  ..............
  86911  E                               Blood typing, antigen system...  ..............  ..............  ..............  ..............  ..............
  86915  A                               Bone marrow/stem cell prep.....  ..............  ..............  ..............  ..............  ..............
  86920  A                               Compatibility test.............  ..............  ..............  ..............  ..............  ..............
  86921  A                               Compatibility test.............  ..............  ..............  ..............  ..............  ..............
  86922  A                               Compatibility test.............  ..............  ..............  ..............  ..............  ..............
  86927  A                               Plasma, fresh frozen...........  ..............  ..............  ..............  ..............  ..............
  86930  A                               Frozen blood prep..............  ..............  ..............  ..............  ..............  ..............
  86931  A                               Frozen blood thaw..............  ..............  ..............  ..............  ..............  ..............
  86932  A                               Frozen blood freeze/thaw.......  ..............  ..............  ..............  ..............  ..............
  86940  A                               Hemolysins/agglutinins, auto...  ..............  ..............  ..............  ..............  ..............
  86941  A                               Hemolysins/agglutinins.........  ..............  ..............  ..............  ..............  ..............
  86945  A                               Blood product/irradiation......  ..............  ..............  ..............  ..............  ..............
  86950  A                               Leukacyte transfusion..........  ..............  ..............  ..............  ..............  ..............
  86965  A                               Pooling blood platelets........  ..............  ..............  ..............  ..............  ..............
  86970  A                               RBC pretreatment...............  ..............  ..............  ..............  ..............  ..............

[[Page 18648]]

 
  86971  A                               RBC pretreatment...............  ..............  ..............  ..............  ..............  ..............
  86972  A                               RBC pretreatment...............  ..............  ..............  ..............  ..............  ..............
  86975  A                               RBC pretreatment, serum........  ..............  ..............  ..............  ..............  ..............
  86976  A                               RBC pretreatment, serum........  ..............  ..............  ..............  ..............  ..............
  86977  A                               RBC pretreatment, serum........  ..............  ..............  ..............  ..............  ..............
  86978  A                               RBC pretreatment, serum........  ..............  ..............  ..............  ..............  ..............
  86985  A                               Split blood or products........  ..............  ..............  ..............  ..............  ..............
  86999  A                               Transfusion procedure..........  ..............  ..............  ..............  ..............  ..............
  87001  A                               Small animal inoculation.......  ..............  ..............  ..............  ..............  ..............
  87003  A                               Small animal inoculation.......  ..............  ..............  ..............  ..............  ..............
  87015  A                               Specimen concentration.........  ..............  ..............  ..............  ..............  ..............
  87040  A                               Blood culture for bacteria.....  ..............  ..............  ..............  ..............  ..............
  87045  A                               Stool culture for bacteria.....  ..............  ..............  ..............  ..............  ..............
  87060  A                               Nose/throat culture, bact......  ..............  ..............  ..............  ..............  ..............
  87070  A                               Culture specimen, bacteria.....  ..............  ..............  ..............  ..............  ..............
  87072  A                               Culture of specimen by kit.....  ..............  ..............  ..............  ..............  ..............
  87075  A                               Culture specimen, bacteria.....  ..............  ..............  ..............  ..............  ..............
  87076  A                               Bacteria identification........  ..............  ..............  ..............  ..............  ..............
  87081  A                               Bacteria culture screen........  ..............  ..............  ..............  ..............  ..............
  87082  A                               Culture of specimen by kit.....  ..............  ..............  ..............  ..............  ..............
  87083  A                               Culture of specimen by kit.....  ..............  ..............  ..............  ..............  ..............
  87084  A                               Culture of specimen by kit.....  ..............  ..............  ..............  ..............  ..............
  87085  A                               Culture of specimen by kit.....  ..............  ..............  ..............  ..............  ..............
  87086  A                               Urine culture/colony count.....  ..............  ..............  ..............  ..............  ..............
  87087  A                               Urine bacteria culture.........  ..............  ..............  ..............  ..............  ..............
  87088  A                               Urine bacteria culture.........  ..............  ..............  ..............  ..............  ..............
  87101  A                               Skin fungus culture............  ..............  ..............  ..............  ..............  ..............
  87102  A                               Fungus isolation culture.......  ..............  ..............  ..............  ..............  ..............
  87103  A                               Blood fungus culture...........  ..............  ..............  ..............  ..............  ..............
  87106  A                               Fungus identification..........  ..............  ..............  ..............  ..............  ..............
  87109  A                               Mycoplasma culture.............  ..............  ..............  ..............  ..............  ..............
  87110  A                               Culture, chlamydia.............  ..............  ..............  ..............  ..............  ..............
  87116  A                               Mycobacteria culture...........  ..............  ..............  ..............  ..............  ..............
  87117  A                               Mycobacteria culture...........  ..............  ..............  ..............  ..............  ..............
  87118  A                               Mycobacteria identification....  ..............  ..............  ..............  ..............  ..............
  87140  A                               Culture typing, fluorescent....  ..............  ..............  ..............  ..............  ..............
  87143  A                               Culture typing, GLC method.....  ..............  ..............  ..............  ..............  ..............
  87145  A                               Culture typing, phage method...  ..............  ..............  ..............  ..............  ..............
  87147  A                               Culture typing, serologic......  ..............  ..............  ..............  ..............  ..............
  87151  A                               Culture typing, serologic......  ..............  ..............  ..............  ..............  ..............
  87155  A                               Culture typing, precipitin.....  ..............  ..............  ..............  ..............  ..............
  87158  A                               Culture typing, added method...  ..............  ..............  ..............  ..............  ..............
  87163  A                               Special microbiology culture...  ..............  ..............  ..............  ..............  ..............
  87164  A                               Dark field examination.........  ..............  ..............  ..............  ..............  ..............
  87166  A                               Dark field examination.........  ..............  ..............  ..............  ..............  ..............
  87174  A                               Endotoxin, bacterial...........  ..............  ..............  ..............  ..............  ..............
  87175  A                               Assay, endotoxin, bacterial....  ..............  ..............  ..............  ..............  ..............
  87176  A                               Endotoxin, bacterial...........  ..............  ..............  ..............  ..............  ..............
  87177  A                               Ova and parasites smears.......  ..............  ..............  ..............  ..............  ..............
  87181  A                               Antibiotic sensitivity, each...  ..............  ..............  ..............  ..............  ..............
  87184  A                               Antibiotic sensitivity, each...  ..............  ..............  ..............  ..............  ..............
  87186  A                               Antibiotic sensitivity, MIC....  ..............  ..............  ..............  ..............  ..............
  87187  A                               Antibiotic sensitivity, MBC....  ..............  ..............  ..............  ..............  ..............
  87188  A                               Antibiotic sensitivity, each...  ..............  ..............  ..............  ..............  ..............
  87190  A                               TB antibiotic sensitivity......  ..............  ..............  ..............  ..............  ..............
  87192  A                               Antibiotic sensitivity, each...  ..............  ..............  ..............  ..............  ..............
  87197  A                               Bactericidal level, serum......  ..............  ..............  ..............  ..............  ..............
  87205  A                               Smear, stain & interpret.......  ..............  ..............  ..............  ..............  ..............
  87206  A                               Smear, stain & interpret.......  ..............  ..............  ..............  ..............  ..............
  87207  A                               Smear, stain & interpret.......  ..............  ..............  ..............  ..............  ..............
  87208  A                               Smear, stain & interpret.......  ..............  ..............  ..............  ..............  ..............
  87210  A                               Smear, stain & interpret.......  ..............  ..............  ..............  ..............  ..............
  87211  A                               Smear, stain & interpret.......  ..............  ..............  ..............  ..............  ..............
  87220  A                               Tissue exam for fungi..........  ..............  ..............  ..............  ..............  ..............
  87230  A                               Assay, toxin or antitoxin......  ..............  ..............  ..............  ..............  ..............
  87250  A                               Virus inoculation for test.....  ..............  ..............  ..............  ..............  ..............
  87252  A                               Virus inoculation for test.....  ..............  ..............  ..............  ..............  ..............
  87253  A                               Virus inoculation for test.....  ..............  ..............  ..............  ..............  ..............
  87260  A                               Adenovirus ag, dfa.............  ..............  ..............  ..............  ..............  ..............
  87265  A                               Pertussis ag, dfa..............  ..............  ..............  ..............  ..............  ..............
  87270  A                               Chylmd trach ag, dfa...........  ..............  ..............  ..............  ..............  ..............
  87272  A                               Cryptosporidum ag, dfa.........  ..............  ..............  ..............  ..............  ..............
  87274  A                               Herpes simplex ag, dfa.........  ..............  ..............  ..............  ..............  ..............

[[Page 18649]]

 
  87276  A                               Influenza ag, dfa..............  ..............  ..............  ..............  ..............  ..............
  87278  A                               Legion pneumo ag, dfa..........  ..............  ..............  ..............  ..............  ..............
  87280  A                               Resp syncytial ag, dfa.........  ..............  ..............  ..............  ..............  ..............
  87285  A                               Trepon pallidum ag, dfa........  ..............  ..............  ..............  ..............  ..............
  87290  A                               Varicella ag, dfa..............  ..............  ..............  ..............  ..............  ..............
  87299  A                               Ag detection nos, dfa..........  ..............  ..............  ..............  ..............  ..............
  87301  A                               Adenovirus ag, eia.............  ..............  ..............  ..............  ..............  ..............
  87320  A                               Chylmd trach ag, eia...........  ..............  ..............  ..............  ..............  ..............
  87324  A                               Clostridium ag, eia............  ..............  ..............  ..............  ..............  ..............
  87328  A                               Cryptospor ag, eia.............  ..............  ..............  ..............  ..............  ..............
  87332  A                               Cytomegalovirus ag, eia........  ..............  ..............  ..............  ..............  ..............
  87335  A                               E coli 0157 ag, eia............  ..............  ..............  ..............  ..............  ..............
  87338  A                               Hpylori, stool, eia............  ..............  ..............  ..............  ..............  ..............
  87340  A                               Hepatitis b surface ag, eia....  ..............  ..............  ..............  ..............  ..............
  87350  A                               Hepatitis be ag, eia...........  ..............  ..............  ..............  ..............  ..............
  87380  A                               Hepatitis delta ag, eia........  ..............  ..............  ..............  ..............  ..............
  87385  A                               Histoplasma capsul ag, eia.....  ..............  ..............  ..............  ..............  ..............
  87390  A                               Hiv-1 ag, eia..................  ..............  ..............  ..............  ..............  ..............
  87391  A                               Hiv-2 ag, eia..................  ..............  ..............  ..............  ..............  ..............
  87420  A                               Resp syncytial ag, eia.........  ..............  ..............  ..............  ..............  ..............
  87425  A                               Rotavirus ag, eia..............  ..............  ..............  ..............  ..............  ..............
  87430  A                               Strep a ag, eia................  ..............  ..............  ..............  ..............  ..............
  87449  A                               Ag detect nos, eia, mult.......  ..............  ..............  ..............  ..............  ..............
  87450  A                               Ag detect nos, eia, single.....  ..............  ..............  ..............  ..............  ..............
  87470  A                               Bartonella, dna, dir probe.....  ..............  ..............  ..............  ..............  ..............
  87471  A                               Bartonella, dna, amp probe.....  ..............  ..............  ..............  ..............  ..............
  87472  A                               Bartonella, dna, quant.........  ..............  ..............  ..............  ..............  ..............
  87475  A                               Lyme dis, dna, dir probe.......  ..............  ..............  ..............  ..............  ..............
  87476  A                               Lyme dis, dna, amp probe.......  ..............  ..............  ..............  ..............  ..............
  87477  A                               Lyme dis, dna, quant...........  ..............  ..............  ..............  ..............  ..............
  87480  A                               Candida, dna, dir probe........  ..............  ..............  ..............  ..............  ..............
  87481  A                               Candida, dna, amp probe........  ..............  ..............  ..............  ..............  ..............
  87482  A                               Candida, dna, quant............  ..............  ..............  ..............  ..............  ..............
  87485  A                               Chylmd pneum, dna, dir probe...  ..............  ..............  ..............  ..............  ..............
  87486  A                               Chylmd pneum, dna, amp probe...  ..............  ..............  ..............  ..............  ..............
  87487  A                               Chylmd pneum, dna, quant.......  ..............  ..............  ..............  ..............  ..............
  87490  A                               Chylmd trach, dna, dir probe...  ..............  ..............  ..............  ..............  ..............
  87491  A                               Chylmd trach, dna, amp probe...  ..............  ..............  ..............  ..............  ..............
  87492  A                               Chylmd trach, dna, quant.......  ..............  ..............  ..............  ..............  ..............
  87495  A                               Cytomeg, dna, dir probe........  ..............  ..............  ..............  ..............  ..............
  87496  A                               Cytomeg, dna, amp probe........  ..............  ..............  ..............  ..............  ..............
  87497  A                               Cytomeg, dna, quant............  ..............  ..............  ..............  ..............  ..............
  87510  A                               Gardner vag, dna, dir probe....  ..............  ..............  ..............  ..............  ..............
  87511  A                               Gardner vag, dna, amp probe....  ..............  ..............  ..............  ..............  ..............
  87512  A                               Gardner vag, dna, quant........  ..............  ..............  ..............  ..............  ..............
  87515  A                               Hepatitis b, dna, dir probe....  ..............  ..............  ..............  ..............  ..............
  87516  A                               Hepatitis b, dna, amp probe....  ..............  ..............  ..............  ..............  ..............
  87517  A                               Hepatitis b, dna, quant........  ..............  ..............  ..............  ..............  ..............
  87520  A                               Hepatitis c, rna, dir probe....  ..............  ..............  ..............  ..............  ..............
  87521  A                               Hepatitis c, rna, amp probe....  ..............  ..............  ..............  ..............  ..............
  87522  A                               Hepatitis c, rna, quant........  ..............  ..............  ..............  ..............  ..............
  87525  A                               Hepatitis g, dna, dir probe....  ..............  ..............  ..............  ..............  ..............
  87526  A                               Hepatitis g, dna, amp probe....  ..............  ..............  ..............  ..............  ..............
  87527  A                               Hepatitis g, dna, quant........  ..............  ..............  ..............  ..............  ..............
  87528  A                               Hsv, dna, dir probe............  ..............  ..............  ..............  ..............  ..............
  87529  A                               Hsv, dna, amp probe............  ..............  ..............  ..............  ..............  ..............
  87530  A                               Hsv, dna, quant................  ..............  ..............  ..............  ..............  ..............
  87531  A                               Hhv-6, dna, dir probe..........  ..............  ..............  ..............  ..............  ..............
  87532  A                               Hhv-6, dna, amp probe..........  ..............  ..............  ..............  ..............  ..............
  87533  A                               Hhv-6, dna, quant..............  ..............  ..............  ..............  ..............  ..............
  87534  A                               Hiv-1, dna, dir probe..........  ..............  ..............  ..............  ..............  ..............
  87535  A                               Hiv-1, dna, amp probe..........  ..............  ..............  ..............  ..............  ..............
  87536  A                               Hiv-1, dna, quant..............  ..............  ..............  ..............  ..............  ..............
  87537  A                               Hiv-2, dna, dir probe..........  ..............  ..............  ..............  ..............  ..............
  87538  A                               Hiv-2, dna, amp probe..........  ..............  ..............  ..............  ..............  ..............
  87539  A                               Hiv-2, dna, quant..............  ..............  ..............  ..............  ..............  ..............
  87540  A                               Legion pneumo, dna, dir prob...  ..............  ..............  ..............  ..............  ..............
  87541  A                               Legion pneumo, dna, amp prob...  ..............  ..............  ..............  ..............  ..............
  87542  A                               Legion pneumo, dna, quant......  ..............  ..............  ..............  ..............  ..............
  87550  A                               Mycobacteria, dna, dir probe...  ..............  ..............  ..............  ..............  ..............
  87551  A                               Mycobacteria, dna, amp probe...  ..............  ..............  ..............  ..............  ..............
  87552  A                               Mycobacteria, dna, quant.......  ..............  ..............  ..............  ..............  ..............
  87555  A                               M.tuberculo, dna, dir probe....  ..............  ..............  ..............  ..............  ..............

[[Page 18650]]

 
  87556  A                               M.tuberculo, dna, amp probe....  ..............  ..............  ..............  ..............  ..............
  87557  A                               M.tuberculo, dna, quant........  ..............  ..............  ..............  ..............  ..............
  87560  A                               M.avium-intra, dna, dir prob...  ..............  ..............  ..............  ..............  ..............
  87561  A                               M.avium-intra, dna, amp prob...  ..............  ..............  ..............  ..............  ..............
  87562  A                               M.avium-intra, dna, quant......  ..............  ..............  ..............  ..............  ..............
  87580  A                               M.pneumon, dna, dir probe......  ..............  ..............  ..............  ..............  ..............
  87581  A                               M.pneumon, dna, amp probe......  ..............  ..............  ..............  ..............  ..............
  87582  A                               M.pneumon, dna, quant..........  ..............  ..............  ..............  ..............  ..............
  87590  A                               N.gonorrhoeae, dna, dir prob...  ..............  ..............  ..............  ..............  ..............
  87591  A                               N.gonorrhoeae, dna, amp prob...  ..............  ..............  ..............  ..............  ..............
  87592  A                               N.gonorrhoeae, dna, quant......  ..............  ..............  ..............  ..............  ..............
  87620  A                               Hpv, dna, dir probe............  ..............  ..............  ..............  ..............  ..............
  87621  A                               Hpv, dna, amp probe............  ..............  ..............  ..............  ..............  ..............
  87622  A                               Hpv, dna, quant................  ..............  ..............  ..............  ..............  ..............
  87650  A                               Strep a, dna, dir probe........  ..............  ..............  ..............  ..............  ..............
  87651  A                               Strep a, dna, amp probe........  ..............  ..............  ..............  ..............  ..............
  87652  A                               Strep a, dna, quant............  ..............  ..............  ..............  ..............  ..............
  87797  A                               Detect agent nos, dna, dir.....  ..............  ..............  ..............  ..............  ..............
  87798  A                               Detect agent nos, dna, amp.....  ..............  ..............  ..............  ..............  ..............
  87799  A                               Detect agent nos, dna, quant...  ..............  ..............  ..............  ..............  ..............
  87810  A                               Chylmd trach assay w/optic.....  ..............  ..............  ..............  ..............  ..............
  87850  A                               N. gonorrhoeae assay w/optic...  ..............  ..............  ..............  ..............  ..............
  87880  A                               Strep a assay w/optic..........  ..............  ..............  ..............  ..............  ..............
  87899  A                               Agent nos assay w/optic........  ..............  ..............  ..............  ..............  ..............
  87999  A                               Microbiology procedure.........  ..............  ..............  ..............  ..............  ..............
  88000  E                               Autopsy (necropsy), gross......  ..............  ..............  ..............  ..............  ..............
  88005  E                               Autopsy (necropsy), gross......  ..............  ..............  ..............  ..............  ..............
  88007  E                               Autopsy (necropsy), gross......  ..............  ..............  ..............  ..............  ..............
  88012  E                               Autopsy (necropsy), gross......  ..............  ..............  ..............  ..............  ..............
  88014  E                               Autopsy (necropsy), gross......  ..............  ..............  ..............  ..............  ..............
  88016  E                               Autopsy (necropsy), gross......  ..............  ..............  ..............  ..............  ..............
  88020  E                               Autopsy (necropsy), complete...  ..............  ..............  ..............  ..............  ..............
  88025  E                               Autopsy (necropsy), complete...  ..............  ..............  ..............  ..............  ..............
  88027  E                               Autopsy (necropsy), complete...  ..............  ..............  ..............  ..............  ..............
  88028  E                               Autopsy (necropsy), complete...  ..............  ..............  ..............  ..............  ..............
  88029  E                               Autopsy (necropsy), complete...  ..............  ..............  ..............  ..............  ..............
  88036  E                               Limited autopsy................  ..............  ..............  ..............  ..............  ..............
  88037  E                               Limited autopsy................  ..............  ..............  ..............  ..............  ..............
  88040  E                               Forensic autopsy (necropsy)....  ..............  ..............  ..............  ..............  ..............
  88045  E                               Coroner's autopsy (necropsy)...  ..............  ..............  ..............  ..............  ..............
  88099  E                               Necropsy (autopsy) procedure...  ..............  ..............  ..............  ..............  ..............
  88104  X                               Cytopathology, fluids..........            0343            0.45          $21.82          $12.16           $4.36
  88106  X                               Cytopathology, fluids..........            0343            0.45          $21.82          $12.16           $4.36
  88107  X                               Cytopathology, fluids..........            0343            0.45          $21.82          $12.16           $4.36
  88108  X                               Cytopath, concentrate tech.....            0343            0.45          $21.82          $12.16           $4.36
  88125  X                               Forensic cytopathology.........            0343            0.45          $21.82          $12.16           $4.36
  88130  A                               Sex chromatin identification...  ..............  ..............  ..............  ..............  ..............
  88140  A                               Sex chromatin identification...  ..............  ..............  ..............  ..............  ..............
  88141  N                               Cytopath, c/v, interpret.......  ..............  ..............  ..............  ..............  ..............
  88142  A                               Cytopath, c/v, thin layer......  ..............  ..............  ..............  ..............  ..............
  88143  A                               Cytopath c/v thin layer redo...  ..............  ..............  ..............  ..............  ..............
  88144  A                               Cytopath, c/v thin lyr redo....  ..............  ..............  ..............  ..............  ..............
  88145  A                               Cytopath, c/v thin lyr sel.....  ..............  ..............  ..............  ..............  ..............
  88147  A                               Cytopath, c/v, automated.......  ..............  ..............  ..............  ..............  ..............
  88148  A                               Cytopath, c/v, auto rescreen...  ..............  ..............  ..............  ..............  ..............
  88150  A                               Cytopath, c/v, manual..........  ..............  ..............  ..............  ..............  ..............
  88152  A                               Cytopath, c/v, auto redo.......  ..............  ..............  ..............  ..............  ..............
  88153  A                               Cytopath, c/v, redo............  ..............  ..............  ..............  ..............  ..............
  88154  A                               Cytopath, c/v, select..........  ..............  ..............  ..............  ..............  ..............
  88155  A                               Cytopath, c/v, index add-on....  ..............  ..............  ..............  ..............  ..............
  88160  X                               Cytopath smear, other source...            0342            0.26          $12.61           $8.03           $2.52
  88161  X                               Cytopath smear, other source...            0343            0.45          $21.82          $12.16           $4.36
  88162  X                               Cytopath smear, other source...            0343            0.45          $21.82          $12.16           $4.36
  88164  A                               Cytopath tbs, c/v, manual......  ..............  ..............  ..............  ..............  ..............
  88165  A                               Cytopath tbs, c/v, redo........  ..............  ..............  ..............  ..............  ..............
  88166  A                               Cytopath tbs, c/v, auto redo...  ..............  ..............  ..............  ..............  ..............
  88167  A                               Cytopath tbs, c/v, select......  ..............  ..............  ..............  ..............  ..............
  88170  T                               Fine needle aspiration.........            0002            0.62          $30.06          $17.66           $6.01
  88171  T                               Fine needle aspiration.........            0002            0.62          $30.06          $17.66           $6.01
  88172  X                               Evaluation of smear............            0343            0.45          $21.82          $12.16           $4.36
  88173  X                               Interpretation of smear........            0343            0.45          $21.82          $12.16           $4.36
  88180  X                               Cell marker study..............            0344            0.79          $38.30          $23.63           $7.66
  88182  X                               Cell marker study..............            0344            0.79          $38.30          $23.63           $7.66

[[Page 18651]]

 
  88199  X                               Cytopathology procedure........            0342            0.26          $12.61           $8.03           $2.52
  88230  A                               Tissue culture, lymphocyte.....  ..............  ..............  ..............  ..............  ..............
  88233  A                               Tissue culture, skin/biopsy....  ..............  ..............  ..............  ..............  ..............
  88235  A                               Tissue culture, placenta.......  ..............  ..............  ..............  ..............  ..............
  88237  A                               Tissue culture, bone marrow....  ..............  ..............  ..............  ..............  ..............
  88239  A                               Tissue culture, tumor..........  ..............  ..............  ..............  ..............  ..............
  88240  A                               Cell cryopreserve/storage......  ..............  ..............  ..............  ..............  ..............
  88241  A                               Frozen cell preparation........  ..............  ..............  ..............  ..............  ..............
  88245  A                               Chromosome analysis, 20-25.....  ..............  ..............  ..............  ..............  ..............
  88248  A                               Chromosome analysis, 50-100....  ..............  ..............  ..............  ..............  ..............
  88249  A                               Chromosome analysis, 100.......  ..............  ..............  ..............  ..............  ..............
  88261  A                               Chromosome analysis, 5.........  ..............  ..............  ..............  ..............  ..............
  88262  A                               Chromosome analysis, 15-20.....  ..............  ..............  ..............  ..............  ..............
  88263  A                               Chromosome analysis, 45........  ..............  ..............  ..............  ..............  ..............
  88264  A                               Chromosome analysis, 20-25.....  ..............  ..............  ..............  ..............  ..............
  88267  A                               Chromosome analys, placenta....  ..............  ..............  ..............  ..............  ..............
  88269  A                               Chromosome analys, amniotic....  ..............  ..............  ..............  ..............  ..............
  88271  A                               Cytogenetics, dna probe........  ..............  ..............  ..............  ..............  ..............
  88272  A                               Cytogenetics, 3-5..............  ..............  ..............  ..............  ..............  ..............
  88273  A                               Cytogenetics, 10-30............  ..............  ..............  ..............  ..............  ..............
  88274  A                               Cytogenetics, 25-99............  ..............  ..............  ..............  ..............  ..............
  88275  A                               Cytogenetics, 100-300..........  ..............  ..............  ..............  ..............  ..............
  88280  A                               Chromosome karyotype study.....  ..............  ..............  ..............  ..............  ..............
  88283  A                               Chromosome banding study.......  ..............  ..............  ..............  ..............  ..............
  88285  A                               Chromosome count, additional...  ..............  ..............  ..............  ..............  ..............
  88289  A                               Chromosome study, additional...  ..............  ..............  ..............  ..............  ..............
  88291  A                               Cyto/molecular report..........  ..............  ..............  ..............  ..............  ..............
  88299  A                               Cytogenetic study..............  ..............  ..............  ..............  ..............  ..............
  88300  X                               Surgical path, gross...........            0342            0.26          $12.61           $8.03           $2.52
  88302  X                               Tissue exam by pathologist.....            0342            0.26          $12.61           $8.03           $2.52
  88304  X                               Tissue exam by pathologist.....            0343            0.45          $21.82          $12.16           $4.36
  88305  X                               Tissue exam by pathologist.....            0343            0.45          $21.82          $12.16           $4.36
  88307  X                               Tissue exam by pathologist.....            0344            0.79          $38.30          $23.63           $7.66
  88309  X                               Tissue exam by pathologist.....            0344            0.79          $38.30          $23.63           $7.66
  88311  X                               Decalcify tissue...............            0342            0.26          $12.61           $8.03           $2.52
  88312  X                               Special stains.................            0343            0.45          $21.82          $12.16           $4.36
  88313  X                               Special stains.................            0342            0.26          $12.61           $8.03           $2.52
  88314  X                               Histochemical stain............            0343            0.45          $21.82          $12.16           $4.36
  88318  X                               Chemical histochemistry........            0343            0.45          $21.82          $12.16           $4.36
  88319  X                               Enzyme histochemistry..........            0342            0.26          $12.61           $8.03           $2.52
  88321  X                               Microslide consultation........            0342            0.26          $12.61           $8.03           $2.52
  88323  X                               Microslide consultation........            0343            0.45          $21.82          $12.16           $4.36
  88325  X                               Comprehensive review of data...            0343            0.45          $21.82          $12.16           $4.36
  88329  X                               Pathology consult in surgery...            0343            0.45          $21.82          $12.16           $4.36
  88331  X                               Pathology consult in surgery...            0343            0.45          $21.82          $12.16           $4.36
  88332  X                               Pathology consult in surgery...            0343            0.45          $21.82          $12.16           $4.36
  88342  X                               Immunocytochemistry............            0344            0.79          $38.30          $23.63           $7.66
  88346  X                               Immunofluorescent study........            0343            0.45          $21.82          $12.16           $4.36
  88347  X                               Immunofluorescent study........            0344            0.79          $38.30          $23.63           $7.66
  88348  X                               Electron microscopy............            0344            0.79          $38.30          $23.63           $7.66
  88349  X                               Scanning electron microscopy...            0344            0.79          $38.30          $23.63           $7.66
  88355  X                               Analysis, skeletal muscle......            0344            0.79          $38.30          $23.63           $7.66
  88356  X                               Analysis, nerve................            0344            0.79          $38.30          $23.63           $7.66
  88358  X                               Analysis, tumor................            0344            0.79          $38.30          $23.63           $7.66
  88362  X                               Nerve teasing preparations.....            0343            0.45          $21.82          $12.16           $4.36
  88365  X                               Tissue hybridization...........            0344            0.79          $38.30          $23.63           $7.66
  88371  A                               Protein, western blot tissue...  ..............  ..............  ..............  ..............  ..............
  88372  A                               Protein analysis w/probe.......  ..............  ..............  ..............  ..............  ..............
  88399  X                               Surgical pathology procedure...            0342            0.26          $12.61           $8.03           $2.52
  89050  A                               Body fluid cell count..........  ..............  ..............  ..............  ..............  ..............
  89051  A                               Body fluid cell count..........  ..............  ..............  ..............  ..............  ..............
  89060  A                               Exam, synovial fluid crystals..  ..............  ..............  ..............  ..............  ..............
  89100  X                               Sample intestinal contents.....            0361            3.53         $171.16          $88.09          $34.23
  89105  X                               Sample intestinal contents.....            0360            1.38          $66.91          $34.75          $13.38
  89125  A                               Specimen fat stain.............  ..............  ..............  ..............  ..............  ..............
  89130  X                               Sample stomach contents........            0360            1.38          $66.91          $34.75          $13.38
  89132  X                               Sample stomach contents........            0360            1.38          $66.91          $34.75          $13.38
  89135  X                               Sample stomach contents........            0360            1.38          $66.91          $34.75          $13.38
  89136  X                               Sample stomach contents........            0360            1.38          $66.91          $34.75          $13.38
  89140  X                               Sample stomach contents........            0360            1.38          $66.91          $34.75          $13.38
  89141  X                               Sample stomach contents........            0361            3.53         $171.16          $88.09          $34.23
  89160  A                               Exam feces for meat fibers.....  ..............  ..............  ..............  ..............  ..............
  89190  A                               Nasal smear for eosinophils....  ..............  ..............  ..............  ..............  ..............

[[Page 18652]]

 
  89250  A                               Fertilization of oocyte........  ..............  ..............  ..............  ..............  ..............
  89251  A                               Culture oocyte w/embryos.......  ..............  ..............  ..............  ..............  ..............
  89252  A                               Assist oocyte fertilization....  ..............  ..............  ..............  ..............  ..............
  89253  A                               Embryo hatching................  ..............  ..............  ..............  ..............  ..............
  89254  A                               Oocyte identification..........  ..............  ..............  ..............  ..............  ..............
  89255  A                               Prepare embryo for transfer....  ..............  ..............  ..............  ..............  ..............
  89256  A                               Prepare cryopreserved embryo...  ..............  ..............  ..............  ..............  ..............
  89257  A                               Sperm identification...........  ..............  ..............  ..............  ..............  ..............
  89258  A                               Cryopreservation, embryo.......  ..............  ..............  ..............  ..............  ..............
  89259  A                               Cryopreservation, sperm........  ..............  ..............  ..............  ..............  ..............
  89260  A                               Sperm isolation, simple........  ..............  ..............  ..............  ..............  ..............
  89261  A                               Sperm isolation, complex.......  ..............  ..............  ..............  ..............  ..............
  89264  A                               Identify sperm tissue..........  ..............  ..............  ..............  ..............  ..............
  89300  A                               Semen analysis.................  ..............  ..............  ..............  ..............  ..............
  89310  A                               Semen analysis.................  ..............  ..............  ..............  ..............  ..............
  89320  A                               Semen analysis.................  ..............  ..............  ..............  ..............  ..............
  89325  A                               Sperm antibody test............  ..............  ..............  ..............  ..............  ..............
  89329  A                               Sperm evaluation test..........  ..............  ..............  ..............  ..............  ..............
  89330  A                               Evaluation, cervical mucus.....  ..............  ..............  ..............  ..............  ..............
  89350  X                               Sputum specimen collection.....            0344            0.79          $38.30          $23.63           $7.66
  89355  A                               Exam feces for starch..........  ..............  ..............  ..............  ..............  ..............
  89360  X                               Collect sweat for test.........            0344            0.79          $38.30          $23.63           $7.66
  89365  A                               Water load test................  ..............  ..............  ..............  ..............  ..............
  89399  X                               Pathology lab procedure........            0343            0.45          $21.82          $12.16           $4.36
  90281  E                               Human ig, im...................  ..............  ..............  ..............  ..............  ..............
  90283  E                               Human ig, iv...................  ..............  ..............  ..............  ..............  ..............
  90287  X                               Botulinum antitoxin............            0357            1.85          $89.70          $38.31          $17.94
  90288  E                               Botulism ig, iv................  ..............  ..............  ..............  ..............  ..............
  90291  E                               Cmv ig, iv.....................  ..............  ..............  ..............  ..............  ..............
  90296  X                               Diphtheria antitoxin...........            0357            1.85          $89.70          $38.31          $17.94
  90371  X                               Hep b ig, im...................            0356            0.36          $17.46           $4.82           $3.49
  90375  X                               Rabies ig, im/sc...............            0357            1.85          $89.70          $38.31          $17.94
  90376  X                               Rabies ig, heat treated........            0357            1.85          $89.70          $38.31          $17.94
  90378  X                               Rsv ig, im.....................            0357            1.85          $89.70          $38.31          $17.94
  90379  X                               Rsv ig, iv.....................            0357            1.85          $89.70          $38.31          $17.94
  90384  X                               Rh ig, full-dose, im...........            0357            1.85          $89.70          $38.31          $17.94
  90385  X                               Rh ig, minidose, im............            0357            1.85          $89.70          $38.31          $17.94
  90386  X                               Rh ig, iv......................            0357            1.85          $89.70          $38.31          $17.94
  90389  X                               Tetanus ig, im.................            0356            0.36          $17.46           $4.82           $3.49
  90393  X                               Vaccina ig, im.................            0357            1.85          $89.70          $38.31          $17.94
  90396  X                               Varicella-zoster ig, im........            0356            0.36          $17.46           $4.82           $3.49
  90399  E                               Immune globulin................  ..............  ..............  ..............  ..............  ..............
  90471  N                               Immunization admin.............  ..............  ..............  ..............  ..............  ..............
  90472  N                               Immunization admin, each add...  ..............  ..............  ..............  ..............  ..............
  90476  X                               Adenovirus vaccine, type 4.....            0356            0.36          $17.46           $4.82           $3.49
  90477  X                               Adenovirus vaccine, type 7.....            0356            0.36          $17.46           $4.82           $3.49
  90581  X                               Anthrax vaccine, sc............            0357            1.85          $89.70          $38.31          $17.94
  90585  X                               Bcg vaccine, percut............            0356            0.36          $17.46           $4.82           $3.49
  90586  X                               Bcg vaccine, intravesical......            0356            0.36          $17.46           $4.82           $3.49
  90632  X                               Hep a vaccine, adult im........            0356            0.36          $17.46           $4.82           $3.49
  90633  X                               Hep a vacc, ped/adol, 2 dose...            0356            0.36          $17.46           $4.82           $3.49
  90634  X                               Hep a vacc, ped/adol, 3 dose...            0356            0.36          $17.46           $4.82           $3.49
  90636  X                               Hep a/hep b vacc, adult im.....            0357            1.85          $89.70          $38.31          $17.94
  90645  X                               Hib vaccine, hboc, im..........            0355            0.19           $9.21           $5.05           $1.84
  90646  X                               Hib vaccine, prp-d, im.........            0355            0.19           $9.21           $5.05           $1.84
  90647  X                               Hib vaccine, prp-omp, im.......            0355            0.19           $9.21           $5.05           $1.84
  90648  X                               Hib vaccine, prp-t, im.........            0355            0.19           $9.21           $5.05           $1.84
  90657  X                               Flu vaccine, 6-35 mo, im.......            0355            0.19           $9.21           $5.05           $1.84
  90658  X                               Flu vaccine, 3 yrs, im.........            0355            0.19           $9.21           $5.05           $1.84
  90659  X                               Flu vaccine, whole, im.........            0355            0.19           $9.21           $5.05           $1.84
  90660  X                               Flu vaccine, nasal.............            0355            0.19           $9.21           $5.05           $1.84
  90665  X                               Lyme disease vaccine, im.......            0357            1.85          $89.70          $38.31          $17.94
  90669  X                               Pneumococcal vaccine, ped......            0357            1.85          $89.70          $38.31          $17.94
  90675  X                               Rabies vaccine, im.............            0357            1.85          $89.70          $38.31          $17.94
  90676  X                               Rabies vaccine, id.............            0357            1.85          $89.70          $38.31          $17.94
  90680  X                               Rotovirus vaccine, oral........            0356            0.36          $17.46           $4.82           $3.49
  90690  X                               Typhoid vaccine, oral..........            0356            0.36          $17.46           $4.82           $3.49
  90691  X                               Typhoid vaccine, im............            0356            0.36          $17.46           $4.82           $3.49
  90692  X                               Typhoid vaccine, h-p, sc/id....            0356            0.36          $17.46           $4.82           $3.49
  90693  X                               Typhoid vaccine, akd, sc.......            0356            0.36          $17.46           $4.82           $3.49
  90700  X                               Dtap vaccine, im...............            0355            0.19           $9.21           $5.05           $1.84
  90701  X                               Dtp vaccine, im................            0356            0.36          $17.46           $4.82           $3.49
  90702  X                               Dt vaccine, im.................            0355            0.19           $9.21           $5.05           $1.84

[[Page 18653]]

 
  90703  X                               Tetanus vaccine, im............            0356            0.36          $17.46           $4.82           $3.49
  90704  X                               Mumps vaccine, sc..............            0355            0.19           $9.21           $5.05           $1.84
  90705  X                               Measles vaccine, sc............            0357            1.85          $89.70          $38.31          $17.94
  90706  X                               Rubella vaccine, sc............            0358            6.98         $338.44         $126.74          $67.69
  90707  X                               Mmr vaccine, sc................            0356            0.36          $17.46           $4.82           $3.49
  90708  X                               Measles-rubella vaccine, sc....            0358            6.98         $338.44         $126.74          $67.69
  90709  X                               Rubella & mumps vaccine, sc....            0358            6.98         $338.44         $126.74          $67.69
  90710  X                               Mmrv vaccine, sc...............            0356            0.36          $17.46           $4.82           $3.49
  90712  X                               Oral poliovirus vaccine........            0356            0.36          $17.46           $4.82           $3.49
  90713  X                               Poliovirus, ipv, sc............            0355            0.19           $9.21           $5.05           $1.84
  90716  X                               Chicken pox vaccine, sc........            0355            0.19           $9.21           $5.05           $1.84
  90717  X                               Yellow fever vaccine, sc.......            0356            0.36          $17.46           $4.82           $3.49
  90718  X                               Td vaccine, im.................            0356            0.36          $17.46           $4.82           $3.49
  90719  X                               Diphtheria vaccine, im.........            0357            1.85          $89.70          $38.31          $17.94
  90720  X                               Dtp/hib vaccine, im............            0355            0.19           $9.21           $5.05           $1.84
  90721  X                               Dtap/hib vaccine, im...........            0355            0.19           $9.21           $5.05           $1.84
  90725  X                               Cholera vaccine, injectable....            0358            6.98         $338.44         $126.74          $67.69
  90727  X                               Plague vaccine, im.............            0355            0.19           $9.21           $5.05           $1.84
  90732  X                               Pneumococcal vaccine, adult....            0355            0.19           $9.21           $5.05           $1.84
  90733  X                               Meningococcal vaccine, sc......            0357            1.85          $89.70          $38.31          $17.94
  90735  X                               Encephalitis vaccine, sc.......            0357            1.85          $89.70          $38.31          $17.94
  90744  X                               Hep b vaccine, ped/adol, im....            0356            0.36          $17.46           $4.82           $3.49
  90746  X                               Hep b vaccine, adult, im.......            0356            0.36          $17.46           $4.82           $3.49
  90747  X                               Hep b vaccine, ill pat, im.....            0356            0.36          $17.46           $4.82           $3.49
  90748  X                               Hep b/hib vaccine, im..........            0358            6.98         $338.44         $126.74          $67.69
  90749  X                               Vaccine toxoid.................            0355            0.19           $9.21           $5.05           $1.84
  90780  E                               IV infusion therapy, 1 hour....  ..............  ..............  ..............  ..............  ..............
  90781  E                               IV infusion, additional hour...  ..............  ..............  ..............  ..............  ..............
  90782  X                               Injection, sc/im...............            0359            0.96          $46.55           $9.31           $9.31
  90783  X                               Injection, ia..................            0359            0.96          $46.55           $9.31           $9.31
  90784  X                               Injection, iv..................            0359            0.96          $46.55           $9.31           $9.31
  90788  X                               Injection of antibiotic........            0359            0.96          $46.55           $9.31           $9.31
  90799  X                               Ther/prophylactic/dx inject....            0359            0.96          $46.55           $9.31           $9.31
  90801  S                               Psy dx interview...............            0323            1.85          $89.70          $22.48          $17.94
  90802  S                               Intac psy dx interview.........            0323            1.85          $89.70          $22.48          $17.94
  90804  S                               Psytx, office, 20-30 min.......            0322            1.32          $64.00          $14.22          $12.80
  90805  S                               Psytx, off, 20-30 min w/e&m....            0322            1.32          $64.00          $14.22          $12.80
  90806  S                               Psytx, off, 45-50 min..........            0323            1.85          $89.70          $22.48          $17.94
  90807  S                               Psytx, off, 45-50 min w/e&m....            0323            1.85          $89.70          $22.48          $17.94
  90808  S                               Psytx, office, 75-80 min.......            0323            1.85          $89.70          $22.48          $17.94
  90809  S                               Psytx, off, 75-80, w/e&m.......            0323            1.85          $89.70          $22.48          $17.94
  90810  S                               Intac psytx, off, 20-30 min....            0322            1.32          $64.00          $14.22          $12.80
  90811  S                               Intac psytx, 20-30, w/e&m......            0322            1.32          $64.00          $14.22          $12.80
  90812  S                               Intac psytx, off, 45-50 min....            0323            1.85          $89.70          $22.48          $17.94
  90813  S                               Intac psytx, 45-50 min w/e&m...            0323            1.85          $89.70          $22.48          $17.94
  90814  S                               Intac psytx, off, 75-80 min....            0323            1.85          $89.70          $22.48          $17.94
  90815  S                               Intac psytx, 75-80 w/e&m.......            0323            1.85          $89.70          $22.48          $17.94
  90816  S                               Psytx, hosp, 20-30 min.........            0322            1.32          $64.00          $14.22          $12.80
  90817  S                               Psytx, hosp, 20-30 min w/e&m...            0322            1.32          $64.00          $14.22          $12.80
  90818  S                               Psytx, hosp, 45-50 min.........            0323            1.85          $89.70          $22.48          $17.94
  90819  S                               Psytx, hosp, 45-50 min w/e&m...            0323            1.85          $89.70          $22.48          $17.94
  90821  S                               Psytx, hosp, 75-80 min.........            0323            1.85          $89.70          $22.48          $17.94
  90822  S                               Psytx, hosp, 75-80 min w/e&m...            0323            1.85          $89.70          $22.48          $17.94
  90823  S                               Intac psytx, hosp, 20-30 min...            0322            1.32          $64.00          $14.22          $12.80
  90824  S                               Intac psytx, hsp 20-30 w/e&m...            0322            1.32          $64.00          $14.22          $12.80
  90826  S                               Intac psytx, hosp, 45-50 min...            0323            1.85          $89.70          $22.48          $17.94
  90827  S                               Intac psytx, hsp 45-50 w/e&m...            0323            1.85          $89.70          $22.48          $17.94
  90828  S                               Intac psytx, hosp, 75-80 min...            0323            1.85          $89.70          $22.48          $17.94
  90829  S                               Intac psytx, hsp 75-80 w/e&m...            0323            1.85          $89.70          $22.48          $17.94
  90845  S                               Psychoanalysis.................            0323            1.85          $89.70          $22.48          $17.94
  90846  S                               Family psytx w/o patient.......            0324            1.87          $90.67          $20.19          $18.13
  90847  S                               Family psytx w/patient.........            0324            1.87          $90.67          $20.19          $18.13
  90849  S                               Multiple family group psytx....            0325            1.55          $75.16          $19.96          $15.03
  90853  S                               Group psychotherapy............            0325            1.55          $75.16          $19.96          $15.03
  90857  S                               Intac group psytx..............            0325            1.55          $75.16          $19.96          $15.03
  90862  X                               Medication management..........            0374            1.17          $56.73          $13.08          $11.35
  90865  S                               Narcosynthesis.................            0323            1.85          $89.70          $22.48          $17.94
  90870  S                               Electroconvulsive therapy......            0320            3.68         $178.43          $80.06          $35.69
  90871  S                               Electroconvulsive therapy......            0320            3.68         $178.43          $80.06          $35.69
  90875  E                               Psychophysiological therapy....  ..............  ..............  ..............  ..............  ..............
  90876  E                               Psychophysiological therapy....  ..............  ..............  ..............  ..............  ..............
  90880  S                               Hypnotherapy...................            0323            1.85          $89.70          $22.48          $17.94
  90882  E                               Environmental manipulation.....  ..............  ..............  ..............  ..............  ..............

[[Page 18654]]

 
  90885  N                               Psy evaluation of records......  ..............  ..............  ..............  ..............  ..............
  90887  N                               Consultation with family.......  ..............  ..............  ..............  ..............  ..............
  90889  N                               Preparation of report..........  ..............  ..............  ..............  ..............  ..............
  90899  S                               Psychiatric service/therapy....            0322            1.32          $64.00          $14.22          $12.80
  90901  S                               Biofeedback train, any meth....            0321            1.26          $61.09          $29.25          $12.22
  90911  S                               Biofeedback peri/uro/rectal....            0321            1.26          $61.09          $29.25          $12.22
  90918  A                               ESRD related services, month...  ..............  ..............  ..............  ..............  ..............
  90919  A                               ESRD related services, month...  ..............  ..............  ..............  ..............  ..............
  90920  A                               ESRD related services, month...  ..............  ..............  ..............  ..............  ..............
  90921  A                               ESRD related services, month...  ..............  ..............  ..............  ..............  ..............
  90922  A                               ESRD related services, day.....  ..............  ..............  ..............  ..............  ..............
  90923  A                               Esrd related services, day.....  ..............  ..............  ..............  ..............  ..............
  90924  A                               Esrd related services, day.....  ..............  ..............  ..............  ..............  ..............
  90925  A                               Esrd related services, day.....  ..............  ..............  ..............  ..............  ..............
  90935  S                               Hemodialysis, one evaluation...            0170            6.68         $323.89          $72.26          $64.78
  90937  E                               Hemodialysis, repeated eval....  ..............  ..............  ..............  ..............  ..............
  90945  S                               Dialysis, one evaluation.......            0170            6.68         $323.89          $72.26          $64.78
  90947  E                               Dialysis, repeated eval........  ..............  ..............  ..............  ..............  ..............
  90989  E                               Dialysis training, complete....  ..............  ..............  ..............  ..............  ..............
  90993  E                               Dialysis training, incompl.....  ..............  ..............  ..............  ..............  ..............
  90997  E                               Hemoperfusion..................  ..............  ..............  ..............  ..............  ..............
  90999  E                               Dialysis procedure.............  ..............  ..............  ..............  ..............  ..............
  91000  X                               Esophageal intubation..........            0361            3.53         $171.16          $88.09          $34.23
  91010  X                               Esophagus motility study.......            0361            3.53         $171.16          $88.09          $34.23
  91011  X                               Esophagus motility study.......            0361            3.53         $171.16          $88.09          $34.23
  91012  X                               Esophagus motility study.......            0361            3.53         $171.16          $88.09          $34.23
  91020  X                               Gastric motility...............            0361            3.53         $171.16          $88.09          $34.23
  91030  X                               Acid perfusion of esophagus....            0360            1.38          $66.91          $34.75          $13.38
  91032  X                               Esophagus, acid reflux test....            0361            3.53         $171.16          $88.09          $34.23
  91033  X                               Prolonged acid reflux test.....            0361            3.53         $171.16          $88.09          $34.23
  91052  X                               Gastric analysis test..........            0361            3.53         $171.16          $88.09          $34.23
  91055  X                               Gastric intubation for smear...            0360            1.38          $66.91          $34.75          $13.38
  91060  X                               Gastric saline load test.......            0361            3.53         $171.16          $88.09          $34.23
  91065  X                               Breath hydrogen test...........            0360            1.38          $66.91          $34.75          $13.38
  91100  X                               Pass intestine bleeding tube...            0360            1.38          $66.91          $34.75          $13.38
  91105  X                               Gastric intubation treatment...            0360            1.38          $66.91          $34.75          $13.38
  91122  T                               Anal pressure record...........            0165            3.89         $188.61          $91.76          $37.72
  91299  X                               Gastroenterology procedure.....            0360            1.38          $66.91          $34.75          $13.38
  92002  V                               Eye exam, new patient..........            0601            1.00          $48.49           $9.70           $9.70
  92004  V                               Eye exam, new patient..........            0602            1.66          $80.49          $16.29          $16.10
  92012  V                               Eye exam established pat.......            0601            1.00          $48.49           $9.70           $9.70
  92014  V                               Eye exam & treatment...........            0602            1.66          $80.49          $16.29          $16.10
  92015  E                               Refraction.....................  ..............  ..............  ..............  ..............  ..............
  92018  S                               New eye exam & treatment.......            0231            2.64         $128.01          $59.87          $25.60
  92019  S                               Eye exam & treatment...........            0231            2.64         $128.01          $59.87          $25.60
  92020  S                               Special eye evaluation.........            0230            0.98          $47.52          $22.48           $9.50
  92060  S                               Special eye evaluation.........            0230            0.98          $47.52          $22.48           $9.50
  92065  S                               Orthoptic/pleoptic training....            0230            0.98          $47.52          $22.48           $9.50
  92070  N                               Fitting of contact lens........  ..............  ..............  ..............  ..............  ..............
  92081  S                               Visual field examination(s)....            0230            0.98          $47.52          $22.48           $9.50
  92082  S                               Visual field examination(s)....            0230            0.98          $47.52          $22.48           $9.50
  92083  S                               Visual field examination(s)....            0230            0.98          $47.52          $22.48           $9.50
  92100  N                               Serial tonometry exam(s).......  ..............  ..............  ..............  ..............  ..............
  92120  S                               Tonography & eye evaluation....            0230            0.98          $47.52          $22.48           $9.50
  92130  S                               Water provocation tonography...            0230            0.98          $47.52          $22.48           $9.50
  92135  S                               Opthalmic dx imaging...........            0231            2.64         $128.01          $59.87          $25.60
  92140  S                               Glaucoma provocative tests.....            0231            2.64         $128.01          $59.87          $25.60
  92225  S                               Special eye exam, initial......            0230            0.98          $47.52          $22.48           $9.50
  92226  S                               Special eye exam, subsequent...            0231            2.64         $128.01          $59.87          $25.60
  92230  S                               Eye exam with photos...........            0231            2.64         $128.01          $59.87          $25.60
  92235  S                               Eye exam with photos...........            0231            2.64         $128.01          $59.87          $25.60
  92240  S                               Icg angiography................            0231            2.64         $128.01          $59.87          $25.60
  92250  S                               Eye exam with photos...........            0230            0.98          $47.52          $22.48           $9.50
  92260  S                               Ophthalmoscopy/dynamometry.....            0230            0.98          $47.52          $22.48           $9.50
  92265  S                               Eye muscle evaluation..........            0230            0.98          $47.52          $22.48           $9.50
  92270  S                               Electro-oculography............            0230            0.98          $47.52          $22.48           $9.50
  92275  S                               Electroretinography............            0216            2.87         $139.16          $64.69          $27.83
  92283  S                               Color vision examination.......            0230            0.98          $47.52          $22.48           $9.50
  92284  S                               Dark adaptation eye exam.......            0231            2.64         $128.01          $59.87          $25.60
  92285  S                               Eye photography................            0230            0.98          $47.52          $22.48           $9.50
  92286  S                               Internal eye photography.......            0231            2.64         $128.01          $59.87          $25.60
  92287  T                               Internal eye photography.......            0231            2.64         $128.01          $59.87          $25.60
  92310  E                               Contact lens fitting...........  ..............  ..............  ..............  ..............  ..............

[[Page 18655]]

 
  92311  X                               Contact lens fitting...........            0362            0.51          $24.73           $9.63           $4.95
  92312  X                               Contact lens fitting...........            0362            0.51          $24.73           $9.63           $4.95
  92313  X                               Contact lens fitting...........            0362            0.51          $24.73           $9.63           $4.95
  92314  E                               Prescription of contact lens...  ..............  ..............  ..............  ..............  ..............
  92315  X                               Prescription of contact lens...            0362            0.51          $24.73           $9.63           $4.95
  92316  X                               Prescription of contact lens...            0362            0.51          $24.73           $9.63           $4.95
  92317  X                               Prescription of contact lens...            0362            0.51          $24.73           $9.63           $4.95
  92325  X                               Modification of contact lens...            0362            0.51          $24.73           $9.63           $4.95
  92326  X                               Replacement of contact lens....            0362            0.51          $24.73           $9.63           $4.95
  92330  S                               Fitting of artificial eye......            0230            0.98          $47.52          $22.48           $9.50
  92335  N                               Fitting of artificial eye......  ..............  ..............  ..............  ..............  ..............
  92340  E                               Fitting of spectacles..........  ..............  ..............  ..............  ..............  ..............
  92341  E                               Fitting of spectacles..........  ..............  ..............  ..............  ..............  ..............
  92342  E                               Fitting of spectacles..........  ..............  ..............  ..............  ..............  ..............
  92352  X                               Special spectacles fitting.....            0362            0.51          $24.73           $9.63           $4.95
  92353  X                               Special spectacles fitting.....            0362            0.51          $24.73           $9.63           $4.95
  92354  X                               Special spectacles fitting.....            0362            0.51          $24.73           $9.63           $4.95
  92355  X                               Special spectacles fitting.....            0362            0.51          $24.73           $9.63           $4.95
  92358  X                               Eye prosthesis service.........            0362            0.51          $24.73           $9.63           $4.95
  92370  E                               Repair & adjust spectacles.....  ..............  ..............  ..............  ..............  ..............
  92371  X                               Repair & adjust spectacles.....            0362            0.51          $24.73           $9.63           $4.95
  92390  E                               Supply of spectacles...........  ..............  ..............  ..............  ..............  ..............
  92391  E                               Supply of contact lenses.......  ..............  ..............  ..............  ..............  ..............
  92392  E                               Supply of low vision aids......  ..............  ..............  ..............  ..............  ..............
  92393  E                               Supply of artificial eye.......  ..............  ..............  ..............  ..............  ..............
  92395  E                               Supply of spectacles...........  ..............  ..............  ..............  ..............  ..............
  92396  E                               Supply of contact lenses.......  ..............  ..............  ..............  ..............  ..............
  92499  S                               Eye service or procedure.......            0230            0.98          $47.52          $22.48           $9.50
  92502  T                               Ear and throat examination.....            0251            1.68          $81.46          $27.99          $16.29
  92504  N                               Ear microscopy examination.....  ..............  ..............  ..............  ..............  ..............
  92506  A                               Speech/hearing evaluation......  ..............  ..............  ..............  ..............  ..............
  92507  A                               Speech/hearing therapy.........  ..............  ..............  ..............  ..............  ..............
  92508  A                               Speech/hearing therapy.........  ..............  ..............  ..............  ..............  ..............
  92510  A                               Rehab for ear implant..........  ..............  ..............  ..............  ..............  ..............
  92511  T                               Nasopharyngoscopy..............            0071            0.55          $26.67          $14.22           $5.33
  92512  X                               Nasal function studies.........            0363            2.83         $137.22          $53.22          $27.44
  92516  X                               Facial nerve function test.....            0363            2.83         $137.22          $53.22          $27.44
  92520  X                               Laryngeal function studies.....            0363            2.83         $137.22          $53.22          $27.44
  92525  A                               Oral function evaluation.......  ..............  ..............  ..............  ..............  ..............
  92526  A                               Oral function therapy..........  ..............  ..............  ..............  ..............  ..............
  92531  N                               Spontaneous nystagmus study....  ..............  ..............  ..............  ..............  ..............
  92532  N                               Positional nystagmus study.....  ..............  ..............  ..............  ..............  ..............
  92533  N                               Caloric vestibular test........  ..............  ..............  ..............  ..............  ..............
  92534  N                               Optokinetic nystagmus..........  ..............  ..............  ..............  ..............  ..............
  92541  X                               Spontaneous nystagmus test.....            0363            2.83         $137.22          $53.22          $27.44
  92542  X                               Positional nystagmus test......            0363            2.83         $137.22          $53.22          $27.44
  92543  X                               Caloric vestibular test........            0363            2.83         $137.22          $53.22          $27.44
  92544  X                               Optokinetic nystagmus test.....            0363            2.83         $137.22          $53.22          $27.44
  92545  X                               Oscillating tracking test......            0363            2.83         $137.22          $53.22          $27.44
  92546  X                               Sinusoidal rotational test.....            0363            2.83         $137.22          $53.22          $27.44
  92547  X                               Supplemental electrical test...            0363            2.83         $137.22          $53.22          $27.44
  92548  X                               Posturography..................            0363            2.83         $137.22          $53.22          $27.44
  92551  E                               Pure tone hearing test, air....  ..............  ..............  ..............  ..............  ..............
  92552  X                               Pure tone audiometry, air......            0364            0.68          $32.97          $13.31           $6.59
  92553  X                               Audiometry, air & bone.........            0364            0.68          $32.97          $13.31           $6.59
  92555  X                               Speech threshold audiometry....            0364            0.68          $32.97          $13.31           $6.59
  92556  X                               Speech audiometry, complete....            0364            0.68          $32.97          $13.31           $6.59
  92557  X                               Comprehensive hearing test.....            0365            1.47          $71.28          $22.48          $14.26
  92559  E                               Group audiometric testing......  ..............  ..............  ..............  ..............  ..............
  92560  E                               Bekesy audiometry, screen......  ..............  ..............  ..............  ..............  ..............
  92561  X                               Bekesy audiometry, diagnosis...            0365            1.47          $71.28          $22.48          $14.26
  92562  X                               Loudness balance test..........            0365            1.47          $71.28          $22.48          $14.26
  92563  X                               Tone decay hearing test........            0365            1.47          $71.28          $22.48          $14.26
  92564  X                               Sisi hearing test..............            0365            1.47          $71.28          $22.48          $14.26
  92565  X                               Stenger test, pure tone........            0365            1.47          $71.28          $22.48          $14.26
  92567  X                               Tympanometry...................            0364            0.68          $32.97          $13.31           $6.59
  92568  X                               Acoustic reflex testing........            0365            1.47          $71.28          $22.48          $14.26
  92569  X                               Acoustic reflex decay test.....            0365            1.47          $71.28          $22.48          $14.26
  92571  X                               Filtered speech hearing test...            0365            1.47          $71.28          $22.48          $14.26
  92572  X                               Staggered spondaic word test...            0365            1.47          $71.28          $22.48          $14.26
  92573  X                               Lombard test...................            0365            1.47          $71.28          $22.48          $14.26
  92575  X                               Sensorineural acuity test......            0365            1.47          $71.28          $22.48          $14.26
  92576  X                               Synthetic sentence test........            0365            1.47          $71.28          $22.48          $14.26

[[Page 18656]]

 
  92577  X                               Stenger test, speech...........            0365            1.47          $71.28          $22.48          $14.26
  92579  X                               Visual audiometry (vra)........            0365            1.47          $71.28          $22.48          $14.26
  92582  X                               Conditioning play audiometry...            0365            1.47          $71.28          $22.48          $14.26
  92583  X                               Select picture audiometry......            0365            1.47          $71.28          $22.48          $14.26
  92584  X                               Electrocochleography...........            0363            2.83         $137.22          $53.22          $27.44
  92585  S                               Auditory evoked potential......            0216            2.87         $139.16          $64.69          $27.83
  92587  X                               Evoked auditory test...........            0363            2.83         $137.22          $53.22          $27.44
  92588  X                               Evoked auditory test...........            0363            2.83         $137.22          $53.22          $27.44
  92589  X                               Auditory function test(s)......            0365            1.47          $71.28          $22.48          $14.26
  92590  E                               Hearing aid exam, one ear......  ..............  ..............  ..............  ..............  ..............
  92591  E                               Hearing aid exam, both ears....  ..............  ..............  ..............  ..............  ..............
  92592  E                               Hearing aid check, one ear.....  ..............  ..............  ..............  ..............  ..............
  92593  E                               Hearing aid check, both ears...  ..............  ..............  ..............  ..............  ..............
  92594  E                               Electro hearng aid test, one...  ..............  ..............  ..............  ..............  ..............
  92595  E                               Electro hearng aid tst, both...  ..............  ..............  ..............  ..............  ..............
  92596  X                               Ear protector evaluation.......            0365            1.47          $71.28          $22.48          $14.26
  92597  A                               Oral speech device eval........  ..............  ..............  ..............  ..............  ..............
  92598  A                               Modify oral speech device......  ..............  ..............  ..............  ..............  ..............
  92599  X                               ENT procedure/service..........            0364            0.68          $32.97          $13.31           $6.59
  92950  S                               Heart/lung resuscitation cpr...            0094            4.51         $218.68         $105.29          $43.74
  92953  S                               Temporary external pacing......            0094            4.51         $218.68         $105.29          $43.74
  92960  S                               Cardioversion electric, ext....            0094            4.51         $218.68         $105.29          $43.74
  92961  S                               Cardioversion, electric, int...            0094            4.51         $218.68         $105.29          $43.74
  92970  C                               Cardioassist, internal.........  ..............  ..............  ..............  ..............  ..............
  92971  C                               Cardioassist, external.........  ..............  ..............  ..............  ..............  ..............
  92975  C                               Dissolve clot, heart vessel....  ..............  ..............  ..............  ..............  ..............
  92977  C                               Dissolve clot, heart vessel....  ..............  ..............  ..............  ..............  ..............
  92978  C                               Intravasc us, heart add-on.....  ..............  ..............  ..............  ..............  ..............
  92979  C                               Intravasc us, heart add-on.....  ..............  ..............  ..............  ..............  ..............
  92980  T                               Insert intracoronary stent.....            0083           45.79       $2,220.22       $1,322.95         $444.04
  92981  T                               Insert intracoronary stent.....            0083           45.79       $2,220.22       $1,322.95         $444.04
  92982  T                               Coronary artery dilation.......            0083           45.79       $2,220.22       $1,322.95         $444.04
  92984  T                               Coronary artery dilation.......            0083           45.79       $2,220.22       $1,322.95         $444.04
  92986  C                               Revision of aortic valve.......  ..............  ..............  ..............  ..............  ..............
  92987  C                               Revision of mitral valve.......  ..............  ..............  ..............  ..............  ..............
  92990  C                               Revision of pulmonary valve....  ..............  ..............  ..............  ..............  ..............
  92992  C                               Revision of heart chamber......  ..............  ..............  ..............  ..............  ..............
  92993  C                               Revision of heart chamber......  ..............  ..............  ..............  ..............  ..............
  92995  T                               Coronary atherectomy...........            0082           40.34       $1,955.97         $859.56         $391.19
  92996  T                               Coronary atherectomy add-on....            0082           40.34       $1,955.97         $859.56         $391.19
  92997  C                               Pul art balloon repr, percut...  ..............  ..............  ..............  ..............  ..............
  92998  C                               Pul art balloon repr, percut...  ..............  ..............  ..............  ..............  ..............
  93000  E                               Electrocardiogram, complete....  ..............  ..............  ..............  ..............  ..............
  93005  X                               Electrocardiogram, tracing.....            0366            0.38          $18.43          $15.60           $3.69
  93010  E                               Electrocardiogram report.......  ..............  ..............  ..............  ..............  ..............
  93012  S                               Transmission of ECG............            0099            0.38          $18.43          $14.68           $3.69
  93014  E                               Report on transmitted ECG......  ..............  ..............  ..............  ..............  ..............
  93015  E                               Cardiovascular stress test.....  ..............  ..............  ..............  ..............  ..............
  93016  E                               Cardiovascular stress test.....  ..............  ..............  ..............  ..............  ..............
  93017  S                               Cardiovascular stress test.....            0097            1.62          $78.55          $62.40          $15.71
  93018  E                               Cardiovascular stress test.....  ..............  ..............  ..............  ..............  ..............
  93024  S                               Cardiac drug stress test.......            0097            1.62          $78.55          $62.40          $15.71
  93040  E                               Rhythm ECG with report.........  ..............  ..............  ..............  ..............  ..............
  93041  X                               Rhythm ECG, tracing............            0366            0.38          $18.43          $15.60           $3.69
  93042  E                               Rhythm ECG, report.............  ..............  ..............  ..............  ..............  ..............
  93224  E                               ECG monitor/report, 24 hrs.....  ..............  ..............  ..............  ..............  ..............
  93225  S                               ECG monitor/record, 24 hrs.....            0100            1.70          $82.43          $71.57          $16.49
  93226  S                               ECG monitor/report, 24 hrs.....            0100            1.70          $82.43          $71.57          $16.49
  93227  E                               ECG monitor/review, 24 hrs.....  ..............  ..............  ..............  ..............  ..............
  93230  E                               ECG monitor/report, 24 hrs.....  ..............  ..............  ..............  ..............  ..............
  93231  S                               ECG monitor/record, 24 hrs.....            0100            1.70          $82.43          $71.57          $16.49
  93232  S                               ECG monitor/report, 24 hrs.....            0100            1.70          $82.43          $71.57          $16.49
  93233  E                               ECG monitor/review, 24 hrs.....  ..............  ..............  ..............  ..............  ..............
  93235  E                               ECG monitor/report, 24 hrs.....  ..............  ..............  ..............  ..............  ..............
  93236  S                               ECG monitor/report, 24 hrs.....            0100            1.70          $82.43          $71.57          $16.49
  93237  E                               ECG monitor/review, 24 hrs.....  ..............  ..............  ..............  ..............  ..............
  93268  S                               ECG record/review..............            0100            1.70          $82.43          $71.57          $16.49
  93270  S                               ECG recording..................            0099            0.38          $18.43          $14.68           $3.69
  93271  S                               ECG/monitoring and analysis....            0100            1.70          $82.43          $71.57          $16.49
  93272  E                               ECG/review, interpret only.....  ..............  ..............  ..............  ..............  ..............
  93278  S                               ECG/signal-averaged............            0099            0.38          $18.43          $14.68           $3.69
  93303  S                               Echo transthoracic.............            0269            4.40         $213.34         $114.01          $42.67
  93304  S                               Echo transthoracic.............            0269            4.40         $213.34         $114.01          $42.67

[[Page 18657]]

 
  93307  S                               Echo exam of heart.............            0269            4.40         $213.34         $114.01          $42.67
  93308  S                               Echo exam of heart.............            0269            4.40         $213.34         $114.01          $42.67
  93312  S                               Echo transesophageal...........            0270            5.55         $269.10         $150.26          $53.82
  93313  S                               Echo transesophageal...........            0270            5.55         $269.10         $150.26          $53.82
  93314  N                               Echo transesophageal...........  ..............  ..............  ..............  ..............  ..............
  93315  S                               Echo transesophageal...........            0270            5.55         $269.10         $150.26          $53.82
  93316  S                               Echo transesophageal...........            0270            5.55         $269.10         $150.26          $53.82
  93317  N                               Echo transesophageal...........  ..............  ..............  ..............  ..............  ..............
  93320  S                               Doppler echo exam, heart.......            0269            4.40         $213.34         $114.01          $42.67
  93321  S                               Doppler echo exam, heart.......            0269            4.40         $213.34         $114.01          $42.67
  93325  S                               Doppler color flow add-on......            0269            4.40         $213.34         $114.01          $42.67
  93350  S                               Echo transthoracic.............            0269            4.40         $213.34         $114.01          $42.67
  93501  T                               Right heart catheterization....            0080           25.77       $1,249.51         $713.89         $249.90
  93503  T                               Insert/place heart catheter....            0080           25.77       $1,249.51         $713.89         $249.90
  93505  T                               Biopsy of heart lining.........            0080           25.77       $1,249.51         $713.89         $249.90
  93508  N                               Cath placement, angiography....  ..............  ..............  ..............  ..............  ..............
  93510  T                               Left heart catheterization.....            0080           25.77       $1,249.51         $713.89         $249.90
  93511  T                               Left heart catheterization.....            0080           25.77       $1,249.51         $713.89         $249.90
  93514  T                               Left heart catheterization.....            0080           25.77       $1,249.51         $713.89         $249.90
  93524  T                               Left heart catheterization.....            0080           25.77       $1,249.51         $713.89         $249.90
  93526  T                               Rt & Lt heart catheters........            0080           25.77       $1,249.51         $713.89         $249.90
  93527  T                               Rt & Lt heart catheters........            0080           25.77       $1,249.51         $713.89         $249.90
  93528  T                               Rt & Lt heart catheters........            0080           25.77       $1,249.51         $713.89         $249.90
  93529  T                               Rt, Lt heart catheterization...            0080           25.77       $1,249.51         $713.89         $249.90
  93530  T                               Rt heart cath, congenital......            0080           25.77       $1,249.51         $713.89         $249.90
  93531  T                               R & l heart cath, congenital...            0080           25.77       $1,249.51         $713.89         $249.90
  93532  T                               R & l heart cath, congenital...            0080           25.77       $1,249.51         $713.89         $249.90
  93533  T                               R & l heart cath, congenital...            0080           25.77       $1,249.51         $713.89         $249.90
  93536  T                               Insert circulation assi........            0080           25.77       $1,249.51         $713.89         $249.90
  93539  N                               Injection, cardiac cath........  ..............  ..............  ..............  ..............  ..............
  93540  N                               Injection, cardiac cath........  ..............  ..............  ..............  ..............  ..............
  93541  N                               Injection for lung angiogram...  ..............  ..............  ..............  ..............  ..............
  93542  N                               Injection for heart x-rays.....  ..............  ..............  ..............  ..............  ..............
  93543  N                               Injection for heart x-rays.....  ..............  ..............  ..............  ..............  ..............
  93544  N                               Injection for aortography......  ..............  ..............  ..............  ..............  ..............
  93545  N                               Inject for coronary x-rays.....  ..............  ..............  ..............  ..............  ..............
  93555  N                               Imaging, cardiac cath..........  ..............  ..............  ..............  ..............  ..............
  93556  N                               Imaging, cardiac cath..........  ..............  ..............  ..............  ..............  ..............
  93561  N                               Cardiac output measurement.....  ..............  ..............  ..............  ..............  ..............
  93562  N                               Cardiac output measurement.....  ..............  ..............  ..............  ..............  ..............
  93571  N                               Heart flow reserve measure.....  ..............  ..............  ..............  ..............  ..............
  93572  N                               Heart flow reserve measure.....  ..............  ..............  ..............  ..............  ..............
  93600  S                               Bundle of His recording........            0087            9.53         $462.08         $214.72          $92.42
  93602  S                               Intra-atrial recording.........            0087            9.53         $462.08         $214.72          $92.42
  93603  S                               Right ventricular recording....            0087            9.53         $462.08         $214.72          $92.42
  93607  S                               Left ventricular recording.....            0087            9.53         $462.08         $214.72          $92.42
  93609  S                               Mapping of tachycardia.........            0087            9.53         $462.08         $214.72          $92.42
  93610  S                               Intra-atrial pacing............            0087            9.53         $462.08         $214.72          $92.42
  93612  S                               Intraventricular pacing........            0087            9.53         $462.08         $214.72          $92.42
  93615  S                               Esophageal recording...........            0087            9.53         $462.08         $214.72          $92.42
  93616  S                               Esophageal recording...........            0087            9.53         $462.08         $214.72          $92.42
  93618  S                               Heart rhythm pacing............            0087            9.53         $462.08         $214.72          $92.42
  93619  S                               Electrophysiology evaluation...            0085           27.06       $1,312.06         $654.48         $262.41
  93620  S                               Electrophysiology evaluation...            0085           27.06       $1,312.06         $654.48         $262.41
  93621  S                               Electrophysiology evaluation...            0085           27.06       $1,312.06         $654.48         $262.41
  93622  S                               Electrophysiology evaluation...            0085           27.06       $1,312.06         $654.48         $262.41
  93623  S                               Stimulation, pacing heart......            0087            9.53         $462.08         $214.72          $92.42
  93624  S                               Electrophysiologic study.......            0087            9.53         $462.08         $214.72          $92.42
  93631  S                               Heart pacing, mapping..........            0087            9.53         $462.08         $214.72          $92.42
  93640  S                               Evaluation heart device........            0084           10.70         $518.81         $177.79         $103.76
  93641  S                               Electrophysiology evaluation...            0084           10.70         $518.81         $177.79         $103.76
  93642  S                               Electrophysiology evaluation...            0084           10.70         $518.81         $177.79         $103.76
  93650  S                               Ablate heart dysrhythm focus...            0086           47.62       $2,308.95       $1,265.37         $461.79
  93651  S                               Ablate heart dysrhythm focus...            0086           47.62       $2,308.95       $1,265.37         $461.79
  93652  S                               Ablate heart dysrhythm focus...            0086           47.62       $2,308.95       $1,265.37         $461.79
  93660  S                               Tilt table evaluation..........            0101            4.47         $216.74         $128.84          $43.35
  93720  E                               Total body plethysmography.....  ..............  ..............  ..............  ..............  ..............
  93721  S                               Plethysmography tracing........            0096            2.06          $99.88          $61.48          $19.98
  93722  E                               Plethysmography report.........  ..............  ..............  ..............  ..............  ..............
  93724  S                               Analyze pacemaker system.......            0100            1.70          $82.43          $71.57          $16.49
  93727  S                               Analyze ilr system.............            0102            0.45          $21.82          $12.62           $4.36
  93731  S                               Analyze pacemaker system.......            0102            0.45          $21.82          $12.62           $4.36
  93732  S                               Analyze pacemaker system.......            0102            0.45          $21.82          $12.62           $4.36

[[Page 18658]]

 
  93733  S                               Telephone analy, pacemaker.....            0102            0.45          $21.82          $12.62           $4.36
  93734  S                               Analyze pacemaker system.......            0102            0.45          $21.82          $12.62           $4.36
  93735  S                               Analyze pacemaker system.......            0102            0.45          $21.82          $12.62           $4.36
  93736  S                               Telephone analy, pacemaker.....            0102            0.45          $21.82          $12.62           $4.36
  93737  S                               Analyze cardio/defibrillator...            0102            0.45          $21.82          $12.62           $4.36
  93738  S                               Analyze cardio/defibrillator...            0102            0.45          $21.82          $12.62           $4.36
  93740  S                               Temperature gradient studies...            0096            2.06          $99.88          $61.48          $19.98
  93741  S                               Analyze ht pace device sngl....            0102            0.45          $21.82          $12.62           $4.36
  93742  S                               Analyze ht pace device sngl....            0102            0.45          $21.82          $12.62           $4.36
  93743  S                               Analyze ht pace device dual....            0102            0.45          $21.82          $12.62           $4.36
  93744  S                               Analyze ht pace device dual....            0102            0.45          $21.82          $12.62           $4.36
  93760  E                               Cephalic thermogram............  ..............  ..............  ..............  ..............  ..............
  93762  E                               Peripheral thermogram..........  ..............  ..............  ..............  ..............  ..............
  93770  N                               Measure venous pressure........  ..............  ..............  ..............  ..............  ..............
  93784  E                               Ambulatory BP monitoring.......  ..............  ..............  ..............  ..............  ..............
  93786  E                               Ambulatory BP recording........  ..............  ..............  ..............  ..............  ..............
  93788  E                               Ambulatory BP analysis.........  ..............  ..............  ..............  ..............  ..............
  93790  E                               Review/report BP recording.....  ..............  ..............  ..............  ..............  ..............
  93797  S                               Cardiac rehab..................            0095            0.64          $31.03          $16.98           $6.21
  93798  S                               Cardiac rehab/monitor..........            0095            0.64          $31.03          $16.98           $6.21
  93799  S                               Cardiovascular procedure.......            0096            2.06          $99.88          $61.48          $19.98
  93875  S                               Extracranial study.............            0096            2.06          $99.88          $61.48          $19.98
  93880  S                               Extracranial study.............            0267            2.72         $131.88          $80.06          $26.38
  93882  S                               Extracranial study.............            0267            2.72         $131.88          $80.06          $26.38
  93886  S                               Intracranial study.............            0267            2.72         $131.88          $80.06          $26.38
  93888  S                               Intracranial study.............            0267            2.72         $131.88          $80.06          $26.38
  93922  S                               Extremity study................            0096            2.06          $99.88          $61.48          $19.98
  93923  S                               Extremity study................            0096            2.06          $99.88          $61.48          $19.98
  93924  S                               Extremity study................            0096            2.06          $99.88          $61.48          $19.98
  93925  S                               Lower extremity study..........            0267            2.72         $131.88          $80.06          $26.38
  93926  S                               Lower extremity study..........            0267            2.72         $131.88          $80.06          $26.38
  93930  S                               Upper extremity study..........            0267            2.72         $131.88          $80.06          $26.38
  93931  S                               Upper extremity study..........            0267            2.72         $131.88          $80.06          $26.38
  93965  S                               Extremity study................            0096            2.06          $99.88          $61.48          $19.98
  93970  S                               Extremity study................            0267            2.72         $131.88          $80.06          $26.38
  93971  S                               Extremity study................            0267            2.72         $131.88          $80.06          $26.38
  93975  S                               Vascular study.................            0267            2.72         $131.88          $80.06          $26.38
  93976  S                               Vascular study.................            0267            2.72         $131.88          $80.06          $26.38
  93978  S                               Vascular study.................            0267            2.72         $131.88          $80.06          $26.38
  93979  S                               Vascular study.................            0267            2.72         $131.88          $80.06          $26.38
  93980  S                               Penile vascular study..........            0267            2.72         $131.88          $80.06          $26.38
  93981  S                               Penile vascular study..........            0267            2.72         $131.88          $80.06          $26.38
  93990  S                               Doppler flow testing...........            0267            2.72         $131.88          $80.06          $26.38
  94010  X                               Breathing capacity test........            0367            0.83          $40.24          $20.65           $8.05
  94014  X                               Patient recorded spirometry....            0369            2.34         $113.46          $58.50          $22.69
  94015  X                               Patient recorded spirometry....            0369            2.34         $113.46          $58.50          $22.69
  94016  X                               Review patient spirometry......            0369            2.34         $113.46          $58.50          $22.69
  94060  X                               Evaluation of wheezing.........            0368            1.66          $80.49          $42.44          $16.10
  94070  X                               Evaluation of wheezing.........            0369            2.34         $113.46          $58.50          $22.69
  94150  N                               Vital capacity test............  ..............  ..............  ..............  ..............  ..............
  94200  X                               Lung function test (MBC/MVV)...            0367            0.83          $40.24          $20.65           $8.05
  94240  X                               Residual lung capacity.........            0368            1.66          $80.49          $42.44          $16.10
  94250  X                               Expired gas collection.........            0367            0.83          $40.24          $20.65           $8.05
  94260  X                               Thoracic gas volume............            0368            1.66          $80.49          $42.44          $16.10
  94350  X                               Lung nitrogen washout curve....            0368            1.66          $80.49          $42.44          $16.10
  94360  X                               Measure airflow resistance.....            0368            1.66          $80.49          $42.44          $16.10
  94370  X                               Breath airway closing volume...            0368            1.66          $80.49          $42.44          $16.10
  94375  X                               Respiratory flow volume loop...            0367            0.83          $40.24          $20.65           $8.05
  94400  X                               CO2 breathing response curve...            0367            0.83          $40.24          $20.65           $8.05
  94450  X                               Hypoxia response curve.........            0367            0.83          $40.24          $20.65           $8.05
  94620  X                               Pulmonary stress test/simple...            0368            1.66          $80.49          $42.44          $16.10
  94621  X                               Pulm stress test/complex.......            0369            2.34         $113.46          $58.50          $22.69
  94640  S                               Airway inhalation treatment....            0077            0.43          $20.85          $12.62           $4.17
  94642  S                               Aerosol inhalation treatment...            0078            1.34          $64.97          $29.13          $12.99
  94650  S                               Pressure breathing (IPPB)......            0077            0.43          $20.85          $12.62           $4.17
  94651  S                               Pressure breathing (IPPB)......            0077            0.43          $20.85          $12.62           $4.17
  94652  C                               Pressure breathing (IPPB)......  ..............  ..............  ..............  ..............  ..............
  94656  S                               Initial ventilator mgmt........            0079            3.18         $154.19         $107.70          $30.84
  94657  S                               Continued ventilator mgmt......            0079            3.18         $154.19         $107.70          $30.84
  94660  S                               Pos airway pressure, CPAP......            0079            3.18         $154.19         $107.70          $30.84
  94662  S                               Neg press ventilation, cnp.....            0079            3.18         $154.19         $107.70          $30.84
  94664  S                               Aerosol or vapor inhalations...            0077            0.43          $20.85          $12.62           $4.17
  94665  S                               Aerosol or vapor inhalations...            0077            0.43          $20.85          $12.62           $4.17

[[Page 18659]]

 
  94667  S                               Chest wall manipulation........            0077            0.43          $20.85          $12.62           $4.17
  94668  S                               Chest wall manipulation........            0077            0.43          $20.85          $12.62           $4.17
  94680  X                               Exhaled air analysis, o2.......            0367            0.83          $40.24          $20.65           $8.05
  94681  X                               Exhaled air analysis, o2/co2...            0368            1.66          $80.49          $42.44          $16.10
  94690  X                               Exhaled air analysis...........            0367            0.83          $40.24          $20.65           $8.05
  94720  X                               Monoxide diffusing capacity....            0367            0.83          $40.24          $20.65           $8.05
  94725  X                               Membrane diffusion capacity....            0368            1.66          $80.49          $42.44          $16.10
  94750  X                               Pulmonary compliance study.....            0368            1.66          $80.49          $42.44          $16.10
  94760  N                               Measure blood oxygen level.....  ..............  ..............  ..............  ..............  ..............
  94761  N                               Measure blood oxygen level.....  ..............  ..............  ..............  ..............  ..............
  94762  C                               Measure blood oxygen level.....  ..............  ..............  ..............  ..............  ..............
  94770  X                               Exhaled carbon dioxide test....            0367            0.83          $40.24          $20.65           $8.05
  94772  X                               Breath recording, infant.......            0369            2.34         $113.46          $58.50          $22.69
  94799  X                               Pulmonary service/procedure....            0367            0.83          $40.24          $20.65           $8.05
  95004  X                               Allergy skin tests.............            0370            0.57          $27.64          $11.81           $5.53
  95010  X                               Sensitivity skin tests.........            0370            0.57          $27.64          $11.81           $5.53
  95015  X                               Sensitivity skin tests.........            0370            0.57          $27.64          $11.81           $5.53
  95024  X                               Allergy skin tests.............            0370            0.57          $27.64          $11.81           $5.53
  95027  X                               Skin end point titration.......            0370            0.57          $27.64          $11.81           $5.53
  95028  X                               Allergy skin tests.............            0370            0.57          $27.64          $11.81           $5.53
  95044  X                               Allergy patch tests............            0370            0.57          $27.64          $11.81           $5.53
  95052  X                               Photo patch test...............            0370            0.57          $27.64          $11.81           $5.53
  95056  X                               Photosensitivity tests.........            0370            0.57          $27.64          $11.81           $5.53
  95060  X                               Eye allergy tests..............            0370            0.57          $27.64          $11.81           $5.53
  95065  X                               Nose allergy test..............            0370            0.57          $27.64          $11.81           $5.53
  95070  X                               Bronchial allergy tests........            0369            2.34         $113.46          $58.50          $22.69
  95071  X                               Bronchial allergy tests........            0369            2.34         $113.46          $58.50          $22.69
  95075  X                               Ingestion challenge test.......            0361            3.53         $171.16          $88.09          $34.23
  95078  X                               Provocative testing............            0370            0.57          $27.64          $11.81           $5.53
  95115  X                               Immunotherapy, one injection...            0371            0.32          $15.52           $3.67           $3.10
  95117  X                               Immunotherapy injections.......            0371            0.32          $15.52           $3.67           $3.10
  95120  E                               Immunotherapy, one injection...  ..............  ..............  ..............  ..............  ..............
  95125  E                               Immunotherapy, many antigens...  ..............  ..............  ..............  ..............  ..............
  95130  E                               Immunotherapy, insect venom....  ..............  ..............  ..............  ..............  ..............
  95131  E                               Immunotherapy, insect venoms...  ..............  ..............  ..............  ..............  ..............
  95132  E                               Immunotherapy, insect venoms...  ..............  ..............  ..............  ..............  ..............
  95133  E                               Immunotherapy, insect venoms...  ..............  ..............  ..............  ..............  ..............
  95134  E                               Immunotherapy, insect venoms...  ..............  ..............  ..............  ..............  ..............
  95144  X                               Antigen therapy services.......            0371            0.32          $15.52           $3.67           $3.10
  95145  X                               Antigen therapy services.......            0371            0.32          $15.52           $3.67           $3.10
  95146  X                               Antigen therapy services.......            0371            0.32          $15.52           $3.67           $3.10
  95147  X                               Antigen therapy services.......            0371            0.32          $15.52           $3.67           $3.10
  95148  X                               Antigen therapy services.......            0371            0.32          $15.52           $3.67           $3.10
  95149  X                               Antigen therapy services.......            0371            0.32          $15.52           $3.67           $3.10
  95165  X                               Antigen therapy services.......            0371            0.32          $15.52           $3.67           $3.10
  95170  X                               Antigen therapy services.......            0371            0.32          $15.52           $3.67           $3.10
  95180  X                               Rapid desensitization..........            0370            0.57          $27.64          $11.81           $5.53
  95199  X                               Allergy immunology services....            0370            0.57          $27.64          $11.81           $5.53
  95805  S                               Multiple sleep latency test....            0213           11.15         $540.63         $290.42         $108.13
  95806  S                               Sleep study, unattended........            0213           11.15         $540.63         $290.42         $108.13
  95807  S                               Sleep study, attended..........            0213           11.15         $540.63         $290.42         $108.13
  95808  S                               Polysomnography, 1-3...........            0213           11.15         $540.63         $290.42         $108.13
  95810  S                               Polysomnography, 4 or more.....            0213           11.15         $540.63         $290.42         $108.13
  95811  S                               Polysomnography w/cpap.........            0213           11.15         $540.63         $290.42         $108.13
  95812  S                               Electroencephalogram (EEG).....            0213           11.15         $540.63         $290.42         $108.13
  95813  S                               Electroencephalogram (EEG).....            0213           11.15         $540.63         $290.42         $108.13
  95816  S                               Electroencephalogram (EEG).....            0214            2.32         $112.49          $58.50          $22.50
  95819  S                               Electroencephalogram (EEG).....            0214            2.32         $112.49          $58.50          $22.50
  95822  S                               Sleep electroencephalogram.....            0214            2.32         $112.49          $58.50          $22.50
  95824  S                               Electroencephalography.........            0214            2.32         $112.49          $58.50          $22.50
  95827  S                               Night electroencephalogram.....            0213           11.15         $540.63         $290.42         $108.13
  95829  S                               Surgery electrocorticogram.....            0214            2.32         $112.49          $58.50          $22.50
  95830  E                               Insert electrodes for EEG......  ..............  ..............  ..............  ..............  ..............
  95831  N                               Limb muscle testing, manual....  ..............  ..............  ..............  ..............  ..............
  95832  N                               Hand muscle testing, manual....  ..............  ..............  ..............  ..............  ..............
  95833  N                               Body muscle testing, manual....  ..............  ..............  ..............  ..............  ..............
  95834  N                               Body muscle testing, manual....  ..............  ..............  ..............  ..............  ..............
  95851  N                               Range of motion measurements...  ..............  ..............  ..............  ..............  ..............
  95852  N                               Range of motion measurements...  ..............  ..............  ..............  ..............  ..............
  95857  S                               Tensilon test..................            0215            1.15          $55.76          $30.05          $11.15
  95858  S                               Tensilon test & myogram........            0215            1.15          $55.76          $30.05          $11.15
  95860  S                               Muscle test, one limb..........            0215            1.15          $55.76          $30.05          $11.15
  95861  S                               Muscle test, two limbs.........            0215            1.15          $55.76          $30.05          $11.15

[[Page 18660]]

 
  95863  S                               Muscle test, 3 limbs...........            0216            2.87         $139.16          $64.69          $27.83
  95864  S                               Muscle test, 4 limbs...........            0215            1.15          $55.76          $30.05          $11.15
  95867  S                               Muscle test, head or neck......            0216            2.87         $139.16          $64.69          $27.83
  95868  S                               Muscle test, head or neck......            0216            2.87         $139.16          $64.69          $27.83
  95869  S                               Muscle test, thor paraspinal...            0215            1.15          $55.76          $30.05          $11.15
  95870  S                               Muscle test, nonparaspinal.....            0215            1.15          $55.76          $30.05          $11.15
  95872  S                               Muscle test, one fiber.........            0215            1.15          $55.76          $30.05          $11.15
  95875  S                               Limb exercise test.............            0217            5.87         $284.62         $156.68          $56.92
  95900  S                               Motor nerve conduction test....            0215            1.15          $55.76          $30.05          $11.15
  95903  S                               Motor nerve conduction test....            0215            1.15          $55.76          $30.05          $11.15
  95904  S                               Sense/mixed n conduction tst...            0215            1.15          $55.76          $30.05          $11.15
  95920  C                               Intraop nerve test add-on......  ..............  ..............  ..............  ..............  ..............
  95921  S                               Autonomic nerv function test...            0216            2.87         $139.16          $64.69          $27.83
  95922  S                               Autonomic nerv function test...            0216            2.87         $139.16          $64.69          $27.83
  95923  S                               Autonomic nerv function test...            0216            2.87         $139.16          $64.69          $27.83
  95925  S                               Somatosensory testing..........            0216            2.87         $139.16          $64.69          $27.83
  95926  S                               Somatosensory testing..........            0216            2.87         $139.16          $64.69          $27.83
  95927  S                               Somatosensory testing..........            0216            2.87         $139.16          $64.69          $27.83
  95930  S                               Visual evoked potential test...            0216            2.87         $139.16          $64.69          $27.83
  95933  S                               Blink reflex test..............            0215            1.15          $55.76          $30.05          $11.15
  95934  S                               H-reflex test..................            0215            1.15          $55.76          $30.05          $11.15
  95936  S                               H-reflex test..................            0216            2.87         $139.16          $64.69          $27.83
  95937  S                               Neuromuscular junction test....            0215            1.15          $55.76          $30.05          $11.15
  95950  S                               Ambulatory eeg monitoring......            0217            5.87         $284.62         $156.68          $56.92
  95951  S                               EEG monitoring/videorecord.....            0213           11.15         $540.63         $290.42         $108.13
  95953  S                               EEG monitoring/computer........            0213           11.15         $540.63         $290.42         $108.13
  95954  S                               EEG monitoring/giving drugs....            0213           11.15         $540.63         $290.42         $108.13
  95955  S                               EEG during surgery.............            0214            2.32         $112.49          $58.50          $22.50
  95956  N                               Eeg monitoring, cable/radio....  ..............  ..............  ..............  ..............  ..............
  95957  N                               EEG digital analysis...........  ..............  ..............  ..............  ..............  ..............
  95958  S                               EEG monitoring/function test...            0213           11.15         $540.63         $290.42         $108.13
  95961  C                               Electrode stimulation, brain...  ..............  ..............  ..............  ..............  ..............
  95962  C                               Electrode stim, brain add-on...  ..............  ..............  ..............  ..............  ..............
  95970  S                               Analyze neurostim, no prog.....            0102            0.45          $21.82          $12.62           $4.36
  95971  S                               Analyze neurostim, simple......            0102            0.45          $21.82          $12.62           $4.36
  95972  S                               Analyze neurostim, complex.....            0102            0.45          $21.82          $12.62           $4.36
  95973  S                               Analyze neurostim, complex.....            0102            0.45          $21.82          $12.62           $4.36
  95974  S                               Cranial neurostim, complex.....            0102            0.45          $21.82          $12.62           $4.36
  95975  S                               Cranial neurostim, complex.....            0102            0.45          $21.82          $12.62           $4.36
  95999  N                               Neurological procedure.........  ..............  ..............  ..............  ..............  ..............
  96100  X                               Psychological testing..........            0373            3.21         $155.64          $44.96          $31.13
  96105  X                               Assessment of aphasia..........            0373            3.21         $155.64          $44.96          $31.13
  96110  X                               Developmental test, lim........            0373            3.21         $155.64          $44.96          $31.13
  96111  X                               Developmental test, extend.....            0373            3.21         $155.64          $44.96          $31.13
  96115  X                               Neurobehavior status exam......            0373            3.21         $155.64          $44.96          $31.13
  96117  X                               Neuropsych test battery........            0373            3.21         $155.64          $44.96          $31.13
  96400  E                               Chemotherapy, sc/im............  ..............  ..............  ..............  ..............  ..............
  96405  E                               Intralesional chemo admin......  ..............  ..............  ..............  ..............  ..............
  96406  E                               Intralesional chemo admin......  ..............  ..............  ..............  ..............  ..............
  96408  E                               Chemotherapy, push technique...  ..............  ..............  ..............  ..............  ..............
  96410  E                               Chemotherapy, infusion method..  ..............  ..............  ..............  ..............  ..............
  96412  E                               Chemo, infuse method add-on....  ..............  ..............  ..............  ..............  ..............
  96414  E                               Chemo, infuse method add-on....  ..............  ..............  ..............  ..............  ..............
  96420  E                               Chemotherapy, push technique...  ..............  ..............  ..............  ..............  ..............
  96422  E                               Chemotherapy, infusion method..  ..............  ..............  ..............  ..............  ..............
  96423  E                               Chemo, infuse method add-on....  ..............  ..............  ..............  ..............  ..............
  96425  E                               Chemotherapy, infusion method..  ..............  ..............  ..............  ..............  ..............
  96440  E                               Chemotherapy, intracavitary....  ..............  ..............  ..............  ..............  ..............
  96445  E                               Chemotherapy, intracavitary....  ..............  ..............  ..............  ..............  ..............
  96450  E                               Chemotherapy, into CNS.........  ..............  ..............  ..............  ..............  ..............
  96520  E                               Pump refilling, maintenance....  ..............  ..............  ..............  ..............  ..............
  96530  E                               Pump refilling, maintenance....  ..............  ..............  ..............  ..............  ..............
  96542  E                               Chemotherapy injection.........  ..............  ..............  ..............  ..............  ..............
  96545  E                               Provide chemotherapy agent.....  ..............  ..............  ..............  ..............  ..............
  96549  E                               Chemotherapy, unspecified......  ..............  ..............  ..............  ..............  ..............
  96570  T                               Photodynamic tx, 30 min........            0075           18.55         $899.44         $467.29         $179.89
  96571  T                               Photodynamic tx, addl 15 min...            0075           18.55         $899.44         $467.29         $179.89
  96900  S                               Ultraviolet light therapy......            0001            0.47          $22.79           $8.49           $4.56
  96902  N                               Trichogram.....................  ..............  ..............  ..............  ..............  ..............
  96910  S                               Photochemotherapy with UV-B....            0001            0.47          $22.79           $8.49           $4.56
  96912  S                               Photochemotherapy with UV-A....            0001            0.47          $22.79           $8.49           $4.56
  96913  S                               Photochemotherapy, UV-A or B...            0001            0.47          $22.79           $8.49           $4.56
  96999  S                               Dermatological procedure.......            0001            0.47          $22.79           $8.49           $4.56

[[Page 18661]]

 
  97001  A                               Pt evaluation..................  ..............  ..............  ..............  ..............  ..............
  97002  A                               Pt re-evaluation...............  ..............  ..............  ..............  ..............  ..............
  97003  A                               Ot evaluation..................  ..............  ..............  ..............  ..............  ..............
  97004  A                               Ot re-evaluation...............  ..............  ..............  ..............  ..............  ..............
  97010  A                               Hot or cold packs therapy......  ..............  ..............  ..............  ..............  ..............
  97012  A                               Mechanical traction therapy....  ..............  ..............  ..............  ..............  ..............
  97014  A                               Electric stimulation therapy...  ..............  ..............  ..............  ..............  ..............
  97016  A                               Vasopneumatic device therapy...  ..............  ..............  ..............  ..............  ..............
  97018  A                               Paraffin bath therapy..........  ..............  ..............  ..............  ..............  ..............
  97020  A                               Microwave therapy..............  ..............  ..............  ..............  ..............  ..............
  97022  A                               Whirlpool therapy..............  ..............  ..............  ..............  ..............  ..............
  97024  A                               Diathermy treatment............  ..............  ..............  ..............  ..............  ..............
  97026  A                               Infrared therapy...............  ..............  ..............  ..............  ..............  ..............
  97028  A                               Ultraviolet therapy............  ..............  ..............  ..............  ..............  ..............
  97032  A                               Electrical stimulation.........  ..............  ..............  ..............  ..............  ..............
  97033  A                               Electric current therapy.......  ..............  ..............  ..............  ..............  ..............
  97034  A                               Contrast bath therapy..........  ..............  ..............  ..............  ..............  ..............
  97035  A                               Ultrasound therapy.............  ..............  ..............  ..............  ..............  ..............
  97036  A                               Hydrotherapy...................  ..............  ..............  ..............  ..............  ..............
  97039  A                               Physical therapy treatment.....  ..............  ..............  ..............  ..............  ..............
  97110  A                               Therapeutic exercises..........  ..............  ..............  ..............  ..............  ..............
  97112  A                               Neuromuscular reeducation......  ..............  ..............  ..............  ..............  ..............
  97113  A                               Aquatic therapy/exercises......  ..............  ..............  ..............  ..............  ..............
  97116  A                               Gait training therapy..........  ..............  ..............  ..............  ..............  ..............
  97124  A                               Massage therapy................  ..............  ..............  ..............  ..............  ..............
  97139  A                               Physical medicine procedure....  ..............  ..............  ..............  ..............  ..............
  97140  A                               Manual therapy.................  ..............  ..............  ..............  ..............  ..............
  97150  A                               Group therapeutic procedures...  ..............  ..............  ..............  ..............  ..............
  97504  A                               Orthotic training..............  ..............  ..............  ..............  ..............  ..............
  97520  A                               Prosthetic training............  ..............  ..............  ..............  ..............  ..............
  97530  A                               Therapeutic activities.........  ..............  ..............  ..............  ..............  ..............
  97535  A                               Self care mngment training.....  ..............  ..............  ..............  ..............  ..............
  97537  A                               Community/work reintegration...  ..............  ..............  ..............  ..............  ..............
  97542  A                               Wheelchair mngment training....  ..............  ..............  ..............  ..............  ..............
  97545  A                               Work hardening.................  ..............  ..............  ..............  ..............  ..............
  97546  A                               Work hardening add-on..........  ..............  ..............  ..............  ..............  ..............
  97703  A                               Prosthetic checkout............  ..............  ..............  ..............  ..............  ..............
  97750  A                               Physical performance test......  ..............  ..............  ..............  ..............  ..............
  97770  A                               Cognitive skills development...  ..............  ..............  ..............  ..............  ..............
  97780  E                               Acupuncture w/o stimul.........  ..............  ..............  ..............  ..............  ..............
  97781  E                               Acupuncture w/stimul...........  ..............  ..............  ..............  ..............  ..............
  97799  A                               Physical medicine procedure....  ..............  ..............  ..............  ..............  ..............
  98925  S                               Osteopathic manipulation.......            0060            0.77          $37.34           $7.80           $7.47
  98926  S                               Osteopathic manipulation.......            0060            0.77          $37.34           $7.80           $7.47
  98927  S                               Osteopathic manipulation.......            0060            0.77          $37.34           $7.80           $7.47
  98928  S                               Osteopathic manipulation.......            0060            0.77          $37.34           $7.80           $7.47
  98929  S                               Osteopathic manipulation.......            0060            0.77          $37.34           $7.80           $7.47
  98940  S                               Chiropractic manipulation......            0060            0.77          $37.34           $7.80           $7.47
  98941  S                               Chiropractic manipulation......            0060            0.77          $37.34           $7.80           $7.47
  98942  S                               Chiropractic manipulation......            0060            0.77          $37.34           $7.80           $7.47
  98943  E                               Chiropractic manipulation......  ..............  ..............  ..............  ..............  ..............
  99000  E                               Specimen handling..............  ..............  ..............  ..............  ..............  ..............
  99001  E                               Specimen handling..............  ..............  ..............  ..............  ..............  ..............
  99002  E                               Device handling................  ..............  ..............  ..............  ..............  ..............
  99024  E                               Postop follow-up visit.........  ..............  ..............  ..............  ..............  ..............
  99025  E                               Initial surgical evaluation....  ..............  ..............  ..............  ..............  ..............
  99050  E                               Medical services after hrs.....  ..............  ..............  ..............  ..............  ..............
  99052  E                               Medical services at night......  ..............  ..............  ..............  ..............  ..............
  99054  E                               Medical servcs, unusual hrs....  ..............  ..............  ..............  ..............  ..............
  99056  E                               Non-office medical services....  ..............  ..............  ..............  ..............  ..............
  99058  E                               Office emergency care..........  ..............  ..............  ..............  ..............  ..............
  99070  E                               Special supplies...............  ..............  ..............  ..............  ..............  ..............
  99071  E                               Patient education materials....  ..............  ..............  ..............  ..............  ..............
  99075  E                               Medical testimony..............  ..............  ..............  ..............  ..............  ..............
  99078  E                               Group health education.........  ..............  ..............  ..............  ..............  ..............
  99080  E                               Special reports or forms.......  ..............  ..............  ..............  ..............  ..............
  99082  E                               Unusual physician travel.......  ..............  ..............  ..............  ..............  ..............
  99090  E                               Computer data analysis.........  ..............  ..............  ..............  ..............  ..............
  99100  E                               Special anesthesia service.....  ..............  ..............  ..............  ..............  ..............
  99116  E                               Anesthesia with hypothermia....  ..............  ..............  ..............  ..............  ..............
  99135  E                               Special anesthesia procedure...  ..............  ..............  ..............  ..............  ..............
  99140  E                               Emergency anesthesia...........  ..............  ..............  ..............  ..............  ..............
  99141  N                               Sedation, iv/im or inhalant....  ..............  ..............  ..............  ..............  ..............

[[Page 18662]]

 
  99142  N                               Sedation, oral/rectal/nasal....  ..............  ..............  ..............  ..............  ..............
  99170  T                               Anogenital exam, child.........            0192            2.38         $115.40          $35.33          $23.08
  99173  N                               Visual screening test..........  ..............  ..............  ..............  ..............  ..............
  99175  N                               Induction of vomiting..........  ..............  ..............  ..............  ..............  ..............
  99183  S                               Hyperbaric oxygen therapy......            0031            3.00         $145.46         $140.85          $29.09
  99185  N                               Regional hypothermia...........  ..............  ..............  ..............  ..............  ..............
  99186  N                               Total body hypothermia.........  ..............  ..............  ..............  ..............  ..............
  99190  C                               Special pump services..........  ..............  ..............  ..............  ..............  ..............
  99191  C                               Special pump services..........  ..............  ..............  ..............  ..............  ..............
  99192  C                               Special pump services..........  ..............  ..............  ..............  ..............  ..............
  99195  X                               Phlebotomy.....................            0372            0.43          $20.85          $10.09           $4.17
  99199  E                               Special service/proc/report....  ..............  ..............  ..............  ..............  ..............
  99201  V                               Office/outpatient visit, new...            0600            0.98          $47.52           $9.50           $9.50
  99202  V                               Office/outpatient visit, new...            0600            0.98          $47.52           $9.50           $9.50
  99203  V                               Office/outpatient visit, new...            0601            1.00          $48.49           $9.70           $9.70
  99204  V                               Office/outpatient visit, new...            0602            1.66          $80.49          $16.29          $16.10
  99205  V                               Office/outpatient visit, new...            0602            1.66          $80.49          $16.29          $16.10
  99211  V                               Office/outpatient visit, est...            0600            0.98          $47.52           $9.50           $9.50
  99212  V                               Office/outpatient visit, est...            0600            0.98          $47.52           $9.50           $9.50
  99213  V                               Office/outpatient visit, est...            0601            1.00          $48.49           $9.70           $9.70
  99214  V                               Office/outpatient visit, est...            0602            1.66          $80.49          $16.29          $16.10
  99215  V                               Office/outpatient visit, est...            0602            1.66          $80.49          $16.29          $16.10
  99217  N                               Observation care discharge.....  ..............  ..............  ..............  ..............  ..............
  99218  N                               Observation care...............  ..............  ..............  ..............  ..............  ..............
  99219  N                               Observation care...............  ..............  ..............  ..............  ..............  ..............
  99220  N                               Observation care...............  ..............  ..............  ..............  ..............  ..............
  99221  E                               Initial hospital care..........  ..............  ..............  ..............  ..............  ..............
  99222  E                               Initial hospital care..........  ..............  ..............  ..............  ..............  ..............
  99223  E                               Initial hospital care..........  ..............  ..............  ..............  ..............  ..............
  99231  E                               Subsequent hospital care.......  ..............  ..............  ..............  ..............  ..............
  99232  E                               Subsequent hospital care.......  ..............  ..............  ..............  ..............  ..............
  99233  E                               Subsequent hospital care.......  ..............  ..............  ..............  ..............  ..............
  99234  C                               Observ/hosp same date..........  ..............  ..............  ..............  ..............  ..............
  99235  C                               Observ/hosp same date..........  ..............  ..............  ..............  ..............  ..............
  99236  C                               Observ/hosp same date..........  ..............  ..............  ..............  ..............  ..............
  99238  E                               Hospital discharge day.........  ..............  ..............  ..............  ..............  ..............
  99239  E                               Hospital discharge day.........  ..............  ..............  ..............  ..............  ..............
  99241  V                               Office consultation............            0600            0.98          $47.52           $9.50           $9.50
  99242  V                               Office consultation............            0600            0.98          $47.52           $9.50           $9.50
  99243  V                               Office consultation............            0601            1.00          $48.49           $9.70           $9.70
  99244  V                               Office consultation............            0602            1.66          $80.49          $16.29          $16.10
  99245  V                               Office consultation............            0602            1.66          $80.49          $16.29          $16.10
  99251  C                               Initial inpatient consult......  ..............  ..............  ..............  ..............  ..............
  99252  C                               Initial inpatient consult......  ..............  ..............  ..............  ..............  ..............
  99253  C                               Initial inpatient consult......  ..............  ..............  ..............  ..............  ..............
  99254  C                               Initial inpatient consult......  ..............  ..............  ..............  ..............  ..............
  99255  C                               Initial inpatient consult......  ..............  ..............  ..............  ..............  ..............
  99261  C                               Follow-up inpatient consult....  ..............  ..............  ..............  ..............  ..............
  99262  C                               Follow-up inpatient consult....  ..............  ..............  ..............  ..............  ..............
  99263  C                               Follow-up inpatient consult....  ..............  ..............  ..............  ..............  ..............
  99271  V                               Confirmatory consultation......            0600            0.98          $47.52           $9.50           $9.50
  99272  V                               Confirmatory consultation......            0600            0.98          $47.52           $9.50           $9.50
  99273  V                               Confirmatory consultation......            0601            1.00          $48.49           $9.70           $9.70
  99274  V                               Confirmatory consultation......            0602            1.66          $80.49          $16.29          $16.10
  99275  V                               Confirmatory consultation......            0602            1.66          $80.49          $16.29          $16.10
  99281  V                               Emergency dept visit...........            0610            1.34          $64.97          $20.65          $12.99
  99282  V                               Emergency dept visit...........            0610            1.34          $64.97          $20.65          $12.99
  99283  V                               Emergency dept visit...........            0611            2.11         $102.31          $36.47          $20.46
  99284  V                               Emergency dept visit...........            0612            3.19         $154.67          $54.14          $30.93
  99285  V                               Emergency dept visit...........            0612            3.19         $154.67          $54.14          $30.93
  99288  E                               Direct advanced life support...  ..............  ..............  ..............  ..............  ..............
  99291  S                               Critical care, first hour......            0620            8.60         $416.99         $152.78          $83.40
  99292  N                               Critical care, addl 30 min.....  ..............  ..............  ..............  ..............  ..............
  99295  C                               Neonatal critical care.........  ..............  ..............  ..............  ..............  ..............
  99296  C                               Neonatal critical care.........  ..............  ..............  ..............  ..............  ..............
  99297  C                               Neonatal critical care.........  ..............  ..............  ..............  ..............  ..............
  99298  C                               Neonatal critical care.........  ..............  ..............  ..............  ..............  ..............
  99301  E                               Nursing facility care..........  ..............  ..............  ..............  ..............  ..............
  99302  E                               Nursing facility care..........  ..............  ..............  ..............  ..............  ..............
  99303  E                               Nursing facility care..........  ..............  ..............  ..............  ..............  ..............
  99311  E                               Nursing fac care, subseq.......  ..............  ..............  ..............  ..............  ..............
  99312  E                               Nursing fac care, subseq.......  ..............  ..............  ..............  ..............  ..............
  99313  E                               Nursing fac care, subseq.......  ..............  ..............  ..............  ..............  ..............

[[Page 18663]]

 
  99315  E                               Nursing fac discharge day......  ..............  ..............  ..............  ..............  ..............
  99316  E                               Nursing fac discharge day......  ..............  ..............  ..............  ..............  ..............
  99321  E                               Rest home visit, new patient...  ..............  ..............  ..............  ..............  ..............
  99322  E                               Rest home visit, new patient...  ..............  ..............  ..............  ..............  ..............
  99323  E                               Rest home visit, new patient...  ..............  ..............  ..............  ..............  ..............
  99331  E                               Rest home visit, est pat.......  ..............  ..............  ..............  ..............  ..............
  99332  E                               Rest home visit, est pat.......  ..............  ..............  ..............  ..............  ..............
  99333  E                               Rest home visit, est pat.......  ..............  ..............  ..............  ..............  ..............
  99341  E                               Home visit, new patient........  ..............  ..............  ..............  ..............  ..............
  99342  E                               Home visit, new patient........  ..............  ..............  ..............  ..............  ..............
  99343  E                               Home visit, new patient........  ..............  ..............  ..............  ..............  ..............
  99344  E                               Home visit, new patient........  ..............  ..............  ..............  ..............  ..............
  99345  E                               Home visit, new patient........  ..............  ..............  ..............  ..............  ..............
  99347  E                               Home visit, est patient........  ..............  ..............  ..............  ..............  ..............
  99348  E                               Home visit, est patient........  ..............  ..............  ..............  ..............  ..............
  99349  E                               Home visit, est patient........  ..............  ..............  ..............  ..............  ..............
  99350  E                               Home visit, est patient........  ..............  ..............  ..............  ..............  ..............
  99354  N                               Prolonged service, office......  ..............  ..............  ..............  ..............  ..............
  99355  N                               Prolonged service, office......  ..............  ..............  ..............  ..............  ..............
  99356  C                               Prolonged service, inpatient...  ..............  ..............  ..............  ..............  ..............
  99357  C                               Prolonged service, inpatient...  ..............  ..............  ..............  ..............  ..............
  99358  N                               Prolonged serv, w/o contact....  ..............  ..............  ..............  ..............  ..............
  99359  N                               Prolonged serv, w/o contact....  ..............  ..............  ..............  ..............  ..............
  99360  E                               Physician standby services.....  ..............  ..............  ..............  ..............  ..............
  99361  E                               Physician/team conference......  ..............  ..............  ..............  ..............  ..............
  99362  E                               Physician/team conference......  ..............  ..............  ..............  ..............  ..............
  99371  E                               Physician phone consultation...  ..............  ..............  ..............  ..............  ..............
  99372  E                               Physician phone consultation...  ..............  ..............  ..............  ..............  ..............
  99373  E                               Physician phone consultation...  ..............  ..............  ..............  ..............  ..............
  99374  E                               Home health care supervision...  ..............  ..............  ..............  ..............  ..............
  99375  E                               Home health care supervision...  ..............  ..............  ..............  ..............  ..............
  99377  E                               Hospice care supervision.......  ..............  ..............  ..............  ..............  ..............
  99378  E                               Hospice care supervision.......  ..............  ..............  ..............  ..............  ..............
  99379  E                               Nursing fac care supervision...  ..............  ..............  ..............  ..............  ..............
  99380  E                               Nursing fac care supervision...  ..............  ..............  ..............  ..............  ..............
  99381  E                               Prev visit, new, infant........  ..............  ..............  ..............  ..............  ..............
  99382  E                               Prev visit, new, age 1-4.......  ..............  ..............  ..............  ..............  ..............
  99383  E                               Prev visit, new, age 5-11......  ..............  ..............  ..............  ..............  ..............
  99384  E                               Prev visit, new, age 12-17.....  ..............  ..............  ..............  ..............  ..............
  99385  E                               Prev visit, new, age 18-39.....  ..............  ..............  ..............  ..............  ..............
  99386  E                               Prev visit, new, age 40-64.....  ..............  ..............  ..............  ..............  ..............
  99387  E                               Prev visit, new, 65 & over.....  ..............  ..............  ..............  ..............  ..............
  99391  E                               Prev visit, est, infant........  ..............  ..............  ..............  ..............  ..............
  99392  E                               Prev visit, est, age 1-4.......  ..............  ..............  ..............  ..............  ..............
  99393  E                               Prev visit, est, age 5-11......  ..............  ..............  ..............  ..............  ..............
  99394  E                               Prev visit, est, age 12-17.....  ..............  ..............  ..............  ..............  ..............
  99395  E                               Prev visit, est, age 18-39.....  ..............  ..............  ..............  ..............  ..............
  99396  E                               Prev visit, est, age 40-64.....  ..............  ..............  ..............  ..............  ..............
  99397  E                               Prev visit, est, 65 & over.....  ..............  ..............  ..............  ..............  ..............
  99401  E                               Preventive counseling, indiv...  ..............  ..............  ..............  ..............  ..............
  99402  E                               Preventive counseling, indiv...  ..............  ..............  ..............  ..............  ..............
  99403  E                               Preventive counseling, indiv...  ..............  ..............  ..............  ..............  ..............
  99404  E                               Preventive counseling, indiv...  ..............  ..............  ..............  ..............  ..............
  99411  E                               Preventive counseling, group...  ..............  ..............  ..............  ..............  ..............
  99412  E                               Preventive counseling, group...  ..............  ..............  ..............  ..............  ..............
  99420  E                               Health risk assessment test....  ..............  ..............  ..............  ..............  ..............
  99429  E                               Unlisted preventive service....  ..............  ..............  ..............  ..............  ..............
  99431  N                               Initial care, normal newborn...  ..............  ..............  ..............  ..............  ..............
  99432  N                               Newborn care, not in hosp......  ..............  ..............  ..............  ..............  ..............
  99433  C                               Normal newborn care/hospital...  ..............  ..............  ..............  ..............  ..............
  99435  E                               Newborn discharge day hosp.....  ..............  ..............  ..............  ..............  ..............
  99436  N                               Attendance, birth..............  ..............  ..............  ..............  ..............  ..............
  99440  S                               Newborn resuscitation..........            0094            4.51         $218.68         $105.29          $43.74
  99450  E                               Life/disability evaluation.....  ..............  ..............  ..............  ..............  ..............
  99455  E                               Disability examination.........  ..............  ..............  ..............  ..............  ..............
  99456  E                               Disability examination.........  ..............  ..............  ..............  ..............  ..............
  99499  E                               Unlisted e&m service...........  ..............  ..............  ..............  ..............  ..............
  A0021  E                               Outside state ambulance serv...  ..............  ..............  ..............  ..............  ..............
  A0030  A                               Air ambulance service..........  ..............  ..............  ..............  ..............  ..............
  A0040  A                               Helicopter ambulance service...  ..............  ..............  ..............  ..............  ..............
  A0050  A                               Water amb service emergency....  ..............  ..............  ..............  ..............  ..............
  A0080  E                               Noninterest escort in non er...  ..............  ..............  ..............  ..............  ..............
  A0090  E                               Interest escort in non er......  ..............  ..............  ..............  ..............  ..............

[[Page 18664]]

 
  A0100  E                               Nonemergency transport taxi....  ..............  ..............  ..............  ..............  ..............
  A0110  E                               Nonemergency transport bus.....  ..............  ..............  ..............  ..............  ..............
  A0120  E                               Noner transport mini-bus.......  ..............  ..............  ..............  ..............  ..............
  A0130  E                               Noner transport wheelch van....  ..............  ..............  ..............  ..............  ..............
  A0140  E                               Nonemergency transport air.....  ..............  ..............  ..............  ..............  ..............
  A0160  E                               Noner transport case worker....  ..............  ..............  ..............  ..............  ..............
  A0170  E                               Noner transport parking fees...  ..............  ..............  ..............  ..............  ..............
  A0180  E                               Noner transport lodgng recip...  ..............  ..............  ..............  ..............  ..............
  A0190  E                               Noner transport meals recip....  ..............  ..............  ..............  ..............  ..............
  A0200  E                               Noner transport lodgng escrt...  ..............  ..............  ..............  ..............  ..............
  A0210  E                               Noner transport meals escort...  ..............  ..............  ..............  ..............  ..............
  A0225  A                               Neonatal emergency transport...  ..............  ..............  ..............  ..............  ..............
  A0300  A                               Ambulance basic non-emer all...  ..............  ..............  ..............  ..............  ..............
  A0302  A                               Ambulance basic emergeny all...  ..............  ..............  ..............  ..............  ..............
  A0304  A                               Amb adv non-er no serv all.....  ..............  ..............  ..............  ..............  ..............
  A0306  A                               Amb adv non-er spec serv all...  ..............  ..............  ..............  ..............  ..............
  A0308  A                               Amb adv er no spec serv all....  ..............  ..............  ..............  ..............  ..............
  A0310  A                               Amb adv er spec serv all.......  ..............  ..............  ..............  ..............  ..............
  A0320  A                               Amb basic non-er + supplies....  ..............  ..............  ..............  ..............  ..............
  A0322  A                               Amb basic emerg + supplies.....  ..............  ..............  ..............  ..............  ..............
  A0324  A                               Adv non-er serv sep mileage....  ..............  ..............  ..............  ..............  ..............
  A0326  A                               Adv non-er no serv sep mile....  ..............  ..............  ..............  ..............  ..............
  A0328  A                               Adv er no serv sep mileage.....  ..............  ..............  ..............  ..............  ..............
  A0330  A                               Adv er spec serv sep mile......  ..............  ..............  ..............  ..............  ..............
  A0340  A                               Amb basic non-er + mileage.....  ..............  ..............  ..............  ..............  ..............
  A0342  A                               Ambul basic emer + mileage.....  ..............  ..............  ..............  ..............  ..............
  A0344  A                               Amb adv non-er no serv +mile...  ..............  ..............  ..............  ..............  ..............
  A0346  A                               Amb adv non-er serv + mile.....  ..............  ..............  ..............  ..............  ..............
  A0348  A                               Adv emer no spec serv + mile...  ..............  ..............  ..............  ..............  ..............
  A0350  A                               Adv emer spec serv + mileage...  ..............  ..............  ..............  ..............  ..............
  A0360  A                               Basic non-er sep mile & supp...  ..............  ..............  ..............  ..............  ..............
  A0362  A                               Basic emer sep mile & supply...  ..............  ..............  ..............  ..............  ..............
  A0364  A                               Adv non-er no serv sep mi&su...  ..............  ..............  ..............  ..............  ..............
  A0366  A                               Adv non-er serv sep mil&supp...  ..............  ..............  ..............  ..............  ..............
  A0368  A                               Adv er no serv sep mile&supp...  ..............  ..............  ..............  ..............  ..............
  A0370  A                               Adv er spec serv sep mi&supp...  ..............  ..............  ..............  ..............  ..............
  A0380  A                               Basic life support mileage.....  ..............  ..............  ..............  ..............  ..............
  A0382  A                               Basic support routine suppls...  ..............  ..............  ..............  ..............  ..............
  A0384  A                               Bls defibrillation supplies....  ..............  ..............  ..............  ..............  ..............
  A0390  A                               Advanced life support mileag...  ..............  ..............  ..............  ..............  ..............
  A0392  A                               Als defibrillation supplies....  ..............  ..............  ..............  ..............  ..............
  A0394  A                               Als IV drug therapy supplies...  ..............  ..............  ..............  ..............  ..............
  A0396  A                               Als esophageal intub suppls....  ..............  ..............  ..............  ..............  ..............
  A0398  A                               Als routine disposble suppls...  ..............  ..............  ..............  ..............  ..............
  A0420  A                               Ambulance waiting 1/2 hr.......  ..............  ..............  ..............  ..............  ..............
  A0422  A                               Ambulance 02 life sustaining...  ..............  ..............  ..............  ..............  ..............
  A0424  A                               Extra ambulance attendant......  ..............  ..............  ..............  ..............  ..............
  A0888  E                               Noncovered ambulance mileage...  ..............  ..............  ..............  ..............  ..............
  A0999  A                               Unlisted ambulance service.....  ..............  ..............  ..............  ..............  ..............
  A4206  A                               1 CC sterile syringe & needle..  ..............  ..............  ..............  ..............  ..............
  A4207  A                               2 CC sterile syringe & needle..  ..............  ..............  ..............  ..............  ..............
  A4208  A                               3 CC sterile syringe & needle..  ..............  ..............  ..............  ..............  ..............
  A4209  A                               5+ CC sterile syringe & needle.  ..............  ..............  ..............  ..............  ..............
  A4210  E                               Nonneedle injection device.....  ..............  ..............  ..............  ..............  ..............
  A4211  A                               Supp for self-adm injections...  ..............  ..............  ..............  ..............  ..............
  A4212  A                               Non coring needle or stylet....  ..............  ..............  ..............  ..............  ..............
  A4213  A                               20+ CC syringe only............  ..............  ..............  ..............  ..............  ..............
  A4214  A                               30 CC sterile water/saline.....  ..............  ..............  ..............  ..............  ..............
  A4215  A                               Sterile needle.................  ..............  ..............  ..............  ..............  ..............
  A4220  A                               Infusion pump refill kit.......  ..............  ..............  ..............  ..............  ..............
  A4221  A                               Maint drug infus cath per wk...  ..............  ..............  ..............  ..............  ..............
  A4222  A                               Drug infusion pump supplies....  ..............  ..............  ..............  ..............  ..............
  A4230  E                               Infus insulin pump non needl...  ..............  ..............  ..............  ..............  ..............
  A4231  E                               Infusion insulin pump needle...  ..............  ..............  ..............  ..............  ..............
  A4232  E                               Syringe w/needle insulin 3cc...  ..............  ..............  ..............  ..............  ..............
  A4244  A                               Alcohol or peroxide per pint...  ..............  ..............  ..............  ..............  ..............
  A4245  A                               Alcohol wipes per box..........  ..............  ..............  ..............  ..............  ..............
  A4246  A                               Betadine/phisohex solution.....  ..............  ..............  ..............  ..............  ..............
  A4247  A                               Betadine/iodine swabs/wipes....  ..............  ..............  ..............  ..............  ..............
  A4250  E                               Urine reagent strips/tablets...  ..............  ..............  ..............  ..............  ..............
  A4253  A                               Blood glucose/reagent strips...  ..............  ..............  ..............  ..............  ..............
  A4254  A                               Battery for glucose monitor....  ..............  ..............  ..............  ..............  ..............
  A4255  A                               Glucose monitor platforms......  ..............  ..............  ..............  ..............  ..............

[[Page 18665]]

 
  A4256  A                               Calibrator solution/chips......  ..............  ..............  ..............  ..............  ..............
  A4258  A                               Lancet device each.............  ..............  ..............  ..............  ..............  ..............
  A4259  A                               Lancets per box................  ..............  ..............  ..............  ..............  ..............
  A4260  E                               Levonorgestrel implant.........  ..............  ..............  ..............  ..............  ..............
  A4261  E                               Cervical cap contraceptive.....  ..............  ..............  ..............  ..............  ..............
  A4262  N                               Temporary tear duct plug.......  ..............  ..............  ..............  ..............  ..............
  A4263  A                               Permanent tear duct plug.......  ..............  ..............  ..............  ..............  ..............
  A4265  A                               Paraffin.......................  ..............  ..............  ..............  ..............  ..............
  A4270  A                               Disposable endoscope sheath....  ..............  ..............  ..............  ..............  ..............
  A4280  A                               Brst prsths adhsv attchmnt.....  ..............  ..............  ..............  ..............  ..............
  A4300  A                               Cath impl vasc access portal...  ..............  ..............  ..............  ..............  ..............
  A4301  A                               Implantable access syst perc...  ..............  ..............  ..............  ..............  ..............
  A4305  A                               Drug delivery system >=50 ML...  ..............  ..............  ..............  ..............  ..............
  A4306  A                               Drug delivery system =5 ML.....  ..............  ..............  ..............  ..............  ..............
  A4310  A                               Insert tray w/o bag/cath.......  ..............  ..............  ..............  ..............  ..............
  A4311  A                               Catheter w/o bag 2-way latex...  ..............  ..............  ..............  ..............  ..............
  A4312  A                               Cath w/o bag 2-way silicone....  ..............  ..............  ..............  ..............  ..............
  A4313  A                               Catheter w/bag 3-way...........  ..............  ..............  ..............  ..............  ..............
  A4314  A                               Cath w/drainage 2-way latex....  ..............  ..............  ..............  ..............  ..............
  A4315  A                               Cath w/drainage 2-way silcne...  ..............  ..............  ..............  ..............  ..............
  A4316  A                               Cath w/drainage 3-way..........  ..............  ..............  ..............  ..............  ..............
  A4320  A                               Irrigation tray................  ..............  ..............  ..............  ..............  ..............
  A4321  A                               Cath therapeutic irrig agent...  ..............  ..............  ..............  ..............  ..............
  A4322  A                               Irrigation syringe.............  ..............  ..............  ..............  ..............  ..............
  A4323  A                               Saline irrigation solution.....  ..............  ..............  ..............  ..............  ..............
  A4326  A                               Male external catheter.........  ..............  ..............  ..............  ..............  ..............
  A4327  A                               Fem urinary collect dev cup....  ..............  ..............  ..............  ..............  ..............
  A4328  A                               Fem urinary collect pouch......  ..............  ..............  ..............  ..............  ..............
  A4329  A                               External catheter start set....  ..............  ..............  ..............  ..............  ..............
  A4330  A                               Stool collection pouch.........  ..............  ..............  ..............  ..............  ..............
  A4335  A                               Incontinence supply............  ..............  ..............  ..............  ..............  ..............
  A4338  A                               Indwelling catheter latex......  ..............  ..............  ..............  ..............  ..............
  A4340  A                               Indwelling catheter special....  ..............  ..............  ..............  ..............  ..............
  A4344  A                               Cath indw foley 2 way silicn...  ..............  ..............  ..............  ..............  ..............
  A4346  A                               Cath indw foley 3 way..........  ..............  ..............  ..............  ..............  ..............
  A4347  A                               Male external catheter.........  ..............  ..............  ..............  ..............  ..............
  A4351  A                               Straight tip urine catheter....  ..............  ..............  ..............  ..............  ..............
  A4352  A                               Coude tip urinary catheter.....  ..............  ..............  ..............  ..............  ..............
  A4353  A                               Intermittent urinary cath......  ..............  ..............  ..............  ..............  ..............
  A4354  A                               Cath insertion tray w/bag......  ..............  ..............  ..............  ..............  ..............
  A4355  A                               Bladder irrigation tubing......  ..............  ..............  ..............  ..............  ..............
  A4356  A                               Ext ureth clmp or compr dvc....  ..............  ..............  ..............  ..............  ..............
  A4357  A                               Bedside drainage bag...........  ..............  ..............  ..............  ..............  ..............
  A4358  A                               Urinary leg bag................  ..............  ..............  ..............  ..............  ..............
  A4359  A                               Urinary suspensory w/o leg b...  ..............  ..............  ..............  ..............  ..............
  A4361  A                               Ostomy face plate..............  ..............  ..............  ..............  ..............  ..............
  A4362  A                               Solid skin barrier.............  ..............  ..............  ..............  ..............  ..............
  A4364  A                               Ostomy/cath adhesive...........  ..............  ..............  ..............  ..............  ..............
  A4365  A                               Ostomy adhesive remover wipe...  ..............  ..............  ..............  ..............  ..............
  A4367  A                               Ostomy belt....................  ..............  ..............  ..............  ..............  ..............
  A4368  A                               Ostomy filter..................  ..............  ..............  ..............  ..............  ..............
  A4369  A                               Skin barrier liquid per oz.....  ..............  ..............  ..............  ..............  ..............
  A4370  A                               Skin barrier paste per oz......  ..............  ..............  ..............  ..............  ..............
  A4371  A                               Skin barrier powder per oz.....  ..............  ..............  ..............  ..............  ..............
  A4372  A                               Skin barrier solid 4x4 equiv...  ..............  ..............  ..............  ..............  ..............
  A4373  A                               Skin barrier with flange.......  ..............  ..............  ..............  ..............  ..............
  A4374  A                               Skin barrier extended wear.....  ..............  ..............  ..............  ..............  ..............
  A4375  A                               Drainable plastic pch w fcpl...  ..............  ..............  ..............  ..............  ..............
  A4376  A                               Drainable rubber pch w fcplt...  ..............  ..............  ..............  ..............  ..............
  A4377  A                               Drainable plstic pch w/o fp....  ..............  ..............  ..............  ..............  ..............
  A4378  A                               Drainable rubber pch w/o fp....  ..............  ..............  ..............  ..............  ..............
  A4379  A                               Urinary plastic pouch w fcpl...  ..............  ..............  ..............  ..............  ..............
  A4380  A                               Urinary rubber pouch w fcplt...  ..............  ..............  ..............  ..............  ..............
  A4381  A                               Urinary plastic pouch w/o fp...  ..............  ..............  ..............  ..............  ..............
  A4382  A                               Urinary hvy plstc pch w/o fp...  ..............  ..............  ..............  ..............  ..............
  A4383  A                               Urinary rubber pouch w/o fp....  ..............  ..............  ..............  ..............  ..............
  A4384  A                               Ostomy faceplt/silicone ring...  ..............  ..............  ..............  ..............  ..............
  A4385  A                               Ost skn barrier sld ext wear...  ..............  ..............  ..............  ..............  ..............
  A4386  A                               Ost skn barrier w flng ex wr...  ..............  ..............  ..............  ..............  ..............
  A4387  A                               Ost clsd pouch w att st barr...  ..............  ..............  ..............  ..............  ..............
  A4388  A                               Drainable pch w ex wear barr...  ..............  ..............  ..............  ..............  ..............
  A4389  A                               Drainable pch w st wear barr...  ..............  ..............  ..............  ..............  ..............
  A4390  A                               Drainable pch ex wear convex...  ..............  ..............  ..............  ..............  ..............

[[Page 18666]]

 
  A4391  A                               Urinary pouch w ex wear barr...  ..............  ..............  ..............  ..............  ..............
  A4392  A                               Urinary pouch w st wear barr...  ..............  ..............  ..............  ..............  ..............
  A4393  A                               Urine pch w ex wear bar conv...  ..............  ..............  ..............  ..............  ..............
  A4394  A                               Ostomy pouch liq deodorant.....  ..............  ..............  ..............  ..............  ..............
  A4395  A                               Ostomy pouch solid deodorant...  ..............  ..............  ..............  ..............  ..............
  A4397  A                               Irrigation supply sleeve.......  ..............  ..............  ..............  ..............  ..............
  A4398  A                               Ostomy irrigation bag..........  ..............  ..............  ..............  ..............  ..............
  A4399  A                               Ostomy irrig cone/cath w brs...  ..............  ..............  ..............  ..............  ..............
  A4400  A                               Ostomy irrigation set..........  ..............  ..............  ..............  ..............  ..............
  A4402  A                               Lubricant per ounce............  ..............  ..............  ..............  ..............  ..............
  A4404  A                               Ostomy ring each...............  ..............  ..............  ..............  ..............  ..............
  A4421  A                               Ostomy supply misc.............  ..............  ..............  ..............  ..............  ..............
  A4454  A                               Tape all types all sizes.......  ..............  ..............  ..............  ..............  ..............
  A4455  A                               Adhesive remover per ounce.....  ..............  ..............  ..............  ..............  ..............
  A4460  A                               Elastic compression bandage....  ..............  ..............  ..............  ..............  ..............
  A4462  A                               Abdmnl drssng holder/binder....  ..............  ..............  ..............  ..............  ..............
  A4465  A                               Non-elastic extremity binder...  ..............  ..............  ..............  ..............  ..............
  A4470  A                               Gravlee jet washer.............  ..............  ..............  ..............  ..............  ..............
  A4480  A                               Vabra aspirator................  ..............  ..............  ..............  ..............  ..............
  A4481  A                               Tracheostoma filter............  ..............  ..............  ..............  ..............  ..............
  A4483  A                               Moisture exchanger.............  ..............  ..............  ..............  ..............  ..............
  A4490  E                               Above knee surgical stocking...  ..............  ..............  ..............  ..............  ..............
  A4495  E                               Thigh length surg stocking.....  ..............  ..............  ..............  ..............  ..............
  A4500  E                               Below knee surgical stocking...  ..............  ..............  ..............  ..............  ..............
  A4510  E                               Full length surg stocking......  ..............  ..............  ..............  ..............  ..............
  A4550  E                               Surgical trays.................  ..............  ..............  ..............  ..............  ..............
  A4554  E                               Disposable underpads...........  ..............  ..............  ..............  ..............  ..............
  A4556  A                               Electrodes, pair...............  ..............  ..............  ..............  ..............  ..............
  A4557  A                               Lead wires, pair...............  ..............  ..............  ..............  ..............  ..............
  A4558  A                               Conductive paste or gel........  ..............  ..............  ..............  ..............  ..............
  A4560  A                               Pessary........................  ..............  ..............  ..............  ..............  ..............
  A4565  A                               Slings.........................  ..............  ..............  ..............  ..............  ..............
  A4570  A                               Splint.........................  ..............  ..............  ..............  ..............  ..............
  A4572  A                               Rib belt.......................  ..............  ..............  ..............  ..............  ..............
  A4575  E                               Hyperbaric o2 chamber disps....  ..............  ..............  ..............  ..............  ..............
  A4580  A                               Cast supplies (plaster)........  ..............  ..............  ..............  ..............  ..............
  A4590  A                               Special casting material.......  ..............  ..............  ..............  ..............  ..............
  A4595  A                               TENS suppl 2 lead per month....  ..............  ..............  ..............  ..............  ..............
  A4611  A                               Heavy duty battery.............  ..............  ..............  ..............  ..............  ..............
  A4612  A                               Battery cables.................  ..............  ..............  ..............  ..............  ..............
  A4613  A                               Battery charger................  ..............  ..............  ..............  ..............  ..............
  A4614  A                               Hand-held PEFR meter...........  ..............  ..............  ..............  ..............  ..............
  A4615  A                               Cannula nasal..................  ..............  ..............  ..............  ..............  ..............
  A4616  A                               Tubing (oxygen) per foot.......  ..............  ..............  ..............  ..............  ..............
  A4617  A                               Mouth piece....................  ..............  ..............  ..............  ..............  ..............
  A4618  A                               Breathing circuits.............  ..............  ..............  ..............  ..............  ..............
  A4619  A                               Face tent......................  ..............  ..............  ..............  ..............  ..............
  A4620  A                               Variable concentration mask....  ..............  ..............  ..............  ..............  ..............
  A4621  A                               Tracheotomy mask or collar.....  ..............  ..............  ..............  ..............  ..............
  A4622  A                               Tracheostomy or larngectomy....  ..............  ..............  ..............  ..............  ..............
  A4623  A                               Tracheostomy inner cannula.....  ..............  ..............  ..............  ..............  ..............
  A4624  A                               Tracheal suction tube..........  ..............  ..............  ..............  ..............  ..............
  A4625  A                               Trach care kit for new trach...  ..............  ..............  ..............  ..............  ..............
  A4626  A                               Tracheostomy cleaning brush....  ..............  ..............  ..............  ..............  ..............
  A4627  E                               Spacer bag/reservoir...........  ..............  ..............  ..............  ..............  ..............
  A4628  A                               Oropharyngeal suction cath.....  ..............  ..............  ..............  ..............  ..............
  A4629  A                               Tracheostomy care kit..........  ..............  ..............  ..............  ..............  ..............
  A4630  A                               Repl bat t.e.n.s. own by pt....  ..............  ..............  ..............  ..............  ..............
  A4631  A                               Wheelchair battery.............  ..............  ..............  ..............  ..............  ..............
  A4635  A                               Underarm crutch pad............  ..............  ..............  ..............  ..............  ..............
  A4636  A                               Handgrip for cane etc..........  ..............  ..............  ..............  ..............  ..............
  A4637  A                               Repl tip cane/crutch/walker....  ..............  ..............  ..............  ..............  ..............
  A4640  A                               Alternating pressure pad.......  ..............  ..............  ..............  ..............  ..............
  A4641  N                               Diagnostic imaging agent.......  ..............  ..............  ..............  ..............  ..............
3 A4642  X                               Satumomab pendetide per dose...            0704  ..............  ..............  ..............          $63.13
  A4643  N                               High dose contrast MRI.........  ..............  ..............  ..............  ..............  ..............
  A4644  N                               Contrast 100-199 MGs iodine....  ..............  ..............  ..............  ..............  ..............
  A4645  N                               Contrast 200-299 MGs iodine....  ..............  ..............  ..............  ..............  ..............
  A4646  N                               Contrast 300-399 MGs iodine....  ..............  ..............  ..............  ..............  ..............
  A4647  N                               Supp-paramagnetic contr mat....  ..............  ..............  ..............  ..............  ..............
  A4649  A                               Surgical supplies..............  ..............  ..............  ..............  ..............  ..............
  A4650  A                               Supp esrd centrifuge...........  ..............  ..............  ..............  ..............  ..............
  A4655  A                               Esrd syringe/needle............  ..............  ..............  ..............  ..............  ..............

[[Page 18667]]

 
  A4660  A                               Esrd blood pressure device.....  ..............  ..............  ..............  ..............  ..............
  A4663  A                               Esrd blood pressure cuff.......  ..............  ..............  ..............  ..............  ..............
  A4670  E                               Auto blood pressure monitor....  ..............  ..............  ..............  ..............  ..............
  A4680  A                               Activated carbon filters.......  ..............  ..............  ..............  ..............  ..............
  A4690  A                               Dialyzers......................  ..............  ..............  ..............  ..............  ..............
  A4700  A                               Standard dialysate solution....  ..............  ..............  ..............  ..............  ..............
  A4705  A                               Bicarb dialysate solution......  ..............  ..............  ..............  ..............  ..............
  A4712  A                               Sterile water..................  ..............  ..............  ..............  ..............  ..............
  A4714  A                               Treated water for dialysis.....  ..............  ..............  ..............  ..............  ..............
  A4730  A                               Fistula cannulation set dial...  ..............  ..............  ..............  ..............  ..............
  A4735  A                               Local/topical anesthetics......  ..............  ..............  ..............  ..............  ..............
  A4740  A                               Esrd shunt accessory...........  ..............  ..............  ..............  ..............  ..............
  A4750  A                               Arterial or venous tubing......  ..............  ..............  ..............  ..............  ..............
  A4755  A                               Arterial and venous tubing.....  ..............  ..............  ..............  ..............  ..............
  A4760  A                               Standard testing solution......  ..............  ..............  ..............  ..............  ..............
  A4765  A                               Dialysate concentrate..........  ..............  ..............  ..............  ..............  ..............
  A4770  A                               Blood testing supplies.........  ..............  ..............  ..............  ..............  ..............
  A4771  A                               Blood clotting time tube.......  ..............  ..............  ..............  ..............  ..............
  A4772  A                               Dextrostick/glucose strips.....  ..............  ..............  ..............  ..............  ..............
  A4773  A                               Hemostix.......................  ..............  ..............  ..............  ..............  ..............
  A4774  A                               Ammonia test paper.............  ..............  ..............  ..............  ..............  ..............
  A4780  A                               Esrd sterilizing agent.........  ..............  ..............  ..............  ..............  ..............
  A4790  A                               Esrd cleansing agents..........  ..............  ..............  ..............  ..............  ..............
  A4800  A                               Heparin/antidote dialysis......  ..............  ..............  ..............  ..............  ..............
  A4820  A                               Supplies hemodialysis kit......  ..............  ..............  ..............  ..............  ..............
  A4850  A                               Rubber tipped hemostats........  ..............  ..............  ..............  ..............  ..............
  A4860  A                               Disposable catheter caps.......  ..............  ..............  ..............  ..............  ..............
  A4870  A                               Plumbing/electrical work.......  ..............  ..............  ..............  ..............  ..............
  A4880  A                               Water storage tanks............  ..............  ..............  ..............  ..............  ..............
  A4890  A                               Contracts/repair/maintenance...  ..............  ..............  ..............  ..............  ..............
  A4900  A                               Capd supply kit................  ..............  ..............  ..............  ..............  ..............
  A4901  A                               Ccpd supply kit................  ..............  ..............  ..............  ..............  ..............
  A4905  A                               Ipd supply kit.................  ..............  ..............  ..............  ..............  ..............
  A4910  A                               Esrd nonmedical supplies.......  ..............  ..............  ..............  ..............  ..............
  A4912  A                               Gomco drain bottle.............  ..............  ..............  ..............  ..............  ..............
  A4913  A                               Esrd supply....................  ..............  ..............  ..............  ..............  ..............
  A4914  A                               Preparation kit................  ..............  ..............  ..............  ..............  ..............
  A4918  A                               Venous pressure clamp..........  ..............  ..............  ..............  ..............  ..............
  A4919  A                               Supp dialysis dialyzer holde...  ..............  ..............  ..............  ..............  ..............
  A4920  A                               Harvard pressure clamp.........  ..............  ..............  ..............  ..............  ..............
  A4921  A                               Measuring cylinder.............  ..............  ..............  ..............  ..............  ..............
  A4927  A                               Gloves.........................  ..............  ..............  ..............  ..............  ..............
  A5051  A                               Pouch clsd w barr attached.....  ..............  ..............  ..............  ..............  ..............
  A5052  A                               Clsd ostomy pouch w/o barr.....  ..............  ..............  ..............  ..............  ..............
  A5053  A                               Clsd ostomy pouch faceplate....  ..............  ..............  ..............  ..............  ..............
  A5054  A                               Clsd ostomy pouch w/flange.....  ..............  ..............  ..............  ..............  ..............
  A5055  A                               Stoma cap......................  ..............  ..............  ..............  ..............  ..............
  A5061  A                               Pouch drainable w barrier at...  ..............  ..............  ..............  ..............  ..............
  A5062  A                               Drnble ostomy pouch w/o barr...  ..............  ..............  ..............  ..............  ..............
  A5063  A                               Drain ostomy pouch w/flange....  ..............  ..............  ..............  ..............  ..............
  A5064  E                               Drain ostomy pouch w/fceplte...  ..............  ..............  ..............  ..............  ..............
  A5065  E                               Drain ostomy pouch on fcplte...  ..............  ..............  ..............  ..............  ..............
  A5071  A                               Urinary pouch w/barrier........  ..............  ..............  ..............  ..............  ..............
  A5072  A                               Urinary pouch w/o barrier......  ..............  ..............  ..............  ..............  ..............
  A5073  A                               Urinary pouch on barr w/flng...  ..............  ..............  ..............  ..............  ..............
  A5074  E                               Urinary pouch w/faceplate......  ..............  ..............  ..............  ..............  ..............
  A5075  E                               Urinary pouch on faceplate.....  ..............  ..............  ..............  ..............  ..............
  A5081  A                               Continent stoma plug...........  ..............  ..............  ..............  ..............  ..............
  A5082  A                               Continent stoma catheter.......  ..............  ..............  ..............  ..............  ..............
  A5093  A                               Ostomy accessory convex inse...  ..............  ..............  ..............  ..............  ..............
  A5102  A                               Bedside drain btl w/wo tube....  ..............  ..............  ..............  ..............  ..............
  A5105  A                               Urinary suspensory.............  ..............  ..............  ..............  ..............  ..............
  A5112  A                               Urinary leg bag................  ..............  ..............  ..............  ..............  ..............
  A5113  A                               Latex leg strap................  ..............  ..............  ..............  ..............  ..............
  A5114  A                               Foam/fabric leg strap..........  ..............  ..............  ..............  ..............  ..............
  A5119  A                               Skin barrier wipes box pr 50...  ..............  ..............  ..............  ..............  ..............
  A5121  A                               Solid skin barrier 6x6.........  ..............  ..............  ..............  ..............  ..............
  A5122  A                               Solid skin barrier 8x8.........  ..............  ..............  ..............  ..............  ..............
  A5123  A                               Skin barrier with flange.......  ..............  ..............  ..............  ..............  ..............
  A5126  A                               Disk/foam pad +or- adhesive....  ..............  ..............  ..............  ..............  ..............
  A5131  A                               Appliance cleaner..............  ..............  ..............  ..............  ..............  ..............
  A5149  A                               Incontinence/ostomy supply.....  ..............  ..............  ..............  ..............  ..............
  A5200  A                               Percutaneous catheter anchor...  ..............  ..............  ..............  ..............  ..............

[[Page 18668]]

 
  A5500  A                               Diab shoe for density insert...  ..............  ..............  ..............  ..............  ..............
  A5501  A                               Diabetic custom molded shoe....  ..............  ..............  ..............  ..............  ..............
  A5502  A                               Diabetic shoe density insert...  ..............  ..............  ..............  ..............  ..............
  A5503  A                               Diabetic shoe w/roller/rockr...  ..............  ..............  ..............  ..............  ..............
  A5504  A                               Diabetic shoe with wedge.......  ..............  ..............  ..............  ..............  ..............
  A5505  A                               Diab shoe w/metatarsal bar.....  ..............  ..............  ..............  ..............  ..............
  A5506  A                               Diabetic shoe w/off set heel...  ..............  ..............  ..............  ..............  ..............
  A5507  A                               Modification diabetic shoe.....  ..............  ..............  ..............  ..............  ..............
  A5508  A                               Diabetic deluxe shoe...........  ..............  ..............  ..............  ..............  ..............
  A6020  A                               Collagen wound dressing........  ..............  ..............  ..............  ..............  ..............
  A6025  E                               Silicone gel sheet, each.......  ..............  ..............  ..............  ..............  ..............
  A6154  A                               Wound pouch each...............  ..............  ..............  ..............  ..............  ..............
  A6196  A                               Alginate dressing =16 sq in....  ..............  ..............  ..............  ..............  ..............
  A6197  A                               Alginate drsg >16 =48 sq in....  ..............  ..............  ..............  ..............  ..............
  A6198  A                               alginate dressing > 48 sq in...  ..............  ..............  ..............  ..............  ..............
  A6199  A                               Alginate drsg wound filler.....  ..............  ..............  ..............  ..............  ..............
  A6200  A                               Compos drsg =16 no border......  ..............  ..............  ..............  ..............  ..............
  A6201  A                               Compos drsg >16=48 no bdr......  ..............  ..............  ..............  ..............  ..............
  A6202  A                               Compos drsg >48 no border......  ..............  ..............  ..............  ..............  ..............
  A6203  A                               Composite drsg = 16 sq in......  ..............  ..............  ..............  ..............  ..............
  A6204  A                               Composite drsg >16=48 sq in....  ..............  ..............  ..............  ..............  ..............
  A6205  A                               Composite drsg > 48 sq in......  ..............  ..............  ..............  ..............  ..............
  A6206  A                               Contact layer = 16 sq in.......  ..............  ..............  ..............  ..............  ..............
  A6207  A                               Contact layer >16= 48 sq in....  ..............  ..............  ..............  ..............  ..............
  A6208  A                               Contact layer > 48 sq in.......  ..............  ..............  ..............  ..............  ..............
  A6209  A                               Foam drsg =16 sq in w/o bdr....  ..............  ..............  ..............  ..............  ..............
  A6210  A                               Foam drg >16=48 sq in w/o b....  ..............  ..............  ..............  ..............  ..............
  A6211  A                               Foam drg > 48 sq in w/o brdr...  ..............  ..............  ..............  ..............  ..............
  A6212  A                               Foam drg =16 sq in w/border....  ..............  ..............  ..............  ..............  ..............
  A6213  A                               Foam drg >16=48 sq in w/bdr....  ..............  ..............  ..............  ..............  ..............
  A6214  A                               Foam drg > 48 sq in w/border...  ..............  ..............  ..............  ..............  ..............
  A6215  A                               Foam dressing wound filler.....  ..............  ..............  ..............  ..............  ..............
  A6216  A                               Non-sterile gauze=16 sq in.....  ..............  ..............  ..............  ..............  ..............
  A6217  A                               Non-sterile gauze>16=48 sq.....  ..............  ..............  ..............  ..............  ..............
  A6218  A                               Non-sterile gauze > 48 sq in...  ..............  ..............  ..............  ..............  ..............
  A6219  A                               Gauze = 16 sq in w/border......  ..............  ..............  ..............  ..............  ..............
  A6220  A                               Gauze >16 =48 sq in w/bordr....  ..............  ..............  ..............  ..............  ..............
  A6221  A                               Gauze > 48 sq in w/border......  ..............  ..............  ..............  ..............  ..............
  A6222  A                               Gauze =16 in no w/sal w/o b....  ..............  ..............  ..............  ..............  ..............
  A6223  A                               Gauze >16=48 no w/sal w/o b....  ..............  ..............  ..............  ..............  ..............
  A6224  A                               Gauze > 48 in no w/sal w/o b...  ..............  ..............  ..............  ..............  ..............
  A6228  A                               Gauze = 16 sq in water/sal.....  ..............  ..............  ..............  ..............  ..............
  A6229  A                               Gauze >16=48 sq in watr/sal....  ..............  ..............  ..............  ..............  ..............
  A6230  A                               Gauze > 48 sq in water/salne...  ..............  ..............  ..............  ..............  ..............
  A6234  A                               Hydrocolld drg =16 w/o bdr.....  ..............  ..............  ..............  ..............  ..............
  A6235  A                               Hydrocolld drg >16=48 w/o b....  ..............  ..............  ..............  ..............  ..............
  A6236  A                               Hydrocolld drg > 48 in w/o b...  ..............  ..............  ..............  ..............  ..............
  A6237  A                               Hydrocolld drg =16 in w/bdr....  ..............  ..............  ..............  ..............  ..............
  A6238  A                               Hydrocolld drg >16=48 w/bdr....  ..............  ..............  ..............  ..............  ..............
  A6239  A                               Hydrocolld drg > 48 in w/bdr...  ..............  ..............  ..............  ..............  ..............
  A6240  A                               Hydrocolld drg filler paste....  ..............  ..............  ..............  ..............  ..............
  A6241  A                               Hydrocolloid drg filler dry....  ..............  ..............  ..............  ..............  ..............
  A6242  A                               Hydrogel drg =16 in w/o bdr....  ..............  ..............  ..............  ..............  ..............
  A6243  A                               Hydrogel drg >16=48 w/o bdr....  ..............  ..............  ..............  ..............  ..............
  A6244  A                               Hydrogel drg >48 in w/o bdr....  ..............  ..............  ..............  ..............  ..............
  A6245  A                               Hydrogel drg = 16 in w/bdr.....  ..............  ..............  ..............  ..............  ..............
  A6246  A                               Hydrogel drg >16=48 in w/b.....  ..............  ..............  ..............  ..............  ..............
  A6247  A                               Hydrogel drg > 48 sq in w/b....  ..............  ..............  ..............  ..............  ..............
  A6248  A                               Hydrogel drsg gel filler.......  ..............  ..............  ..............  ..............  ..............
  A6250  A                               Skin seal protect moisturizr...  ..............  ..............  ..............  ..............  ..............
  A6251  A                               Absorpt drg =16 sq in w/o b....  ..............  ..............  ..............  ..............  ..............
  A6252  A                               Absorpt drg >16 =48 w/o bdr....  ..............  ..............  ..............  ..............  ..............
  A6253  A                               Absorpt drg > 48 sq in w/o b...  ..............  ..............  ..............  ..............  ..............
  A6254  A                               Absorpt drg =16 sq in w/bdr....  ..............  ..............  ..............  ..............  ..............
  A6255  A                               Absorpt drg >16=48 in w/bdr....  ..............  ..............  ..............  ..............  ..............
  A6256  A                               Absorpt drg > 48 sq in w/bdr...  ..............  ..............  ..............  ..............  ..............
  A6257  A                               Transparent film = 16 sq in....  ..............  ..............  ..............  ..............  ..............
  A6258  A                               Transparent film >16=48 in.....  ..............  ..............  ..............  ..............  ..............
  A6259  A                               Transparent film > 48 sq in....  ..............  ..............  ..............  ..............  ..............
  A6260  A                               Wound cleanser any type/size...  ..............  ..............  ..............  ..............  ..............
  A6261  A                               Wound filler gel/paste/oz......  ..............  ..............  ..............  ..............  ..............
  A6262  A                               Wound filler dry form/gram.....  ..............  ..............  ..............  ..............  ..............
  A6263  A                               Non-sterile elastic gauze/yd...  ..............  ..............  ..............  ..............  ..............

[[Page 18669]]

 
  A6264  A                               Non-sterile no elastic gauze...  ..............  ..............  ..............  ..............  ..............
  A6265  A                               Tape per 18 sq inches..........  ..............  ..............  ..............  ..............  ..............
  A6266  A                               Impreg gauze no h20/sal/yard...  ..............  ..............  ..............  ..............  ..............
  A6402  A                               Sterile gauze = 16 sq in.......  ..............  ..............  ..............  ..............  ..............
  A6403  A                               Sterile gauze>16 = 48 sq in....  ..............  ..............  ..............  ..............  ..............
  A6404  A                               Sterile gauze > 48 sq in.......  ..............  ..............  ..............  ..............  ..............
  A6405  A                               Sterile elastic gauze/yd.......  ..............  ..............  ..............  ..............  ..............
  A6406  A                               Sterile non-elastic gauze/yd...  ..............  ..............  ..............  ..............  ..............
  A7000  A                               Disposable canister for pump...  ..............  ..............  ..............  ..............  ..............
  A7001  A                               Nondisposable pump canister....  ..............  ..............  ..............  ..............  ..............
  A7002  A                               Tubing used w suction pump.....  ..............  ..............  ..............  ..............  ..............
  A7003  A                               Nebulizer administration set...  ..............  ..............  ..............  ..............  ..............
  A7004  A                               Disposable nebulizer sml vol...  ..............  ..............  ..............  ..............  ..............
  A7005  A                               Nondisposable nebulizer set....  ..............  ..............  ..............  ..............  ..............
  A7006  A                               Filtered nebulizer admin set...  ..............  ..............  ..............  ..............  ..............
  A7007  A                               Lg vol nebulizer disposable....  ..............  ..............  ..............  ..............  ..............
  A7008  A                               Disposable nebulizer prefill...  ..............  ..............  ..............  ..............  ..............
  A7009  A                               Nebulizer reservoir bottle.....  ..............  ..............  ..............  ..............  ..............
  A7010  A                               Disposable corrugated tubing...  ..............  ..............  ..............  ..............  ..............
  A7011  A                               Nondispos corrugated tubing....  ..............  ..............  ..............  ..............  ..............
  A7012  A                               Nebulizer water collec devic...  ..............  ..............  ..............  ..............  ..............
  A7013  A                               Disposable compressor filter...  ..............  ..............  ..............  ..............  ..............
  A7014  A                               Compressor nondispos filter....  ..............  ..............  ..............  ..............  ..............
  A7015  A                               Aerosol mask used w nebulize...  ..............  ..............  ..............  ..............  ..............
  A7016  A                               Nebulizer dome & mouthpiece....  ..............  ..............  ..............  ..............  ..............
  A7017  A                               Nebulizer not used w oxygen....  ..............  ..............  ..............  ..............  ..............
  A9150  E                               Misc/exper non-prescript dru...  ..............  ..............  ..............  ..............  ..............
  A9160  E                               Podiatrist non-covered servi...  ..............  ..............  ..............  ..............  ..............
  A9170  E                               Chiropractor non-covered ser...  ..............  ..............  ..............  ..............  ..............
  A9190  E                               Misc/expe personal comfort i...  ..............  ..............  ..............  ..............  ..............
  A9270  E                               Non-covered item or service....  ..............  ..............  ..............  ..............  ..............
  A9300  E                               Exercise equipment.............  ..............  ..............  ..............  ..............  ..............
  A9500  N                               Technetium TC 99m sestamibi....  ..............  ..............  ..............  ..............  ..............
3 A9502  X                               Technetium TC99M tetrofosmin...            0705  ..............  ..............  ..............          $71.08
  A9503  N                               Technetium TC 99m medronate....  ..............  ..............  ..............  ..............  ..............
  A9504  N                               Technetium tc 99m apcitide.....  ..............  ..............  ..............  ..............  ..............
  A9505  N                               Thallous chloride TL 201/mci...  ..............  ..............  ..............  ..............  ..............
  A9507  N                               Indium/111 capromab pendetid...  ..............  ..............  ..............  ..............  ..............
3 A9600  X                               Strontium-89 chloride..........            0701  ..............  ..............  ..............          $84.76
3 A9605  X                               Samarium sm153 lexidronamm.....            0702  ..............  ..............  ..............         $139.06
  A9900  E                               Supply/accessory/service.......  ..............  ..............  ..............  ..............  ..............
  A9901  E                               Delivery/set up/dispensing.....  ..............  ..............  ..............  ..............  ..............
  B4034  A                               Enter feed supkit syr by day...  ..............  ..............  ..............  ..............  ..............
  B4035  A                               Enteral feed supp pump per d...  ..............  ..............  ..............  ..............  ..............
  B4036  A                               Enteral feed sup kit grav by...  ..............  ..............  ..............  ..............  ..............
  B4081  A                               Enteral ng tubing w/stylet.....  ..............  ..............  ..............  ..............  ..............
  B4082  A                               Enteral ng tubing w/o stylet...  ..............  ..............  ..............  ..............  ..............
  B4083  A                               Enteral stomach tube levine....  ..............  ..............  ..............  ..............  ..............
  B4084  A                               Gastrostomy/jejunostomy tubi...  ..............  ..............  ..............  ..............  ..............
  B4085  A                               Gastrostomy tube w/ring each...  ..............  ..............  ..............  ..............  ..............
  B4150  A                               Enteral formulae category i....  ..............  ..............  ..............  ..............  ..............
  B4151  A                               Enteral formulae category i-...  ..............  ..............  ..............  ..............  ..............
  B4152  A                               Enteral formulae category ii...  ..............  ..............  ..............  ..............  ..............
  B4153  A                               Enteral formulae category ii...  ..............  ..............  ..............  ..............  ..............
  B4154  A                               Enteral formulae category IV...  ..............  ..............  ..............  ..............  ..............
  B4155  A                               Enteral formulae category v....  ..............  ..............  ..............  ..............  ..............
  B4156  A                               Enteral formulae category vi...  ..............  ..............  ..............  ..............  ..............
  B4164  A                               Parenteral 50% dextrose solu...  ..............  ..............  ..............  ..............  ..............
  B4168  A                               Parenteral sol amino acid 3....  ..............  ..............  ..............  ..............  ..............
  B4172  A                               Parenteral sol amino acid 5....  ..............  ..............  ..............  ..............  ..............
  B4176  A                               Parenteral sol amino acid 7-...  ..............  ..............  ..............  ..............  ..............
  B4178  A                               Parenteral sol amino acid >....  ..............  ..............  ..............  ..............  ..............
  B4180  A                               Parenteral sol carb > 50%......  ..............  ..............  ..............  ..............  ..............
  B4184  A                               Parenteral sol lipids 10%......  ..............  ..............  ..............  ..............  ..............
  B4186  A                               Parenteral sol lipids 20%......  ..............  ..............  ..............  ..............  ..............
  B4189  A                               Parenteral sol amino acid &....  ..............  ..............  ..............  ..............  ..............
  B4193  A                               Parenteral sol 52-73 gm prot...  ..............  ..............  ..............  ..............  ..............
  B4197  A                               Parenteral sol 74-100 gm pro...  ..............  ..............  ..............  ..............  ..............
  B4199  A                               Parenteral sol > 100gm prote...  ..............  ..............  ..............  ..............  ..............
  B4216  A                               Parenteral nutrition additiv...  ..............  ..............  ..............  ..............  ..............
  B4220  A                               Parenteral supply kit premix...  ..............  ..............  ..............  ..............  ..............
  B4222  A                               Parenteral supply kit homemi...  ..............  ..............  ..............  ..............  ..............
  B4224  A                               Parenteral administration ki...  ..............  ..............  ..............  ..............  ..............

[[Page 18670]]

 
  B5000  A                               Parenteral sol renal-amirosy...  ..............  ..............  ..............  ..............  ..............
  B5100  A                               Parenteral sol hepatic-fream...  ..............  ..............  ..............  ..............  ..............
  B5200  A                               Parenteral sol stres-brnch c...  ..............  ..............  ..............  ..............  ..............
  B9000  A                               Enter infusion pump w/o alrm...  ..............  ..............  ..............  ..............  ..............
  B9002  A                               Enteral infusion pump w/ala....  ..............  ..............  ..............  ..............  ..............
  B9004  A                               Parenteral infus pump portab...  ..............  ..............  ..............  ..............  ..............
  B9006  A                               Parenteral infus pump statio...  ..............  ..............  ..............  ..............  ..............
  B9998  A                               Enteral supp not otherwise c...  ..............  ..............  ..............  ..............  ..............
  B9999  A                               Parenteral supp not othrws c...  ..............  ..............  ..............  ..............  ..............
  D0120  E                               Periodic oral evaluation.......  ..............  ..............  ..............  ..............  ..............
  D0140  E                               Limit oral eval problm focus...  ..............  ..............  ..............  ..............  ..............
  D0150  S                               Comprehensve oral evaluation...            0330            1.51          $73.22          $14.64          $14.64
  D0160  E                               Extensv oral eval prob focus...  ..............  ..............  ..............  ..............  ..............
  D0170  E                               Re-eval, est pt, problem focus.  ..............  ..............  ..............  ..............  ..............
  D0210  E                               Intraor complete film series...  ..............  ..............  ..............  ..............  ..............
  D0220  E                               Intraoral periapical first f...  ..............  ..............  ..............  ..............  ..............
  D0230  E                               Intraoral periapical ea add....  ..............  ..............  ..............  ..............  ..............
  D0240  S                               Intraoral occlusal film........            0330            1.51          $73.22          $14.64          $14.64
  D0250  S                               Extraoral first film...........            0330            1.51          $73.22          $14.64          $14.64
  D0260  S                               Extraoral ea additional film...            0330            1.51          $73.22          $14.64          $14.64
  D0270  S                               Dental bitewing single film....            0330            1.51          $73.22          $14.64          $14.64
  D0272  S                               Dental bitewings two films.....            0330            1.51          $73.22          $14.64          $14.64
  D0274  S                               Dental bitewings four films....            0330            1.51          $73.22          $14.64          $14.64
  D0277  E                               Vert bitewings-sev to eight....  ..............  ..............  ..............  ..............  ..............
  D0290  E                               Dental film skull/facial bon...  ..............  ..............  ..............  ..............  ..............
  D0310  E                               Dental saliography.............  ..............  ..............  ..............  ..............  ..............
  D0320  E                               Dental tmj arthrogram incl i...  ..............  ..............  ..............  ..............  ..............
  D0321  E                               Dental other tmj films.........  ..............  ..............  ..............  ..............  ..............
  D0322  E                               Dental tomographic survey......  ..............  ..............  ..............  ..............  ..............
  D0330  E                               Dental panoramic film..........  ..............  ..............  ..............  ..............  ..............
  D0340  E                               Dental cephalometric film......  ..............  ..............  ..............  ..............  ..............
  D0350  E                               Oral/facial images.............  ..............  ..............  ..............  ..............  ..............
  D0415  E                               Bacteriologic study............  ..............  ..............  ..............  ..............  ..............
  D0425  E                               Caries susceptibility test.....  ..............  ..............  ..............  ..............  ..............
  D0460  S                               Pulp vitality test.............            0330            1.51          $73.22          $14.64          $14.64
  D0470  E                               Diagnostic casts...............  ..............  ..............  ..............  ..............  ..............
  D0472  E                               Gross exam, prep & report......  ..............  ..............  ..............  ..............  ..............
  D0473  E                               Micro exam, prep & report......  ..............  ..............  ..............  ..............  ..............
  D0474  E                               Micro w exam of surg margins...  ..............  ..............  ..............  ..............  ..............
  D0480  E                               Cytopath smear prep & report...  ..............  ..............  ..............  ..............  ..............
  D0501  S                               Histopathologic examinations...            0330            1.51          $73.22          $14.64          $14.64
  D0502  S                               Other oral pathology procedu...            0330            1.51          $73.22          $14.64          $14.64
  D0999  S                               Unspecified diagnostic proce...            0330            1.51          $73.22          $14.64          $14.64
  D1110  E                               Dental prophylaxis adult.......  ..............  ..............  ..............  ..............  ..............
  D1120  E                               Dental prophylaxis child.......  ..............  ..............  ..............  ..............  ..............
  D1201  E                               Topical fluor w prophy child...  ..............  ..............  ..............  ..............  ..............
  D1203  E                               Topical fluor w/o prophy chi...  ..............  ..............  ..............  ..............  ..............
  D1204  E                               Topical fluor w/o prophy adu...  ..............  ..............  ..............  ..............  ..............
  D1205  E                               Topical fluoride w/prophy a....  ..............  ..............  ..............  ..............  ..............
  D1310  E                               Nutri counsel-control caries...  ..............  ..............  ..............  ..............  ..............
  D1320  E                               Tobacco counseling.............  ..............  ..............  ..............  ..............  ..............
  D1330  E                               Oral hygiene instruction.......  ..............  ..............  ..............  ..............  ..............
  D1351  E                               Dental sealant per tooth.......  ..............  ..............  ..............  ..............  ..............
  D1510  S                               Space maintainer fxd unilat....            0330            1.51          $73.22          $14.64          $14.64
  D1515  S                               Fixed bilat space maintainer...            0330            1.51          $73.22          $14.64          $14.64
  D1520  S                               Remove unilat space maintain...            0330            1.51          $73.22          $14.64          $14.64
  D1525  S                               Remove bilat space maintain....            0330            1.51          $73.22          $14.64          $14.64
  D1550  S                               Recement space maintainer......            0330            1.51          $73.22          $14.64          $14.64
  D2110  E                               Amalgam one surface primary....  ..............  ..............  ..............  ..............  ..............
  D2120  E                               Amalgam two surfaces primary...  ..............  ..............  ..............  ..............  ..............
  D2130  E                               Amalgam three surfaces prima...  ..............  ..............  ..............  ..............  ..............
  D2131  E                               Amalgam four/more surf prima...  ..............  ..............  ..............  ..............  ..............
  D2140  E                               Amalgam one surface permanen...  ..............  ..............  ..............  ..............  ..............
  D2150  E                               Amalgam two surfaces permane...  ..............  ..............  ..............  ..............  ..............
  D2160  E                               Amalgam three surfaces perma...  ..............  ..............  ..............  ..............  ..............
  D2161  E                               Amalgam 4 or > surfaces perm...  ..............  ..............  ..............  ..............  ..............
  D2330  E                               Resin one surface-anterior.....  ..............  ..............  ..............  ..............  ..............
  D2331  E                               Resin two surfaces-anterior....  ..............  ..............  ..............  ..............  ..............
  D2332  E                               Resin three surfaces-anterio...  ..............  ..............  ..............  ..............  ..............
  D2335  E                               Resin 4/> surf or w incis an...  ..............  ..............  ..............  ..............  ..............
  D2336  E                               Composite resin crown..........  ..............  ..............  ..............  ..............  ..............
  D2337  E                               Compo resin crown ant-perm.....  ..............  ..............  ..............  ..............  ..............
  D2380  E                               Resin one surf poster primar...  ..............  ..............  ..............  ..............  ..............

[[Page 18671]]

 
  D2381  E                               Resin two surf poster primar...  ..............  ..............  ..............  ..............  ..............
  D2382  E                               Resin three/more surf post p...  ..............  ..............  ..............  ..............  ..............
  D2385  E                               Resin one surf poster perman...  ..............  ..............  ..............  ..............  ..............
  D2386  E                               Resin two surf poster perman...  ..............  ..............  ..............  ..............  ..............
  D2387  E                               Resin three/more surf post p...  ..............  ..............  ..............  ..............  ..............
  D2388  E                               Resin four/more, post perm.....  ..............  ..............  ..............  ..............  ..............
  D2410  E                               Dental gold foil one surface...  ..............  ..............  ..............  ..............  ..............
  D2420  E                               Dental gold foil two surface...  ..............  ..............  ..............  ..............  ..............
  D2430  E                               Dental gold foil three surfa...  ..............  ..............  ..............  ..............  ..............
  D2510  E                               Dental inlay metalic 1 surf....  ..............  ..............  ..............  ..............  ..............
  D2520  E                               Dental inlay metallic 2 surf...  ..............  ..............  ..............  ..............  ..............
  D2530  E                               Dental inlay metl 3/more sur...  ..............  ..............  ..............  ..............  ..............
  D2542  E                               Dental onlay metallic 2 surf...  ..............  ..............  ..............  ..............  ..............
  D2543  E                               Dental onlay metallic 3 surf...  ..............  ..............  ..............  ..............  ..............
  D2544  E                               Dental onlay metl 4/more sur...  ..............  ..............  ..............  ..............  ..............
  D2610  E                               Inlay porcelain/ceramic 1 su...  ..............  ..............  ..............  ..............  ..............
  D2620  E                               Inlay porcelain/ceramic 2 su...  ..............  ..............  ..............  ..............  ..............
  D2630  E                               Dental onlay porc 3/more sur...  ..............  ..............  ..............  ..............  ..............
  D2642  E                               Dental onlay porcelin 2 surf...  ..............  ..............  ..............  ..............  ..............
  D2643  E                               Dental onlay porcelin 3 surf...  ..............  ..............  ..............  ..............  ..............
  D2644  E                               Dental onlay porc 4/more sur...  ..............  ..............  ..............  ..............  ..............
  D2650  E                               Inlay composite/resin one su...  ..............  ..............  ..............  ..............  ..............
  D2651  E                               Inlay composite/resin two su...  ..............  ..............  ..............  ..............  ..............
  D2652  E                               Dental inlay resin 3/mre sur...  ..............  ..............  ..............  ..............  ..............
  D2662  E                               Dental onlay resin 2 surface...  ..............  ..............  ..............  ..............  ..............
  D2663  E                               Dental onlay resin 3 surface...  ..............  ..............  ..............  ..............  ..............
  D2664  E                               Dental onlay resin 4/mre sur...  ..............  ..............  ..............  ..............  ..............
  D2710  E                               Crown resin laboratory.........  ..............  ..............  ..............  ..............  ..............
  D2720  E                               Crown resin w/high noble me....  ..............  ..............  ..............  ..............  ..............
  D2721  E                               Crown resin w/base metal.......  ..............  ..............  ..............  ..............  ..............
  D2722  E                               Crown resin w/noble metal......  ..............  ..............  ..............  ..............  ..............
  D2740  E                               Crown porcelain/ceramic subs...  ..............  ..............  ..............  ..............  ..............
  D2750  E                               Crown porcelain w/h noble m....  ..............  ..............  ..............  ..............  ..............
  D2751  E                               Crown porcelain fused base m...  ..............  ..............  ..............  ..............  ..............
  D2752  E                               Crown porcelain w/noble met....  ..............  ..............  ..............  ..............  ..............
  D2780  E                               Crown 3/4 cast hi noble met....  ..............  ..............  ..............  ..............  ..............
  D2781  E                               Crown 3/4 cast base metal......  ..............  ..............  ..............  ..............  ..............
  D2782  E                               Crown 3/4 cast noble metal.....  ..............  ..............  ..............  ..............  ..............
  D2783  E                               Crown 3/4 porcelain/ceramic....  ..............  ..............  ..............  ..............  ..............
  D2790  E                               Crown full cast high noble m...  ..............  ..............  ..............  ..............  ..............
  D2791  E                               Crown full cast base metal.....  ..............  ..............  ..............  ..............  ..............
  D2792  E                               Crown full cast noble metal....  ..............  ..............  ..............  ..............  ..............
  D2799  E                               Provisional crown..............  ..............  ..............  ..............  ..............  ..............
  D2910  E                               Dental recement inlay..........  ..............  ..............  ..............  ..............  ..............
  D2920  E                               Dental recement crown..........  ..............  ..............  ..............  ..............  ..............
  D2930  E                               Prefab stnlss steel crwn pri...  ..............  ..............  ..............  ..............  ..............
  D2931  E                               Prefab stnlss steel crown pe...  ..............  ..............  ..............  ..............  ..............
  D2932  E                               Prefabricated resin crown......  ..............  ..............  ..............  ..............  ..............
  D2933  E                               Prefab stainless steel crown...  ..............  ..............  ..............  ..............  ..............
  D2940  E                               Dental sedative filling........  ..............  ..............  ..............  ..............  ..............
  D2950  E                               Core build-up incl any pins....  ..............  ..............  ..............  ..............  ..............
  D2951  E                               Tooth pin retention............  ..............  ..............  ..............  ..............  ..............
  D2952  E                               Post and core cast + crown.....  ..............  ..............  ..............  ..............  ..............
  D2953  E                               Each addtnl cast post..........  ..............  ..............  ..............  ..............  ..............
  D2954  E                               Prefab post/core + crown.......  ..............  ..............  ..............  ..............  ..............
  D2955  E                               Post removal...................  ..............  ..............  ..............  ..............  ..............
  D2957  E                               Each addtnl prefab post........  ..............  ..............  ..............  ..............  ..............
  D2960  E                               Laminate labial veneer.........  ..............  ..............  ..............  ..............  ..............
  D2961  E                               Lab labial veneer resin........  ..............  ..............  ..............  ..............  ..............
  D2962  E                               Lab labial veneer porcelain....  ..............  ..............  ..............  ..............  ..............
  D2970  S                               Temporary-fractured tooth......            0330            1.51          $73.22          $14.64          $14.64
  D2980  E                               Crown repair...................  ..............  ..............  ..............  ..............  ..............
  D2999  S                               Dental unspec restorative pr...            0330            1.51          $73.22          $14.64          $14.64
  D3110  E                               Pulp cap direct................  ..............  ..............  ..............  ..............  ..............
  D3120  E                               Pulp cap indirect..............  ..............  ..............  ..............  ..............  ..............
  D3220  E                               Therapeutic pulpotomy..........  ..............  ..............  ..............  ..............  ..............
  D3221  E                               Gross pulpal debridement.......  ..............  ..............  ..............  ..............  ..............
  D3230  E                               Pulpal therapy anterior prim...  ..............  ..............  ..............  ..............  ..............
  D3240  E                               Pulpal therapy posterior pri...  ..............  ..............  ..............  ..............  ..............
  D3310  E                               Anterior.......................  ..............  ..............  ..............  ..............  ..............
  D3320  E                               Root canal therapy 2 canals....  ..............  ..............  ..............  ..............  ..............
  D3330  E                               Root canal therapy 3 canals....  ..............  ..............  ..............  ..............  ..............
  D3331  E                               Non-surg tx root canal obs.....  ..............  ..............  ..............  ..............  ..............

[[Page 18672]]

 
  D3332  E                               Incomplete endodontic tx.......  ..............  ..............  ..............  ..............  ..............
  D3333  E                               Internal root repair...........  ..............  ..............  ..............  ..............  ..............
  D3346  E                               Retreat root canal anterior....  ..............  ..............  ..............  ..............  ..............
  D3347  E                               Retreat root canal bicuspid....  ..............  ..............  ..............  ..............  ..............
  D3348  E                               Retreat root canal molar.......  ..............  ..............  ..............  ..............  ..............
  D3351  E                               Apexification/recalc initial...  ..............  ..............  ..............  ..............  ..............
  D3352  E                               Apexification/recalc interim...  ..............  ..............  ..............  ..............  ..............
  D3353  E                               Apexification/recalc final.....  ..............  ..............  ..............  ..............  ..............
  D3410  E                               Apicoect/perirad surg anter....  ..............  ..............  ..............  ..............  ..............
  D3421  E                               Root surgery bicuspid..........  ..............  ..............  ..............  ..............  ..............
  D3425  E                               Root surgery molar.............  ..............  ..............  ..............  ..............  ..............
  D3426  E                               Root surgery ea add root.......  ..............  ..............  ..............  ..............  ..............
  D3430  E                               Retrograde filling.............  ..............  ..............  ..............  ..............  ..............
  D3450  E                               Root amputation................  ..............  ..............  ..............  ..............  ..............
  D3460  S                               Endodontic endosseous implan...            0330            1.51          $73.22          $14.64          $14.64
  D3470  E                               Intentional replantation.......  ..............  ..............  ..............  ..............  ..............
  D3910  E                               Isolation-tooth w rubb dam.....  ..............  ..............  ..............  ..............  ..............
  D3920  E                               Tooth splitting................  ..............  ..............  ..............  ..............  ..............
  D3950  E                               Canal prep/fitting of dowel....  ..............  ..............  ..............  ..............  ..............
  D3999  S                               Endodontic procedure...........            0330            1.51          $73.22          $14.64          $14.64
  D4210  E                               Gingivectomy/plasty per quad...  ..............  ..............  ..............  ..............  ..............
  D4211  E                               Gingivectomy/plasty per toot...  ..............  ..............  ..............  ..............  ..............
  D4220  E                               Gingival curettage per quadr...  ..............  ..............  ..............  ..............  ..............
  D4240  E                               Gingival flap proc w/planin....  ..............  ..............  ..............  ..............  ..............
  D4245  E                               Apically positioned flap.......  ..............  ..............  ..............  ..............  ..............
  D4249  E                               Crown lengthen hard tissue.....  ..............  ..............  ..............  ..............  ..............
  D4260  S                               Osseous surgery per quadrant...            0330            1.51          $73.22          $14.64          $14.64
  D4263  S                               Bone replce graft first site...            0330            1.51          $73.22          $14.64          $14.64
  D4264  S                               Bone replce graft each add.....            0330            1.51          $73.22          $14.64          $14.64
  D4266  E                               Guided tiss regen resorble.....  ..............  ..............  ..............  ..............  ..............
  D4267  E                               Guided tiss regen nonresorb....  ..............  ..............  ..............  ..............  ..............
  D4268  E                               Surgical revision procedure....  ..............  ..............  ..............  ..............  ..............
  D4270  S                               Pedicle soft tissue graft pr...            0330            1.51          $73.22          $14.64          $14.64
  D4271  S                               Free soft tissue graft proc....            0330            1.51          $73.22          $14.64          $14.64
  D4273  S                               Subepithelial tissue graft.....            0330            1.51          $73.22          $14.64          $14.64
  D4274  E                               Distal/proximal wedge proc.....  ..............  ..............  ..............  ..............  ..............
  D4320  E                               Provision splnt intracoronal...  ..............  ..............  ..............  ..............  ..............
  D4321  E                               Provisional splint extracoro...  ..............  ..............  ..............  ..............  ..............
  D4341  E                               Periodontal scaling & root.....  ..............  ..............  ..............  ..............  ..............
  D4355  S                               Full mouth debridement.........            0330            1.51          $73.22          $14.64          $14.64
  D4381  S                               Localized chemo delivery.......            0330            1.51          $73.22          $14.64          $14.64
  D4910  E                               Periodontal maint procedures...  ..............  ..............  ..............  ..............  ..............
  D4920  E                               Unscheduled dressing change....  ..............  ..............  ..............  ..............  ..............
  D4999  E                               Unspecified periodontal proc...  ..............  ..............  ..............  ..............  ..............
  D5110  E                               Dentures complete maxillary....  ..............  ..............  ..............  ..............  ..............
  D5120  E                               Dentures complete mandible.....  ..............  ..............  ..............  ..............  ..............
  D5130  E                               Dentures immediat maxillary....  ..............  ..............  ..............  ..............  ..............
  D5140  E                               Dentures immediat mandible.....  ..............  ..............  ..............  ..............  ..............
  D5211  E                               Dentures maxill part resin.....  ..............  ..............  ..............  ..............  ..............
  D5212  E                               Dentures mand part resin.......  ..............  ..............  ..............  ..............  ..............
  D5213  E                               Dentures maxill part metal.....  ..............  ..............  ..............  ..............  ..............
  D5214  E                               Dentures mandibl part metal....  ..............  ..............  ..............  ..............  ..............
  D5281  E                               Removable partial denture......  ..............  ..............  ..............  ..............  ..............
  D5410  E                               Dentures adjust cmplt maxil....  ..............  ..............  ..............  ..............  ..............
  D5411  E                               Dentures adjust cmplt mand.....  ..............  ..............  ..............  ..............  ..............
  D5421  E                               Dentures adjust part maxill....  ..............  ..............  ..............  ..............  ..............
  D5422  E                               Dentures adjust part mandbl....  ..............  ..............  ..............  ..............  ..............
  D5510  E                               Dentur repr broken compl bas...  ..............  ..............  ..............  ..............  ..............
  D5520  E                               Replace denture teeth complt...  ..............  ..............  ..............  ..............  ..............
  D5610  E                               Dentures repair resin base.....  ..............  ..............  ..............  ..............  ..............
  D5620  E                               Rep part denture cast frame....  ..............  ..............  ..............  ..............  ..............
  D5630  E                               Rep partial denture clasp......  ..............  ..............  ..............  ..............  ..............
  D5640  E                               Replace part denture teeth.....  ..............  ..............  ..............  ..............  ..............
  D5650  E                               Add tooth to partial denture...  ..............  ..............  ..............  ..............  ..............
  D5660  E                               Add clasp to partial denture...  ..............  ..............  ..............  ..............  ..............
  D5710  E                               Dentures rebase cmplt maxil....  ..............  ..............  ..............  ..............  ..............
  D5711  E                               Dentures rebase cmplt mand.....  ..............  ..............  ..............  ..............  ..............
  D5720  E                               Dentures rebase part maxill....  ..............  ..............  ..............  ..............  ..............
  D5721  E                               Dentures rebase part mandbl....  ..............  ..............  ..............  ..............  ..............
  D5730  E                               Denture reln cmplt maxil ch....  ..............  ..............  ..............  ..............  ..............
  D5731  E                               Denture reln cmplt mand chr....  ..............  ..............  ..............  ..............  ..............
  D5740  E                               Denture reln part maxil chr....  ..............  ..............  ..............  ..............  ..............
  D5741  E                               Denture reln part mand chr.....  ..............  ..............  ..............  ..............  ..............

[[Page 18673]]

 
  D5750  E                               Denture reln cmplt max lab.....  ..............  ..............  ..............  ..............  ..............
  D5751  E                               Denture reln cmplt mand lab....  ..............  ..............  ..............  ..............  ..............
  D5760  E                               Denture reln part maxil lab....  ..............  ..............  ..............  ..............  ..............
  D5761  E                               Denture reln part mand lab.....  ..............  ..............  ..............  ..............  ..............
  D5810  E                               Denture interm cmplt maxill....  ..............  ..............  ..............  ..............  ..............
  D5811  E                               Denture interm cmplt mandbl....  ..............  ..............  ..............  ..............  ..............
  D5820  E                               Denture interm part maxill.....  ..............  ..............  ..............  ..............  ..............
  D5821  E                               Denture interm part mandbl.....  ..............  ..............  ..............  ..............  ..............
  D5850  E                               Denture tiss conditn maxill....  ..............  ..............  ..............  ..............  ..............
  D5851  E                               Denture tiss condtin mandbl....  ..............  ..............  ..............  ..............  ..............
  D5860  E                               Overdenture complete...........  ..............  ..............  ..............  ..............  ..............
  D5861  E                               Overdenture partial............  ..............  ..............  ..............  ..............  ..............
  D5862  E                               Precision attachment...........  ..............  ..............  ..............  ..............  ..............
  D5867  E                               Replacement of precision att...  ..............  ..............  ..............  ..............  ..............
  D5875  E                               Prosthesis modification........  ..............  ..............  ..............  ..............  ..............
  D5899  E                               Removable prosthodontic proc...  ..............  ..............  ..............  ..............  ..............
  D5911  S                               Facial moulage sectional.......            0330            1.51          $73.22          $14.64          $14.64
  D5912  S                               Facial moulage complete........            0330            1.51          $73.22          $14.64          $14.64
  D5913  E                               Nasal prosthesis...............  ..............  ..............  ..............  ..............  ..............
  D5914  E                               Auricular prosthesis...........  ..............  ..............  ..............  ..............  ..............
  D5915  E                               Orbital prosthesis.............  ..............  ..............  ..............  ..............  ..............
  D5916  E                               Ocular prosthesis..............  ..............  ..............  ..............  ..............  ..............
  D5919  E                               Facial prosthesis..............  ..............  ..............  ..............  ..............  ..............
  D5922  E                               Nasal septal prosthesis........  ..............  ..............  ..............  ..............  ..............
  D5923  E                               Ocular prosthesis interim......  ..............  ..............  ..............  ..............  ..............
  D5924  E                               Cranial prosthesis.............  ..............  ..............  ..............  ..............  ..............
  D5925  E                               Facial augmentation implant....  ..............  ..............  ..............  ..............  ..............
  D5926  E                               Replacement nasal prosthesis...  ..............  ..............  ..............  ..............  ..............
  D5927  E                               Auricular replacement..........  ..............  ..............  ..............  ..............  ..............
  D5928  E                               Orbital replacement............  ..............  ..............  ..............  ..............  ..............
  D5929  E                               Facial replacement.............  ..............  ..............  ..............  ..............  ..............
  D5931  E                               Surgical obturator.............  ..............  ..............  ..............  ..............  ..............
  D5932  E                               Postsurgical obturator.........  ..............  ..............  ..............  ..............  ..............
  D5933  E                               Refitting of obturator.........  ..............  ..............  ..............  ..............  ..............
  D5934  E                               Mandibular flange prosthesis...  ..............  ..............  ..............  ..............  ..............
  D5935  E                               Mandibular denture prosth......  ..............  ..............  ..............  ..............  ..............
  D5936  E                               Temp obturator prosthesis......  ..............  ..............  ..............  ..............  ..............
  D5937  E                               Trismus appliance..............  ..............  ..............  ..............  ..............  ..............
  D5951  E                               Feeding aid....................  ..............  ..............  ..............  ..............  ..............
  D5952  E                               Pediatric speech aid...........  ..............  ..............  ..............  ..............  ..............
  D5953  E                               Adult speech aid...............  ..............  ..............  ..............  ..............  ..............
  D5954  E                               Superimposed prosthesis........  ..............  ..............  ..............  ..............  ..............
  D5955  E                               Palatal lift prosthesis........  ..............  ..............  ..............  ..............  ..............
  D5958  E                               Intraoral con def inter plt....  ..............  ..............  ..............  ..............  ..............
  D5959  E                               Intraoral con def mod palat....  ..............  ..............  ..............  ..............  ..............
  D5960  E                               Modify speech aid prosthesis...  ..............  ..............  ..............  ..............  ..............
  D5982  E                               Surgical stent.................  ..............  ..............  ..............  ..............  ..............
  D5983  S                               Radiation applicator...........            0330            1.51          $73.22          $14.64          $14.64
  D5984  S                               Radiation shield...............            0330            1.51          $73.22          $14.64          $14.64
  D5985  S                               Radiation cone locator.........            0330            1.51          $73.22          $14.64          $14.64
  D5986  E                               Fluoride applicator............  ..............  ..............  ..............  ..............  ..............
  D5987  S                               Commissure splint..............            0330            1.51          $73.22          $14.64          $14.64
  D5988  E                               Surgical splint................  ..............  ..............  ..............  ..............  ..............
  D5999  E                               Maxillofacial prosthesis.......  ..............  ..............  ..............  ..............  ..............
  D6010  E                               Odontics endosteal implant.....  ..............  ..............  ..............  ..............  ..............
  D6020  E                               Odontics abutment placement....  ..............  ..............  ..............  ..............  ..............
  D6040  E                               Odontics eposteal implant......  ..............  ..............  ..............  ..............  ..............
  D6050  E                               Odontics transosteal implnt....  ..............  ..............  ..............  ..............  ..............
  D6055  E                               Implant connecting bar.........  ..............  ..............  ..............  ..............  ..............
  D6056  E                               Prefabricated abutment.........  ..............  ..............  ..............  ..............  ..............
  D6057  E                               Custom abutment................  ..............  ..............  ..............  ..............  ..............
  D6058  E                               Abutment supported crown.......  ..............  ..............  ..............  ..............  ..............
  D6059  E                               Abutment supported mtl crown...  ..............  ..............  ..............  ..............  ..............
  D6060  E                               Abutment supported mtl crown...  ..............  ..............  ..............  ..............  ..............
  D6061  E                               Abutment supported mtl crown...  ..............  ..............  ..............  ..............  ..............
  D6062  E                               Abutment supported mtl crown...  ..............  ..............  ..............  ..............  ..............
  D6063  E                               Abutment supported mtl crown...  ..............  ..............  ..............  ..............  ..............
  D6064  E                               Abutment supported mtl crown...  ..............  ..............  ..............  ..............  ..............
  D6065  E                               Implant supported crown........  ..............  ..............  ..............  ..............  ..............
  D6066  E                               Implant supported mtl crown....  ..............  ..............  ..............  ..............  ..............
  D6067  E                               Implant supported mtl crown....  ..............  ..............  ..............  ..............  ..............
  D6068  E                               Abutment supported retainer....  ..............  ..............  ..............  ..............  ..............
  D6069  E                               Abutment supported retainer....  ..............  ..............  ..............  ..............  ..............

[[Page 18674]]

 
  D6070  E                               Abutment supported retainer....  ..............  ..............  ..............  ..............  ..............
  D6071  E                               Abutment supported retainer....  ..............  ..............  ..............  ..............  ..............
  D6072  E                               Abutment supported retainer....  ..............  ..............  ..............  ..............  ..............
  D6073  E                               Abutment supported retainer....  ..............  ..............  ..............  ..............  ..............
  D6074  E                               Abutment supported retainer....  ..............  ..............  ..............  ..............  ..............
  D6075  E                               Implant supported retainer.....  ..............  ..............  ..............  ..............  ..............
  D6076  E                               Implant supported retainer.....  ..............  ..............  ..............  ..............  ..............
  D6077  E                               Implant supported retainer.....  ..............  ..............  ..............  ..............  ..............
  D6078  E                               Implnt/abut suprtd fixd dent...  ..............  ..............  ..............  ..............  ..............
  D6079  E                               Implnt/abut suprtd fixd dent...  ..............  ..............  ..............  ..............  ..............
  D6080  E                               Implant maintenance............  ..............  ..............  ..............  ..............  ..............
  D6090  E                               Repair implant.................  ..............  ..............  ..............  ..............  ..............
  D6095  E                               Odontics repr abutment.........  ..............  ..............  ..............  ..............  ..............
  D6100  E                               Removal of implant.............  ..............  ..............  ..............  ..............  ..............
  D6199  E                               Implant procedure..............  ..............  ..............  ..............  ..............  ..............
  D6210  E                               Prosthodont high noble metal...  ..............  ..............  ..............  ..............  ..............
  D6211  E                               Bridge base metal cast.........  ..............  ..............  ..............  ..............  ..............
  D6212  E                               Bridge noble metal cast........  ..............  ..............  ..............  ..............  ..............
  D6240  E                               Bridge porcelain high noble....  ..............  ..............  ..............  ..............  ..............
  D6241  E                               Bridge porcelain base metal....  ..............  ..............  ..............  ..............  ..............
  D6242  E                               Bridge porcelain nobel metal...  ..............  ..............  ..............  ..............  ..............
  D6245  E                               Bridge porcelain/ceramic.......  ..............  ..............  ..............  ..............  ..............
  D6250  E                               Bridge resin w/high noble......  ..............  ..............  ..............  ..............  ..............
  D6251  E                               Bridge resin base metal........  ..............  ..............  ..............  ..............  ..............
  D6252  E                               Bridge resin w/noble metal.....  ..............  ..............  ..............  ..............  ..............
  D6519  E                               Inlay/onlay porce/ceramic......  ..............  ..............  ..............  ..............  ..............
  D6520  E                               Dental retainer two surfaces...  ..............  ..............  ..............  ..............  ..............
  D6530  E                               Retainer metallic 3+ surface...  ..............  ..............  ..............  ..............  ..............
  D6543  E                               Dental retainr onlay 3 surf....  ..............  ..............  ..............  ..............  ..............
  D6544  E                               Dental retainr onlay 4/more....  ..............  ..............  ..............  ..............  ..............
  D6545  E                               Dental retainr cast metl.......  ..............  ..............  ..............  ..............  ..............
  D6548  E                               Porcelain/ceramic retainer.....  ..............  ..............  ..............  ..............  ..............
  D6720  E                               Retain crown resin w hi nble...  ..............  ..............  ..............  ..............  ..............
  D6721  E                               Crown resin w/base metal.......  ..............  ..............  ..............  ..............  ..............
  D6722  E                               Crown resin w/noble metal......  ..............  ..............  ..............  ..............  ..............
  D6740  E                               Crown porcelain/ceramic........  ..............  ..............  ..............  ..............  ..............
  D6750  E                               Crown porcelain high noble.....  ..............  ..............  ..............  ..............  ..............
  D6751  E                               Crown porcelain base metal.....  ..............  ..............  ..............  ..............  ..............
  D6752  E                               Crown porcelain noble metal....  ..............  ..............  ..............  ..............  ..............
  D6780  E                               Crown 3/4 high noble metal.....  ..............  ..............  ..............  ..............  ..............
  D6781  E                               Crown 3/4 cast based metal.....  ..............  ..............  ..............  ..............  ..............
  D6782  E                               Crown 3/4 cast noble metal.....  ..............  ..............  ..............  ..............  ..............
  D6783  E                               Crown 3/4 porcelain/ceramic....  ..............  ..............  ..............  ..............  ..............
  D6790  E                               Crown full high noble metal....  ..............  ..............  ..............  ..............  ..............
  D6791  E                               Crown full base metal cast.....  ..............  ..............  ..............  ..............  ..............
  D6792  E                               Crown full noble metal cast....  ..............  ..............  ..............  ..............  ..............
  D6920  S                               Dental connector bar...........            0330            1.51          $73.22          $14.64          $14.64
  D6930  E                               Dental recement bridge.........  ..............  ..............  ..............  ..............  ..............
  D6940  E                               Stress breaker.................  ..............  ..............  ..............  ..............  ..............
  D6950  E                               Precision attachment...........  ..............  ..............  ..............  ..............  ..............
  D6970  E                               Post & core plus retainer......  ..............  ..............  ..............  ..............  ..............
  D6971  E                               Cast post bridge retainer......  ..............  ..............  ..............  ..............  ..............
  D6972  E                               Prefab post & core plus reta...  ..............  ..............  ..............  ..............  ..............
  D6973  E                               Core build up for retainer.....  ..............  ..............  ..............  ..............  ..............
  D6975  E                               Coping metal...................  ..............  ..............  ..............  ..............  ..............
  D6976  E                               Each addtnl cast post..........  ..............  ..............  ..............  ..............  ..............
  D6977  E                               Each addtl prefab post.........  ..............  ..............  ..............  ..............  ..............
  D6980  E                               Bridge repair..................  ..............  ..............  ..............  ..............  ..............
  D6999  E                               Fixed prosthodontic proc.......  ..............  ..............  ..............  ..............  ..............
  D7110  S                               Oral surgery single tooth......            0330            1.51          $73.22          $14.64          $14.64
  D7120  S                               Each add tooth extraction......            0330            1.51          $73.22          $14.64          $14.64
  D7130  S                               Tooth root removal.............            0330            1.51          $73.22          $14.64          $14.64
  D7210  S                               Rem imp tooth w mucoper flp....            0330            1.51          $73.22          $14.64          $14.64
  D7220  S                               Impact tooth remov soft tiss...            0330            1.51          $73.22          $14.64          $14.64
  D7230  S                               Impact tooth remov part bony...            0330            1.51          $73.22          $14.64          $14.64
  D7240  S                               Impact tooth remov comp bony...            0330            1.51          $73.22          $14.64          $14.64
  D7241  S                               Impact tooth rem bony w/comp...            0330            1.51          $73.22          $14.64          $14.64
  D7250  S                               Tooth root removal.............            0330            1.51          $73.22          $14.64          $14.64
  D7260  S                               Oral antral fistula closure....            0330            1.51          $73.22          $14.64          $14.64
  D7270  E                               Tooth reimplantation...........  ..............  ..............  ..............  ..............  ..............
  D7272  E                               Tooth transplantation..........  ..............  ..............  ..............  ..............  ..............
  D7280  E                               Exposure impact tooth orthod...  ..............  ..............  ..............  ..............  ..............
  D7281  E                               Exposure tooth aid eruption....  ..............  ..............  ..............  ..............  ..............

[[Page 18675]]

 
  D7285  E                               Biopsy of oral tissue hard.....  ..............  ..............  ..............  ..............  ..............
  D7286  E                               Biopsy of oral tissue soft.....  ..............  ..............  ..............  ..............  ..............
  D7290  E                               Repositioning of teeth.........  ..............  ..............  ..............  ..............  ..............
  D7291  S                               Transseptal fiberotomy.........            0330            1.51          $73.22          $14.64          $14.64
  D7310  E                               Alveoplasty w/extraction.......  ..............  ..............  ..............  ..............  ..............
  D7320  E                               Alveoplasty w/o extraction.....  ..............  ..............  ..............  ..............  ..............
  D7340  E                               Vestibuloplasty ridge extens...  ..............  ..............  ..............  ..............  ..............
  D7350  E                               Vestibuloplasty exten graft....  ..............  ..............  ..............  ..............  ..............
  D7410  E                               Rad exc lesion up to 1.25 cm...  ..............  ..............  ..............  ..............  ..............
  D7420  E                               Lesion > 1.25 cm...............  ..............  ..............  ..............  ..............  ..............
  D7430  E                               Exc benign tumor to 1.25 cm....  ..............  ..............  ..............  ..............  ..............
  D7431  E                               Benign tumor exc > 1.25 cm.....  ..............  ..............  ..............  ..............  ..............
  D7440  E                               Malig tumor exc to 1.25 cm.....  ..............  ..............  ..............  ..............  ..............
  D7441  E                               Malig tumor > 1.25 cm..........  ..............  ..............  ..............  ..............  ..............
  D7450  E                               Rem odontogen cyst to 1.25cm...  ..............  ..............  ..............  ..............  ..............
  D7451  E                               Rem odontogen cyst > 1.25 cm...  ..............  ..............  ..............  ..............  ..............
  D7460  E                               Rem nonodonto cyst to 1.25cm...  ..............  ..............  ..............  ..............  ..............
  D7461  E                               Rem nonodonto cyst > 1.25 cm...  ..............  ..............  ..............  ..............  ..............
  D7465  E                               Lesion destruction.............  ..............  ..............  ..............  ..............  ..............
  D7471  E                               Rem exostosis any site.........  ..............  ..............  ..............  ..............  ..............
  D7480  E                               Partial ostectomy..............  ..............  ..............  ..............  ..............  ..............
  D7490  E                               Mandible resection.............  ..............  ..............  ..............  ..............  ..............
  D7510  E                               I&d absc intraoral soft tiss...  ..............  ..............  ..............  ..............  ..............
  D7520  E                               I&d abscess extraoral..........  ..............  ..............  ..............  ..............  ..............
  D7530  E                               Removal fb skin/areolar tiss...  ..............  ..............  ..............  ..............  ..............
  D7540  E                               Removal of fb reaction.........  ..............  ..............  ..............  ..............  ..............
  D7550  E                               Removal of sloughed off bone...  ..............  ..............  ..............  ..............  ..............
  D7560  E                               Maxillary sinusotomy...........  ..............  ..............  ..............  ..............  ..............
  D7610  E                               Maxilla open reduct simple.....  ..............  ..............  ..............  ..............  ..............
  D7620  E                               Clsd reduct simpl maxilla fx...  ..............  ..............  ..............  ..............  ..............
  D7630  E                               Open red simpl mandible fx.....  ..............  ..............  ..............  ..............  ..............
  D7640  E                               Clsd red simpl mandible fx.....  ..............  ..............  ..............  ..............  ..............
  D7650  E                               Open red simp malar/zygom fx...  ..............  ..............  ..............  ..............  ..............
  D7660  E                               Clsd red simp malar/zygom fx...  ..............  ..............  ..............  ..............  ..............
  D7670  E                               Closd rductn splint alveolus...  ..............  ..............  ..............  ..............  ..............
  D7680  E                               Reduct simple facial bone fx...  ..............  ..............  ..............  ..............  ..............
  D7710  E                               Maxilla open reduct compound...  ..............  ..............  ..............  ..............  ..............
  D7720  E                               Clsd reduct compd maxilla fx...  ..............  ..............  ..............  ..............  ..............
  D7730  E                               Open reduct compd mandble fx...  ..............  ..............  ..............  ..............  ..............
  D7740  E                               Clsd reduct compd mandble fx...  ..............  ..............  ..............  ..............  ..............
  D7750  E                               Open red comp malar/zygma fx...  ..............  ..............  ..............  ..............  ..............
  D7760  E                               Clsd red comp malar/zygma fx...  ..............  ..............  ..............  ..............  ..............
  D7770  E                               Open reduc compd alveolus fx...  ..............  ..............  ..............  ..............  ..............
  D7780  E                               Reduct compnd facial bone fx...  ..............  ..............  ..............  ..............  ..............
  D7810  E                               Tmj open reduct-dislocation....  ..............  ..............  ..............  ..............  ..............
  D7820  E                               Closed tmp manipulation........  ..............  ..............  ..............  ..............  ..............
  D7830  E                               Tmj manipulation under anest...  ..............  ..............  ..............  ..............  ..............
  D7840  E                               Removal of tmj condyle.........  ..............  ..............  ..............  ..............  ..............
  D7850  E                               Tmj meniscectomy...............  ..............  ..............  ..............  ..............  ..............
  D7852  E                               Tmj repair of joint disc.......  ..............  ..............  ..............  ..............  ..............
  D7854  E                               Tmj excisn of joint membrane...  ..............  ..............  ..............  ..............  ..............
  D7856  E                               Tmj cutting of a muscle........  ..............  ..............  ..............  ..............  ..............
  D7858  E                               Tmj reconstruction.............  ..............  ..............  ..............  ..............  ..............
  D7860  E                               Tmj cutting into joint.........  ..............  ..............  ..............  ..............  ..............
  D7865  E                               Tmj reshaping components.......  ..............  ..............  ..............  ..............  ..............
  D7870  E                               Tmj aspiration joint fluid.....  ..............  ..............  ..............  ..............  ..............
  D7871  E                               Lysis + lavage w catheters.....  ..............  ..............  ..............  ..............  ..............
  D7872  E                               Tmj diagnostic arthroscopy.....  ..............  ..............  ..............  ..............  ..............
  D7873  E                               Tmj arthroscopy lysis adhesn...  ..............  ..............  ..............  ..............  ..............
  D7874  E                               Tmj arthroscopy disc reposit...  ..............  ..............  ..............  ..............  ..............
  D7875  E                               Tmj arthroscopy synovectomy....  ..............  ..............  ..............  ..............  ..............
  D7876  E                               Tmj arthroscopy discectomy.....  ..............  ..............  ..............  ..............  ..............
  D7877  E                               Tmj arthroscopy debridement....  ..............  ..............  ..............  ..............  ..............
  D7880  E                               Occlusal orthotic appliance....  ..............  ..............  ..............  ..............  ..............
  D7899  E                               Tmj unspecified therapy........  ..............  ..............  ..............  ..............  ..............
  D7910  E                               Dent sutur recent wnd to 5cm...  ..............  ..............  ..............  ..............  ..............
  D7911  E                               Dental suture wound to 5 cm....  ..............  ..............  ..............  ..............  ..............
  D7912  E                               Suture complicate wnd > 5 cm...  ..............  ..............  ..............  ..............  ..............
  D7920  E                               Dental skin graft..............  ..............  ..............  ..............  ..............  ..............
  D7940  S                               Reshaping bone orthognathic....            0330            1.51          $73.22          $14.64          $14.64
  D7941  E                               Bone cutting ramus closed......  ..............  ..............  ..............  ..............  ..............
  D7943  E                               Cutting ramus open w/graft.....  ..............  ..............  ..............  ..............  ..............
  D7944  E                               Bone cutting segmented.........  ..............  ..............  ..............  ..............  ..............

[[Page 18676]]

 
  D7945  E                               Bone cutting body mandible.....  ..............  ..............  ..............  ..............  ..............
  D7946  E                               Reconstruction maxilla total...  ..............  ..............  ..............  ..............  ..............
  D7947  E                               Reconstruct maxilla segment....  ..............  ..............  ..............  ..............  ..............
  D7948  E                               Reconstruct midface no graft...  ..............  ..............  ..............  ..............  ..............
  D7949  E                               Reconstruct midface w/graft....  ..............  ..............  ..............  ..............  ..............
  D7950  E                               Mandible graft.................  ..............  ..............  ..............  ..............  ..............
  D7955  E                               Repair maxillofacial defects...  ..............  ..............  ..............  ..............  ..............
  D7960  E                               Frenulectomy/frenulotomy.......  ..............  ..............  ..............  ..............  ..............
  D7970  E                               Excision hyperplastic tissue...  ..............  ..............  ..............  ..............  ..............
  D7971  E                               Excision pericoronal gingiva...  ..............  ..............  ..............  ..............  ..............
  D7980  E                               Sialolithotomy.................  ..............  ..............  ..............  ..............  ..............
  D7981  E                               Excision of salivary gland.....  ..............  ..............  ..............  ..............  ..............
  D7982  E                               Sialodochoplasty...............  ..............  ..............  ..............  ..............  ..............
  D7983  E                               Closure of salivary fistula....  ..............  ..............  ..............  ..............  ..............
  D7990  E                               Emergency tracheotomy..........  ..............  ..............  ..............  ..............  ..............
  D7991  E                               Dental coronoidectomy..........  ..............  ..............  ..............  ..............  ..............
  D7995  E                               Synthetic graft facial bones...  ..............  ..............  ..............  ..............  ..............
  D7996  E                               Implant mandible for augment...  ..............  ..............  ..............  ..............  ..............
  D7997  E                               Appliance removal..............  ..............  ..............  ..............  ..............  ..............
  D7999  E                               Oral surgery procedure.........  ..............  ..............  ..............  ..............  ..............
  D8010  E                               Limited dental tx primary......  ..............  ..............  ..............  ..............  ..............
  D8020  E                               Limited dental tx transition...  ..............  ..............  ..............  ..............  ..............
  D8030  E                               Limited dental tx adolescent...  ..............  ..............  ..............  ..............  ..............
  D8040  E                               Limited dental tx adult........  ..............  ..............  ..............  ..............  ..............
  D8050  E                               Intercep dental tx primary.....  ..............  ..............  ..............  ..............  ..............
  D8060  E                               Intercep dental tx transitn....  ..............  ..............  ..............  ..............  ..............
  D8070  E                               Compre dental tx transition....  ..............  ..............  ..............  ..............  ..............
  D8080  E                               Compre dental tx adolescent....  ..............  ..............  ..............  ..............  ..............
  D8090  E                               Compre dental tx adult.........  ..............  ..............  ..............  ..............  ..............
  D8210  E                               Orthodontic rem appliance tx...  ..............  ..............  ..............  ..............  ..............
  D8220  E                               Fixed appliance therapy habt...  ..............  ..............  ..............  ..............  ..............
  D8660  E                               Preorthodontic tx visit........  ..............  ..............  ..............  ..............  ..............
  D8670  E                               Periodic orthodontc tx visit...  ..............  ..............  ..............  ..............  ..............
  D8680  E                               Orthodontic retention..........  ..............  ..............  ..............  ..............  ..............
  D8690  E                               Orthodontic treatment..........  ..............  ..............  ..............  ..............  ..............
  D8691  E                               Repair ortho appliance.........  ..............  ..............  ..............  ..............  ..............
  D8692  E                               Replacement retainer...........  ..............  ..............  ..............  ..............  ..............
  D8999  E                               Orthodontic procedure..........  ..............  ..............  ..............  ..............  ..............
  D9110  N                               Tx dental pain minor proc......  ..............  ..............  ..............  ..............  ..............
  D9210  E                               Dent anesthesia w/o surgery....  ..............  ..............  ..............  ..............  ..............
  D9211  E                               Regional block anesthesia......  ..............  ..............  ..............  ..............  ..............
  D9212  E                               Trigeminal block anesthesia....  ..............  ..............  ..............  ..............  ..............
  D9215  E                               Local anesthesia...............  ..............  ..............  ..............  ..............  ..............
  D9220  E                               General anesthesia.............  ..............  ..............  ..............  ..............  ..............
  D9221  E                               General anesthesia ea ad 15m...  ..............  ..............  ..............  ..............  ..............
  D9230  N                               Analgesia......................  ..............  ..............  ..............  ..............  ..............
  D9241  E                               Intravenous sedation...........  ..............  ..............  ..............  ..............  ..............
  D9242  E                               IV sedation ea ad 30 m.........  ..............  ..............  ..............  ..............  ..............
  D9248  E                               Sedation (non-iv)..............  ..............  ..............  ..............  ..............  ..............
  D9310  E                               Dental consultation............  ..............  ..............  ..............  ..............  ..............
  D9410  E                               Dental house call..............  ..............  ..............  ..............  ..............  ..............
  D9420  E                               Hospital call..................  ..............  ..............  ..............  ..............  ..............
  D9430  E                               Office visit during hours......  ..............  ..............  ..............  ..............  ..............
  D9440  E                               Office visit after hours.......  ..............  ..............  ..............  ..............  ..............
  D9610  E                               Dent therapeutic drug inject...  ..............  ..............  ..............  ..............  ..............
  D9630  S                               Other drugs/medicaments........            0330            1.51          $73.22          $14.64          $14.64
  D9910  E                               Dent appl desensitizing med....  ..............  ..............  ..............  ..............  ..............
  D9911  E                               Appl desensitizing resin.......  ..............  ..............  ..............  ..............  ..............
  D9920  E                               Behavior management............  ..............  ..............  ..............  ..............  ..............
  D9930  S                               Treatment of complications.....            0330            1.51          $73.22          $14.64          $14.64
  D9940  S                               Dental occlusal guard..........            0330            1.51          $73.22          $14.64          $14.64
  D9941  E                               Fabrication athletic guard.....  ..............  ..............  ..............  ..............  ..............
  D9950  S                               Occlusion analysis.............            0330            1.51          $73.22          $14.64          $14.64
  D9951  S                               Limited occlusal adjustment....            0330            1.51          $73.22          $14.64          $14.64
  D9952  S                               Complete occlusal adjustment...            0330            1.51          $73.22          $14.64          $14.64
  D9970  E                               Enamel microabrasion...........  ..............  ..............  ..............  ..............  ..............
  D9971  E                               Odontoplasty 1-2 teeth.........  ..............  ..............  ..............  ..............  ..............
  D9972  E                               Extrnl bleaching per arch......  ..............  ..............  ..............  ..............  ..............
  D9973  E                               Extrnl bleaching per tooth.....  ..............  ..............  ..............  ..............  ..............
  D9974  E                               Intrnl bleaching per tooth.....  ..............  ..............  ..............  ..............  ..............
  D9999  E                               Adjunctive procedure...........  ..............  ..............  ..............  ..............  ..............
  E0100  A                               Cane adjust/fixed with tip.....  ..............  ..............  ..............  ..............  ..............
  E0105  A                               Cane adjust/fixed quad/3 pro...  ..............  ..............  ..............  ..............  ..............

[[Page 18677]]

 
  E0110  A                               Crutch forearm pair............  ..............  ..............  ..............  ..............  ..............
  E0111  A                               Crutch forearm each............  ..............  ..............  ..............  ..............  ..............
  E0112  A                               Crutch underarm pair wood......  ..............  ..............  ..............  ..............  ..............
  E0113  A                               Crutch underarm each wood......  ..............  ..............  ..............  ..............  ..............
  E0114  A                               Crutch underarm pair no wood...  ..............  ..............  ..............  ..............  ..............
  E0116  A                               Crutch underarm each no wood...  ..............  ..............  ..............  ..............  ..............
  E0130  A                               Walker rigid adjust/fixed ht...  ..............  ..............  ..............  ..............  ..............
  E0135  A                               Walker folding adjust/fixed....  ..............  ..............  ..............  ..............  ..............
  E0141  A                               Rigid walker wheeled wo seat...  ..............  ..............  ..............  ..............  ..............
  E0142  A                               Walker rigid wheeled with se...  ..............  ..............  ..............  ..............  ..............
  E0143  A                               Walker folding wheeled w/o s...  ..............  ..............  ..............  ..............  ..............
  E0144  A                               Enclosed walker w rear seat....  ..............  ..............  ..............  ..............  ..............
  E0145  A                               Walker whled seat/crutch att...  ..............  ..............  ..............  ..............  ..............
  E0146  A                               Folding walker wheels w seat...  ..............  ..............  ..............  ..............  ..............
  E0147  A                               Walker variable wheel resist...  ..............  ..............  ..............  ..............  ..............
  E0153  A                               Forearm crutch platform atta...  ..............  ..............  ..............  ..............  ..............
  E0154  A                               Walker platform attachment.....  ..............  ..............  ..............  ..............  ..............
  E0155  A                               Walker wheel attachment, pair..  ..............  ..............  ..............  ..............  ..............
  E0156  A                               Walker seat attachment.........  ..............  ..............  ..............  ..............  ..............
  E0157  A                               Walker crutch attachment.......  ..............  ..............  ..............  ..............  ..............
  E0158  A                               Walker leg extenders set of4...  ..............  ..............  ..............  ..............  ..............
  E0159  A                               Brake for wheeled walker.......  ..............  ..............  ..............  ..............  ..............
  E0160  A                               Sitz type bath or equipment....  ..............  ..............  ..............  ..............  ..............
  E0161  A                               Sitz bath/equipment w/faucet...  ..............  ..............  ..............  ..............  ..............
  E0162  A                               Sitz bath chair................  ..............  ..............  ..............  ..............  ..............
  E0163  A                               Commode chair stationry fxd....  ..............  ..............  ..............  ..............  ..............
  E0164  A                               Commode chair mobile fixed a...  ..............  ..............  ..............  ..............  ..............
  E0165  A                               Commode chair stationry det....  ..............  ..............  ..............  ..............  ..............
  E0166  A                               Commode chair mobile detach....  ..............  ..............  ..............  ..............  ..............
  E0167  A                               Commode chair pail or pan......  ..............  ..............  ..............  ..............  ..............
  E0175  A                               Commode chair foot rest........  ..............  ..............  ..............  ..............  ..............
  E0176  A                               Air pressre pad/cushion nonp...  ..............  ..............  ..............  ..............  ..............
  E0177  A                               Water press pad/cushion nonp...  ..............  ..............  ..............  ..............  ..............
  E0178  A                               Gel pressre pad/cushion nonp...  ..............  ..............  ..............  ..............  ..............
  E0179  A                               Dry pressre pad/cushion nonp...  ..............  ..............  ..............  ..............  ..............
  E0180  A                               Press pad alternating w pump...  ..............  ..............  ..............  ..............  ..............
  E0181  A                               Press pad alternating w/pum....  ..............  ..............  ..............  ..............  ..............
  E0182  A                               Pressure pad alternating pum...  ..............  ..............  ..............  ..............  ..............
  E0184  A                               Dry pressure mattress..........  ..............  ..............  ..............  ..............  ..............
  E0185  A                               Gel pressure mattress pad......  ..............  ..............  ..............  ..............  ..............
  E0186  A                               Air pressure mattress..........  ..............  ..............  ..............  ..............  ..............
  E0187  A                               Water pressure mattress........  ..............  ..............  ..............  ..............  ..............
  E0188  E                               Synthetic sheepskin pad........  ..............  ..............  ..............  ..............  ..............
  E0189  E                               Lambswool sheepskin pad........  ..............  ..............  ..............  ..............  ..............
  E0191  A                               Protector heel or elbow........  ..............  ..............  ..............  ..............  ..............
  E0192  A                               Pad wheelchr low press/posit...  ..............  ..............  ..............  ..............  ..............
  E0193  A                               Powered air flotation bed......  ..............  ..............  ..............  ..............  ..............
  E0194  A                               Air fluidized bed..............  ..............  ..............  ..............  ..............  ..............
  E0196  A                               Gel pressure mattress..........  ..............  ..............  ..............  ..............  ..............
  E0197  A                               Air pressure pad for mattres...  ..............  ..............  ..............  ..............  ..............
  E0198  A                               Water pressure pad for mattr...  ..............  ..............  ..............  ..............  ..............
  E0199  A                               Dry pressure pad for mattres...  ..............  ..............  ..............  ..............  ..............
  E0200  A                               Heat lamp without stand........  ..............  ..............  ..............  ..............  ..............
  E0202  A                               Phototherapy light w/photom....  ..............  ..............  ..............  ..............  ..............
  E0205  A                               Heat lamp with stand...........  ..............  ..............  ..............  ..............  ..............
  E0210  A                               Electric heat pad standard.....  ..............  ..............  ..............  ..............  ..............
  E0215  A                               Electric heat pad moist........  ..............  ..............  ..............  ..............  ..............
  E0217  A                               Water circ heat pad w pump.....  ..............  ..............  ..............  ..............  ..............
  E0218  A                               Water circ cold pad w pump.....  ..............  ..............  ..............  ..............  ..............
  E0220  A                               Hot water bottle...............  ..............  ..............  ..............  ..............  ..............
  E0225  A                               Hydrocollator unit.............  ..............  ..............  ..............  ..............  ..............
  E0230  A                               Ice cap or collar..............  ..............  ..............  ..............  ..............  ..............
  E0235  A                               Paraffin bath unit portable....  ..............  ..............  ..............  ..............  ..............
  E0236  A                               Pump for water circulating p...  ..............  ..............  ..............  ..............  ..............
  E0238  A                               Heat pad non-electric moist....  ..............  ..............  ..............  ..............  ..............
  E0239  A                               Hydrocollator unit portable....  ..............  ..............  ..............  ..............  ..............
  E0241  E                               Bath tub wall rail.............  ..............  ..............  ..............  ..............  ..............
  E0242  E                               Bath tub rail floor............  ..............  ..............  ..............  ..............  ..............
  E0243  E                               Toilet rail....................  ..............  ..............  ..............  ..............  ..............
  E0244  E                               Toilet seat raised.............  ..............  ..............  ..............  ..............  ..............
  E0245  E                               Tub stool or bench.............  ..............  ..............  ..............  ..............  ..............
  E0246  A                               Transfer tub rail attachment...  ..............  ..............  ..............  ..............  ..............
  E0249  A                               Pad water circulating heat u...  ..............  ..............  ..............  ..............  ..............

[[Page 18678]]

 
  E0250  A                               Hosp bed fixed ht w/mattres....  ..............  ..............  ..............  ..............  ..............
  E0251  A                               Hosp bed fixd ht w/o mattres...  ..............  ..............  ..............  ..............  ..............
  E0255  A                               Hospital bed var ht w/mattr....  ..............  ..............  ..............  ..............  ..............
  E0256  A                               Hospital bed var ht w/o matt...  ..............  ..............  ..............  ..............  ..............
  E0260  A                               Hosp bed semi-electr w/matt....  ..............  ..............  ..............  ..............  ..............
  E0261  A                               Hosp bed semi-electr w/o mat...  ..............  ..............  ..............  ..............  ..............
  E0265  A                               Hosp bed total electr w/mat....  ..............  ..............  ..............  ..............  ..............
  E0266  A                               Hosp bed total elec w/o matt...  ..............  ..............  ..............  ..............  ..............
  E0270  A                               Hospital bed institutional t...  ..............  ..............  ..............  ..............  ..............
  E0271  A                               Mattress innerspring...........  ..............  ..............  ..............  ..............  ..............
  E0272  A                               Mattress foam rubber...........  ..............  ..............  ..............  ..............  ..............
  E0273  A                               Bed board......................  ..............  ..............  ..............  ..............  ..............
  E0274  A                               Over-bed table.................  ..............  ..............  ..............  ..............  ..............
  E0275  A                               Bed pan standard...............  ..............  ..............  ..............  ..............  ..............
  E0276  A                               Bed pan fracture...............  ..............  ..............  ..............  ..............  ..............
  E0277  A                               Powered pres-redu air mattrs...  ..............  ..............  ..............  ..............  ..............
  E0280  A                               Bed cradle.....................  ..............  ..............  ..............  ..............  ..............
  E0290  A                               Hosp bed fx ht w/o rails w/m...  ..............  ..............  ..............  ..............  ..............
  E0291  A                               Hosp bed fx ht w/o rail w/o....  ..............  ..............  ..............  ..............  ..............
  E0292  A                               Hosp bed var ht w/o rail w/o...  ..............  ..............  ..............  ..............  ..............
  E0293  A                               Hosp bed var ht w/o rail w/....  ..............  ..............  ..............  ..............  ..............
  E0294  A                               Hosp bed semi-elect w/mattr....  ..............  ..............  ..............  ..............  ..............
  E0295  A                               Hosp bed semi-elect w/o matt...  ..............  ..............  ..............  ..............  ..............
  E0296  A                               Hosp bed total elect w/matt....  ..............  ..............  ..............  ..............  ..............
  E0297  A                               Hosp bed total elect w/o mat...  ..............  ..............  ..............  ..............  ..............
  E0305  A                               Rails bed side half length.....  ..............  ..............  ..............  ..............  ..............
  E0310  A                               Rails bed side full length.....  ..............  ..............  ..............  ..............  ..............
  E0315  A                               Bed accessory brd/tbl/supprt...  ..............  ..............  ..............  ..............  ..............
  E0325  A                               Urinal male jug-type...........  ..............  ..............  ..............  ..............  ..............
  E0326  A                               Urinal female jug-type.........  ..............  ..............  ..............  ..............  ..............
  E0350  A                               Control unit bowel system......  ..............  ..............  ..............  ..............  ..............
  E0352  A                               Disposable pack w/bowel syst...  ..............  ..............  ..............  ..............  ..............
  E0370  A                               Air elevator for heel..........  ..............  ..............  ..............  ..............  ..............
  E0371  A                               Nonpower mattress overlay......  ..............  ..............  ..............  ..............  ..............
  E0372  A                               Powered air mattress overlay...  ..............  ..............  ..............  ..............  ..............
  E0373  A                               Nonpowered pressure mattress...  ..............  ..............  ..............  ..............  ..............
  E0424  A                               Stationary compressed gas 02...  ..............  ..............  ..............  ..............  ..............
  E0425  A                               Gas system stationary compre...  ..............  ..............  ..............  ..............  ..............
  E0430  A                               Oxygen system gas portable.....  ..............  ..............  ..............  ..............  ..............
  E0431  A                               Portable gaseous 02............  ..............  ..............  ..............  ..............  ..............
  E0434  A                               Portable liquid 02.............  ..............  ..............  ..............  ..............  ..............
  E0435  A                               Oxygen system liquid portabl...  ..............  ..............  ..............  ..............  ..............
  E0439  A                               Stationary liquid 02...........  ..............  ..............  ..............  ..............  ..............
  E0440  A                               Oxygen system liquid station...  ..............  ..............  ..............  ..............  ..............
  E0441  A                               Oxygen contents gas per/unit...  ..............  ..............  ..............  ..............  ..............
  E0442  A                               Oxygen contents liq per/unit...  ..............  ..............  ..............  ..............  ..............
  E0443  A                               Port 02 contents gas/unit......  ..............  ..............  ..............  ..............  ..............
  E0444  A                               Port 02 contents liq/unit......  ..............  ..............  ..............  ..............  ..............
  E0450  A                               Volume vent stationary/porta...  ..............  ..............  ..............  ..............  ..............
  E0455  A                               Oxygen tent excl croup/ped t...  ..............  ..............  ..............  ..............  ..............
  E0457  A                               Chest shell....................  ..............  ..............  ..............  ..............  ..............
  E0459  A                               Chest wrap.....................  ..............  ..............  ..............  ..............  ..............
  E0460  A                               Neg press vent portabl/statn...  ..............  ..............  ..............  ..............  ..............
  E0462  A                               Rocking bed w/ or w/o side r...  ..............  ..............  ..............  ..............  ..............
  E0480  A                               Percussor elect/pneum home m...  ..............  ..............  ..............  ..............  ..............
  E0500  A                               Ippb all types.................  ..............  ..............  ..............  ..............  ..............
  E0550  A                               Humidif extens supple w ippb...  ..............  ..............  ..............  ..............  ..............
  E0555  A                               Humidifier for use w/regula....  ..............  ..............  ..............  ..............  ..............
  E0560  A                               Humidifier supplemental w/i....  ..............  ..............  ..............  ..............  ..............
  E0565  A                               Compressor air power source....  ..............  ..............  ..............  ..............  ..............
  E0570  A                               Nebulizer with compression.....  ..............  ..............  ..............  ..............  ..............
  E0575  A                               Nebulizer ultrasonic...........  ..............  ..............  ..............  ..............  ..............
  E0580  A                               Nebulizer for use w/regulat....  ..............  ..............  ..............  ..............  ..............
  E0585  A                               Nebulizer w/compressor & he....  ..............  ..............  ..............  ..............  ..............
  E0590  A                               Dispensing fee dme neb drug....  ..............  ..............  ..............  ..............  ..............
  E0600  A                               Suction pump portab hom modl...  ..............  ..............  ..............  ..............  ..............
  E0601  A                               Cont airway pressure device....  ..............  ..............  ..............  ..............  ..............
  E0602  A                               Breast pump....................  ..............  ..............  ..............  ..............  ..............
  E0605  A                               Vaporizer room type............  ..............  ..............  ..............  ..............  ..............
  E0606  A                               Drainage board postural........  ..............  ..............  ..............  ..............  ..............
  E0607  A                               Blood glucose monitor home.....  ..............  ..............  ..............  ..............  ..............
  E0608  A                               Apnea monitor..................  ..............  ..............  ..............  ..............  ..............
  E0609  A                               Blood gluc mon w/special fea...  ..............  ..............  ..............  ..............  ..............

[[Page 18679]]

 
  E0610  A                               Pacemaker monitr audible/vis...  ..............  ..............  ..............  ..............  ..............
  E0615  A                               Pacemaker monitr digital/vis...  ..............  ..............  ..............  ..............  ..............
  E0616  A                               Cardiac event recorder.........  ..............  ..............  ..............  ..............  ..............
  E0621  A                               Patient lift sling or seat.....  ..............  ..............  ..............  ..............  ..............
  E0625  A                               Patient lift bathroom or toi...  ..............  ..............  ..............  ..............  ..............
  E0627  A                               Seat lift incorp lift-chair....  ..............  ..............  ..............  ..............  ..............
  E0628  A                               Seat lift for pt furn-electr...  ..............  ..............  ..............  ..............  ..............
  E0629  A                               Seat lift for pt furn-non-el...  ..............  ..............  ..............  ..............  ..............
  E0630  A                               Patient lift hydraulic.........  ..............  ..............  ..............  ..............  ..............
  E0635  A                               Patient lift electric..........  ..............  ..............  ..............  ..............  ..............
  E0650  A                               Pneuma compresor non-segment...  ..............  ..............  ..............  ..............  ..............
  E0651  A                               Pneum compressor segmental.....  ..............  ..............  ..............  ..............  ..............
  E0652  A                               Pneum compres w/cal pressure...  ..............  ..............  ..............  ..............  ..............
  E0655  A                               Pneumatic appliance half arm...  ..............  ..............  ..............  ..............  ..............
  E0660  A                               Pneumatic appliance full leg...  ..............  ..............  ..............  ..............  ..............
  E0665  A                               Pneumatic appliance full arm...  ..............  ..............  ..............  ..............  ..............
  E0666  A                               Pneumatic appliance half leg...  ..............  ..............  ..............  ..............  ..............
  E0667  A                               Seg pneumatic appl full leg....  ..............  ..............  ..............  ..............  ..............
  E0668  A                               Seg pneumatic appl full arm....  ..............  ..............  ..............  ..............  ..............
  E0669  A                               Seg pneumatic appli half leg...  ..............  ..............  ..............  ..............  ..............
  E0671  A                               Pressure pneum appl full leg...  ..............  ..............  ..............  ..............  ..............
  E0672  A                               Pressure pneum appl full arm...  ..............  ..............  ..............  ..............  ..............
  E0673  A                               Pressure pneum appl half leg...  ..............  ..............  ..............  ..............  ..............
  E0690  A                               Ultraviolet cabinet............  ..............  ..............  ..............  ..............  ..............
  E0700  A                               Safety equipment...............  ..............  ..............  ..............  ..............  ..............
  E0710  A                               Restraints any type............  ..............  ..............  ..............  ..............  ..............
  E0720  A                               Tens two lead..................  ..............  ..............  ..............  ..............  ..............
  E0730  A                               Tens four lead.................  ..............  ..............  ..............  ..............  ..............
  E0731  A                               Conductive garment for tens/...  ..............  ..............  ..............  ..............  ..............
  E0740  A                               Incontinence treatment systm...  ..............  ..............  ..............  ..............  ..............
  E0744  A                               Neuromuscular stim for scoli...  ..............  ..............  ..............  ..............  ..............
  E0745  A                               Neuromuscular stim for shock...  ..............  ..............  ..............  ..............  ..............
  E0746  A                               Electromyograph biofeedback....  ..............  ..............  ..............  ..............  ..............
  E0747  A                               Elec osteogen stim not spine...  ..............  ..............  ..............  ..............  ..............
  E0748  A                               Elec osteogen stim spinal......  ..............  ..............  ..............  ..............  ..............
  E0749  A                               Elec osteogen stim implanted...  ..............  ..............  ..............  ..............  ..............
  E0751  A                               Pulse generator or receiver....  ..............  ..............  ..............  ..............  ..............
  E0753  A                               Neurostimulator electrodes.....  ..............  ..............  ..............  ..............  ..............
  E0755  A                               Electronic salivary reflex s...  ..............  ..............  ..............  ..............  ..............
  E0760  A                               Osteogen ultrasound stimltor...  ..............  ..............  ..............  ..............  ..............
  E0776  A                               Iv pole........................  ..............  ..............  ..............  ..............  ..............
  E0779  A                               Amb infusion pump mechanical...  ..............  ..............  ..............  ..............  ..............
  E0780  A                               Mech amb infusion pump 8hrs....  ..............  ..............  ..............  ..............  ..............
  E0781  A                               External ambulatory infus pu...  ..............  ..............  ..............  ..............  ..............
  E0782  A                               Non-programble infusion pump...  ..............  ..............  ..............  ..............  ..............
  E0783  A                               Programmable infusion pump.....  ..............  ..............  ..............  ..............  ..............
  E0784  A                               Ext amb infusn pump insulin....  ..............  ..............  ..............  ..............  ..............
  E0785  A                               Replacement impl pump cathet...  ..............  ..............  ..............  ..............  ..............
  E0791  A                               Parenteral infusion pump sta...  ..............  ..............  ..............  ..............  ..............
  E0840  A                               Tract frame attach headboard...  ..............  ..............  ..............  ..............  ..............
  E0850  A                               Traction stand free standing...  ..............  ..............  ..............  ..............  ..............
  E0855  A                               Cervical traction equipment....  ..............  ..............  ..............  ..............  ..............
  E0860  A                               Tract equip cervical tract.....  ..............  ..............  ..............  ..............  ..............
  E0870  A                               Tract frame attach footboard...  ..............  ..............  ..............  ..............  ..............
  E0880  A                               Trac stand free stand extrem...  ..............  ..............  ..............  ..............  ..............
  E0890  A                               Traction frame attach pelvic...  ..............  ..............  ..............  ..............  ..............
  E0900  A                               Trac stand free stand pelvic...  ..............  ..............  ..............  ..............  ..............
  E0910  A                               Trapeze bar attached to bed....  ..............  ..............  ..............  ..............  ..............
  E0920  A                               Fracture frame attached to b...  ..............  ..............  ..............  ..............  ..............
  E0930  A                               Fracture frame free standing...  ..............  ..............  ..............  ..............  ..............
  E0935  A                               Exercise device passive moti...  ..............  ..............  ..............  ..............  ..............
  E0940  A                               Trapeze bar free standing......  ..............  ..............  ..............  ..............  ..............
  E0941  A                               Gravity assisted traction de...  ..............  ..............  ..............  ..............  ..............
  E0942  A                               Cervical head harness/halter...  ..............  ..............  ..............  ..............  ..............
  E0943  A                               Cervical pillow................  ..............  ..............  ..............  ..............  ..............
  E0944  A                               Pelvic belt/harness/boot.......  ..............  ..............  ..............  ..............  ..............
  E0945  A                               Belt/harness extremity.........  ..............  ..............  ..............  ..............  ..............
  E0946  A                               Fracture frame dual w cross....  ..............  ..............  ..............  ..............  ..............
  E0947  A                               Fracture frame attachmnts pe...  ..............  ..............  ..............  ..............  ..............
  E0948  A                               Fracture frame attachmnts ce...  ..............  ..............  ..............  ..............  ..............
  E0950  A                               Tray...........................  ..............  ..............  ..............  ..............  ..............
  E0951  A                               Loop heel......................  ..............  ..............  ..............  ..............  ..............
  E0952  A                               Loop tie.......................  ..............  ..............  ..............  ..............  ..............

[[Page 18680]]

 
  E0953  A                               Pneumatic tire.................  ..............  ..............  ..............  ..............  ..............
  E0954  A                               Wheelchair semi-pneumatic ca...  ..............  ..............  ..............  ..............  ..............
  E0958  A                               Whlchr att-conv 1 arm drive....  ..............  ..............  ..............  ..............  ..............
  E0959  A                               Amputee adapter................  ..............  ..............  ..............  ..............  ..............
  E0961  A                               Wheelchair brake extension.....  ..............  ..............  ..............  ..............  ..............
  E0962  A                               Wheelchair 1 inch cushion......  ..............  ..............  ..............  ..............  ..............
  E0963  A                               Wheelchair 2 inch cushion......  ..............  ..............  ..............  ..............  ..............
  E0964  A                               Wheelchair 3 inch cushion......  ..............  ..............  ..............  ..............  ..............
  E0965  A                               Wheelchair 4 inch cushion......  ..............  ..............  ..............  ..............  ..............
  E0966  A                               Wheelchair head rest extensi...  ..............  ..............  ..............  ..............  ..............
  E0967  A                               Wheelchair hand rims...........  ..............  ..............  ..............  ..............  ..............
  E0968  A                               Wheelchair commode seat........  ..............  ..............  ..............  ..............  ..............
  E0969  A                               Wheelchair narrowing device....  ..............  ..............  ..............  ..............  ..............
  E0970  A                               Wheelchair no. 2 footplates....  ..............  ..............  ..............  ..............  ..............
  E0971  A                               Wheelchair anti-tipping devi...  ..............  ..............  ..............  ..............  ..............
  E0972  A                               Transfer board or device.......  ..............  ..............  ..............  ..............  ..............
  E0973  A                               Wheelchair adjustabl height....  ..............  ..............  ..............  ..............  ..............
  E0974  A                               Wheelchair grade-aid...........  ..............  ..............  ..............  ..............  ..............
  E0975  A                               Wheelchair reinforced seat u...  ..............  ..............  ..............  ..............  ..............
  E0976  A                               Wheelchair reinforced back u...  ..............  ..............  ..............  ..............  ..............
  E0977  A                               Wheelchair wedge cushion.......  ..............  ..............  ..............  ..............  ..............
  E0978  A                               Wheelchair belt w/airplane b...  ..............  ..............  ..............  ..............  ..............
  E0979  A                               Wheelchair belt with velcro....  ..............  ..............  ..............  ..............  ..............
  E0980  A                               Wheelchair safety vest.........  ..............  ..............  ..............  ..............  ..............
  E0990  A                               Whellchair elevating leg res...  ..............  ..............  ..............  ..............  ..............
  E0991  A                               Wheelchair upholstry seat......  ..............  ..............  ..............  ..............  ..............
  E0992  A                               Wheelchair solid seat insert...  ..............  ..............  ..............  ..............  ..............
  E0993  A                               Wheelchair back upholstery.....  ..............  ..............  ..............  ..............  ..............
  E0994  A                               Wheelchair arm rest............  ..............  ..............  ..............  ..............  ..............
  E0995  A                               Wheelchair calf rest...........  ..............  ..............  ..............  ..............  ..............
  E0996  A                               Wheelchair tire solid..........  ..............  ..............  ..............  ..............  ..............
  E0997  A                               Wheelchair caster w/a fork.....  ..............  ..............  ..............  ..............  ..............
  E0998  A                               Wheelchair caster w/o a fork...  ..............  ..............  ..............  ..............  ..............
  E0999  A                               Wheelchr pneumatic tire w/wh...  ..............  ..............  ..............  ..............  ..............
  E1000  A                               Wheelchair tire pneumatic ca...  ..............  ..............  ..............  ..............  ..............
  E1001  A                               Wheelchair wheel...............  ..............  ..............  ..............  ..............  ..............
  E1031  A                               Rollabout chair with casters...  ..............  ..............  ..............  ..............  ..............
  E1050  A                               Whelchr fxd full length arms...  ..............  ..............  ..............  ..............  ..............
  E1060  A                               Wheelchair detachable arms.....  ..............  ..............  ..............  ..............  ..............
  E1065  A                               Wheelchair power attachment....  ..............  ..............  ..............  ..............  ..............
  E1066  A                               Wheelchair battery charger.....  ..............  ..............  ..............  ..............  ..............
  E1069  A                               Wheelchair deep cycle batter...  ..............  ..............  ..............  ..............  ..............
  E1070  A                               Wheelchair detachable foot r...  ..............  ..............  ..............  ..............  ..............
  E1083  A                               Hemi-wheelchair fixed arms.....  ..............  ..............  ..............  ..............  ..............
  E1084  A                               Hemi-wheelchair detachable a...  ..............  ..............  ..............  ..............  ..............
  E1085  A                               Hemi-wheelchair fixed arms.....  ..............  ..............  ..............  ..............  ..............
  E1086  A                               Hemi-wheelchair detachable a...  ..............  ..............  ..............  ..............  ..............
  E1087  A                               Wheelchair lightwt fixed arm...  ..............  ..............  ..............  ..............  ..............
  E1088  A                               Wheelchair lightweight det a...  ..............  ..............  ..............  ..............  ..............
  E1089  A                               Wheelchair lightwt fixed arm...  ..............  ..............  ..............  ..............  ..............
  E1090  A                               Wheelchair lightweight det a...  ..............  ..............  ..............  ..............  ..............
  E1091  A                               Wheelchair youth...............  ..............  ..............  ..............  ..............  ..............
  E1092  A                               Wheelchair wide w/leg rests....  ..............  ..............  ..............  ..............  ..............
  E1093  A                               Wheelchair wide w/foot rest....  ..............  ..............  ..............  ..............  ..............
  E1100  A                               Whchr s-recl fxd arm leg res...  ..............  ..............  ..............  ..............  ..............
  E1110  A                               Wheelchair semi-recl detach....  ..............  ..............  ..............  ..............  ..............
  E1130  A                               Whlchr stand fxd arm ft rest...  ..............  ..............  ..............  ..............  ..............
  E1140  A                               Wheelchair standard detach a...  ..............  ..............  ..............  ..............  ..............
  E1150  A                               Wheelchair standard w/leg r....  ..............  ..............  ..............  ..............  ..............
  E1160  A                               Wheelchair fixed arms..........  ..............  ..............  ..............  ..............  ..............
  E1170  A                               Whlchr ampu fxd arm leg rest...  ..............  ..............  ..............  ..............  ..............
  E1171  A                               Wheelchair amputee w/o leg r...  ..............  ..............  ..............  ..............  ..............
  E1172  A                               Wheelchair amputee detach ar...  ..............  ..............  ..............  ..............  ..............
  E1180  A                               Wheelchair amputee w/foot r....  ..............  ..............  ..............  ..............  ..............
  E1190  A                               Wheelchair amputee w/leg re....  ..............  ..............  ..............  ..............  ..............
  E1195  A                               Wheelchair amputee heavy dut...  ..............  ..............  ..............  ..............  ..............
  E1200  A                               Wheelchair amputee fixed arm...  ..............  ..............  ..............  ..............  ..............
  E1210  A                               Whlchr moto ful arm leg rest...  ..............  ..............  ..............  ..............  ..............
  E1211  A                               Wheelchair motorized w/det.....  ..............  ..............  ..............  ..............  ..............
  E1212  A                               Wheelchair motorized w full....  ..............  ..............  ..............  ..............  ..............
  E1213  A                               Wheelchair motorized w/det.....  ..............  ..............  ..............  ..............  ..............
  E1220  A                               Whlchr special size/constrc....  ..............  ..............  ..............  ..............  ..............
  E1221  A                               Wheelchair spec size w foot....  ..............  ..............  ..............  ..............  ..............

[[Page 18681]]

 
  E1222  A                               Wheelchair spec size w/leg.....  ..............  ..............  ..............  ..............  ..............
  E1223  A                               Wheelchair spec size w foot....  ..............  ..............  ..............  ..............  ..............
  E1224  A                               Wheelchair spec size w/leg.....  ..............  ..............  ..............  ..............  ..............
  E1225  A                               Wheelchair spec sz semi-recl...  ..............  ..............  ..............  ..............  ..............
  E1226  A                               Wheelchair spec sz full-recl...  ..............  ..............  ..............  ..............  ..............
  E1227  A                               Wheelchair spec sz spec ht a...  ..............  ..............  ..............  ..............  ..............
  E1228  A                               Wheelchair spec sz spec ht b...  ..............  ..............  ..............  ..............  ..............
  E1230  A                               Power operated vehicle.........  ..............  ..............  ..............  ..............  ..............
  E1240  A                               Whchr litwt det arm leg rest...  ..............  ..............  ..............  ..............  ..............
  E1250  A                               Wheelchair lightwt fixed arm...  ..............  ..............  ..............  ..............  ..............
  E1260  A                               Wheelchair lightwt foot rest...  ..............  ..............  ..............  ..............  ..............
  E1270  A                               Wheelchair lightweight leg r...  ..............  ..............  ..............  ..............  ..............
  E1280  A                               Whchr h-duty det arm leg res...  ..............  ..............  ..............  ..............  ..............
  E1285  A                               Wheelchair heavy duty fixed....  ..............  ..............  ..............  ..............  ..............
  E1290  A                               Wheelchair hvy duty detach a...  ..............  ..............  ..............  ..............  ..............
  E1295  A                               Wheelchair heavy duty fixed....  ..............  ..............  ..............  ..............  ..............
  E1296  A                               Wheelchair special seat heig...  ..............  ..............  ..............  ..............  ..............
  E1297  A                               Wheelchair special seat dept...  ..............  ..............  ..............  ..............  ..............
  E1298  A                               Wheelchair spec seat depth/w...  ..............  ..............  ..............  ..............  ..............
  E1300  A                               Whirlpool portable.............  ..............  ..............  ..............  ..............  ..............
  E1310  A                               Whirlpool non-portable.........  ..............  ..............  ..............  ..............  ..............
  E1340  A                               Repair for DME, per 15 min.....  ..............  ..............  ..............  ..............  ..............
  E1353  A                               Oxygen supplies regulator......  ..............  ..............  ..............  ..............  ..............
  E1355  A                               Oxygen supplies stand/rack.....  ..............  ..............  ..............  ..............  ..............
  E1372  A                               Oxy suppl heater for nebuliz...  ..............  ..............  ..............  ..............  ..............
  E1375  A                               Oxygen suppl nebulizer porta...  ..............  ..............  ..............  ..............  ..............
  E1377  A                               Oxygen concentrator to 244 c...  ..............  ..............  ..............  ..............  ..............
  E1378  A                               Oxygen concentrator to 488 c...  ..............  ..............  ..............  ..............  ..............
  E1379  A                               Oxygen concentrator to 732 c...  ..............  ..............  ..............  ..............  ..............
  E1380  A                               Oxygen concentrator to 976 c...  ..............  ..............  ..............  ..............  ..............
  E1381  A                               Oxygen concentrat to 1220 cu...  ..............  ..............  ..............  ..............  ..............
  E1382  A                               Oxygen concentrat to 1464 cu...  ..............  ..............  ..............  ..............  ..............
  E1383  A                               Oxygen concentrat to 1708 cu...  ..............  ..............  ..............  ..............  ..............
  E1384  A                               Oxygen concentrat to 1952 cu...  ..............  ..............  ..............  ..............  ..............
  E1385  A                               Oxygen concentrator > 1952 c...  ..............  ..............  ..............  ..............  ..............
  E1390  A                               Oxygen concentrator............  ..............  ..............  ..............  ..............  ..............
  E1399  A                               Durable medical equipment mi...  ..............  ..............  ..............  ..............  ..............
  E1405  A                               O2/water vapor enrich w/heat...  ..............  ..............  ..............  ..............  ..............
  E1406  A                               O2/water vapor enrich w/o he...  ..............  ..............  ..............  ..............  ..............
  E1510  A                               Kidney dialysate delivry sys...  ..............  ..............  ..............  ..............  ..............
  E1520  A                               Heparin infusion pump for di...  ..............  ..............  ..............  ..............  ..............
  E1530  A                               Air bubble detector for dial...  ..............  ..............  ..............  ..............  ..............
  E1540  A                               Pressure alarm for dialysis....  ..............  ..............  ..............  ..............  ..............
  E1550  A                               Bath conductivity meter........  ..............  ..............  ..............  ..............  ..............
  E1560  A                               Blood leak detector for dial...  ..............  ..............  ..............  ..............  ..............
  E1570  A                               Adjustable chair for esrd pt...  ..............  ..............  ..............  ..............  ..............
  E1575  A                               Transducer protector/fluid b...  ..............  ..............  ..............  ..............  ..............
  E1580  A                               Unipuncture control system.....  ..............  ..............  ..............  ..............  ..............
  E1590  A                               Hemodialysis machine...........  ..............  ..............  ..............  ..............  ..............
  E1592  A                               Auto interm peritoneal dialy...  ..............  ..............  ..............  ..............  ..............
  E1594  A                               Cycler dialysis machine........  ..............  ..............  ..............  ..............  ..............
  E1600  A                               Deliv/install equip for dial...  ..............  ..............  ..............  ..............  ..............
  E1610  A                               Reverse osmosis water purifi...  ..............  ..............  ..............  ..............  ..............
  E1615  A                               Deionizer water purification...  ..............  ..............  ..............  ..............  ..............
  E1620  A                               Blood pump for dialysis........  ..............  ..............  ..............  ..............  ..............
  E1625  A                               Water softening system.........  ..............  ..............  ..............  ..............  ..............
  E1630  A                               Reciprocating peritoneal dia...  ..............  ..............  ..............  ..............  ..............
  E1632  A                               Wearable artificial kidney.....  ..............  ..............  ..............  ..............  ..............
  E1635  A                               Compact travel hemodialyzer....  ..............  ..............  ..............  ..............  ..............
  E1636  A                               Sorbent cartridges for dialy...  ..............  ..............  ..............  ..............  ..............
  E1640  A                               Replacement components for d...  ..............  ..............  ..............  ..............  ..............
  E1699  A                               Dialysis equipment unspecifi...  ..............  ..............  ..............  ..............  ..............
  E1700  A                               Jaw motion rehab system........  ..............  ..............  ..............  ..............  ..............
  E1701  A                               Repl cushions for jaw motion...  ..............  ..............  ..............  ..............  ..............
  E1702  A                               Repl measr scales jaw motion...  ..............  ..............  ..............  ..............  ..............
  E1800  A                               Adjust elbow ext/flex device...  ..............  ..............  ..............  ..............  ..............
  E1805  A                               Adjust wrist ext/flex device...  ..............  ..............  ..............  ..............  ..............
  E1810  A                               Adjust knee ext/flex device....  ..............  ..............  ..............  ..............  ..............
  E1815  A                               Adjust ankle ext/flex device...  ..............  ..............  ..............  ..............  ..............
  E1820  A                               Soft interface material........  ..............  ..............  ..............  ..............  ..............
  E1825  A                               Adjust finger ext/flex devc....  ..............  ..............  ..............  ..............  ..............
  E1830  A                               Adjust toe ext/flex device.....  ..............  ..............  ..............  ..............  ..............
  E1900  A                               Speech communication device....  ..............  ..............  ..............  ..............  ..............

[[Page 18682]]

 
  G0001  A                               Drawing blood for specimen.....  ..............  ..............  ..............  ..............  ..............
  G0002  N                               Temporary urinary catheter.....  ..............  ..............  ..............  ..............  ..............
  G0004  S                               ECG transm phys review & int...            0100            1.70          $82.43          $71.57          $16.49
  G0005  S                               ECG 24 hour recording..........            0099            0.38          $18.43          $14.68           $3.69
  G0006  S                               ECG transmission & analysis....            0100            1.70          $82.43          $71.57          $16.49
  G0007  N                               ECG phy review & interpret.....  ..............  ..............  ..............  ..............  ..............
2 G0008  X                               Admin influenza virus vac......            0354            0.13           $6.19  ..............  ..............
  G0009  N                               Admin pneumococcal vaccine.....  ..............  ..............  ..............  ..............  ..............
  G0010  N                               Admin hepatitis b vaccine......  ..............  ..............  ..............  ..............  ..............
  G0015  S                               Post symptom ECG tracing.......            0099            0.38          $18.43          $14.68           $3.69
  G0016  N                               Post symptom ECG md review.....  ..............  ..............  ..............  ..............  ..............
  G0025  X                               Collagen skin test kit.........            0343            0.45          $21.82          $12.16           $4.36
  G0026  A                               Fecal leukocyte examination....  ..............  ..............  ..............  ..............  ..............
  G0027  A                               Semen analysis.................  ..............  ..............  ..............  ..............  ..............
  G0030  S                               PET imaging prev PET single....            0285           15.06         $730.22         $415.21         $146.04
  G0031  S                               PET imaging prev PET multple...            0285           15.06         $730.22         $415.21         $146.04
  G0032  S                               PET follow SPECT 78464 singl...            0285           15.06         $730.22         $415.21         $146.04
  G0033  S                               PET follow SPECT 78464 mult....            0285           15.06         $730.22         $415.21         $146.04
  G0034  S                               PET follow SPECT 76865 singl...            0285           15.06         $730.22         $415.21         $146.04
  G0035  S                               PET follow SPECT 78465 mult....            0285           15.06         $730.22         $415.21         $146.04
  G0036  S                               PET follow cornry angio sing...            0285           15.06         $730.22         $415.21         $146.04
  G0037  S                               PET follow cornry angio mult...            0285           15.06         $730.22         $415.21         $146.04
  G0038  S                               PET follow myocard perf sing...            0285           15.06         $730.22         $415.21         $146.04
  G0039  S                               PET follow myocard perf mult...            0285           15.06         $730.22         $415.21         $146.04
  G0040  S                               PET follow stress echo singl...            0285           15.06         $730.22         $415.21         $146.04
  G0041  S                               PET follow stress echo mult....            0285           15.06         $730.22         $415.21         $146.04
  G0042  S                               PET follow ventriculogm sing...            0285           15.06         $730.22         $415.21         $146.04
  G0043  S                               PET follow ventriculogm mult...            0285           15.06         $730.22         $415.21         $146.04
  G0044  S                               PET following rest ECG singl...            0285           15.06         $730.22         $415.21         $146.04
  G0045  S                               PET following rest ECG mult....            0285           15.06         $730.22         $415.21         $146.04
  G0046  S                               PET follow stress ECG singl....            0285           15.06         $730.22         $415.21         $146.04
  G0047  S                               PET follow stress ECG mult.....            0285           15.06         $730.22         $415.21         $146.04
  G0050  S                               Residual urine by ultrasound...            0265            1.17          $56.73          $38.08          $11.35
  G0101  V                               CA screen; pelvic/breast exam..            0601            1.00          $48.49           $9.70           $9.70
  G0102  E                               Prostate ca screening; dre.....  ..............  ..............  ..............  ..............  ..............
  G0103  E                               Psa, total screening...........  ..............  ..............  ..............  ..............  ..............
1 G0104  S                               CA screen; flexi sigmoidscope..            0158            7.98         $386.93  ..............          $96.73
1 G0105  S                               Colorectal scrn; hi risk ind...            0159            2.83         $137.22  ..............          $34.31
2 G0106  S                               Colon CA screen; barium enema..            0157            1.79          $86.79  ..............          $17.36
  G0107  A                               CA screen; fecal blood test....  ..............  ..............  ..............  ..............  ..............
  G0108  A                               Diab manage trn per indiv......  ..............  ..............  ..............  ..............  ..............
  G0109  A                               Diab manage trn ind/group......  ..............  ..............  ..............  ..............  ..............
  G0110  A                               Nett pulm-rehab educ; ind......  ..............  ..............  ..............  ..............  ..............
  G0111  A                               Nett pulm-rehab educ; group....  ..............  ..............  ..............  ..............  ..............
  G0112  A                               Nett; nutrition guid, initial..  ..............  ..............  ..............  ..............  ..............
  G0113  A                               Nett; nutrition guid, subseqnt.  ..............  ..............  ..............  ..............  ..............
  G0114  A                               Nett; psychosocial consult.....  ..............  ..............  ..............  ..............  ..............
  G0115  A                               Nett; psychological testing....  ..............  ..............  ..............  ..............  ..............
  G0116  A                               Nett; psychosocial counsel.....  ..............  ..............  ..............  ..............  ..............
2 G0120  S                               Colon ca scrn; barium enema....            0157            1.79          $86.79  ..............          $17.36
  G0121  E                               Colon ca scrn not hi rsk ind...  ..............  ..............  ..............  ..............  ..............
  G0122  E                               Colon ca scrn; barium enema....  ..............  ..............  ..............  ..............  ..............
  G0123  E                               Screen cerv/vag thin layer.....  ..............  ..............  ..............  ..............  ..............
  G0124  E                               Screen c/v thin layer by MD....  ..............  ..............  ..............  ..............  ..............
2 G0125  T                               Lung image (PET)...............            0980           38.67       $1,875.00  ..............         $375.00
2 G0126  T                               Lung image (PET) staging.......            0980           38.67       $1,875.00  ..............         $375.00
  G0127  T                               Trim nail(s)...................            0009            0.74          $35.88           $9.63           $7.18
  G0128  E                               CORF skilled nursing service...  ..............  ..............  ..............  ..............  ..............
  G0129  P                               Partial hosp prog service......            0033            4.17         $202.19          $48.17          $40.44
  G0130  X                               Single energy x-ray study......            0261            1.38          $66.91          $38.77          $13.38
  G0131  X                               CT scan, bone density study....            0261            1.38          $66.91          $38.77          $13.38
  G0132  X                               CT scan, bone density study....            0261            1.38          $66.91          $38.77          $13.38
  G0141  E                               Scr c/v cyto, autosys and md...  ..............  ..............  ..............  ..............  ..............
  G0143  E                               Scr c/v cyto, thinlayer, rescr.  ..............  ..............  ..............  ..............  ..............
  G0144  E                               Scr c/v cyto, thinlayer, rescr.  ..............  ..............  ..............  ..............  ..............
  G0145  E                               Scr c/v cyto, thinlayer, rescr.  ..............  ..............  ..............  ..............  ..............
  G0147  E                               Scr c/v cyto, automated sys....  ..............  ..............  ..............  ..............  ..............
  G0148  E                               Scr c/v cyto, autosys, rescr...  ..............  ..............  ..............  ..............  ..............
  G0151  E                               HHCP-serv of pt, ea 15 min.....  ..............  ..............  ..............  ..............  ..............
  G0152  E                               HHCP-serv of ot, ea 15 min.....  ..............  ..............  ..............  ..............  ..............
  G0153  E                               HHCP-svs of s/l path, ea 15mn..  ..............  ..............  ..............  ..............  ..............
  G0154  E                               HHCP-svs of rn, ea 15 min......  ..............  ..............  ..............  ..............  ..............
  G0155  E                               HHCP-svs of csw, ea 15 min.....  ..............  ..............  ..............  ..............  ..............

[[Page 18683]]

 
  G0156  E                               HHCP-svs of aide, ea 15 min....  ..............  ..............  ..............  ..............  ..............
  G0159  T                               Perc declot dialysis graft.....            0088           26.49       $1,284.42         $678.68         $256.88
  G0160  C                               Cryo. ablation, prostate.......  ..............  ..............  ..............  ..............  ..............
  G0161  X                               Echo guide for cryo probes.....            0268            2.23         $108.13          $69.51          $21.63
2 G0163  T                               Pet for rec of colorectal ca...            0980           38.67       $1,875.00  ..............         $375.00
2 G0164  T                               Pet for lymphoma staging.......            0980           38.67       $1,875.00  ..............         $375.00
2 G0165  T                               Pet, rec of melanoma/met ca....            0980           38.67       $1,875.00  ..............         $375.00
2 G0166  T                               Extrnl counterpulse, per tx....            0972            3.09         $149.83  ..............          $29.97
  G0167  S                               Hyperbaric oz tx; no md reqrd..            0031            3.00         $145.46         $140.85          $29.09
  G0168  T                               Wound closure by adhesive......            0026           12.11         $587.18         $277.92         $117.44
  G0169  T                               Removal tissue; no anesthsia...            0026           12.11         $587.18         $277.92         $117.44
  G0170  T                               Skin biograft..................            0026           12.11         $587.18         $277.92         $117.44
  G0171  T                               Skin biograft add-on...........            0026           12.11         $587.18         $277.92         $117.44
  G0172  P                               Partial hosp prog service......            0033            4.17         $202.19          $48.17          $40.44
  G0173  S                               Stereotactic, one session......            0302            8.21         $398.08         $216.55          $79.62
  G0174  S                               Stereotactic, mult session.....            0302            8.21         $398.08         $216.55          $79.62
  G0175  V                               Multidisciplinary team visit...            0603            1.66          $80.49          $16.29          $16.10
  J0120  N                               Tetracyclin injection..........  ..............  ..............  ..............  ..............  ..............
  J0130  N                               Abciximab injection............  ..............  ..............  ..............  ..............  ..............
2 J0150  X                               Injection adenosine 6 MG.......            0917            0.36          $17.46  ..............           $3.49
  J0151  E                               Adenosine injection............  ..............  ..............  ..............  ..............  ..............
  J0170  N                               Adrenalin epinephrin inject....  ..............  ..............  ..............  ..............  ..............
  J0190  N                               Inj biperiden lactate/5 mg.....  ..............  ..............  ..............  ..............  ..............
  J0200  N                               Alatrofloxacin mesylate........  ..............  ..............  ..............  ..............  ..............
3 J0205  X                               Alglucerase injection..........            0900  ..............  ..............  ..............           $5.14
3 J0207  X                               Amifostine.....................            7000  ..............  ..............  ..............          $41.99
  J0210  N                               Methyldopate hcl injection.....  ..............  ..............  ..............  ..............  ..............
3 J0256  X                               Alpha 1 proteinase inhibitor...            0901  ..............  ..............  ..............          $15.22
  J0270  E                               Alprostadil for injection......  ..............  ..............  ..............  ..............  ..............
  J0275  E                               Alprostadil urethral suppos....  ..............  ..............  ..............  ..............  ..............
  J0280  N                               Aminophyllin 250 MG inj........  ..............  ..............  ..............  ..............  ..............
  J0285  N                               Amphotericin B.................  ..............  ..............  ..............  ..............  ..............
3 J0286  X                               Amphotericin B lipid complex...            7001  ..............  ..............  ..............          $12.12
  J0290  N                               Ampicillin 500 MG inj..........  ..............  ..............  ..............  ..............  ..............
  J0295  N                               Ampicillin sodium per 1.5 gm...  ..............  ..............  ..............  ..............  ..............
  J0300  N                               Amobarbital 125 MG inj.........  ..............  ..............  ..............  ..............  ..............
  J0330  N                               Succinycholine chloride inj....  ..............  ..............  ..............  ..............  ..............
  J0340  N                               Nandrolon phenpropionate inj...  ..............  ..............  ..............  ..............  ..............
  J0350  N                               Injection anistreplase 30 u....  ..............  ..............  ..............  ..............  ..............
  J0360  N                               Hydralazine hcl injection......  ..............  ..............  ..............  ..............  ..............
  J0380  N                               Inj metaraminol bitartrate.....  ..............  ..............  ..............  ..............  ..............
  J0390  N                               Chloroquine injection..........  ..............  ..............  ..............  ..............  ..............
  J0395  N                               Arbutamine HCl injection.......  ..............  ..............  ..............  ..............  ..............
  J0400  N                               Inj trimethaphan camsylate.....  ..............  ..............  ..............  ..............  ..............
  J0456  N                               Azithromycin...................  ..............  ..............  ..............  ..............  ..............
  J0460  N                               Atropine sulfate injection.....  ..............  ..............  ..............  ..............  ..............
  J0470  N                               Dimecaprol injection...........  ..............  ..............  ..............  ..............  ..............
  J0475  N                               Baclofen 10 MG injection.......  ..............  ..............  ..............  ..............  ..............
3 J0476  X                               Baclofen intrathecal trial.....            7021  ..............  ..............  ..............            $.10
  J0500  N                               Dicyclomine injection..........  ..............  ..............  ..............  ..............  ..............
  J0510  N                               Benzquinamide injection........  ..............  ..............  ..............  ..............  ..............
  J0515  N                               Inj benztropine mesylate.......  ..............  ..............  ..............  ..............  ..............
  J0520  N                               Bethanechol chloride inject....  ..............  ..............  ..............  ..............  ..............
  J0530  N                               Penicillin g benzathine inj....  ..............  ..............  ..............  ..............  ..............
  J0540  N                               Penicillin g benzathine inj....  ..............  ..............  ..............  ..............  ..............
  J0550  N                               Penicillin g benzathine inj....  ..............  ..............  ..............  ..............  ..............
  J0560  N                               Penicillin g benzathine inj....  ..............  ..............  ..............  ..............  ..............
  J0570  N                               Penicillin g benzathine inj....  ..............  ..............  ..............  ..............  ..............
  J0580  N                               Penicillin g benzathine inj....  ..............  ..............  ..............  ..............  ..............
3 J0585  X                               Botulinum toxin a per unit.....            0902  ..............  ..............  ..............          $56.05
  J0590  N                               Ethylnorepinephrine hcl inj....  ..............  ..............  ..............  ..............  ..............
  J0600  N                               Edetate calcium disodium inj...  ..............  ..............  ..............  ..............  ..............
  J0610  N                               Calcium gluconate injection....  ..............  ..............  ..............  ..............  ..............
  J0620  N                               Calcium glycer & lact/10 ML....  ..............  ..............  ..............  ..............  ..............
  J0630  N                               Calcitonin salmon injection....  ..............  ..............  ..............  ..............  ..............
  J0635  N                               Calcitriol injection...........  ..............  ..............  ..............  ..............  ..............
3 J0640  X                               Leucovorin calcium injection...            0725  ..............  ..............  ..............           $1.07
  J0670  N                               Inj mepivacaine HCL/10 ml......  ..............  ..............  ..............  ..............  ..............
  J0690  N                               Cefazolin sodium injection.....  ..............  ..............  ..............  ..............  ..............
  J0694  N                               Cefoxitin sodium injection.....  ..............  ..............  ..............  ..............  ..............
  J0695  N                               Cefonocid sodium injection.....  ..............  ..............  ..............  ..............  ..............
  J0696  N                               Ceftriaxone sodium injection...  ..............  ..............  ..............  ..............  ..............
  J0697  N                               Sterile cefuroxime injection...  ..............  ..............  ..............  ..............  ..............

[[Page 18684]]

 
  J0698  N                               Cefotaxime sodium injection....  ..............  ..............  ..............  ..............  ..............
  J0702  N                               Betamethasone acet & sod phosp.  ..............  ..............  ..............  ..............  ..............
  J0704  N                               Betamethasone sod phosp/4 MG...  ..............  ..............  ..............  ..............  ..............
  J0710  N                               Cephapirin sodium injection....  ..............  ..............  ..............  ..............  ..............
  J0713  N                               Inj ceftazidime per 500 mg.....  ..............  ..............  ..............  ..............  ..............
  J0715  N                               Ceftizoxime sodium/500 MG......  ..............  ..............  ..............  ..............  ..............
  J0720  N                               Chloramphenicol sodium injec...  ..............  ..............  ..............  ..............  ..............
  J0725  N                               Chorionic gonadotropin/1000u...  ..............  ..............  ..............  ..............  ..............
  J0730  N                               Chlorpheniramin maleate inj....  ..............  ..............  ..............  ..............  ..............
3 J0735  X                               Clonidine hydrochloride........            7002  ..............  ..............  ..............           $4.17
  J0740  N                               Cidofovir injection............  ..............  ..............  ..............  ..............  ..............
  J0743  N                               Cilastatin sodium injection....  ..............  ..............  ..............  ..............  ..............
  J0745  N                               Inj codeine phosphate/30 MG....  ..............  ..............  ..............  ..............  ..............
  J0760  N                               Colchicine injection...........  ..............  ..............  ..............  ..............  ..............
  J0770  N                               Colistimethate sodium inj......  ..............  ..............  ..............  ..............  ..............
  J0780  N                               Prochlorperazine injection.....  ..............  ..............  ..............  ..............  ..............
  J0800  N                               Corticotropin injection........  ..............  ..............  ..............  ..............  ..............
  J0810  N                               Cortisone injection............  ..............  ..............  ..............  ..............  ..............
  J0835  N                               Inj cosyntropin per 0.25 MG....  ..............  ..............  ..............  ..............  ..............
3 J0850  X                               Cytomegalovirus imm IV/vial....            0903  ..............  ..............  ..............          $54.11
  J0895  N                               Deferoxamine mesylate inj......  ..............  ..............  ..............  ..............  ..............
  J0900  N                               Testosterone enanthate inj.....  ..............  ..............  ..............  ..............  ..............
  J0945  N                               Brompheniramine maleate inj....  ..............  ..............  ..............  ..............  ..............
  J0970  N                               Estradiol valerate injection...  ..............  ..............  ..............  ..............  ..............
  J1000  N                               Depo-estradiol cypionate inj...  ..............  ..............  ..............  ..............  ..............
  J1020  N                               Methylprednisolone 20 MG inj...  ..............  ..............  ..............  ..............  ..............
  J1030  N                               Methylprednisolone 40 MG inj...  ..............  ..............  ..............  ..............  ..............
  J1040  N                               Methylprednisolone 80 MG inj...  ..............  ..............  ..............  ..............  ..............
  J1050  N                               Medroxyprogesterone inj........  ..............  ..............  ..............  ..............  ..............
  J1055  E                               Medrxyprogester acetate inj....  ..............  ..............  ..............  ..............  ..............
  J1060  N                               Testosterone cypionate 1 ML....  ..............  ..............  ..............  ..............  ..............
  J1070  N                               Testosterone cypionat 100 MG...  ..............  ..............  ..............  ..............  ..............
  J1080  N                               Testosterone cypionat 200 MG...  ..............  ..............  ..............  ..............  ..............
  J1090  N                               Testosterone cypionate 50 MG...  ..............  ..............  ..............  ..............  ..............
  J1095  N                               Inj dexamethasone acetate......  ..............  ..............  ..............  ..............  ..............
  J1100  N                               Dexamethasone sodium phos......  ..............  ..............  ..............  ..............  ..............
  J1110  N                               Inj dihydroergotamine mesylt...  ..............  ..............  ..............  ..............  ..............
  J1120  N                               Acetazolamid sodium injectio...  ..............  ..............  ..............  ..............  ..............
  J1160  N                               Digoxin injection..............  ..............  ..............  ..............  ..............  ..............
  J1165  N                               Phenytoin sodium injection.....  ..............  ..............  ..............  ..............  ..............
  J1170  N                               Hydromorphone injection........  ..............  ..............  ..............  ..............  ..............
  J1180  N                               Dyphylline injection...........  ..............  ..............  ..............  ..............  ..............
3 J1190  X                               Dexrazoxane HCl injection......            0726  ..............  ..............  ..............          $18.81
  J1200  N                               Diphenhydramine hcl injectio...  ..............  ..............  ..............  ..............  ..............
  J1205  N                               Chlorothiazide sodium inj......  ..............  ..............  ..............  ..............  ..............
  J1212  N                               Dimethyl sulfoxide 50% 50 ML...  ..............  ..............  ..............  ..............  ..............
  J1230  N                               Methadone injection............  ..............  ..............  ..............  ..............  ..............
  J1240  N                               Dimenhydrinate injection.......  ..............  ..............  ..............  ..............  ..............
2 J1245  X                               Dipyridamole injection.........            0917            0.36          $17.46  ..............           $3.49
  J1250  N                               Inj dobutamine HCL/250 mg......  ..............  ..............  ..............  ..............  ..............
3 J1260  X                               Dolasetron mesylate............            0750  ..............  ..............  ..............           $1.94
  J1320  N                               Amitriptyline injection........  ..............  ..............  ..............  ..............  ..............
3 J1325  X                               Epoprostenol injection.........            7003  ..............  ..............  ..............           $2.23
  J1327  N                               Eptifibatide injection.........  ..............  ..............  ..............  ..............  ..............
  J1330  N                               Ergonovine maleate injection...  ..............  ..............  ..............  ..............  ..............
  J1362  N                               Erythromycin glucep/250 MG.....  ..............  ..............  ..............  ..............  ..............
  J1364  N                               Erythro lactobionate/500 MG....  ..............  ..............  ..............  ..............  ..............
  J1380  N                               Estradiol valerate 10 MG inj...  ..............  ..............  ..............  ..............  ..............
  J1390  N                               Estradiol valerate 20 MG inj...  ..............  ..............  ..............  ..............  ..............
  J1410  N                               Inj estrogen conjugate 25 MG...  ..............  ..............  ..............  ..............  ..............
  J1435  N                               Injection estrone per 1 MG.....  ..............  ..............  ..............  ..............  ..............
  J1436  X                               Etidronate disodium inj........            0727  ..............  ..............  ..............           $9.31
  J1438  N                               Etanercept injection...........  ..............  ..............  ..............  ..............  ..............
3 J1440  X                               Filgrastim 300 mcg injeciton...            0728  ..............  ..............  ..............          $25.21
  J1441  E                               Filgrastim 480 mcg injection...  ..............  ..............  ..............  ..............  ..............
  J1450  N                               Fluconazole....................  ..............  ..............  ..............  ..............  ..............
  J1455  N                               Foscarnet sodium injection.....  ..............  ..............  ..............  ..............  ..............
  J1460  N                               Gamma globulin 1 CC inj........  ..............  ..............  ..............  ..............  ..............
  J1470  E                               Gamma globulin 2 CC inj........  ..............  ..............  ..............  ..............  ..............
  J1480  E                               Gamma globulin 3 CC inj........  ..............  ..............  ..............  ..............  ..............
  J1490  E                               Gamma globulin 4 CC inj........  ..............  ..............  ..............  ..............  ..............
  J1500  E                               Gamma globulin 5 CC inj........  ..............  ..............  ..............  ..............  ..............
  J1510  E                               Gamma globulin 6 CC inj........  ..............  ..............  ..............  ..............  ..............

[[Page 18685]]

 
  J1520  E                               Gamma globulin 7 CC inj........  ..............  ..............  ..............  ..............  ..............
  J1530  E                               Gamma globulin 8 CC inj........  ..............  ..............  ..............  ..............  ..............
  J1540  E                               Gamma globulin 9 CC inj........  ..............  ..............  ..............  ..............  ..............
  J1550  E                               Gamma globulin 10 CC inj.......  ..............  ..............  ..............  ..............  ..............
  J1560  E                               Gamma globulin > 10 CC inj.....  ..............  ..............  ..............  ..............  ..............
3 J1561  X                               Immune globulin 500 mg.........            0905  ..............  ..............  ..............           $6.40
3 J1562  X                               Immune globulin 5 gms..........            7004  ..............  ..............  ..............          $45.48
3 J1565  X                               RSV-ivig.......................            0906  ..............  ..............  ..............          $85.53
2 J1570  X                               Ganciclovir sodium injection...            0907            0.51          $24.73  ..............           $4.95
  J1580  N                               Garamycin gentamicin inj.......  ..............  ..............  ..............  ..............  ..............
  J1600  N                               Gold sodium thiomaleate inj....  ..............  ..............  ..............  ..............  ..............
  J1610  N                               Glucagon hydrochloride/1 MG....  ..............  ..............  ..............  ..............  ..............
3 J1620  X                               Gonadorelin hydroch/100 mcg....            7005  ..............  ..............  ..............           $9.12
3 J1626  X                               Granisetron HCl injection......            0764  ..............  ..............  ..............           $2.33
  J1630  N                               Haloperidol injection..........  ..............  ..............  ..............  ..............  ..............
  J1631  N                               Haloperidol decanoate inj......  ..............  ..............  ..............  ..............  ..............
  J1642  N                               Inj heparin sodium per 10 u....  ..............  ..............  ..............  ..............  ..............
  J1644  N                               Inj heparin sodium per 1000u...  ..............  ..............  ..............  ..............  ..............
  J1645  N                               Dalteparin sodium..............  ..............  ..............  ..............  ..............  ..............
  J1650  N                               Inj enoxaparin sodium..........  ..............  ..............  ..............  ..............  ..............
2 J1670  X                               Tetanus immune globulin inj....            0908            0.90          $43.64  ..............           $8.73
  J1690  N                               Prednisolone tebutate inj......  ..............  ..............  ..............  ..............  ..............
  J1700  N                               Hydrocortisone acetate inj.....  ..............  ..............  ..............  ..............  ..............
  J1710  N                               Hydrocortisone sodium ph inj...  ..............  ..............  ..............  ..............  ..............
  J1720  N                               Hydrocortisone sodium succ i...  ..............  ..............  ..............  ..............  ..............
  J1730  N                               Diazoxide injection............  ..............  ..............  ..............  ..............  ..............
  J1739  N                               Hydroxyprogesterone cap 125....  ..............  ..............  ..............  ..............  ..............
  J1741  N                               Hydroxyprogesterone cap 250....  ..............  ..............  ..............  ..............  ..............
  J1742  N                               Ibutilide fumarate injection...  ..............  ..............  ..............  ..............  ..............
3 J1745  X                               Infliximab injection...........            7043  ..............  ..............  ..............           $6.89
  J1750  N                               Iron dextran...................  ..............  ..............  ..............  ..............  ..............
3 J1785  X                               Injection imiglucerase/unit....            0916  ..............  ..............  ..............            $.58
  J1790  N                               Droperidol injection...........  ..............  ..............  ..............  ..............  ..............
  J1800  N                               Propranolol injection..........  ..............  ..............  ..............  ..............  ..............
  J1810  N                               Droperidol/fentanyl inj........  ..............  ..............  ..............  ..............  ..............
  J1820  N                               Insulin injection..............  ..............  ..............  ..............  ..............  ..............
3 J1825  X                               Interferon beta-1a.............            0909  ..............  ..............  ..............          $28.70
3 J1830  X                               Interferon beta-1b/.25 MG......            0910  ..............  ..............  ..............           $8.44
  J1840  N                               Kanamycin sulfate 500 MG inj...  ..............  ..............  ..............  ..............  ..............
  J1850  N                               Kanamycin sulfate 75 MG inj....  ..............  ..............  ..............  ..............  ..............
  J1885  N                               Ketorolac tromethamine inj.....  ..............  ..............  ..............  ..............  ..............
  J1890  N                               Cephalothin sodium injection...  ..............  ..............  ..............  ..............  ..............
  J1910  N                               Kutapressin injection..........  ..............  ..............  ..............  ..............  ..............
  J1930  N                               Propiomazine injection.........  ..............  ..............  ..............  ..............  ..............
  J1940  N                               Furosemide injection...........  ..............  ..............  ..............  ..............  ..............
3 J1950  X                               Leuprolide acetate/3.75 MG.....            0800  ..............  ..............  ..............          $68.56
  J1955  E                               Inj levocarnitine per 1 gm.....  ..............  ..............  ..............  ..............  ..............
  J1956  N                               Levofloxacin injection.........  ..............  ..............  ..............  ..............  ..............
  J1960  N                               Levorphanol tartrate inj.......  ..............  ..............  ..............  ..............  ..............
  J1970  N                               Methotrimeprazine injection....  ..............  ..............  ..............  ..............  ..............
  J1980  N                               Hyoscyamine sulfate inj........  ..............  ..............  ..............  ..............  ..............
  J1990  N                               Chlordiazepoxide injection.....  ..............  ..............  ..............  ..............  ..............
  J2000  N                               Lidocaine injection............  ..............  ..............  ..............  ..............  ..............
  J2010  N                               Lincomycin injection...........  ..............  ..............  ..............  ..............  ..............
  J2060  N                               Lorazepam injection............  ..............  ..............  ..............  ..............  ..............
  J2150  N                               Mannitol injection.............  ..............  ..............  ..............  ..............  ..............
  J2175  N                               Meperidine hydrochl/100 MG.....  ..............  ..............  ..............  ..............  ..............
  J2180  N                               Meperidine/promethazine inj....  ..............  ..............  ..............  ..............  ..............
  J2210  N                               Methylergonovin maleate inj....  ..............  ..............  ..............  ..............  ..............
  J2240  N                               Metocurine iodide injection....  ..............  ..............  ..............  ..............  ..............
  J2250  N                               Inj midazolam hydrochloride....  ..............  ..............  ..............  ..............  ..............
2 J2260  X                               Inj milrinone lactate/5 ML.....            7007            0.47          $22.79  ..............           $4.56
  J2270  N                               Morphine sulfate injection.....  ..............  ..............  ..............  ..............  ..............
  J2271  N                               Morphine so4 injection 100mg...  ..............  ..............  ..............  ..............  ..............
3 J2275  X                               Morphine sulfate injection.....            7010  ..............  ..............  ..............            $.68
  J2300  N                               Inj nalbuphine hydrochloride...  ..............  ..............  ..............  ..............  ..............
  J2310  N                               Inj naloxone hydrochloride.....  ..............  ..............  ..............  ..............  ..............
  J2320  N                               Nandrolone decanoate 50 MG.....  ..............  ..............  ..............  ..............  ..............
  J2321  N                               Nandrolone decanoate 100 MG....  ..............  ..............  ..............  ..............  ..............
  J2322  N                               Nandrolone decanoate 200 MG....  ..............  ..............  ..............  ..............  ..............
  J2330  N                               Thiothixene injection..........  ..............  ..............  ..............  ..............  ..............
  J2350  N                               Niacinamide/niacin injection...  ..............  ..............  ..............  ..............  ..............
3 J2352  N                               Octreotide acetate injection...            7031  ..............  ..............  ..............           $5.43

[[Page 18686]]

 
3 J2355  X                               Oprelvekin injection...........            7011  ..............  ..............  ..............          $30.35
  J2360  N                               Orphenadrine injection.........  ..............  ..............  ..............  ..............  ..............
  J2370  N                               Phenylephrine hcl injection....  ..............  ..............  ..............  ..............  ..............
  J2400  N                               Chloroprocaine hcl injection...  ..............  ..............  ..............  ..............  ..............
3 J2405  X                               Ondansetron hcl injection......            0768  ..............  ..............  ..............            $.87
  J2410  N                               Oxymorphone hcl injection......  ..............  ..............  ..............  ..............  ..............
3 J2430  X                               Pamidronate disodium/30 MG.....            0730  ..............  ..............  ..............          $30.93
  J2440  N                               Papaverin hcl injection........  ..............  ..............  ..............  ..............  ..............
  J2460  N                               Oxytetracycline injection......  ..............  ..............  ..............  ..............  ..............
  J2480  N                               Hydrochlorides of opium inj....  ..............  ..............  ..............  ..............  ..............
  J2500  N                               Paricalcitol...................  ..............  ..............  ..............  ..............  ..............
  J2510  N                               Penicillin g procaine inj......  ..............  ..............  ..............  ..............  ..............
  J2512  N                               Inj pentagastrin per 2 ML......  ..............  ..............  ..............  ..............  ..............
  J2515  N                               Pentobarbital sodium inj.......  ..............  ..............  ..............  ..............  ..............
  J2540  N                               Penicillin g potassium inj.....  ..............  ..............  ..............  ..............  ..............
  J2543  N                               Piperacillin/tazobactam........  ..............  ..............  ..............  ..............  ..............
3 J2545  X                               Pentamidine isethionte/300mg...            7012  ..............  ..............  ..............           $8.73
  J2550  N                               Promethazine hcl injection.....  ..............  ..............  ..............  ..............  ..............
  J2560  N                               Phenobarbital sodium inj.......  ..............  ..............  ..............  ..............  ..............
  J2590  N                               Oxytocin injection.............  ..............  ..............  ..............  ..............  ..............
  J2597  E                               Inj desmopressin acetate.......  ..............  ..............  ..............  ..............  ..............
  J2640  N                               Prednisolone sodium ph inj.....  ..............  ..............  ..............  ..............  ..............
  J2650  N                               Prednisolone acetate inj.......  ..............  ..............  ..............  ..............  ..............
  J2670  N                               Totazoline hcl injection.......  ..............  ..............  ..............  ..............  ..............
  J2675  N                               Inj progesterone per 50 MG.....  ..............  ..............  ..............  ..............  ..............
  J2680  N                               Fluphenazine decanoate 25 MG...  ..............  ..............  ..............  ..............  ..............
  J2690  N                               Procainamide hcl injection.....  ..............  ..............  ..............  ..............  ..............
  J2700  N                               Oxacillin sodium injeciton.....  ..............  ..............  ..............  ..............  ..............
  J2710  N                               Neostigmine methylslfte inj....  ..............  ..............  ..............  ..............  ..............
  J2720  N                               Inj protamine sulfate/10 MG....  ..............  ..............  ..............  ..............  ..............
  J2725  N                               Inj protirelin per 250 mcg.....  ..............  ..............  ..............  ..............  ..............
  J2730  N                               Pralidoxime chloride inj.......  ..............  ..............  ..............  ..............  ..............
  J2760  N                               Phentolaine mesylate inj.......  ..............  ..............  ..............  ..............  ..............
3 J2765  X                               Metoclopramide hcl injection...            0754  ..............  ..............  ..............            $.19
  J2780  N                               Ranitidine hydrochloride inj...  ..............  ..............  ..............  ..............  ..............
3 J2790  X                               Rho d immune globulin inj......            0884  ..............  ..............  ..............           $3.78
  J2792  N                               Rho(D) immune globulin h, sd...  ..............  ..............  ..............  ..............  ..............
  J2800  N                               Methocarbamol injection........  ..............  ..............  ..............  ..............  ..............
  J2810  N                               Inj theophylline per 40 MG.....  ..............  ..............  ..............  ..............  ..............
3 J2820  X                               Sargramostim injection.........            0731  ..............  ..............  ..............          $16.97
  J2860  N                               Secobarbital sodium inj........  ..............  ..............  ..............  ..............  ..............
  J2910  N                               Aurothioglucose injeciton......  ..............  ..............  ..............  ..............  ..............
  J2912  N                               Sodium chloride injection......  ..............  ..............  ..............  ..............  ..............
  J2920  N                               Methylprednisolone injection...  ..............  ..............  ..............  ..............  ..............
  J2930  N                               Methylprednisolone injection...  ..............  ..............  ..............  ..............  ..............
  J2950  N                               Promazine hcl injeciton........  ..............  ..............  ..............  ..............  ..............
  J2970  N                               Methicillin sodium injection...  ..............  ..............  ..............  ..............  ..............
2 J2994  X                               Reteplase double bolus.........            0914           38.20       $1,852.21  ..............         $370.44
2 J2995  X                               Inj streptokinase/250000 IU....            0911            1.64          $79.69  ..............          $15.94
2 J2996  X                               Alteplase recombinant inj......            0915            5.85         $283.70  ..............          $56.74
  J3000  N                               Streptomycin injection.........  ..............  ..............  ..............  ..............  ..............
3 J3010  X                               Fentanyl citrate injeciton.....            7014  ..............  ..............  ..............            $.19
  J3030  N                               Sumatriptan succinate/6 MG.....  ..............  ..............  ..............  ..............  ..............
  J3070  N                               Pentazocine hcl injeciton......  ..............  ..............  ..............  ..............  ..............
  J3080  N                               Chlorprothixene injection......  ..............  ..............  ..............  ..............  ..............
  J3105  N                               Terbutaline sulfate inj........  ..............  ..............  ..............  ..............  ..............
  J3120  N                               Testosterone enanthate inj.....  ..............  ..............  ..............  ..............  ..............
  J3130  N                               Testosterone enanthate inj.....  ..............  ..............  ..............  ..............  ..............
  J3140  N                               Testosterone suspension inj....  ..............  ..............  ..............  ..............  ..............
  J3150  N                               Testosteron propionate inj.....  ..............  ..............  ..............  ..............  ..............
  J3230  N                               Chlorpromazine hcl injection...  ..............  ..............  ..............  ..............  ..............
  J3240  N                               Thyrotropin injection..........  ..............  ..............  ..............  ..............  ..............
2 J3245  X                               Tirofiban hydrochloride........            7041            0.02            $.97  ..............            $.19
  J3250  N                               Trimethobenzamide hcl inj......  ..............  ..............  ..............  ..............  ..............
  J3260  N                               Tobramycin sulfate injection...  ..............  ..............  ..............  ..............  ..............
  J3265  N                               Injection torsemide 10 mg/ml...  ..............  ..............  ..............  ..............  ..............
  J3270  N                               Imipramine hcl injection.......  ..............  ..............  ..............  ..............  ..............
3 J3280  X                               Thiethylperazine maleate inj...            0755  ..............  ..............  ..............            $.68
  J3301  N                               Triamcinolone acetonide inj....  ..............  ..............  ..............  ..............  ..............
  J3302  N                               Triamcinolone diacetate inj....  ..............  ..............  ..............  ..............  ..............
  J3303  N                               Triamcinolone hexacetonl inj...  ..............  ..............  ..............  ..............  ..............
3 J3305  X                               Inj trimetrexate glucoronate...            7045  ..............  ..............  ..............           $8.15
  J3310  N                               Perphenazine injeciton.........  ..............  ..............  ..............  ..............  ..............

[[Page 18687]]

 
  J3320  N                               Spectinomycn di-hcl inj........  ..............  ..............  ..............  ..............  ..............
  J3350  N                               Urea injection.................  ..............  ..............  ..............  ..............  ..............
  J3360  N                               Diazepam injection.............  ..............  ..............  ..............  ..............  ..............
  J3364  N                               Urokinase 5000 IU injection....  ..............  ..............  ..............  ..............  ..............
2 J3365  X                               Urokinase 250,000 IU inj.......            7036            0.73          $35.40  ..............           $7.08
  J3370  N                               Vancomycin hcl injeciton.......  ..............  ..............  ..............  ..............  ..............
  J3390  N                               Methoxamine injection..........  ..............  ..............  ..............  ..............  ..............
  J3400  N                               Triflupromazine hcl inj........  ..............  ..............  ..............  ..............  ..............
  J3410  N                               Hydroxyzine hcl injeciton......  ..............  ..............  ..............  ..............  ..............
  J3420  N                               Vitamin b12 injection..........  ..............  ..............  ..............  ..............  ..............
  J3430  N                               Vitamin k phytonadione inj.....  ..............  ..............  ..............  ..............  ..............
  J3450  N                               Mephentermine sulfate inj......  ..............  ..............  ..............  ..............  ..............
  J3470  N                               Hyaluronidase injection........  ..............  ..............  ..............  ..............  ..............
  J3475  N                               Inj magnesium sulfate..........  ..............  ..............  ..............  ..............  ..............
  J3480  N                               Inj potassium chloride.........  ..............  ..............  ..............  ..............  ..............
  J3490  N                               Drugs unclassified injection...  ..............  ..............  ..............  ..............  ..............
  J3520  E                               Edetate disodium per 150 mg....  ..............  ..............  ..............  ..............  ..............
  J3530  N                               Nasal vaccine inhalation.......  ..............  ..............  ..............  ..............  ..............
  J3535  E                               Metered dose inhaler drug......  ..............  ..............  ..............  ..............  ..............
  J3570  E                               Laetrile amygdalin vit B17.....  ..............  ..............  ..............  ..............  ..............
  J7030  N                               Normal saline solution infus...  ..............  ..............  ..............  ..............  ..............
  J7040  N                               Normal saline solution infus...  ..............  ..............  ..............  ..............  ..............
  J7042  N                               5% dextrose/normal saline......  ..............  ..............  ..............  ..............  ..............
  J7050  N                               Normal saline solution infus...  ..............  ..............  ..............  ..............  ..............
  J7051  N                               Sterile saline/water...........  ..............  ..............  ..............  ..............  ..............
  J7060  N                               5% dextrose/water..............  ..............  ..............  ..............  ..............  ..............
  J7070  N                               D5w infusion...................  ..............  ..............  ..............  ..............  ..............
  J7100  N                               Dextran 40 infusion............  ..............  ..............  ..............  ..............  ..............
  J7110  N                               Dextran 75 infusion............  ..............  ..............  ..............  ..............  ..............
  J7120  N                               Ringers lactate infusion.......  ..............  ..............  ..............  ..............  ..............
  J7130  N                               Hypertonic saline solution.....  ..............  ..............  ..............  ..............  ..............
3 J7190  X                               Factor viii....................            0925  ..............  ..............  ..............            $.19
3 J7191  X                               Factor VIII (porcine)..........            0926  ..............  ..............  ..............            $.19
3 J7192  X                               Factor viii recombinant........            0927  ..............  ..............  ..............            $.19
3 J7194  X                               Factor ix complex..............            0928  ..............  ..............  ..............            $.08
3 J7197  X                               Antithrombin iii injection.....            0930  ..............  ..............  ..............            $.19
3 J7198  X                               Anti-inhibitor.................            0929  ..............  ..............  ..............            $.27
  J7199  E                               Hemophilia clot factor noc.....  ..............  ..............  ..............  ..............  ..............
  J7300  E                               Intraut copper contraceptive...  ..............  ..............  ..............  ..............  ..............
3 J7310  X                               Ganciclovir long act implant...            0913  ..............  ..............  ..............         $701.51
  J7315  N                               Sodium hyaluronate injection...  ..............  ..............  ..............  ..............  ..............
  J7320  N                               Hylan G-F 20 injection.........  ..............  ..............  ..............  ..............  ..............
2 J7500  X                               Azathioprine oral 50mg.........            0886            0.02            $.97  ..............            $.19
2 J7501  X                               Azathioprine parenteral........            0887            1.40          $67.88  ..............          $13.58
2 J7502  X                               Cyclosporine oral 100 mg.......            0888            0.08           $3.88  ..............            $.78
2 J7504  X                               Lymphocyte immune globulin.....            0890            3.79         $183.77  ..............          $36.75
3 J7505  E                               Monoclonal antibodies..........            7038  ..............  ..............  ..............          $89.60
  J7506  N                               Prednisone oral................  ..............  ..............  ..............  ..............  ..............
2 J7507  X                               Tacrolimus oral per 1 MG.......            0891            3.15         $152.73  ..............          $30.55
  J7508  E                               Tacrolimus oral per 5 MG.......  ..............  ..............  ..............  ..............  ..............
  J7509  N                               Methylprednisolone oral........  ..............  ..............  ..............  ..............  ..............
  J7510  N                               Prednisolone oral per 5 mg.....  ..............  ..............  ..............  ..............  ..............
  J7513  X                               Daclizumab, parenteral.........  ..............  ..............  ..............  ..............  ..............
  J7515  N                               Cyclosporine oral 25 mg........  ..............  ..............  ..............  ..............  ..............
2 J7516  X                               Cyclosporin parenteral 250mg...            0889            0.36          $17.46  ..............           $3.49
  J7517  N                               Mycophenolate mofetil oral.....  ..............  ..............  ..............  ..............  ..............
  J7599  E                               Immunosuppressive drug noc.....  ..............  ..............  ..............  ..............  ..............
  J7608  A                               Acetylcysteine inh sol u d.....  ..............  ..............  ..............  ..............  ..............
  J7610  A                               Acetylcysteine 10% injection...  ..............  ..............  ..............  ..............  ..............
  J7615  A                               Acetylcysteine 20% injection...  ..............  ..............  ..............  ..............  ..............
  J7618  A                               Albuterol inh sol con..........  ..............  ..............  ..............  ..............  ..............
  J7619  A                               Albuterol inh sol u d..........  ..............  ..............  ..............  ..............  ..............
  J7620  A                               Albuterol sulfate .083%/ml.....  ..............  ..............  ..............  ..............  ..............
  J7625  A                               Albuterol sulfate .5% inj......  ..............  ..............  ..............  ..............  ..............
  J7627  A                               Bitolterolmesylate inhal sol...  ..............  ..............  ..............  ..............  ..............
  J7628  A                               Bitolterol mes inhal sol con...  ..............  ..............  ..............  ..............  ..............
  J7629  A                               Bitolterol mes inh sol u d.....  ..............  ..............  ..............  ..............  ..............
  J7630  A                               Cromolyn sodium injeciton......  ..............  ..............  ..............  ..............  ..............
  J7631  A                               Cromolyn sodium inh sol u d....  ..............  ..............  ..............  ..............  ..............
  J7635  A                               Atropine inhal sol con.........  ..............  ..............  ..............  ..............  ..............
  J7636  A                               Atropine inhal sol unit dose...  ..............  ..............  ..............  ..............  ..............
  J7637  A                               Dexamethasone inhal sol con....  ..............  ..............  ..............  ..............  ..............
  J7638  A                               Dexamethasone inhal sol u d....  ..............  ..............  ..............  ..............  ..............

[[Page 18688]]

 
  J7639  A                               Dornase alpha inhal sol u d....  ..............  ..............  ..............  ..............  ..............
  J7640  A                               Epinephrine injection..........  ..............  ..............  ..............  ..............  ..............
  J7642  A                               Glycopyrrolate inhal sol con...  ..............  ..............  ..............  ..............  ..............
  J7643  A                               Glycopyrrolate inhal sol u d...  ..............  ..............  ..............  ..............  ..............
  J7644  A                               Ipratropium brom inh sol u d...  ..............  ..............  ..............  ..............  ..............
  J7645  A                               Ipratropium bromide .02%/ml....  ..............  ..............  ..............  ..............  ..............
  J7648  A                               Isoetharine hcl inh sol con....  ..............  ..............  ..............  ..............  ..............
  J7649  A                               Isoetharine hcl inh sol u d....  ..............  ..............  ..............  ..............  ..............
  J7650  A                               Isoetharine hcl .1% inj........  ..............  ..............  ..............  ..............  ..............
  J7651  A                               Isoetharine hcl .125% inj......  ..............  ..............  ..............  ..............  ..............
  J7652  A                               Isoetharine hcl .167% inj......  ..............  ..............  ..............  ..............  ..............
  J7653  A                               Isoetharine hcl .2%/inj........  ..............  ..............  ..............  ..............  ..............
  J7654  A                               Isoetharine hcl .25% inj.......  ..............  ..............  ..............  ..............  ..............
  J7655  A                               Isoetharine hcl 1% inj.........  ..............  ..............  ..............  ..............  ..............
  J7658  A                               Isoproterenolhcl inh sol con...  ..............  ..............  ..............  ..............  ..............
  J7659  A                               Isoproterenol hcl inh sol ud...  ..............  ..............  ..............  ..............  ..............
  J7660  A                               Isoproterenol hcl .5% inj......  ..............  ..............  ..............  ..............  ..............
  J7665  A                               Isoproterenol hcl 1% inj.......  ..............  ..............  ..............  ..............  ..............
  J7668  A                               Metaproterenol inh sol con.....  ..............  ..............  ..............  ..............  ..............
  J7669  A                               Metaproterenol inh sol u d.....  ..............  ..............  ..............  ..............  ..............
  J7670  A                               Metaproterenol sulfate .4%.....  ..............  ..............  ..............  ..............  ..............
  J7672  A                               Metaproterenol sulfate .6%.....  ..............  ..............  ..............  ..............  ..............
  J7675  A                               Metaproterenol sulfate 5%......  ..............  ..............  ..............  ..............  ..............
  J7680  A                               Terbutaline so4 inh sol con....  ..............  ..............  ..............  ..............  ..............
  J7681  A                               Terbutaline so4 inh sol u d....  ..............  ..............  ..............  ..............  ..............
  J7682  A                               Tobramycin inhalation sol......  ..............  ..............  ..............  ..............  ..............
  J7683  A                               Triamcinolone inh sol con......  ..............  ..............  ..............  ..............  ..............
  J7684  A                               Triamcinolone inh sol u d......  ..............  ..............  ..............  ..............  ..............
  J7699  A                               Inhalation solution for DME....  ..............  ..............  ..............  ..............  ..............
  J7799  A                               Non-inhalation drug for DME....  ..............  ..............  ..............  ..............  ..............
3 J7913  X                               Daclizumab, Parenteral, 25 m...            0892  ..............  ..............  ..............          $54.11
  J8499  E                               Oral prescrip drug non chemo...  ..............  ..............  ..............  ..............  ..............
3 J8510  X                               Oral busulfan..................            7015  ..............  ..............  ..............            $.19
3 J8520  X                               Capecitabine, oral, 150 mg.....            7042  ..............  ..............  ..............            $.19
  J8521  N                               Capecitabine, oral, 500 mg.....  ..............  ..............  ..............  ..............  ..............
3 J8530  X                               Cyclophosphamide oral 25 MG....            0801  ..............  ..............  ..............            $.19
3 J8560  X                               Etoposide oral 50 MG...........            0802  ..............  ..............  ..............           $3.10
3 J8600  X                               Melphalan oral 2 MG............            0803  ..............  ..............  ..............            $.19
3 J8610  X                               Methotrexate oral 2.5 MG.......            0826  ..............  ..............  ..............            $.29
  J8999  E                               Oral prescription drug chemo...  ..............  ..............  ..............  ..............  ..............
3 J9000  X                               Doxorubic hcl 10 MG vl chemo...            0847  ..............  ..............  ..............           $2.81
3 J9001  X                               Doxorubicin hcl liposome inj...            7046  ..............  ..............  ..............          $39.18
3 J9015  X                               Aldesleukin/single use vial....            0807  ..............  ..............  ..............          $65.07
3 J9020  X                               Asparaginase injection.........            0814  ..............  ..............  ..............           $8.34
3 J9031  X                               Bcg live intravesical vac......            0809  ..............  ..............  ..............          $19.78
3 J9040  X                               Bleomycin sulfate injection....            0857  ..............  ..............  ..............          $48.29
3 J9045  X                               Carboplatin injection..........            0811  ..............  ..............  ..............          $13.96
3 J9050  X                               Carmus bischl nitro inj........            0812  ..............  ..............  ..............          $10.57
3 J9060  X                               Cisplatin 10 MG injeciton......            0813  ..............  ..............  ..............           $4.56
  J9062  E                               Cisplatin 50 MG injeciton......  ..............  ..............  ..............  ..............  ..............
3 J9065  X                               Inj cladribine per 1 MG........            0858  ..............  ..............  ..............           $8.24
3 J9070  X                               Cyclophosphamide 100 MG inj....            0815  ..............  ..............  ..............            $.48
  J9080  E                               Cyclophosphamide 200 MG inj....  ..............  ..............  ..............  ..............  ..............
  J9090  E                               Cyclophosphamide 500 MG inj....  ..............  ..............  ..............  ..............  ..............
  J9091  E                               Cyclophosphamide 1.0 grm inj...  ..............  ..............  ..............  ..............  ..............
  J9092  E                               Cyclophosphamide 2.0 grm inj...  ..............  ..............  ..............  ..............  ..............
3 J9093  X                               Cyclophosphamide lyophilized...            0816  ..............  ..............  ..............           $1.16
  J9094  E                               Cyclophosphamide lyophilized...  ..............  ..............  ..............  ..............  ..............
  J9095  E                               Cyclophosphamide lyophilized...  ..............  ..............  ..............  ..............  ..............
  J9096  E                               Cyclophosphamide lyophilized...  ..............  ..............  ..............  ..............  ..............
  J9097  E                               Cyclophosphamide lyophilized...  ..............  ..............  ..............  ..............  ..............
3 J9100  X                               Cytarabine hcl 100 MG inj......            0817  ..............  ..............  ..............            $.68
  J9110  E                               Cytarabine hcl 500 MG inj......  ..............  ..............  ..............  ..............  ..............
3 J9120  X                               Dactinomycin actinomycin d.....            0818  ..............  ..............  ..............           $1.75
3 J9130  X                               Dacarbazine 10 MG inj..........            0819  ..............  ..............  ..............           $1.26
  J9140  E                               Dacarbazine 200 MG inj.........  ..............  ..............  ..............  ..............  ..............
3 J9150  X                               Daunorubicin...................            0820  ..............  ..............  ..............          $11.64
3 J9151  X                               Daunorubicin citrate liposom...            0821  ..............  ..............  ..............           $7.76
3 J9165  X                               Diethylstilbestrol injection...            0822  ..............  ..............  ..............           $2.13
3 J9170  X                               Docetaxel......................            0823  ..............  ..............  ..............          $34.72
3 J9181  X                               Etoposide 10 MG inj............            0824  ..............  ..............  ..............            $.58
  J9182  E                               Etoposide 100 MG inj...........  ..............  ..............  ..............  ..............  ..............
3 J9185  X                               Fludarabine phosphate inj......            0842  ..............  ..............  ..............          $30.84

[[Page 18689]]

 
3 J9190  X                               Fluorouracil injection.........            0859  ..............  ..............  ..............            $.19
3 J9200  X                               Floxuridine injection..........            0827  ..............  ..............  ..............          $18.81
3 J9201  X                               Gemcitabine HCl................            0828  ..............  ..............  ..............           $9.31
3 J9202  X                               Goserelin acetate implant......            0810  ..............  ..............  ..............          $59.74
3 J9206  X                               Irinotecan injection...........            0830  ..............  ..............  ..............          $14.16
3 J9208  X                               Ifosfomide injection...........            0831  ..............  ..............  ..............          $13.58
3 J9209  X                               Mesna injection................            0732  ..............  ..............  ..............           $2.42
3 J9211  X                               Idarubicin hcl injeciton.......            0832  ..............  ..............  ..............          $46.45
3 J9212  X                               Interferon alfacon-1...........            0833  ..............  ..............  ..............            $.19
3 J9213  X                               Interferon alfa-2a inj.........            0834  ..............  ..............  ..............           $3.20
3 J9214  X                               Interferon alfa-2b inj.........            0836  ..............  ..............  ..............           $1.36
3 J9215  X                               Interferon alfa-n3 inj.........            0865  ..............  ..............  ..............           $1.07
3 J9216  X                               Interferon gamma 1-b inj.......            0838  ..............  ..............  ..............          $22.79
  J9217  E                               Leuprolide acetate suspnsion...  ..............  ..............  ..............  ..............  ..............
3 J9218  X                               Leuprolide acetate injeciton...            0861  ..............  ..............  ..............          $19.39
3 J9230  X                               Mechlorethamine hcl inj........            0839  ..............  ..............  ..............           $1.65
3 J9245  X                               Inj melphalan hydrochl 50 MG...            0840  ..............  ..............  ..............          $44.71
3 J9250  X                               Methotrexate sodium inj........            0841  ..............  ..............  ..............            $.10
  J9260  E                               Methotrexate sodium inj........  ..............  ..............  ..............  ..............  ..............
3 J9265  X                               Paclitaxel injection...........            0863  ..............  ..............  ..............          $30.16
3 J9266  X                               Pegaspargase/singl dose vial...            0843  ..............  ..............  ..............         $178.72
3 J9268  X                               Pentostatin injection..........            0844  ..............  ..............  ..............         $133.73
3 J9270  X                               Plicamycin (mithramycin) inj...            0860  ..............  ..............  ..............           $1.36
3 J9280  X                               Mitomycin 5 MG inj.............            0862  ..............  ..............  ..............          $19.88
  J9290  E                               Mitomycin 20 MG inj............  ..............  ..............  ..............  ..............  ..............
  J9291  E                               Mitomycin 40 MG inj............  ..............  ..............  ..............  ..............  ..............
3 J9293  X                               Mitoxantrone hydrochl/5 MG.....            0864  ..............  ..............  ..............          $25.80
3 J9310  X                               Rituximab cancer treatment.....            0849  ..............  ..............  ..............          $51.40
3 J9320  X                               Streptozocin injection.........            0850  ..............  ..............  ..............          $14.64
3 J9340  X                               Thiotepa injection.............            0851  ..............  ..............  ..............           $9.50
3 J9350  X                               Topotecan......................            0852  ..............  ..............  ..............          $73.22
  J9355  N                               Trastuzumab....................  ..............  ..............  ..............  ..............  ..............
  J9357  N                               Valrubicin, 200 mg.............  ..............  ..............  ..............  ..............  ..............
3 J9360  X                               Vinblastine sulfate inj........            0853  ..............  ..............  ..............            $.39
3 J9370  X                               Vincristine sulfate 1 MG inj...            0854  ..............  ..............  ..............           $2.23
  J9375  E                               Vincristine sulfate 2 MG inj...  ..............  ..............  ..............  ..............  ..............
  J9380  E                               Vincristine sulfate 5 MG inj...  ..............  ..............  ..............  ..............  ..............
3 J9390  X                               Vinorelbine tartrate/10 mg.....            0855  ..............  ..............  ..............           $9.60
3 J9600  X                               Porfimer sodium................            0856  ..............  ..............  ..............          $34.62
  J9999  E                               Chemotherapy drug..............  ..............  ..............  ..............  ..............  ..............
  K0001  A                               Standard wheelchair............  ..............  ..............  ..............  ..............  ..............
  K0002  A                               Stnd hemi (low seat) whlchr....  ..............  ..............  ..............  ..............  ..............
  K0003  A                               Lightweight wheelchair.........  ..............  ..............  ..............  ..............  ..............
  K0004  A                               High strength ltwt whlchr......  ..............  ..............  ..............  ..............  ..............
  K0005  A                               Ultralightweight wheelchair....  ..............  ..............  ..............  ..............  ..............
  K0006  A                               Heavy duty wheelchair..........  ..............  ..............  ..............  ..............  ..............
  K0007  A                               Extra heavy duty wheelchair....  ..............  ..............  ..............  ..............  ..............
  K0008  A                               Cstm manual wheelchair/base....  ..............  ..............  ..............  ..............  ..............
  K0009  A                               Other manual wheelchair/base...  ..............  ..............  ..............  ..............  ..............
  K0010  A                               Stnd wt frame power whlchr.....  ..............  ..............  ..............  ..............  ..............
  K0011  A                               Stnd wt pwr whlchr w control...  ..............  ..............  ..............  ..............  ..............
  K0012  A                               Ltwt portbl power whlchr.......  ..............  ..............  ..............  ..............  ..............
  K0013  A                               Custom power whlchr base.......  ..............  ..............  ..............  ..............  ..............
  K0014  A                               Other power whlchr base........  ..............  ..............  ..............  ..............  ..............
  K0015  A                               Detach non-adjus hght armrst...  ..............  ..............  ..............  ..............  ..............
  K0016  A                               Detach adjust armrst cmplete...  ..............  ..............  ..............  ..............  ..............
  K0017  A                               Detach adjust armrest base.....  ..............  ..............  ..............  ..............  ..............
  K0018  A                               Detach adjust armrst upper.....  ..............  ..............  ..............  ..............  ..............
  K0019  A                               Arm pad each...................  ..............  ..............  ..............  ..............  ..............
  K0020  A                               Fixed adjust armrest pair......  ..............  ..............  ..............  ..............  ..............
  K0021  A                               Anti-tipping device each.......  ..............  ..............  ..............  ..............  ..............
  K0022  A                               Reinforced back upholstery.....  ..............  ..............  ..............  ..............  ..............
  K0023  A                               Planr back insrt foam w/strp...  ..............  ..............  ..............  ..............  ..............
  K0024  A                               Plnr back insrt foam w/hrdwr...  ..............  ..............  ..............  ..............  ..............
  K0025  A                               Hook-on headrest extension.....  ..............  ..............  ..............  ..............  ..............
  K0026  A                               Back upholst lgtwt whlchr......  ..............  ..............  ..............  ..............  ..............
  K0027  A                               Back upholst other whlchr......  ..............  ..............  ..............  ..............  ..............
  K0028  A                               Manual fully reclining back....  ..............  ..............  ..............  ..............  ..............
  K0029  A                               Reinforced seat upholstery.....  ..............  ..............  ..............  ..............  ..............
  K0030  A                               Solid plnr seat sngl dnsfoam...  ..............  ..............  ..............  ..............  ..............
  K0031  A                               Safety belt/pelvic strap.......  ..............  ..............  ..............  ..............  ..............
  K0032  A                               Seat uphols lgtwt whlchr.......  ..............  ..............  ..............  ..............  ..............
  K0033  A                               Seat upholstery other whlchr...  ..............  ..............  ..............  ..............  ..............

[[Page 18690]]

 
  K0034  A                               Heel loop each.................  ..............  ..............  ..............  ..............  ..............
  K0035  A                               Heel loop with ankle strap.....  ..............  ..............  ..............  ..............  ..............
  K0036  A                               Toe loop each..................  ..............  ..............  ..............  ..............  ..............
  K0037  A                               High mount flip-up footrest....  ..............  ..............  ..............  ..............  ..............
  K0038  A                               Leg strap each.................  ..............  ..............  ..............  ..............  ..............
  K0039  A                               Leg strap h style each.........  ..............  ..............  ..............  ..............  ..............
  K0040  A                               Adjustable angle footplate.....  ..............  ..............  ..............  ..............  ..............
  K0041  A                               Large size footplate each......  ..............  ..............  ..............  ..............  ..............
  K0042  A                               Standard size footplate each...  ..............  ..............  ..............  ..............  ..............
  K0043  A                               Ftrst lower extension tube.....  ..............  ..............  ..............  ..............  ..............
  K0044  A                               Ftrst upper hanger bracket.....  ..............  ..............  ..............  ..............  ..............
  K0045  A                               Footrest complete assembly.....  ..............  ..............  ..............  ..............  ..............
  K0046  A                               Elevat legrst low extension....  ..............  ..............  ..............  ..............  ..............
  K0047  A                               Elevat legrst up hangr brack...  ..............  ..............  ..............  ..............  ..............
  K0048  A                               Elevate legrest complete.......  ..............  ..............  ..............  ..............  ..............
  K0049  A                               Calf pad each..................  ..............  ..............  ..............  ..............  ..............
  K0050  A                               Ratchet assembly...............  ..............  ..............  ..............  ..............  ..............
  K0051  A                               Cam relese assem ftrst/lgrst...  ..............  ..............  ..............  ..............  ..............
  K0052  A                               Swingaway detach footrest......  ..............  ..............  ..............  ..............  ..............
  K0053  A                               Elevate footrest articulate....  ..............  ..............  ..............  ..............  ..............
  K0054  A                               Seat wdth 10-12/15/17/20 wc....  ..............  ..............  ..............  ..............  ..............
  K0055  A                               Seat dpth 15/17/18 ltwt wc.....  ..............  ..............  ..............  ..............  ..............
  K0056  A                               Seat ht 17 or >=21 ltwt wc.....  ..............  ..............  ..............  ..............  ..............
  K0057  A                               Seat wdth 19/20 hvy dty wc.....  ..............  ..............  ..............  ..............  ..............
  K0058  A                               Seat dpth 17/18 power wc.......  ..............  ..............  ..............  ..............  ..............
  K0059  A                               Plastic coated handrim each....  ..............  ..............  ..............  ..............  ..............
  K0060  A                               Steel handrim each.............  ..............  ..............  ..............  ..............  ..............
  K0061  A                               Aluminum handrim each..........  ..............  ..............  ..............  ..............  ..............
  K0062  A                               Handrim 8-10 vert/obliq proj...  ..............  ..............  ..............  ..............  ..............
  K0063  A                               Hndrm 12-16 vert/obliq proj....  ..............  ..............  ..............  ..............  ..............
  K0064  A                               Zero pressure tube flat free...  ..............  ..............  ..............  ..............  ..............
  K0065  A                               Spoke protectors...............  ..............  ..............  ..............  ..............  ..............
  K0066  A                               Solid tire any size each.......  ..............  ..............  ..............  ..............  ..............
  K0067  A                               Pneumatic tire any size each...  ..............  ..............  ..............  ..............  ..............
  K0068  A                               Pneumatic tire tube each.......  ..............  ..............  ..............  ..............  ..............
  K0069  A                               Rear whl complete solid tire...  ..............  ..............  ..............  ..............  ..............
  K0070  A                               Rear whl compl pneum tire......  ..............  ..............  ..............  ..............  ..............
  K0071  A                               Front castr compl pneum tire...  ..............  ..............  ..............  ..............  ..............
  K0072  A                               Frnt cstr cmpl sem-pneum tir...  ..............  ..............  ..............  ..............  ..............
  K0073  A                               Caster pin lock each...........  ..............  ..............  ..............  ..............  ..............
  K0074  A                               Pneumatic caster tire each.....  ..............  ..............  ..............  ..............  ..............
  K0075  A                               Semi-pneumatic caster tire.....  ..............  ..............  ..............  ..............  ..............
  K0076  A                               Solid caster tire each.........  ..............  ..............  ..............  ..............  ..............
  K0077  A                               Front caster assem complete....  ..............  ..............  ..............  ..............  ..............
  K0078  A                               Pneumatic caster tire tube.....  ..............  ..............  ..............  ..............  ..............
  K0079  A                               Wheel lock extension pair......  ..............  ..............  ..............  ..............  ..............
  K0080  A                               Anti-rollback device pair......  ..............  ..............  ..............  ..............  ..............
  K0081  A                               Wheel lock assembly complete...  ..............  ..............  ..............  ..............  ..............
  K0082  A                               22 nf deep cycl acid battery...  ..............  ..............  ..............  ..............  ..............
  K0083  A                               22 nf gel cell battery each....  ..............  ..............  ..............  ..............  ..............
  K0084  A                               Grp 24 deep cycl acid battry...  ..............  ..............  ..............  ..............  ..............
  K0085  A                               Group 24 gel cell battery......  ..............  ..............  ..............  ..............  ..............
  K0086  A                               U-1 lead acid battery each.....  ..............  ..............  ..............  ..............  ..............
  K0087  A                               U-1 gel cell battery each......  ..............  ..............  ..............  ..............  ..............
  K0088  A                               Battry chrgr acid/gel cell.....  ..............  ..............  ..............  ..............  ..............
  K0089  A                               Battery charger dual mode......  ..............  ..............  ..............  ..............  ..............
  K0090  A                               Rear tire power wheelchair.....  ..............  ..............  ..............  ..............  ..............
  K0091  A                               Rear tire tube power whlchr....  ..............  ..............  ..............  ..............  ..............
  K0092  A                               Rear assem cmplt powr whlchr...  ..............  ..............  ..............  ..............  ..............
  K0093  A                               Rear zero pressure tire tube...  ..............  ..............  ..............  ..............  ..............
  K0094  A                               Wheel tire for power base......  ..............  ..............  ..............  ..............  ..............
  K0095  A                               Wheel tire tube each base......  ..............  ..............  ..............  ..............  ..............
  K0096  A                               Wheel assem powr base complt...  ..............  ..............  ..............  ..............  ..............
  K0097  A                               Wheel zero presure tire tube...  ..............  ..............  ..............  ..............  ..............
  K0098  A                               Drive belt power wheelchair....  ..............  ..............  ..............  ..............  ..............
  K0099  A                               Pwr wheelchair front caster....  ..............  ..............  ..............  ..............  ..............
  K0100  A                               Amputee adapter pair...........  ..............  ..............  ..............  ..............  ..............
  K0101  A                               One-arm drive attachment.......  ..............  ..............  ..............  ..............  ..............
  K0102  A                               Crutch and cane holder.........  ..............  ..............  ..............  ..............  ..............
  K0103  A                               Transfer board  25"............  ..............  ..............  ..............  ..............  ..............
  K0104  A                               Cylinder tank carrier..........  ..............  ..............  ..............  ..............  ..............
  K0105  A                               Iv hanger......................  ..............  ..............  ..............  ..............  ..............
  K0106  A                               Arm trough each................  ..............  ..............  ..............  ..............  ..............

[[Page 18691]]

 
  K0107  A                               Wheelchair tray................  ..............  ..............  ..............  ..............  ..............
  K0108  A                               W/c component-accessory NOS....  ..............  ..............  ..............  ..............  ..............
  K0112  A                               Trunk vest supprt innr frame...  ..............  ..............  ..............  ..............  ..............
  K0113  A                               Trunk vest suprt w/o inr frm...  ..............  ..............  ..............  ..............  ..............
  K0114  A                               Whlchr back suprt inr frame....  ..............  ..............  ..............  ..............  ..............
  K0115  A                               Back module orthotic system....  ..............  ..............  ..............  ..............  ..............
  K0116  A                               Back & seat modul orthot sys...  ..............  ..............  ..............  ..............  ..............
  K0182  A                               Water distilled w/nebulizer....  ..............  ..............  ..............  ..............  ..............
  K0183  A                               Nasal application device.......  ..............  ..............  ..............  ..............  ..............
  K0184  A                               Nasal pillows/seals pair.......  ..............  ..............  ..............  ..............  ..............
  K0185  A                               Pos airway pressure headgear...  ..............  ..............  ..............  ..............  ..............
  K0186  A                               Pos airway prssure chinstrap...  ..............  ..............  ..............  ..............  ..............
  K0187  A                               Pos airway pressure tubing.....  ..............  ..............  ..............  ..............  ..............
  K0188  A                               Pos airway pressure filter.....  ..............  ..............  ..............  ..............  ..............
  K0189  A                               Filter nondisposable w PAP.....  ..............  ..............  ..............  ..............  ..............
  K0195  A                               Elevating whlchair leg rests...  ..............  ..............  ..............  ..............  ..............
  K0268  A                               Humidifier nonheated w PAP.....  ..............  ..............  ..............  ..............  ..............
  K0269  A                               Aerosol compressor cpap dev....  ..............  ..............  ..............  ..............  ..............
  K0270  A                               Ultrasonic generator w nebul...  ..............  ..............  ..............  ..............  ..............
  K0280  A                               Extension drainage tubing......  ..............  ..............  ..............  ..............  ..............
  K0281  A                               Lubricant catheter insertion...  ..............  ..............  ..............  ..............  ..............
  K0283  A                               Saline solution dispenser......  ..............  ..............  ..............  ..............  ..............
  K0407  A                               Urinary cath skin attachment...  ..............  ..............  ..............  ..............  ..............
  K0408  A                               Urinary cath leg strap.........  ..............  ..............  ..............  ..............  ..............
  K0409  A                               Sterile H2O irrigation solut...  ..............  ..............  ..............  ..............  ..............
  K0410  A                               Male ext cath w/adh coating....  ..............  ..............  ..............  ..............  ..............
  K0411  A                               Male ext cath w/adh strip......  ..............  ..............  ..............  ..............  ..............
  K0415  E                               RX antiemetic drg, oral NOS....  ..............  ..............  ..............  ..............  ..............
  K0416  E                               Rx antiemetic drg, rectal NOS..  ..............  ..............  ..............  ..............  ..............
  K0440  A                               Nasal prosthesis...............  ..............  ..............  ..............  ..............  ..............
  K0441  A                               Midfacial prosthesis...........  ..............  ..............  ..............  ..............  ..............
  K0442  A                               Orbital prosthesis.............  ..............  ..............  ..............  ..............  ..............
  K0443  A                               Upper facial prosthesis........  ..............  ..............  ..............  ..............  ..............
  K0444  A                               Hemi-facial prosthesis.........  ..............  ..............  ..............  ..............  ..............
  K0445  A                               Auricular prosthesis...........  ..............  ..............  ..............  ..............  ..............
  K0446  A                               Partial facial prosthesis......  ..............  ..............  ..............  ..............  ..............
  K0447  A                               Nasal septal prosthesis........  ..............  ..............  ..............  ..............  ..............
  K0448  A                               Unspec maxillofacial prosth....  ..............  ..............  ..............  ..............  ..............
  K0449  A                               Repair maxillofacial prosth....  ..............  ..............  ..............  ..............  ..............
  K0450  A                               Liq adhes for facial prosth....  ..............  ..............  ..............  ..............  ..............
  K0451  A                               Adhesive remover wipes.........  ..............  ..............  ..............  ..............  ..............
  K0452  A                               Wheelchair bearings............  ..............  ..............  ..............  ..............  ..............
  K0455  A                               Pump uninterrupted infusion....  ..............  ..............  ..............  ..............  ..............
  K0456  A                               Heavyduty/xtra wide hosp bed...  ..............  ..............  ..............  ..............  ..............
  K0457  A                               Heavyduty/wide commode chair...  ..............  ..............  ..............  ..............  ..............
  K0458  A                               Heavyduty walker no wheels.....  ..............  ..............  ..............  ..............  ..............
  K0459  A                               Heavy duty wheeled walker......  ..............  ..............  ..............  ..............  ..............
  K0460  A                               WC power add-on joystick.......  ..............  ..............  ..............  ..............  ..............
  K0461  A                               WC power add-on tiller cntrl...  ..............  ..............  ..............  ..............  ..............
  K0462  A                               Temporary replacement eqpmnt...  ..............  ..............  ..............  ..............  ..............
  K0501  A                               Aerosol compressor for svneb...  ..............  ..............  ..............  ..............  ..............
  K0529  A                               Sterile H20 or nss w lv neb....  ..............  ..............  ..............  ..............  ..............
  K0531  A                               Heated humidifier used w pap...  ..............  ..............  ..............  ..............  ..............
  K0532  A                               Noninvasive assist wo backup...  ..............  ..............  ..............  ..............  ..............
  K0533  A                               Noninvasive assist w backup....  ..............  ..............  ..............  ..............  ..............
  K0534  A                               Invasive assist w backup.......  ..............  ..............  ..............  ..............  ..............
  L0100  A                               Cerv craniosten helmet mold....  ..............  ..............  ..............  ..............  ..............
  L0110  A                               Cerv craniostenosis hel non-...  ..............  ..............  ..............  ..............  ..............
  L0120  A                               Cerv flexible non-adjustable...  ..............  ..............  ..............  ..............  ..............
  L0130  A                               Flex thermoplastic collar mo...  ..............  ..............  ..............  ..............  ..............
  L0140  A                               Cervical semi-rigid adjustab...  ..............  ..............  ..............  ..............  ..............
  L0150  A                               Cerv semi-rig adj molded chn...  ..............  ..............  ..............  ..............  ..............
  L0160  A                               Cerv semi-rig wire occ/mand....  ..............  ..............  ..............  ..............  ..............
  L0170  A                               Cervical collar molded to pt...  ..............  ..............  ..............  ..............  ..............
  L0172  A                               Cerv col thermplas foam 2 pi...  ..............  ..............  ..............  ..............  ..............
  L0174  A                               Cerv col foam 2 piece w thor...  ..............  ..............  ..............  ..............  ..............
  L0180  A                               Cer post col occ/man sup adj...  ..............  ..............  ..............  ..............  ..............
  L0190  A                               Cerv collar supp adj cerv ba...  ..............  ..............  ..............  ..............  ..............
  L0200  A                               Cerv col supp adj bar & thor...  ..............  ..............  ..............  ..............  ..............
  L0210  A                               Thoracic rib belt..............  ..............  ..............  ..............  ..............  ..............
  L0220  A                               Thor rib belt custom fabrica...  ..............  ..............  ..............  ..............  ..............
  L0300  A                               TLSO flex surgical support.....  ..............  ..............  ..............  ..............  ..............
  L0310  A                               Tlso flexible custom fabrica...  ..............  ..............  ..............  ..............  ..............

[[Page 18692]]

 
  L0315  A                               Tlso flex elas rigid post pa...  ..............  ..............  ..............  ..............  ..............
  L0317  A                               Tlso flex hypext elas post p...  ..............  ..............  ..............  ..............  ..............
  L0320  A                               Tlso a-p contrl w apron frnt...  ..............  ..............  ..............  ..............  ..............
  L0330  A                               Tlso ant-pos-lateral control...  ..............  ..............  ..............  ..............  ..............
  L0340  A                               Tlso a-p-l-rotary with apron...  ..............  ..............  ..............  ..............  ..............
  L0350  A                               Tlso flex compress jacket cu...  ..............  ..............  ..............  ..............  ..............
  L0360  A                               Tlso flex compress jacket mo...  ..............  ..............  ..............  ..............  ..............
  L0370  A                               Tlso a-p-l-rotary hyperexten...  ..............  ..............  ..............  ..............  ..............
  L0380  A                               Tlso a-p-l-rot w/pos extens....  ..............  ..............  ..............  ..............  ..............
  L0390  A                               Tlso a-p-l control molded......  ..............  ..............  ..............  ..............  ..............
  L0400  A                               Tlso a-p-l w interface mater...  ..............  ..............  ..............  ..............  ..............
  L0410  A                               Tlso a-p-l two piece constr....  ..............  ..............  ..............  ..............  ..............
  L0420  A                               Tlso a-p-l 2 piece w interfa...  ..............  ..............  ..............  ..............  ..............
  L0430  A                               Tlso a-p-l w interface custm...  ..............  ..............  ..............  ..............  ..............
  L0440  A                               Tlso a-p-l overlap frnt cust...  ..............  ..............  ..............  ..............  ..............
  L0500  A                               Lso flex surgical support......  ..............  ..............  ..............  ..............  ..............
  L0510  A                               Lso flexible custom fabricat...  ..............  ..............  ..............  ..............  ..............
  L0515  A                               Lso flex elas w/rig post pa....  ..............  ..............  ..............  ..............  ..............
  L0520  A                               Lso a-p-l control with apron...  ..............  ..............  ..............  ..............  ..............
  L0530  A                               Lso ant-pos control w apron....  ..............  ..............  ..............  ..............  ..............
  L0540  A                               Lso lumbar flexion a-p-l.......  ..............  ..............  ..............  ..............  ..............
  L0550  A                               Lso a-p-l control molded.......  ..............  ..............  ..............  ..............  ..............
  L0560  A                               Lso a-p-l w interface..........  ..............  ..............  ..............  ..............  ..............
  L0565  A                               Lso a-p-l control custom.......  ..............  ..............  ..............  ..............  ..............
  L0600  A                               Sacroiliac flex surg support...  ..............  ..............  ..............  ..............  ..............
  L0610  A                               Sacroiliac flexible custm fa...  ..............  ..............  ..............  ..............  ..............
  L0620  A                               Sacroiliac semi-rig w apron....  ..............  ..............  ..............  ..............  ..............
  L0700  A                               Ctlso a-p-l control molded.....  ..............  ..............  ..............  ..............  ..............
  L0710  A                               Ctlso a-p-l control w/inter....  ..............  ..............  ..............  ..............  ..............
  L0810  A                               Halo cervical into jckt vest...  ..............  ..............  ..............  ..............  ..............
  L0820  A                               Halo cervical into body jack...  ..............  ..............  ..............  ..............  ..............
  L0830  A                               Halo cerv into milwaukee typ...  ..............  ..............  ..............  ..............  ..............
  L0860  A                               Magnetic resonanc image comp...  ..............  ..............  ..............  ..............  ..............
  L0900  A                               Torso/ptosis support...........  ..............  ..............  ..............  ..............  ..............
  L0910  A                               Torso & ptosis supp custm fa...  ..............  ..............  ..............  ..............  ..............
  L0920  A                               Torso/pendulous abd support....  ..............  ..............  ..............  ..............  ..............
  L0930  A                               Pendulous abdomen supp custm...  ..............  ..............  ..............  ..............  ..............
  L0940  A                               Torso/postsurgical support.....  ..............  ..............  ..............  ..............  ..............
  L0950  A                               Post surg support custom fab...  ..............  ..............  ..............  ..............  ..............
  L0960  A                               Post surgical support pads.....  ..............  ..............  ..............  ..............  ..............
  L0970  A                               Tlso corset front..............  ..............  ..............  ..............  ..............  ..............
  L0972  A                               Lso corset front...............  ..............  ..............  ..............  ..............  ..............
  L0974  A                               Tlso full corset...............  ..............  ..............  ..............  ..............  ..............
  L0976  A                               Lso full corset................  ..............  ..............  ..............  ..............  ..............
  L0978  A                               Axillary crutch extension......  ..............  ..............  ..............  ..............  ..............
  L0980  A                               Peroneal straps pair...........  ..............  ..............  ..............  ..............  ..............
  L0982  A                               Stocking supp grips set of f...  ..............  ..............  ..............  ..............  ..............
  L0984  A                               Protective body sock each......  ..............  ..............  ..............  ..............  ..............
  L0999  A                               Add to spinal orthosis NOS.....  ..............  ..............  ..............  ..............  ..............
  L1000  A                               Ctlso milwauke initial model...  ..............  ..............  ..............  ..............  ..............
  L1010  A                               Ctlso axilla sling.............  ..............  ..............  ..............  ..............  ..............
  L1020  A                               Kyphosis pad...................  ..............  ..............  ..............  ..............  ..............
  L1025  A                               Kyphosis pad floating..........  ..............  ..............  ..............  ..............  ..............
  L1030  A                               Lumbar bolster pad.............  ..............  ..............  ..............  ..............  ..............
  L1040  A                               Lumbar or lumbar rib pad.......  ..............  ..............  ..............  ..............  ..............
  L1050  A                               Sternal pad....................  ..............  ..............  ..............  ..............  ..............
  L1060  A                               Thoracic pad...................  ..............  ..............  ..............  ..............  ..............
  L1070  A                               Trapezius sling................  ..............  ..............  ..............  ..............  ..............
  L1080  A                               Outrigger......................  ..............  ..............  ..............  ..............  ..............
  L1085  A                               Outrigger bil w/vert extens....  ..............  ..............  ..............  ..............  ..............
  L1090  A                               Lumbar sling...................  ..............  ..............  ..............  ..............  ..............
  L1100  A                               Ring flange plastic/leather....  ..............  ..............  ..............  ..............  ..............
  L1110  A                               Ring flange plas/leather mol...  ..............  ..............  ..............  ..............  ..............
  L1120  A                               Covers for upright each........  ..............  ..............  ..............  ..............  ..............
  L1200  A                               Furnsh initial orthosis only...  ..............  ..............  ..............  ..............  ..............
  L1210  A                               Lateral thoracic extension.....  ..............  ..............  ..............  ..............  ..............
  L1220  A                               Anterior thoracic extension....  ..............  ..............  ..............  ..............  ..............
  L1230  A                               Milwaukee type superstructur...  ..............  ..............  ..............  ..............  ..............
  L1240  A                               Lumbar derotation pad..........  ..............  ..............  ..............  ..............  ..............
  L1250  A                               Anterior asis pad..............  ..............  ..............  ..............  ..............  ..............
  L1260  A                               Anterior thoracic derotation...  ..............  ..............  ..............  ..............  ..............
  L1270  A                               Abdominal pad..................  ..............  ..............  ..............  ..............  ..............
  L1280  A                               Rib gusset (elastic) each......  ..............  ..............  ..............  ..............  ..............

[[Page 18693]]

 
  L1290  A                               Lateral trochanteric pad.......  ..............  ..............  ..............  ..............  ..............
  L1300  A                               Body jacket mold to patient....  ..............  ..............  ..............  ..............  ..............
  L1310  A                               Post-operative body jacket.....  ..............  ..............  ..............  ..............  ..............
  L1499  A                               Spinal orthosis NOS............  ..............  ..............  ..............  ..............  ..............
  L1500  A                               Thkao mobility frame...........  ..............  ..............  ..............  ..............  ..............
  L1510  A                               Thkao standing frame...........  ..............  ..............  ..............  ..............  ..............
  L1520  A                               Thkao swivel walker............  ..............  ..............  ..............  ..............  ..............
  L1600  A                               Abduct hip flex frejka w cvr...  ..............  ..............  ..............  ..............  ..............
  L1610  A                               Abduct hip flex frejka covr....  ..............  ..............  ..............  ..............  ..............
  L1620  A                               Abduct hip flex pavlik harne...  ..............  ..............  ..............  ..............  ..............
  L1630  A                               Abduct control hip semi-flex...  ..............  ..............  ..............  ..............  ..............
  L1640  A                               Pelv band/spread bar thigh c...  ..............  ..............  ..............  ..............  ..............
  L1650  A                               HO abduction hip adjustable....  ..............  ..............  ..............  ..............  ..............
  L1660  A                               HO abduction static plastic....  ..............  ..............  ..............  ..............  ..............
  L1680  A                               Pelvic & hip control thigh c...  ..............  ..............  ..............  ..............  ..............
  L1685  A                               Post-op hip abduct custom fa...  ..............  ..............  ..............  ..............  ..............
  L1686  A                               HO post-op hip abduction.......  ..............  ..............  ..............  ..............  ..............
  L1690  A                               Combination bilateral HO.......  ..............  ..............  ..............  ..............  ..............
  L1700  A                               Leg perthes orth toronto typ...  ..............  ..............  ..............  ..............  ..............
  L1710  A                               Legg perthes orth newington....  ..............  ..............  ..............  ..............  ..............
  L1720  A                               Legg perthes orthosis trilat...  ..............  ..............  ..............  ..............  ..............
  L1730  A                               Legg perthes orth scottish r...  ..............  ..............  ..............  ..............  ..............
  L1750  A                               Legg perthes sling.............  ..............  ..............  ..............  ..............  ..............
  L1755  A                               Legg perthes patten bottom t...  ..............  ..............  ..............  ..............  ..............
  L1800  A                               Knee orthoses elas w stays.....  ..............  ..............  ..............  ..............  ..............
  L1810  A                               Ko elastic with joints.........  ..............  ..............  ..............  ..............  ..............
  L1815  A                               Elastic with condylar pads.....  ..............  ..............  ..............  ..............  ..............
  L1820  A                               Ko elas w/condyle pads & jo....  ..............  ..............  ..............  ..............  ..............
  L1825  A                               Ko elastic knee cap............  ..............  ..............  ..............  ..............  ..............
  L1830  A                               Ko immobilizer canvas longit...  ..............  ..............  ..............  ..............  ..............
  L1832  A                               KO adj jnt pos rigid support...  ..............  ..............  ..............  ..............  ..............
  L1834  A                               Ko w/0 joint rigid molded to...  ..............  ..............  ..............  ..............  ..............
  L1840  A                               Ko derot ant cruciate custom...  ..............  ..............  ..............  ..............  ..............
  L1843  A                               KO single upright custom fit...  ..............  ..............  ..............  ..............  ..............
  L1844  A                               Ko w/adj jt rot cntrl molded...  ..............  ..............  ..............  ..............  ..............
  L1845  A                               Ko w/adj flex/ext rotat cus....  ..............  ..............  ..............  ..............  ..............
  L1846  A                               Ko w adj flex/ext rotat mold...  ..............  ..............  ..............  ..............  ..............
  L1847  A                               KO adjustable w air chambers...  ..............  ..............  ..............  ..............  ..............
  L1850  A                               Ko swedish type................  ..............  ..............  ..............  ..............  ..............
  L1855  A                               Ko plas doub upright jnt mol...  ..............  ..............  ..............  ..............  ..............
  L1858  A                               Ko polycentric pneumatic pad...  ..............  ..............  ..............  ..............  ..............
  L1860  A                               Ko supracondylar socket mold...  ..............  ..............  ..............  ..............  ..............
  L1870  A                               Ko doub upright lacers molde...  ..............  ..............  ..............  ..............  ..............
  L1880  A                               Ko doub upright cuffs/lacers...  ..............  ..............  ..............  ..............  ..............
  L1885  A                               Knee upright w/resistance......  ..............  ..............  ..............  ..............  ..............
  L1900  A                               Afo sprng wir drsflx calf bd...  ..............  ..............  ..............  ..............  ..............
  L1902  A                               Afo ankle gauntlet.............  ..............  ..............  ..............  ..............  ..............
  L1904  A                               Afo molded ankle gauntlet......  ..............  ..............  ..............  ..............  ..............
  L1906  A                               Afo multiligamentus ankle su...  ..............  ..............  ..............  ..............  ..............
  L1910  A                               Afo sing bar clasp attach sh...  ..............  ..............  ..............  ..............  ..............
  L1920  A                               Afo sing upright w/adjust s....  ..............  ..............  ..............  ..............  ..............
  L1930  A                               Afo plastic....................  ..............  ..............  ..............  ..............  ..............
  L1940  A                               Afo molded to patient plasti...  ..............  ..............  ..............  ..............  ..............
  L1945  A                               Afo molded plas rig ant tib....  ..............  ..............  ..............  ..............  ..............
  L1950  A                               Afo spiral molded to pt plas...  ..............  ..............  ..............  ..............  ..............
  L1960  A                               Afo pos solid ank plastic mo...  ..............  ..............  ..............  ..............  ..............
  L1970  A                               Afo plastic molded w/ankle j...  ..............  ..............  ..............  ..............  ..............
  L1980  A                               Afo sing solid stirrup calf....  ..............  ..............  ..............  ..............  ..............
  L1990  A                               Afo doub solid stirrup calf....  ..............  ..............  ..............  ..............  ..............
  L2000  A                               Kafo sing fre stirr thi/calf...  ..............  ..............  ..............  ..............  ..............
  L2010  A                               Kafo sng solid stirrup w/o j...  ..............  ..............  ..............  ..............  ..............
  L2020  A                               Kafo dbl solid stirrup band/...  ..............  ..............  ..............  ..............  ..............
  L2030  A                               Kafo dbl solid stirrup w/o j...  ..............  ..............  ..............  ..............  ..............
  L2035  A                               KAFO plastic pediatric size....  ..............  ..............  ..............  ..............  ..............
  L2036  A                               Kafo plas doub free knee mol...  ..............  ..............  ..............  ..............  ..............
  L2037  A                               Kafo plas sing free knee mol...  ..............  ..............  ..............  ..............  ..............
  L2038  A                               Kafo w/o joint multi-axis an...  ..............  ..............  ..............  ..............  ..............
  L2039  A                               KAFO, plstic, medlat rotat con.  ..............  ..............  ..............  ..............  ..............
  L2040  A                               Hkafo torsion bil rot straps...  ..............  ..............  ..............  ..............  ..............
  L2050  A                               Hkafo torsion cable hip pelv...  ..............  ..............  ..............  ..............  ..............
  L2060  A                               Hkafo torsion ball bearing j...  ..............  ..............  ..............  ..............  ..............
  L2070  A                               Hkafo torsion unilat rot str...  ..............  ..............  ..............  ..............  ..............
  L2080  A                               Hkafo unilat torsion cable.....  ..............  ..............  ..............  ..............  ..............

[[Page 18694]]

 
  L2090  A                               Hkafo unilat torsion ball br...  ..............  ..............  ..............  ..............  ..............
  L2102  A                               Afo tibial fx cast plstr mol...  ..............  ..............  ..............  ..............  ..............
  L2104  A                               Afo tib fx cast synthetic mo...  ..............  ..............  ..............  ..............  ..............
  L2106  A                               Afo tib fx cast plaster mold...  ..............  ..............  ..............  ..............  ..............
  L2108  A                               Afo tib fx cast molded to pt...  ..............  ..............  ..............  ..............  ..............
  L2112  A                               Afo tibial fracture soft.......  ..............  ..............  ..............  ..............  ..............
  L2114  A                               Afo tib fx semi-rigid..........  ..............  ..............  ..............  ..............  ..............
  L2116  A                               Afo tibial fracture rigid......  ..............  ..............  ..............  ..............  ..............
  L2122  A                               Kafo fem fx cast plaster mol...  ..............  ..............  ..............  ..............  ..............
  L2124  A                               Kafo fem fx cast synthet mol...  ..............  ..............  ..............  ..............  ..............
  L2126  A                               Kafo fem fx cast thermoplas....  ..............  ..............  ..............  ..............  ..............
  L2128  A                               Kafo fem fx cast molded to p...  ..............  ..............  ..............  ..............  ..............
  L2132  A                               Kafo femoral fx cast soft......  ..............  ..............  ..............  ..............  ..............
  L2134  A                               Kafo fem fx cast semi-rigid....  ..............  ..............  ..............  ..............  ..............
  L2136  A                               Kafo femoral fx cast rigid.....  ..............  ..............  ..............  ..............  ..............
  L2180  A                               Plas shoe insert w ank joint...  ..............  ..............  ..............  ..............  ..............
  L2182  A                               Drop lock knee.................  ..............  ..............  ..............  ..............  ..............
  L2184  A                               Limited motion knee joint......  ..............  ..............  ..............  ..............  ..............
  L2186  A                               Adj motion knee jnt lerman t...  ..............  ..............  ..............  ..............  ..............
  L2188  A                               Quadrilateral brim.............  ..............  ..............  ..............  ..............  ..............
  L2190  A                               Waist belt.....................  ..............  ..............  ..............  ..............  ..............
  L2192  A                               Pelvic band & belt thigh fla...  ..............  ..............  ..............  ..............  ..............
  L2200  A                               Limited ankle motion ea jnt....  ..............  ..............  ..............  ..............  ..............
  L2210  A                               Dorsiflexion assist each joi...  ..............  ..............  ..............  ..............  ..............
  L2220  A                               Dorsi & plantar flex ass/res...  ..............  ..............  ..............  ..............  ..............
  L2230  A                               Split flat caliper stirr & p...  ..............  ..............  ..............  ..............  ..............
  L2240  A                               Round caliper and plate atta...  ..............  ..............  ..............  ..............  ..............
  L2250  A                               Foot plate molded stirrup at...  ..............  ..............  ..............  ..............  ..............
  L2260  A                               Reinforced solid stirrup.......  ..............  ..............  ..............  ..............  ..............
  L2265  A                               Long tongue stirrup............  ..............  ..............  ..............  ..............  ..............
  L2270  A                               Varus/valgus strap padded/li...  ..............  ..............  ..............  ..............  ..............
  L2275  A                               Plastic mod low ext pad/line...  ..............  ..............  ..............  ..............  ..............
  L2280  A                               Molded inner boot..............  ..............  ..............  ..............  ..............  ..............
  L2300  A                               Abduction bar jointed adjust...  ..............  ..............  ..............  ..............  ..............
  L2310  A                               Abduction bar-straight.........  ..............  ..............  ..............  ..............  ..............
  L2320  A                               Non-molded lacer...............  ..............  ..............  ..............  ..............  ..............
  L2330  A                               Lacer molded to patient mode...  ..............  ..............  ..............  ..............  ..............
  L2335  A                               Anterior swing band............  ..............  ..............  ..............  ..............  ..............
  L2340  A                               Pre-tibial shell molded to p...  ..............  ..............  ..............  ..............  ..............
  L2350  A                               Prosthetic type socket molde...  ..............  ..............  ..............  ..............  ..............
  L2360  A                               Extended steel shank...........  ..............  ..............  ..............  ..............  ..............
  L2370  A                               Patten bottom..................  ..............  ..............  ..............  ..............  ..............
  L2375  A                               Torsion ank & half solid sti...  ..............  ..............  ..............  ..............  ..............
  L2380  A                               Torsion straight knee joint....  ..............  ..............  ..............  ..............  ..............
  L2385  A                               Straight knee joint heavy du...  ..............  ..............  ..............  ..............  ..............
  L2390  A                               Offset knee joint each.........  ..............  ..............  ..............  ..............  ..............
  L2395  A                               Offset knee joint heavy duty...  ..............  ..............  ..............  ..............  ..............
  L2397  A                               Suspension sleeve lower ext....  ..............  ..............  ..............  ..............  ..............
  L2405  A                               Knee joint drop lock ea jnt....  ..............  ..............  ..............  ..............  ..............
  L2415  A                               Knee joint cam lock each joi...  ..............  ..............  ..............  ..............  ..............
  L2425  A                               Knee disc/dial lock/adj flex...  ..............  ..............  ..............  ..............  ..............
  L2430  A                               Knee jnt ratchet lock ea jnt...  ..............  ..............  ..............  ..............  ..............
  L2435  A                               Knee joint polycentric joint...  ..............  ..............  ..............  ..............  ..............
  L2492  A                               Knee lift loop drop lock rin...  ..............  ..............  ..............  ..............  ..............
  L2500  A                               Thi/glut/ischia wgt bearing....  ..............  ..............  ..............  ..............  ..............
  L2510  A                               Th/wght bear quad-lat brim m...  ..............  ..............  ..............  ..............  ..............
  L2520  A                               Th/wght bear quad-lat brim c...  ..............  ..............  ..............  ..............  ..............
  L2525  A                               Th/wght bear nar m-l brim mo...  ..............  ..............  ..............  ..............  ..............
  L2526  A                               Th/wght bear nar m-l brim cu...  ..............  ..............  ..............  ..............  ..............
  L2530  A                               Thigh/wght bear lacer non-mo...  ..............  ..............  ..............  ..............  ..............
  L2540  A                               Thigh/wght bear lacer molded...  ..............  ..............  ..............  ..............  ..............
  L2550  A                               Thigh/wght bear high roll cu...  ..............  ..............  ..............  ..............  ..............
  L2570  A                               Hip clevis type 2 posit jnt....  ..............  ..............  ..............  ..............  ..............
  L2580  A                               Pelvic control pelvic sling....  ..............  ..............  ..............  ..............  ..............
  L2600  A                               Hip clevis/thrust bearing fr...  ..............  ..............  ..............  ..............  ..............
  L2610  A                               Hip clevis/thrust bearing lo...  ..............  ..............  ..............  ..............  ..............
  L2620  A                               Pelvic control hip heavy dut...  ..............  ..............  ..............  ..............  ..............
  L2622  A                               Hip joint adjustable flexion...  ..............  ..............  ..............  ..............  ..............
  L2624  A                               Hip adj flex ext abduct cont...  ..............  ..............  ..............  ..............  ..............
  L2627  A                               Plastic mold recipro hip & c...  ..............  ..............  ..............  ..............  ..............
  L2628  A                               Metal frame recipro hip & ca...  ..............  ..............  ..............  ..............  ..............
  L2630  A                               Pelvic control band & belt u...  ..............  ..............  ..............  ..............  ..............
  L2640  A                               Pelvic control band & belt b...  ..............  ..............  ..............  ..............  ..............

[[Page 18695]]

 
  L2650  A                               Pelv & thor control gluteal....  ..............  ..............  ..............  ..............  ..............
  L2660  A                               Thoracic control thoracic ba...  ..............  ..............  ..............  ..............  ..............
  L2670  A                               Thorac cont paraspinal uprig...  ..............  ..............  ..............  ..............  ..............
  L2680  A                               Thorac cont lat support upri...  ..............  ..............  ..............  ..............  ..............
  L2750  A                               Plating chrome/nickel pr bar...  ..............  ..............  ..............  ..............  ..............
  L2755  A                               Carbon graphite lamination.....  ..............  ..............  ..............  ..............  ..............
  L2760  A                               Extension per extension per....  ..............  ..............  ..............  ..............  ..............
  L2770  A                               Low ext orthosis per bar/jnt...  ..............  ..............  ..............  ..............  ..............
  L2780  A                               Non-corrosive finish...........  ..............  ..............  ..............  ..............  ..............
  L2785  A                               Drop lock retainer each........  ..............  ..............  ..............  ..............  ..............
  L2795  A                               Knee control full kneecap......  ..............  ..............  ..............  ..............  ..............
  L2800  A                               Knee cap medial or lateral p...  ..............  ..............  ..............  ..............  ..............
  L2810  A                               Knee control condylar pad......  ..............  ..............  ..............  ..............  ..............
  L2820  A                               Soft interface below knee se...  ..............  ..............  ..............  ..............  ..............
  L2830  A                               Soft interface above knee se...  ..............  ..............  ..............  ..............  ..............
  L2840  A                               Tibial length sock fx or equ...  ..............  ..............  ..............  ..............  ..............
  L2850  A                               Femoral lgth sock fx or equa...  ..............  ..............  ..............  ..............  ..............
  L2860  A                               Torsion mechanism knee/ankle...  ..............  ..............  ..............  ..............  ..............
  L2999  A                               Lower extremity orthosis NOS...  ..............  ..............  ..............  ..............  ..............
  L3000  A                               Ft insert ucb berkeley shell...  ..............  ..............  ..............  ..............  ..............
  L3001  A                               Foot insert remov molded spe...  ..............  ..............  ..............  ..............  ..............
  L3002  A                               Foot insert plastazote or eq...  ..............  ..............  ..............  ..............  ..............
  L3003  A                               Foot insert silicone gel eac...  ..............  ..............  ..............  ..............  ..............
  L3010  A                               Foot longitudinal arch suppo...  ..............  ..............  ..............  ..............  ..............
  L3020  A                               Foot longitud/metatarsal sup...  ..............  ..............  ..............  ..............  ..............
  L3030  A                               Foot arch support remov prem...  ..............  ..............  ..............  ..............  ..............
  L3040  A                               Ft arch suprt premold longit...  ..............  ..............  ..............  ..............  ..............
  L3050  A                               Foot arch supp premold metat...  ..............  ..............  ..............  ..............  ..............
  L3060  A                               Foot arch supp longitud/meta...  ..............  ..............  ..............  ..............  ..............
  L3070  A                               Arch suprt att to sho longit...  ..............  ..............  ..............  ..............  ..............
  L3080  A                               Arch supp att to shoe metata...  ..............  ..............  ..............  ..............  ..............
  L3090  A                               Arch supp att to shoe long/m...  ..............  ..............  ..............  ..............  ..............
  L3100  A                               Hallus-valgus nght dynamic s...  ..............  ..............  ..............  ..............  ..............
  L3140  A                               Abduction rotation bar shoe....  ..............  ..............  ..............  ..............  ..............
  L3150  A                               Abduct rotation bar w/o shoe...  ..............  ..............  ..............  ..............  ..............
  L3160  A                               Shoe styled positioning dev....  ..............  ..............  ..............  ..............  ..............
  L3170  A                               Foot plastic heel stabilizer...  ..............  ..............  ..............  ..............  ..............
  L3201  A                               Oxford w supinat/pronat inf....  ..............  ..............  ..............  ..............  ..............
  L3202  A                               Oxford w/supinat/pronator c....  ..............  ..............  ..............  ..............  ..............
  L3203  A                               Oxford w/supinator/pronator....  ..............  ..............  ..............  ..............  ..............
  L3204  A                               Hightop w/supp/pronator inf....  ..............  ..............  ..............  ..............  ..............
  L3206  A                               Hightop w/supp/pronator chi....  ..............  ..............  ..............  ..............  ..............
  L3207  A                               Hightop w/supp/pronator jun....  ..............  ..............  ..............  ..............  ..............
  L3208  A                               Surgical boot each infant......  ..............  ..............  ..............  ..............  ..............
  L3209  A                               Surgical boot each child.......  ..............  ..............  ..............  ..............  ..............
  L3211  A                               Surgical boot each junior......  ..............  ..............  ..............  ..............  ..............
  L3212  A                               Benesch boot pair infant.......  ..............  ..............  ..............  ..............  ..............
  L3213  A                               Benesch boot pair child........  ..............  ..............  ..............  ..............  ..............
  L3214  A                               Benesch boot pair junior.......  ..............  ..............  ..............  ..............  ..............
  L3215  A                               Orthopedic ftwear ladies oxf...  ..............  ..............  ..............  ..............  ..............
  L3216  A                               Orthoped ladies shoes dpth i...  ..............  ..............  ..............  ..............  ..............
  L3217  A                               Ladies shoes hightop depth i...  ..............  ..............  ..............  ..............  ..............
  L3218  A                               Ladies surgical boot each......  ..............  ..............  ..............  ..............  ..............
  L3219  A                               Orthopedic mens shoes oxford...  ..............  ..............  ..............  ..............  ..............
  L3221  A                               Orthopedic mens shoes dpth i...  ..............  ..............  ..............  ..............  ..............
  L3222  A                               Mens shoes hightop depth inl...  ..............  ..............  ..............  ..............  ..............
  L3223  A                               Mens surgical boot each........  ..............  ..............  ..............  ..............  ..............
  L3224  A                               Woman's shoe oxford brace......  ..............  ..............  ..............  ..............  ..............
  L3225  A                               Man's shoe oxford brace........  ..............  ..............  ..............  ..............  ..............
  L3230  A                               Custom shoes depth inlay.......  ..............  ..............  ..............  ..............  ..............
  L3250  A                               Custom mold shoe remov prost...  ..............  ..............  ..............  ..............  ..............
  L3251  A                               Shoe molded to pt silicone s...  ..............  ..............  ..............  ..............  ..............
  L3252  A                               Shoe molded plastazote cust....  ..............  ..............  ..............  ..............  ..............
  L3253  A                               Shoe molded plastazote cust....  ..............  ..............  ..............  ..............  ..............
  L3254  A                               Orth foot non-stndard size/w...  ..............  ..............  ..............  ..............  ..............
  L3255  A                               Orth foot non-standard size/...  ..............  ..............  ..............  ..............  ..............
  L3257  A                               Orth foot add charge split s...  ..............  ..............  ..............  ..............  ..............
  L3260  A                               Ambulatory surgical boot eac...  ..............  ..............  ..............  ..............  ..............
  L3265  A                               Plastazote sandal each.........  ..............  ..............  ..............  ..............  ..............
  L3300  A                               Sho lift taper to metatarsal...  ..............  ..............  ..............  ..............  ..............
  L3310  A                               Shoe lift elev heel/sole neo...  ..............  ..............  ..............  ..............  ..............
  L3320  A                               Shoe lift elev heel/sole cor...  ..............  ..............  ..............  ..............  ..............
  L3330  A                               Lifts elevation metal extens...  ..............  ..............  ..............  ..............  ..............

[[Page 18696]]

 
  L3332  A                               Shoe lifts tapered to one-ha...  ..............  ..............  ..............  ..............  ..............
  L3334  A                               Shoe lifts elevation heel/i....  ..............  ..............  ..............  ..............  ..............
  L3340  A                               Shoe wedge sach................  ..............  ..............  ..............  ..............  ..............
  L3350  A                               Shoe heel wedge................  ..............  ..............  ..............  ..............  ..............
  L3360  A                               Shoe sole wedge outside sole...  ..............  ..............  ..............  ..............  ..............
  L3370  A                               Shoe sole wedge between sole...  ..............  ..............  ..............  ..............  ..............
  L3380  A                               Shoe clubfoot wedge............  ..............  ..............  ..............  ..............  ..............
  L3390  A                               Shoe outflare wedge............  ..............  ..............  ..............  ..............  ..............
  L3400  A                               Shoe metatarsal bar wedge ro...  ..............  ..............  ..............  ..............  ..............
  L3410  A                               Shoe metatarsal bar between....  ..............  ..............  ..............  ..............  ..............
  L3420  A                               Full sole/heel wedge btween....  ..............  ..............  ..............  ..............  ..............
  L3430  A                               Sho heel count plast reinfor...  ..............  ..............  ..............  ..............  ..............
  L3440  A                               Heel leather reinforced........  ..............  ..............  ..............  ..............  ..............
  L3450  A                               Shoe heel sach cushion type....  ..............  ..............  ..............  ..............  ..............
  L3455  A                               Shoe heel new leather standa...  ..............  ..............  ..............  ..............  ..............
  L3460  A                               Shoe heel new rubber standar...  ..............  ..............  ..............  ..............  ..............
  L3465  A                               Shoe heel thomas with wedge....  ..............  ..............  ..............  ..............  ..............
  L3470  A                               Shoe heel thomas extend to b...  ..............  ..............  ..............  ..............  ..............
  L3480  A                               Shoe heel pad & depress for....  ..............  ..............  ..............  ..............  ..............
  L3485  A                               Shoe heel pad removable for....  ..............  ..............  ..............  ..............  ..............
  L3500  A                               Ortho shoe add leather insol...  ..............  ..............  ..............  ..............  ..............
  L3510  A                               Orthopedic shoe add rub insl...  ..............  ..............  ..............  ..............  ..............
  L3520  A                               O shoe add felt w leath insl...  ..............  ..............  ..............  ..............  ..............
  L3530  A                               Ortho shoe add half sole.......  ..............  ..............  ..............  ..............  ..............
  L3540  A                               Ortho shoe add full sole.......  ..............  ..............  ..............  ..............  ..............
  L3550  A                               O shoe add standard toe tap....  ..............  ..............  ..............  ..............  ..............
  L3560  A                               O shoe add horseshoe toe tap...  ..............  ..............  ..............  ..............  ..............
  L3570  A                               O shoe add instep extension....  ..............  ..............  ..............  ..............  ..............
  L3580  A                               O shoe add instep velcro clo...  ..............  ..............  ..............  ..............  ..............
  L3590  A                               O shoe convert to sof counte...  ..............  ..............  ..............  ..............  ..............
  L3595  A                               Ortho shoe add march bar.......  ..............  ..............  ..............  ..............  ..............
  L3600  A                               Trans shoe calip plate exist...  ..............  ..............  ..............  ..............  ..............
  L3610  A                               Trans shoe caliper plate new...  ..............  ..............  ..............  ..............  ..............
  L3620  A                               Trans shoe solid stirrup exi...  ..............  ..............  ..............  ..............  ..............
  L3630  A                               Trans shoe solid stirrup new...  ..............  ..............  ..............  ..............  ..............
  L3640  A                               Shoe dennis browne splint bo...  ..............  ..............  ..............  ..............  ..............
  L3649  A                               Orthopedic shoe modifica NOS...  ..............  ..............  ..............  ..............  ..............
  L3650  A                               Shlder fig 8 abduct restrain...  ..............  ..............  ..............  ..............  ..............
  L3660  A                               Abduct restrainer canvas & web.  ..............  ..............  ..............  ..............  ..............
  L3670  A                               Acromio/clavicular canvas & we.  ..............  ..............  ..............  ..............  ..............
  L3675  A                               Canvas vest SO.................  ..............  ..............  ..............  ..............  ..............
  L3700  A                               Elbow orthoses elas w stays....  ..............  ..............  ..............  ..............  ..............
  L3710  A                               Elbow elastic with metal joi...  ..............  ..............  ..............  ..............  ..............
  L3720  A                               Forearm/arm cuffs free motio...  ..............  ..............  ..............  ..............  ..............
  L3730  A                               Forearm/arm cuffs ext/flex a...  ..............  ..............  ..............  ..............  ..............
  L3740  A                               Cuffs adj lock w/active con....  ..............  ..............  ..............  ..............  ..............
  L3800  A                               Whfo short opponen no attach...  ..............  ..............  ..............  ..............  ..............
  L3805  A                               Whfo long opponens no attach...  ..............  ..............  ..............  ..............  ..............
  L3807  A                               Whfo w inflatable airchamber...  ..............  ..............  ..............  ..............  ..............
  L3810  A                               Whfo thumb abduction bar.......  ..............  ..............  ..............  ..............  ..............
  L3815  A                               Whfo second m.p. abduction a...  ..............  ..............  ..............  ..............  ..............
  L3820  A                               Whfo ip ext asst w/mp ext s....  ..............  ..............  ..............  ..............  ..............
  L3825  A                               Whfo m.p. extension stop.......  ..............  ..............  ..............  ..............  ..............
  L3830  A                               Whfo m.p. extension assist.....  ..............  ..............  ..............  ..............  ..............
  L3835  A                               Whfo m.p. spring extension a...  ..............  ..............  ..............  ..............  ..............
  L3840  A                               Whfo spring swivel thumb.......  ..............  ..............  ..............  ..............  ..............
  L3845  A                               Whfo thumb ip ext ass w/mp.....  ..............  ..............  ..............  ..............  ..............
  L3850  A                               Action wrist w/dorsiflex as....  ..............  ..............  ..............  ..............  ..............
  L3855  A                               Whfo adj m.p. flexion contro...  ..............  ..............  ..............  ..............  ..............
  L3860  A                               Whfo adj m.p. flex ctrl & i....  ..............  ..............  ..............  ..............  ..............
  L3890  A                               Torsion mechanism wrist/elbo...  ..............  ..............  ..............  ..............  ..............
  L3900  A                               Hinge extension/flex wrist/f...  ..............  ..............  ..............  ..............  ..............
  L3901  A                               Hinge ext/flex wrist finger....  ..............  ..............  ..............  ..............  ..............
  L3902  A                               Whfo ext power compress gas....  ..............  ..............  ..............  ..............  ..............
  L3904  A                               Whfo electric custom fitted....  ..............  ..............  ..............  ..............  ..............
  L3906  A                               Wrist gauntlet molded to pt....  ..............  ..............  ..............  ..............  ..............
  L3907  A                               Whfo wrst gauntlt thmb spica...  ..............  ..............  ..............  ..............  ..............
  L3908  A                               Wrist cock-up non-molded.......  ..............  ..............  ..............  ..............  ..............
  L3910  A                               Whfo swanson design............  ..............  ..............  ..............  ..............  ..............
  L3912  A                               Flex glove w/elastic finger....  ..............  ..............  ..............  ..............  ..............
  L3914  A                               WHO wrist extension cock-up....  ..............  ..............  ..............  ..............  ..............
  L3916  A                               Whfo wrist extens w/outrigg....  ..............  ..............  ..............  ..............  ..............
  L3918  A                               HFO knuckle bender.............  ..............  ..............  ..............  ..............  ..............

[[Page 18697]]

 
  L3920  A                               Knuckle bender with outrigge...  ..............  ..............  ..............  ..............  ..............
  L3922  A                               Knuckle bend 2 seg to flex j...  ..............  ..............  ..............  ..............  ..............
  L3924  A                               Oppenheimer....................  ..............  ..............  ..............  ..............  ..............
  L3926  A                               Thomas suspension..............  ..............  ..............  ..............  ..............  ..............
  L3928  A                               Finger extension w/clock sp....  ..............  ..............  ..............  ..............  ..............
  L3930  A                               Finger extension with wrist....  ..............  ..............  ..............  ..............  ..............
  L3932  A                               Safety pin spring wire.........  ..............  ..............  ..............  ..............  ..............
  L3934  A                               Safety pin modified............  ..............  ..............  ..............  ..............  ..............
  L3936  A                               Palmer.........................  ..............  ..............  ..............  ..............  ..............
  L3938  A                               Dorsal wrist...................  ..............  ..............  ..............  ..............  ..............
  L3940  A                               Dorsal wrist w/outrigger at....  ..............  ..............  ..............  ..............  ..............
  L3942  A                               Reverse knuckle bender.........  ..............  ..............  ..............  ..............  ..............
  L3944  A                               Reverse knuckle bend w/outr....  ..............  ..............  ..............  ..............  ..............
  L3946  A                               HFO composite elastic..........  ..............  ..............  ..............  ..............  ..............
  L3948  A                               Finger knuckle bender..........  ..............  ..............  ..............  ..............  ..............
  L3950  A                               Oppenheimer w/knuckle bend.....  ..............  ..............  ..............  ..............  ..............
  L3952  A                               Oppenheimer w/rev knuckle 2....  ..............  ..............  ..............  ..............  ..............
  L3954  A                               Spreading hand.................  ..............  ..............  ..............  ..............  ..............
  L3956  A                               Add joint upper ext orthosis...  ..............  ..............  ..............  ..............  ..............
  L3960  A                               Sewho airplan desig abdu pos...  ..............  ..............  ..............  ..............  ..............
  L3962  A                               Sewho erbs palsey design abd...  ..............  ..............  ..............  ..............  ..............
  L3963  A                               Molded w/articulating elbow....  ..............  ..............  ..............  ..............  ..............
  L3964  A                               Seo mobile arm sup att to wc...  ..............  ..............  ..............  ..............  ..............
  L3965  A                               Arm supp att to wc rancho ty...  ..............  ..............  ..............  ..............  ..............
  L3966  A                               Mobile arm supports reclinin...  ..............  ..............  ..............  ..............  ..............
  L3968  A                               Friction dampening arm supp....  ..............  ..............  ..............  ..............  ..............
  L3969  A                               Monosuspension arm/hand supp...  ..............  ..............  ..............  ..............  ..............
  L3970  A                               Elevat proximal arm support....  ..............  ..............  ..............  ..............  ..............
  L3972  A                               Offset/lat rocker arm w/ela....  ..............  ..............  ..............  ..............  ..............
  L3974  A                               Mobile arm support supinator...  ..............  ..............  ..............  ..............  ..............
  L3980  A                               Upp ext fx orthosis humeral....  ..............  ..............  ..............  ..............  ..............
  L3982  A                               Upper ext fx orthosis rad/ul...  ..............  ..............  ..............  ..............  ..............
  L3984  A                               Upper ext fx orthosis wrist....  ..............  ..............  ..............  ..............  ..............
  L3985  A                               Forearm hand fx orth w/wr h....  ..............  ..............  ..............  ..............  ..............
  L3986  A                               Humeral rad/ulna wrist fx or...  ..............  ..............  ..............  ..............  ..............
  L3995  A                               Sock fracture or equal each....  ..............  ..............  ..............  ..............  ..............
  L3999  A                               Upper limb orthosis NOS........  ..............  ..............  ..............  ..............  ..............
  L4000  A                               Repl girdle milwaukee orth.....  ..............  ..............  ..............  ..............  ..............
  L4010  A                               Replace trilateral socket br...  ..............  ..............  ..............  ..............  ..............
  L4020  A                               Replace quadlat socket brim....  ..............  ..............  ..............  ..............  ..............
  L4030  A                               Replace socket brim cust fit...  ..............  ..............  ..............  ..............  ..............
  L4040  A                               Replace molded thigh lacer.....  ..............  ..............  ..............  ..............  ..............
  L4045  A                               Replace non-molded thigh lac...  ..............  ..............  ..............  ..............  ..............
  L4050  A                               Replace molded calf lacer......  ..............  ..............  ..............  ..............  ..............
  L4055  A                               Replace non-molded calf lace...  ..............  ..............  ..............  ..............  ..............
  L4060  A                               Replace high roll cuff.........  ..............  ..............  ..............  ..............  ..............
  L4070  A                               Replace prox & dist upright....  ..............  ..............  ..............  ..............  ..............
  L4080  A                               Repl met band kafo-afo prox....  ..............  ..............  ..............  ..............  ..............
  L4090  A                               Repl met band kafo-afo calf/...  ..............  ..............  ..............  ..............  ..............
  L4100  A                               Repl leath cuff kafo prox th...  ..............  ..............  ..............  ..............  ..............
  L4110  A                               Repl leath cuff kafo-afo cal...  ..............  ..............  ..............  ..............  ..............
  L4130  A                               Replace pretibial shell........  ..............  ..............  ..............  ..............  ..............
  L4205  A                               Ortho dvc repair per 15 min....  ..............  ..............  ..............  ..............  ..............
  L4210  A                               Orth dev repair/repl minor p...  ..............  ..............  ..............  ..............  ..............
  L4350  A                               Pneumatic ankle cntrl splint...  ..............  ..............  ..............  ..............  ..............
  L4360  A                               Pneumatic walking splint.......  ..............  ..............  ..............  ..............  ..............
  L4370  A                               Pneumatic full leg splint......  ..............  ..............  ..............  ..............  ..............
  L4380  A                               Pneumatic knee splint..........  ..............  ..............  ..............  ..............  ..............
  L4392  A                               Replace AFO soft interface.....  ..............  ..............  ..............  ..............  ..............
  L4394  A                               Replace foot drop spint........  ..............  ..............  ..............  ..............  ..............
  L4396  A                               Static AFO.....................  ..............  ..............  ..............  ..............  ..............
  L4398  A                               Foot drop splint recumbent.....  ..............  ..............  ..............  ..............  ..............
  L5000  A                               Sho insert w arch toe filler...  ..............  ..............  ..............  ..............  ..............
  L5010  A                               Mold socket ank hgt w/toe f....  ..............  ..............  ..............  ..............  ..............
  L5020  A                               Tibial tubercle hgt w/toe f....  ..............  ..............  ..............  ..............  ..............
  L5050  A                               Ank symes mold sckt sach ft....  ..............  ..............  ..............  ..............  ..............
  L5060  A                               Symes met fr leath socket ar...  ..............  ..............  ..............  ..............  ..............
  L5100  A                               Molded socket shin sach foot...  ..............  ..............  ..............  ..............  ..............
  L5105  A                               Plast socket jts/thgh lacer....  ..............  ..............  ..............  ..............  ..............
  L5150  A                               Mold sckt ext knee shin sach...  ..............  ..............  ..............  ..............  ..............
  L5160  A                               Mold socket bent knee shin s...  ..............  ..............  ..............  ..............  ..............
  L5200  A                               Kne sing axis fric shin sach...  ..............  ..............  ..............  ..............  ..............
  L5210  A                               No knee/ankle joints w/ft b....  ..............  ..............  ..............  ..............  ..............

[[Page 18698]]

 
  L5220  A                               No knee joint with artic ali...  ..............  ..............  ..............  ..............  ..............
  L5230  A                               Fem focal defic constant fri...  ..............  ..............  ..............  ..............  ..............
  L5250  A                               Hip canad sing axi cons fric...  ..............  ..............  ..............  ..............  ..............
  L5270  A                               Tilt table locking hip sing....  ..............  ..............  ..............  ..............  ..............
  L5280  A                               Hemipelvect canad sing axis....  ..............  ..............  ..............  ..............  ..............
  L5300  A                               Bk sach soft cover & finish....  ..............  ..............  ..............  ..............  ..............
  L5310  A                               Knee disart sach soft cv/fin...  ..............  ..............  ..............  ..............  ..............
  L5320  A                               Ak open end sach soft cv/fin...  ..............  ..............  ..............  ..............  ..............
  L5330  A                               Hip canadian sach sft cv/fin...  ..............  ..............  ..............  ..............  ..............
  L5340  A                               Hemipelvectomy canad cv/fin....  ..............  ..............  ..............  ..............  ..............
  L5400  A                               Postop dress & 1 cast chg bk...  ..............  ..............  ..............  ..............  ..............
  L5410  A                               Postop dsg bk ea add cast ch...  ..............  ..............  ..............  ..............  ..............
  L5420  A                               Postop dsg & 1 cast chg ak/d...  ..............  ..............  ..............  ..............  ..............
  L5430  A                               Postop dsg ak ea add cast ch...  ..............  ..............  ..............  ..............  ..............
  L5450  A                               Postop app non-wgt bear dsg....  ..............  ..............  ..............  ..............  ..............
  L5460  A                               Postop app non-wgt bear dsg....  ..............  ..............  ..............  ..............  ..............
  L5500  A                               Init bk ptb plaster direct.....  ..............  ..............  ..............  ..............  ..............
  L5505  A                               Init ak ischal plstr direct....  ..............  ..............  ..............  ..............  ..............
  L5510  A                               Prep BK ptb plaster molded.....  ..............  ..............  ..............  ..............  ..............
  L5520  A                               Perp BK ptb thermopls direct...  ..............  ..............  ..............  ..............  ..............
  L5530  A                               Prep BK ptb thermopls molded...  ..............  ..............  ..............  ..............  ..............
  L5535  A                               Prep BK ptb open end socket....  ..............  ..............  ..............  ..............  ..............
  L5540  A                               Prep BK ptb laminated socket...  ..............  ..............  ..............  ..............  ..............
  L5560  A                               Prep AK ischial plast molded...  ..............  ..............  ..............  ..............  ..............
  L5570  A                               Prep AK ischial direct form....  ..............  ..............  ..............  ..............  ..............
  L5580  A                               Prep AK ischial thermo mold....  ..............  ..............  ..............  ..............  ..............
  L5585  A                               Prep AK ischial open end.......  ..............  ..............  ..............  ..............  ..............
  L5590  A                               Prep AK ischial laminated......  ..............  ..............  ..............  ..............  ..............
  L5595  A                               Hip disartic sach thermopls....  ..............  ..............  ..............  ..............  ..............
  L5600  A                               Hip disart sach laminat mold...  ..............  ..............  ..............  ..............  ..............
  L5610  A                               Above knee hydracadence........  ..............  ..............  ..............  ..............  ..............
  L5611  A                               Ak 4 bar link w/fric swing.....  ..............  ..............  ..............  ..............  ..............
  L5613  A                               Ak 4 bar ling w/hydraul swig...  ..............  ..............  ..............  ..............  ..............
  L5614  A                               4-bar link above knee w/swng...  ..............  ..............  ..............  ..............  ..............
  L5616  A                               Ak univ multiplex sys frict....  ..............  ..............  ..............  ..............  ..............
  L5617  A                               AK/BK self-aligning unit ea....  ..............  ..............  ..............  ..............  ..............
  L5618  A                               Test socket symes..............  ..............  ..............  ..............  ..............  ..............
  L5620  A                               Test socket below knee.........  ..............  ..............  ..............  ..............  ..............
  L5622  A                               Test socket knee disarticula...  ..............  ..............  ..............  ..............  ..............
  L5624  A                               Test socket above knee.........  ..............  ..............  ..............  ..............  ..............
  L5626  A                               Test socket hip disarticulat...  ..............  ..............  ..............  ..............  ..............
  L5628  A                               Test socket hemipelvectomy.....  ..............  ..............  ..............  ..............  ..............
  L5629  A                               Below knee acrylic socket......  ..............  ..............  ..............  ..............  ..............
  L5630  A                               Syme typ expandabl wall sckt...  ..............  ..............  ..............  ..............  ..............
  L5631  A                               Ak/knee disartic acrylic soc...  ..............  ..............  ..............  ..............  ..............
  L5632  A                               Symes type ptb brim design s...  ..............  ..............  ..............  ..............  ..............
  L5634  A                               Symes type poster opening so...  ..............  ..............  ..............  ..............  ..............
  L5636  A                               Symes type medial opening so...  ..............  ..............  ..............  ..............  ..............
  L5637  A                               Below knee total contact.......  ..............  ..............  ..............  ..............  ..............
  L5638  A                               Below knee leather socket......  ..............  ..............  ..............  ..............  ..............
  L5639  A                               Below knee wood socket.........  ..............  ..............  ..............  ..............  ..............
  L5640  A                               Knee disarticulat leather so...  ..............  ..............  ..............  ..............  ..............
  L5642  A                               Above knee leather socket......  ..............  ..............  ..............  ..............  ..............
  L5643  A                               Hip flex inner socket ext fr...  ..............  ..............  ..............  ..............  ..............
  L5644  A                               Above knee wood socket.........  ..............  ..............  ..............  ..............  ..............
  L5645  A                               Ak flexibl inner socket ext....  ..............  ..............  ..............  ..............  ..............
  L5646  A                               Below knee air cushion socke...  ..............  ..............  ..............  ..............  ..............
  L5647  A                               Below knee suction socket......  ..............  ..............  ..............  ..............  ..............
  L5648  A                               Above knee air cushion socke...  ..............  ..............  ..............  ..............  ..............
  L5649  A                               Isch containmt/narrow m-l so...  ..............  ..............  ..............  ..............  ..............
  L5650  A                               Tot contact ak/knee disart s...  ..............  ..............  ..............  ..............  ..............
  L5651  A                               Ak flex inner socket ext fra...  ..............  ..............  ..............  ..............  ..............
  L5652  A                               Suction susp ak/knee disart....  ..............  ..............  ..............  ..............  ..............
  L5653  A                               Knee disart expand wall sock...  ..............  ..............  ..............  ..............  ..............
  L5654  A                               Socket insert symes............  ..............  ..............  ..............  ..............  ..............
  L5655  A                               Socket insert below knee.......  ..............  ..............  ..............  ..............  ..............
  L5656  A                               Socket insert knee articulat...  ..............  ..............  ..............  ..............  ..............
  L5658  A                               Socket insert above knee.......  ..............  ..............  ..............  ..............  ..............
  L5660  A                               Sock insrt syme silicone gel...  ..............  ..............  ..............  ..............  ..............
  L5661  A                               Multi-durometer symes..........  ..............  ..............  ..............  ..............  ..............
  L5662  A                               Socket insert bk silicone ge...  ..............  ..............  ..............  ..............  ..............
  L5663  A                               Sock knee disartic silicone....  ..............  ..............  ..............  ..............  ..............
  L5664  A                               Socket insert ak silicone ge...  ..............  ..............  ..............  ..............  ..............

[[Page 18699]]

 
  L5665  A                               Multi-durometer below knee.....  ..............  ..............  ..............  ..............  ..............
  L5666  A                               Below knee cuff suspension.....  ..............  ..............  ..............  ..............  ..............
  L5667  A                               Socket insert w lock lower.....  ..............  ..............  ..............  ..............  ..............
  L5668  A                               Socket insert w/o lock lower...  ..............  ..............  ..............  ..............  ..............
  L5669  A                               Below knee socket w/o lock.....  ..............  ..............  ..............  ..............  ..............
  L5670  A                               Bk molded supracondylar susp...  ..............  ..............  ..............  ..............  ..............
  L5672  A                               Bk removable medial brim sus...  ..............  ..............  ..............  ..............  ..............
  L5674  A                               Bk latex sleeve suspension/e...  ..............  ..............  ..............  ..............  ..............
  L5675  A                               Bk latex sleeve susp/eq hvy....  ..............  ..............  ..............  ..............  ..............
  L5676  A                               Bk knee joints single axis p...  ..............  ..............  ..............  ..............  ..............
  L5677  A                               Bk knee joints polycentric p...  ..............  ..............  ..............  ..............  ..............
  L5678  A                               Bk joint covers pair...........  ..............  ..............  ..............  ..............  ..............
  L5680  A                               Bk thigh lacer non-molded......  ..............  ..............  ..............  ..............  ..............
  L5682  A                               Bk thigh lacer glut/ischia m...  ..............  ..............  ..............  ..............  ..............
  L5684  A                               Bk fork strap..................  ..............  ..............  ..............  ..............  ..............
  L5686  A                               Bk back check..................  ..............  ..............  ..............  ..............  ..............
  L5688  A                               Bk waist belt webbing..........  ..............  ..............  ..............  ..............  ..............
  L5690  A                               Bk waist belt padded and lin...  ..............  ..............  ..............  ..............  ..............
  L5692  A                               Ak pelvic control belt light...  ..............  ..............  ..............  ..............  ..............
  L5694  A                               Ak pelvic control belt pad/l...  ..............  ..............  ..............  ..............  ..............
  L5695  A                               Ak sleeve susp neoprene/equa...  ..............  ..............  ..............  ..............  ..............
  L5696  A                               Ak/knee disartic pelvic join...  ..............  ..............  ..............  ..............  ..............
  L5697  A                               Ak/knee disartic pelvic band...  ..............  ..............  ..............  ..............  ..............
  L5698  A                               Ak/knee disartic silesian ba...  ..............  ..............  ..............  ..............  ..............
  L5699  A                               Shoulder harness...............  ..............  ..............  ..............  ..............  ..............
  L5700  A                               Replace socket below knee......  ..............  ..............  ..............  ..............  ..............
  L5701  A                               Replace socket above knee......  ..............  ..............  ..............  ..............  ..............
  L5702  A                               Replace socket hip.............  ..............  ..............  ..............  ..............  ..............
  L5704  A                               Custom shape covr below knee...  ..............  ..............  ..............  ..............  ..............
  L5705  A                               Custm shape cover above knee...  ..............  ..............  ..............  ..............  ..............
  L5706  A                               Custm shape cvr knee disart....  ..............  ..............  ..............  ..............  ..............
  L5707  A                               Custm shape cover hip disart...  ..............  ..............  ..............  ..............  ..............
  L5710  A                               Kne-shin exo sng axi mnl loc...  ..............  ..............  ..............  ..............  ..............
  L5711  A                               Knee-shin exo mnl lock ultra...  ..............  ..............  ..............  ..............  ..............
  L5712  A                               Knee-shin exo frict swg & st...  ..............  ..............  ..............  ..............  ..............
  L5714  A                               Knee-shin exo variable frict...  ..............  ..............  ..............  ..............  ..............
  L5716  A                               Knee-shin exo mech stance ph...  ..............  ..............  ..............  ..............  ..............
  L5718  A                               Knee-shin exo frct swg & sta...  ..............  ..............  ..............  ..............  ..............
  L5722  A                               Knee-shin pneum swg frct exo...  ..............  ..............  ..............  ..............  ..............
  L5724  A                               Knee-shin exo fluid swing ph...  ..............  ..............  ..............  ..............  ..............
  L5726  A                               Knee-shin ext jnts fld swg e...  ..............  ..............  ..............  ..............  ..............
  L5728  A                               Knee-shin fluid swg & stance...  ..............  ..............  ..............  ..............  ..............
  L5780  A                               Knee-shin pneum/hydra pneum....  ..............  ..............  ..............  ..............  ..............
  L5785  A                               Exoskeletal bk ultralt mater...  ..............  ..............  ..............  ..............  ..............
  L5790  A                               Exoskeletal ak ultra-light m...  ..............  ..............  ..............  ..............  ..............
  L5795  A                               Exoskel hip ultra-light mate...  ..............  ..............  ..............  ..............  ..............
  L5810  A                               Endoskel knee-shin mnl lock....  ..............  ..............  ..............  ..............  ..............
  L5811  A                               Endo knee-shin mnl lck ultra...  ..............  ..............  ..............  ..............  ..............
  L5812  A                               Endo knee-shin frct swg & st...  ..............  ..............  ..............  ..............  ..............
  L5814  A                               Endo knee-shin hydral swg ph...  ..............  ..............  ..............  ..............  ..............
  L5816  A                               Endo knee-shin polyc mch sta...  ..............  ..............  ..............  ..............  ..............
  L5818  A                               Endo knee-shin frct swg & st...  ..............  ..............  ..............  ..............  ..............
  L5822  A                               Endo knee-shin pneum swg frc...  ..............  ..............  ..............  ..............  ..............
  L5824  A                               Endo knee-shin fluid swing p...  ..............  ..............  ..............  ..............  ..............
  L5826  A                               Miniature knee joint...........  ..............  ..............  ..............  ..............  ..............
  L5828  A                               Endo knee-shin fluid swg/sta...  ..............  ..............  ..............  ..............  ..............
  L5830  A                               Endo knee-shin pneum/swg pha...  ..............  ..............  ..............  ..............  ..............
  L5840  A                               Multi-axial knee/shin system...  ..............  ..............  ..............  ..............  ..............
  L5845  A                               Knee-shin sys stance flexion...  ..............  ..............  ..............  ..............  ..............
  L5846  A                               Knee-shin sys microprocessor...  ..............  ..............  ..............  ..............  ..............
  L5850  A                               Endo ak/hip knee extens assi...  ..............  ..............  ..............  ..............  ..............
  L5855  A                               Mech hip extension assist......  ..............  ..............  ..............  ..............  ..............
  L5910  A                               Endo below knee alignable sy...  ..............  ..............  ..............  ..............  ..............
  L5920  A                               Endo ak/hip alignable system...  ..............  ..............  ..............  ..............  ..............
  L5925  A                               Above knee manual lock.........  ..............  ..............  ..............  ..............  ..............
  L5930  A                               High activity knee frame.......  ..............  ..............  ..............  ..............  ..............
  L5940  A                               Endo bk ultra-light material...  ..............  ..............  ..............  ..............  ..............
  L5950  A                               Endo ak ultra-light material...  ..............  ..............  ..............  ..............  ..............
  L5960  A                               Endo hip ultra-light materia...  ..............  ..............  ..............  ..............  ..............
  L5962  A                               Below knee flex cover system...  ..............  ..............  ..............  ..............  ..............
  L5964  A                               Above knee flex cover system...  ..............  ..............  ..............  ..............  ..............
  L5966  A                               Hip flexible cover system......  ..............  ..............  ..............  ..............  ..............
  L5968  A                               Multiaxial ankle w dorsiflex...  ..............  ..............  ..............  ..............  ..............

[[Page 18700]]

 
  L5970  A                               Foot external keel sach foot...  ..............  ..............  ..............  ..............  ..............
  L5972  A                               Flexible keel foot.............  ..............  ..............  ..............  ..............  ..............
  L5974  A                               Foot single axis ankle/foot....  ..............  ..............  ..............  ..............  ..............
  L5975  A                               Combo ankle/foot prosthesis....  ..............  ..............  ..............  ..............  ..............
  L5976  A                               Energy storing foot............  ..............  ..............  ..............  ..............  ..............
  L5978  A                               Ft prosth multiaxial ankl/ft...  ..............  ..............  ..............  ..............  ..............
  L5979  A                               Multi-axial ankle/ft prosth....  ..............  ..............  ..............  ..............  ..............
  L5980  A                               Flex foot system...............  ..............  ..............  ..............  ..............  ..............
  L5981  A                               Flex-walk sys low ext prosth...  ..............  ..............  ..............  ..............  ..............
  L5982  A                               Exoskeletal axial rotation u...  ..............  ..............  ..............  ..............  ..............
  L5984  A                               Endoskeletal axial rotation....  ..............  ..............  ..............  ..............  ..............
  L5985  A                               Lwr ext dynamic prosth pylon...  ..............  ..............  ..............  ..............  ..............
  L5986  A                               Multi-axial rotation unit......  ..............  ..............  ..............  ..............  ..............
  L5987  A                               Shank ft w vert load pylon.....  ..............  ..............  ..............  ..............  ..............
  L5988  A                               Vertical shock reducing pylo...  ..............  ..............  ..............  ..............  ..............
  L5999  A                               Lowr extremity prosthes NOS....  ..............  ..............  ..............  ..............  ..............
  L6000  A                               Par hand robin-aids thum rem...  ..............  ..............  ..............  ..............  ..............
  L6010  A                               Hand robin-aids little/ring....  ..............  ..............  ..............  ..............  ..............
  L6020  A                               Part hand robin-aids no fing...  ..............  ..............  ..............  ..............  ..............
  L6050  A                               Wrst MLd sck flx hng tri pad...  ..............  ..............  ..............  ..............  ..............
  L6055  A                               Wrst mold sock w/exp interfa...  ..............  ..............  ..............  ..............  ..............
  L6100  A                               Elb mold sock flex hinge pad...  ..............  ..............  ..............  ..............  ..............
  L6110  A                               Elbow mold sock suspension t...  ..............  ..............  ..............  ..............  ..............
  L6120  A                               Elbow mold doub splt soc ste...  ..............  ..............  ..............  ..............  ..............
  L6130  A                               Elbow stump activated lock h...  ..............  ..............  ..............  ..............  ..............
  L6200  A                               Elbow mold outsid lock hinge...  ..............  ..............  ..............  ..............  ..............
  L6205  A                               Elbow molded w/expand inter....  ..............  ..............  ..............  ..............  ..............
  L6250  A                               Elbow inter loc elbow forarm...  ..............  ..............  ..............  ..............  ..............
  L6300  A                               Shlder disart int lock elbow...  ..............  ..............  ..............  ..............  ..............
  L6310  A                               Shoulder passive restor comp...  ..............  ..............  ..............  ..............  ..............
  L6320  A                               Shoulder passive restor cap....  ..............  ..............  ..............  ..............  ..............
  L6350  A                               Thoracic intern lock elbow.....  ..............  ..............  ..............  ..............  ..............
  L6360  A                               Thoracic passive restor comp...  ..............  ..............  ..............  ..............  ..............
  L6370  A                               Thoracic passive restor cap....  ..............  ..............  ..............  ..............  ..............
  L6380  A                               Postop dsg cast chg wrst/elb...  ..............  ..............  ..............  ..............  ..............
  L6382  A                               Postop dsg cast chg elb dis/...  ..............  ..............  ..............  ..............  ..............
  L6384  A                               Postop dsg cast chg shlder/t...  ..............  ..............  ..............  ..............  ..............
  L6386  A                               Postop ea cast chg & realign...  ..............  ..............  ..............  ..............  ..............
  L6388  A                               Postop applicat rigid dsg on...  ..............  ..............  ..............  ..............  ..............
  L6400  A                               Below elbow prosth tiss shap...  ..............  ..............  ..............  ..............  ..............
  L6450  A                               Elb disart prosth tiss shap....  ..............  ..............  ..............  ..............  ..............
  L6500  A                               Above elbow prosth tiss shap...  ..............  ..............  ..............  ..............  ..............
  L6550  A                               Shldr disar prosth tiss shap...  ..............  ..............  ..............  ..............  ..............
  L6570  A                               Scap thorac prosth tiss shap...  ..............  ..............  ..............  ..............  ..............
  L6580  A                               Wrist/elbow bowden cable mol...  ..............  ..............  ..............  ..............  ..............
  L6582  A                               Wrist/elbow bowden cbl dir f...  ..............  ..............  ..............  ..............  ..............
  L6584  A                               Elbow fair lead cable molded...  ..............  ..............  ..............  ..............  ..............
  L6586  A                               Elbow fair lead cable dir fo...  ..............  ..............  ..............  ..............  ..............
  L6588  A                               Shdr fair lead cable molded....  ..............  ..............  ..............  ..............  ..............
  L6590  A                               Shdr fair lead cable direct....  ..............  ..............  ..............  ..............  ..............
  L6600  A                               Polycentric hinge pair.........  ..............  ..............  ..............  ..............  ..............
  L6605  A                               Single pivot hinge pair........  ..............  ..............  ..............  ..............  ..............
  L6610  A                               Flexible metal hinge pair......  ..............  ..............  ..............  ..............  ..............
  L6615  A                               Disconnect locking wrist uni...  ..............  ..............  ..............  ..............  ..............
  L6616  A                               Disconnect insert locking wr...  ..............  ..............  ..............  ..............  ..............
  L6620  A                               Flexion-friction wrist unit....  ..............  ..............  ..............  ..............  ..............
  L6623  A                               Spring-ass rot wrst w/latch....  ..............  ..............  ..............  ..............  ..............
  L6625  A                               Rotation wrst w/cable lock.....  ..............  ..............  ..............  ..............  ..............
  L6628  A                               Quick disconn hook adapter o...  ..............  ..............  ..............  ..............  ..............
  L6629  A                               Lamination collar w/couplin....  ..............  ..............  ..............  ..............  ..............
  L6630  A                               Stainless steel any wrist......  ..............  ..............  ..............  ..............  ..............
  L6632  A                               Latex suspension sleeve each...  ..............  ..............  ..............  ..............  ..............
  L6635  A                               Lift assist for elbow..........  ..............  ..............  ..............  ..............  ..............
  L6637  A                               Nudge control elbow lock.......  ..............  ..............  ..............  ..............  ..............
  L6640  A                               Shoulder abduction joint pai...  ..............  ..............  ..............  ..............  ..............
  L6641  A                               Excursion amplifier pulley t...  ..............  ..............  ..............  ..............  ..............
  L6642  A                               Excursion amplifier lever ty...  ..............  ..............  ..............  ..............  ..............
  L6645  A                               Shoulder flexion-abduction j...  ..............  ..............  ..............  ..............  ..............
  L6650  A                               Shoulder universal joint.......  ..............  ..............  ..............  ..............  ..............
  L6655  A                               Standard control cable extra...  ..............  ..............  ..............  ..............  ..............
  L6660  A                               Heavy duty control cable.......  ..............  ..............  ..............  ..............  ..............
  L6665  A                               Teflon or equal cable lining...  ..............  ..............  ..............  ..............  ..............
  L6670  A                               Hook to hand cable adapter.....  ..............  ..............  ..............  ..............  ..............

[[Page 18701]]

 
  L6672  A                               Harness chest/shlder saddle....  ..............  ..............  ..............  ..............  ..............
  L6675  A                               Harness figure of 8 sing con...  ..............  ..............  ..............  ..............  ..............
  L6676  A                               Harness figure of 8 dual con...  ..............  ..............  ..............  ..............  ..............
  L6680  A                               Test sock wrist disart/bel e...  ..............  ..............  ..............  ..............  ..............
  L6682  A                               Test sock elbw disart/above....  ..............  ..............  ..............  ..............  ..............
  L6684  A                               Test socket shldr disart/tho...  ..............  ..............  ..............  ..............  ..............
  L6686  A                               Suction socket.................  ..............  ..............  ..............  ..............  ..............
  L6687  A                               Frame typ socket bel elbow/w...  ..............  ..............  ..............  ..............  ..............
  L6688  A                               Frame typ sock above elb/dis...  ..............  ..............  ..............  ..............  ..............
  L6689  A                               Frame typ socket shoulder di...  ..............  ..............  ..............  ..............  ..............
  L6690  A                               Frame typ sock interscap-tho...  ..............  ..............  ..............  ..............  ..............
  L6691  A                               Removable insert each..........  ..............  ..............  ..............  ..............  ..............
  L6692  A                               Silicone gel insert or equal...  ..............  ..............  ..............  ..............  ..............
  L6693  A                               Lockingelbow forearm cntrbal...  ..............  ..............  ..............  ..............  ..............
  L6700  A                               Terminal device model #3.......  ..............  ..............  ..............  ..............  ..............
  L6705  A                               Terminal device model #5.......  ..............  ..............  ..............  ..............  ..............
  L6710  A                               Terminal device model #5x......  ..............  ..............  ..............  ..............  ..............
  L6715  A                               Terminal device model #5xa.....  ..............  ..............  ..............  ..............  ..............
  L6720  A                               Terminal device model #6.......  ..............  ..............  ..............  ..............  ..............
  L6725  A                               Terminal device model #7.......  ..............  ..............  ..............  ..............  ..............
  L6730  A                               Terminal device model #7lo.....  ..............  ..............  ..............  ..............  ..............
  L6735  A                               Terminal device model #8.......  ..............  ..............  ..............  ..............  ..............
  L6740  A                               Terminal device model #8x......  ..............  ..............  ..............  ..............  ..............
  L6745  A                               Terminal device model #88x.....  ..............  ..............  ..............  ..............  ..............
  L6750  A                               Terminal device model #10p.....  ..............  ..............  ..............  ..............  ..............
  L6755  A                               Terminal device model #10x.....  ..............  ..............  ..............  ..............  ..............
  L6765  A                               Terminal device model #12p.....  ..............  ..............  ..............  ..............  ..............
  L6770  A                               Terminal device model #99x.....  ..............  ..............  ..............  ..............  ..............
  L6775  A                               Terminal device model #555.....  ..............  ..............  ..............  ..............  ..............
  L6780  A                               Terminal device model #ss555...  ..............  ..............  ..............  ..............  ..............
  L6790  A                               Hooks-accu hook or equal.......  ..............  ..............  ..............  ..............  ..............
  L6795  A                               Hooks-2 load or equal..........  ..............  ..............  ..............  ..............  ..............
  L6800  A                               Hooks-aprl vc or equal.........  ..............  ..............  ..............  ..............  ..............
  L6805  A                               Modifier wrist flexion unit....  ..............  ..............  ..............  ..............  ..............
  L6806  A                               Trs grip vc or equal...........  ..............  ..............  ..............  ..............  ..............
  L6807  A                               Term device grip 1/2 or equal..  ..............  ..............  ..............  ..............  ..............
  L6808  A                               Term device infant or child....  ..............  ..............  ..............  ..............  ..............
  L6809  A                               Trs super sport passive........  ..............  ..............  ..............  ..............  ..............
  L6810  A                               Pincher tool otto bock or eq...  ..............  ..............  ..............  ..............  ..............
  L6825  A                               Hands dorrance vo..............  ..............  ..............  ..............  ..............  ..............
  L6830  A                               Hand aprl vc...................  ..............  ..............  ..............  ..............  ..............
  L6835  A                               Hand sierra vo.................  ..............  ..............  ..............  ..............  ..............
  L6840  A                               Hand becker imperial...........  ..............  ..............  ..............  ..............  ..............
  L6845  A                               Hand becker lock grip..........  ..............  ..............  ..............  ..............  ..............
  L6850  A                               Term dvc-hand becker plylite...  ..............  ..............  ..............  ..............  ..............
  L6855  A                               Hand robin-aids vo.............  ..............  ..............  ..............  ..............  ..............
  L6860  A                               Hand robin-aids vo soft........  ..............  ..............  ..............  ..............  ..............
  L6865  A                               Hand passive hand..............  ..............  ..............  ..............  ..............  ..............
  L6867  A                               Hand detroit infant hand.......  ..............  ..............  ..............  ..............  ..............
  L6868  A                               Passive inf hand steeper/hos...  ..............  ..............  ..............  ..............  ..............
  L6870  A                               Hand child mitt................  ..............  ..............  ..............  ..............  ..............
  L6872  A                               Hand nyu child hand............  ..............  ..............  ..............  ..............  ..............
  L6873  A                               Hand mech inf steeper or equ...  ..............  ..............  ..............  ..............  ..............
  L6875  A                               Hand bock vc...................  ..............  ..............  ..............  ..............  ..............
  L6880  A                               Hand bock vo...................  ..............  ..............  ..............  ..............  ..............
  L6890  A                               Production glove...............  ..............  ..............  ..............  ..............  ..............
  L6895  A                               Custom glove...................  ..............  ..............  ..............  ..............  ..............
  L6900  A                               Hand restorat thumb/1 finger...  ..............  ..............  ..............  ..............  ..............
  L6905  A                               Hand restoration multiple fi...  ..............  ..............  ..............  ..............  ..............
  L6910  A                               Hand restoration no fingers....  ..............  ..............  ..............  ..............  ..............
  L6915  A                               Hand restoration replacmnt g...  ..............  ..............  ..............  ..............  ..............
  L6920  A                               Wrist disarticul switch ctrl...  ..............  ..............  ..............  ..............  ..............
  L6925  A                               Wrist disart myoelectronic c...  ..............  ..............  ..............  ..............  ..............
  L6930  A                               Below elbow switch control.....  ..............  ..............  ..............  ..............  ..............
  L6935  A                               Below elbow myoelectronic ct...  ..............  ..............  ..............  ..............  ..............
  L6940  A                               Elbow disarticulation switch...  ..............  ..............  ..............  ..............  ..............
  L6945  A                               Elbow disart myoelectronic c...  ..............  ..............  ..............  ..............  ..............
  L6950  A                               Above elbow switch control.....  ..............  ..............  ..............  ..............  ..............
  L6955  A                               Above elbow myoelectronic ct...  ..............  ..............  ..............  ..............  ..............
  L6960  A                               Shldr disartic switch contro...  ..............  ..............  ..............  ..............  ..............
  L6965  A                               Shldr disartic myoelectronic...  ..............  ..............  ..............  ..............  ..............
  L6970  A                               Interscapular-thor switch ct...  ..............  ..............  ..............  ..............  ..............
  L6975  A                               Interscap-thor myoelectronic...  ..............  ..............  ..............  ..............  ..............

[[Page 18702]]

 
  L7010  A                               Hand otto back steeper/eq sw...  ..............  ..............  ..............  ..............  ..............
  L7015  A                               Hand sys teknik village swit...  ..............  ..............  ..............  ..............  ..............
  L7020  A                               Electronic greifer switch ct...  ..............  ..............  ..............  ..............  ..............
  L7025  A                               Electron hand myoelectronic....  ..............  ..............  ..............  ..............  ..............
  L7030  A                               Hand sys teknik vill myoelec...  ..............  ..............  ..............  ..............  ..............
  L7035  A                               Electron greifer myoelectro....  ..............  ..............  ..............  ..............  ..............
  L7040  A                               Prehensile actuator hosmer s...  ..............  ..............  ..............  ..............  ..............
  L7045  A                               Electron hook child michigan...  ..............  ..............  ..............  ..............  ..............
  L7170  A                               Electronic elbow hosmer swit...  ..............  ..............  ..............  ..............  ..............
  L7180  A                               Electronic elbow utah myoele...  ..............  ..............  ..............  ..............  ..............
  L7185  A                               Electron elbow adolescent sw...  ..............  ..............  ..............  ..............  ..............
  L7186  A                               Electron elbow child switch....  ..............  ..............  ..............  ..............  ..............
  L7190  A                               Elbow adolescent myoelectron...  ..............  ..............  ..............  ..............  ..............
  L7191  A                               Elbow child myoelectronic ct...  ..............  ..............  ..............  ..............  ..............
  L7260  A                               Electron wrist rotator otto....  ..............  ..............  ..............  ..............  ..............
  L7261  A                               Electron wrist rotator utah....  ..............  ..............  ..............  ..............  ..............
  L7266  A                               Servo control steeper or equ...  ..............  ..............  ..............  ..............  ..............
  L7272  A                               Analogue control unb or equa...  ..............  ..............  ..............  ..............  ..............
  L7274  A                               Proportional ctl 12 volt uta...  ..............  ..............  ..............  ..............  ..............
  L7360  A                               Six volt bat otto bock/eq ea...  ..............  ..............  ..............  ..............  ..............
  L7362  A                               Battery chrgr six volt otto....  ..............  ..............  ..............  ..............  ..............
  L7364  A                               Twelve volt battery utah/equ...  ..............  ..............  ..............  ..............  ..............
  L7366  A                               Battery chrgr 12 volt utah/e...  ..............  ..............  ..............  ..............  ..............
  L7499  A                               Upper extremity prosthes NOS...  ..............  ..............  ..............  ..............  ..............
  L7500  A                               Prosthetic dvc repair hourly...  ..............  ..............  ..............  ..............  ..............
  L7510  A                               Prosthetic device repair rep...  ..............  ..............  ..............  ..............  ..............
  L7520  A                               Repair prosthesis per 15 min...  ..............  ..............  ..............  ..............  ..............
  L7900  A                               Vacuum erection system.........  ..............  ..............  ..............  ..............  ..............
  L8000  A                               Mastectomy bra.................  ..............  ..............  ..............  ..............  ..............
  L8010  A                               Mastectomy sleeve..............  ..............  ..............  ..............  ..............  ..............
  L8015  A                               Ext breastprosthesis garment...  ..............  ..............  ..............  ..............  ..............
  L8020  A                               Mastectomy form................  ..............  ..............  ..............  ..............  ..............
  L8030  A                               Breast prosthesis silicone/e...  ..............  ..............  ..............  ..............  ..............
  L8035  A                               Custom breast prosthesis.......  ..............  ..............  ..............  ..............  ..............
  L8039  A                               Breast prosthesis NOS..........  ..............  ..............  ..............  ..............  ..............
  L8100  A                               Compression stocking BK18-30...  ..............  ..............  ..............  ..............  ..............
  L8110  A                               Compression stocking BK30-40...  ..............  ..............  ..............  ..............  ..............
  L8120  A                               Compression stocking BK40-50...  ..............  ..............  ..............  ..............  ..............
  L8130  A                               Gc stocking thighlngth 18-30...  ..............  ..............  ..............  ..............  ..............
  L8140  A                               Gc stocking thighlngth 30-40...  ..............  ..............  ..............  ..............  ..............
  L8150  A                               Gc stocking thighlngth 40-50...  ..............  ..............  ..............  ..............  ..............
  L8160  A                               Gc stocking full lngth 18-30...  ..............  ..............  ..............  ..............  ..............
  L8170  A                               Gc stocking full lngth 30-40...  ..............  ..............  ..............  ..............  ..............
  L8180  A                               Gc stocking full lngth 40-50...  ..............  ..............  ..............  ..............  ..............
  L8190  A                               Gc stocking waistlngth 18-30...  ..............  ..............  ..............  ..............  ..............
  L8195  A                               Gc stocking waistlngth 30-40...  ..............  ..............  ..............  ..............  ..............
  L8200  A                               Gc stocking waistlngth 40-50...  ..............  ..............  ..............  ..............  ..............
  L8210  A                               Gc stocking custom made........  ..............  ..............  ..............  ..............  ..............
  L8220  A                               Gc stocking lymphedema.........  ..............  ..............  ..............  ..............  ..............
  L8230  A                               Gc stocking garter belt........  ..............  ..............  ..............  ..............  ..............
  L8239  A                               G compression stocking NOS.....  ..............  ..............  ..............  ..............  ..............
  L8300  A                               Truss single w/standard pad....  ..............  ..............  ..............  ..............  ..............
  L8310  A                               Truss double w/standard pad....  ..............  ..............  ..............  ..............  ..............
  L8320  A                               Truss addition to std pad wa...  ..............  ..............  ..............  ..............  ..............
  L8330  A                               Truss add to std pad scrotal...  ..............  ..............  ..............  ..............  ..............
  L8400  A                               Sheath below knee..............  ..............  ..............  ..............  ..............  ..............
  L8410  A                               Sheath above knee..............  ..............  ..............  ..............  ..............  ..............
  L8415  A                               Sheath upper limb..............  ..............  ..............  ..............  ..............  ..............
  L8417  A                               Pros sheath/sock w gel cushn...  ..............  ..............  ..............  ..............  ..............
  L8420  A                               Prosthetic sock multi ply BK...  ..............  ..............  ..............  ..............  ..............
  L8430  A                               Prosthetic sock multi ply AK...  ..............  ..............  ..............  ..............  ..............
  L8435  A                               Pros sock multi ply upper lm...  ..............  ..............  ..............  ..............  ..............
  L8440  A                               Shrinker below knee............  ..............  ..............  ..............  ..............  ..............
  L8460  A                               Shrinker above knee............  ..............  ..............  ..............  ..............  ..............
  L8465  A                               Shrinker upper limb............  ..............  ..............  ..............  ..............  ..............
  L8470  A                               Pros sock single ply BK........  ..............  ..............  ..............  ..............  ..............
  L8480  A                               Pros sock single ply AK........  ..............  ..............  ..............  ..............  ..............
  L8485  A                               Pros sock single ply upper l...  ..............  ..............  ..............  ..............  ..............
  L8490  A                               Air seal suction reten systm...  ..............  ..............  ..............  ..............  ..............
  L8499  A                               Unlisted misc prosthetic ser...  ..............  ..............  ..............  ..............  ..............
  L8500  A                               Artificial larynx..............  ..............  ..............  ..............  ..............  ..............
  L8501  A                               Tracheostomy speaking valve....  ..............  ..............  ..............  ..............  ..............
  L8600  A                               Implant breast silicone/eq.....  ..............  ..............  ..............  ..............  ..............

[[Page 18703]]

 
  L8603  A                               Collagen imp urinary 2.5 CC....  ..............  ..............  ..............  ..............  ..............
  L8610  A                               Ocular implant.................  ..............  ..............  ..............  ..............  ..............
  L8612  A                               Aqueous shunt prosthesis.......  ..............  ..............  ..............  ..............  ..............
  L8613  A                               Ossicular implant..............  ..............  ..............  ..............  ..............  ..............
  L8614  A                               Cochlear device/system.........  ..............  ..............  ..............  ..............  ..............
  L8619  A                               Replace cochlear processor.....  ..............  ..............  ..............  ..............  ..............
  L8630  A                               Metacarpophalangeal implant....  ..............  ..............  ..............  ..............  ..............
  L8641  A                               Metatarsal joint implant.......  ..............  ..............  ..............  ..............  ..............
  L8642  A                               Hallux implant.................  ..............  ..............  ..............  ..............  ..............
  L8658  A                               Interphalangeal joint implnt...  ..............  ..............  ..............  ..............  ..............
  L8670  A                               Vascular graft, synthetic......  ..............  ..............  ..............  ..............  ..............
  L8699  A                               Prosthetic implant NOS.........  ..............  ..............  ..............  ..............  ..............
  L9900  A                               O&P supply/accessory/service...  ..............  ..............  ..............  ..............  ..............
  M0064  X                               Visit for drug monitoring......            0374            1.17          $56.73          $13.08          $11.35
  M0075  E                               Cellular therapy...............  ..............  ..............  ..............  ..............  ..............
  M0076  E                               Prolotherapy...................  ..............  ..............  ..............  ..............  ..............
  M0100  E                               Intragastric hypothermia.......  ..............  ..............  ..............  ..............  ..............
  M0300  E                               IV chelationtherapy............  ..............  ..............  ..............  ..............  ..............
  M0301  E                               Fabric wrapping of aneurysm....  ..............  ..............  ..............  ..............  ..............
  M0302  E                               Assessment of cardiac output...  ..............  ..............  ..............  ..............  ..............
  P2028  A                               Cephalin floculation test......  ..............  ..............  ..............  ..............  ..............
  P2029  A                               Congo red blood test...........  ..............  ..............  ..............  ..............  ..............
  P2031  E                               Hair analysis..................  ..............  ..............  ..............  ..............  ..............
  P2033  A                               Blood thymol turbidity.........  ..............  ..............  ..............  ..............  ..............
  P2038  A                               Blood mucoprotein..............  ..............  ..............  ..............  ..............  ..............
  P3000  A                               Screen pap by tech w md supv...  ..............  ..............  ..............  ..............  ..............
  P3001  E                               Screening pap smear by phys....  ..............  ..............  ..............  ..............  ..............
  P7001  E                               Culture bacterial urine........  ..............  ..............  ..............  ..............  ..............
2 P9010  S                               Whole blood for transfusion....            0950            2.08         $101.02  ..............          $20.20
  P9011  S                               Blood split unit...............  ..............  ..............  ..............  ..............  ..............
2 P9012  S                               Cryoprecipitate each unit......            0952            0.70          $33.92  ..............           $6.78
2 P9013  S                               Unit/s blood fibrinogen........            0953            0.48          $23.27  ..............           $4.65
2 P9016  S                               Leukocyte poor blood, unit.....            0954            2.83         $137.21  ..............          $27.44
2 P9017  S                               One donor fresh frozn plasma...            0955            2.26         $109.35  ..............          $21.87
2 P9018  S                               Plasma protein fract, unit.....            0956            1.26          $61.09  ..............          $12.22
2 P9019  S                               Platelet concentrate unit......            0957            0.98          $47.46  ..............           $9.49
2 P9020  S                               Platelet rich plasma unit......            0958            1.16          $56.25  ..............          $11.25
2 P9021  S                               Red blood cells unit...........            0959            2.04          $99.04  ..............          $19.81
2 P9022  S                               Washed red blood cells unit....            0960            3.81         $184.53  ..............          $36.91
2 P9023  S                               Frozen plasma, pooled, sd......            0949            3.49         $169.22  ..............          $33.84
  P9603  A                               One-way allow prorated miles...  ..............  ..............  ..............  ..............  ..............
  P9604  A                               One-way allow prorated trip....  ..............  ..............  ..............  ..............  ..............
  P9612  N                               Catheterize for urine spec.....  ..............  ..............  ..............  ..............  ..............
  P9615  N                               Urine specimen collect mult....  ..............  ..............  ..............  ..............  ..............
 2 0034  X                               Admin of influenza vaccine.....            0354            0.13           $6.19  ..............  ..............
  Q0035  X                               Cardiokymography...............            0366            0.38          $18.43          $15.60           $3.69
  Q0081  S                               Infusion ther other than che...            0120            1.66          $80.49          $42.67          $16.10
  Q0082  P                               Activity therapy w/partial h...            0033            4.17         $202.19          $48.17          $40.44
  Q0083  S                               Chemo by other than infusion...            0116            2.34         $113.46          $22.69          $22.69
  Q0084  S                               Chemotherapy by infusion.......            0117            1.84          $89.22          $71.80          $17.84
  Q0085  S                               Chemo by both infusion and o...            0118            2.90         $140.61          $72.03          $28.12
  Q0086  A                               Physical therapy evaluation/...  ..............  ..............  ..............  ..............  ..............
  Q0091  T                               Obtaining screen pap smear.....            0191            1.19          $57.70          $17.43          $11.54
  Q0092  N                               Set up port x-ray equipment....  ..............  ..............  ..............  ..............  ..............
  Q0111  A                               Wet mounts/w preparations......  ..............  ..............  ..............  ..............  ..............
  Q0112  A                               Potassium hydroxide preps......  ..............  ..............  ..............  ..............  ..............
  Q0113  A                               Pinworm examinations...........  ..............  ..............  ..............  ..............  ..............
  Q0114  A                               Fern test......................  ..............  ..............  ..............  ..............  ..............
  Q0115  A                               Post-coital mucous exam........  ..............  ..............  ..............  ..............  ..............
3 Q0136  X                               Non esrd epoetin alpha inj.....            0733  ..............  ..............  ..............           $1.75
  Q0144  E                               Azithromycin dihydrate, oral...  ..............  ..............  ..............  ..............  ..............
2 Q0156  X                               Human albumin 5%...............            0961            2.77         $134.31  ..............          $26.86
2 Q0157  X                               Human albumin 25%..............            0962            1.38          $66.91  ..............          $13.38
3 Q0160  X                               Factor IX non-recombinant......            0931  ..............  ..............  ..............            $.04
3 Q0161  X                               Factor IX recombinant..........            0932  ..............  ..............  ..............            $.10
3 Q0163  X                               Diphenhydramine HCl 50mg.......            0761  ..............  ..............  ..............            $.10
3 Q0164  X                               Prochlorperazine maleate 5mg...            0761  ..............  ..............  ..............            $.10
  Q0165  E                               Prochlorperazine maleate10mg...  ..............  ..............  ..............  ..............  ..............
3 Q0166  X                               Granisetron HCl 1 mg oral......            0765  ..............  ..............  ..............           $3.20
3 Q0167  X                               Dronabinol 2.5mg oral..........            0762  ..............  ..............  ..............            $.48
  Q0168  E                               Dronabinol 5mg oral............  ..............  ..............  ..............  ..............  ..............
3 Q0169  X                               Promethazine HCl 12.5mg oral...            0761  ..............  ..............  ..............            $.10
  Q0170  E                               Promethazine HCl 25 mg oral....  ..............  ..............  ..............  ..............  ..............

[[Page 18704]]

 
3 Q0171  X                               Chlorpromazine HCl 10mg oral...            0761  ..............  ..............  ..............            $.10
  Q0172  E                               Chlorpromazine HCl 25mg oral...  ..............  ..............  ..............  ..............  ..............
3 Q0173  X                               Trimethobenzamide HCl 250mg....            0761  ..............  ..............  ..............            $.10
3 Q0174  X                               Thiethylperazine maleate10mg...            0761  ..............  ..............  ..............            $.10
3 Q0175  X                               Perphenazine 4mg oral..........            0761  ..............  ..............  ..............            $.10
  Q0176  E                               Perphenazine 8mg oral..........  ..............  ..............  ..............  ..............  ..............
3 Q0177  X                               Hydroxyzine pamoate 25mg.......            0761  ..............  ..............  ..............            $.10
  Q0178  E                               Hydroxyzine pamoate 50mg.......  ..............  ..............  ..............  ..............  ..............
3 Q0179  X                               Ondansetron HCl 8mg oral.......            0769  ..............  ..............  ..............           $2.62
3 Q0180  X                               Dolasetron mesylate oral.......            0763  ..............  ..............  ..............           $8.53
  Q0181  E                               Unspecified oral anti-emetic...  ..............  ..............  ..............  ..............  ..............
  Q0183  N                               Nonmetabolic active tissue.....  ..............  ..............  ..............  ..............  ..............
  Q0184  N                               Metabolically active tissue....  ..............  ..............  ..............  ..............  ..............
  Q0185  N                               Metabolic active D/E tissue....  ..............  ..............  ..............  ..............  ..............
  Q0186  E                               Paramedic intercept, rural.....  ..............  ..............  ..............  ..............  ..............
3 Q0187  X                               Factor viia recombinant........            0929  ..............  ..............  ..............            $.27
  Q1001  E                               Ntiol category 1...............  ..............  ..............  ..............  ..............  ..............
  Q1002  E                               Ntiol category 2...............  ..............  ..............  ..............  ..............  ..............
  Q1003  E                               Ntiol category 3...............  ..............  ..............  ..............  ..............  ..............
  Q1004  E                               Ntiol category 4...............  ..............  ..............  ..............  ..............  ..............
  Q1005  E                               Ntiol category 5...............  ..............  ..............  ..............  ..............  ..............
  Q2001  E                               Cabergoline, 0.5 mg, oral......  ..............  ..............  ..............  ..............  ..............
3 Q2002  X                               Elliot's B solution............            7022  ..............  ..............  ..............          $19.20
3 Q2003  X                               Aprotinin, 10,000 kiu..........            7019  ..............  ..............  ..............           $2.42
3 Q2004  X                               Treatment for bladder calcul...            7023  ..............  ..............  ..............           $4.46
3 Q2005  X                               Corticorelin ovine triflutat...            7024  ..............  ..............  ..............          $45.77
3 Q2006  X                               Digoxin immune FAB (Ovine),....            7025  ..............  ..............  ..............          $14.06
3 Q2007  X                               Ethanolamine oleate, 1000 ml...            7026  ..............  ..............  ..............           $2.13
3 Q2008  X                               Fomepizole, 1.5 G..............            7027  ..............  ..............  ..............         $141.29
3 Q2009  X                               Fosphenytoin, 50 mg............            7028  ..............  ..............  ..............            $.78
3 Q2010  X                               Glatiramer acetate, 25 mgeny...            7029  ..............  ..............  ..............           $3.59
3 Q2011  X                               Hemin, 1 mg....................            7030  ..............  ..............  ..............            $.10
3 Q2012  X                               Pegademase bovine inj 25 I.U...            7039  ..............  ..............  ..............           $1.16
3 Q2013  X                               Pentastarch 10% inj, 100 ml....            7040  ..............  ..............  ..............           $2.04
3 Q2014  X                               Sermorelin acetate, 0.5 mg.....            7032  ..............  ..............  ..............          $53.34
3 Q2015  X                               Somatrem, 5 mg.................            7033  ..............  ..............  ..............          $28.03
3 Q2016  X                               Somatropin, 1 mg...............            7034  ..............  ..............  ..............           $5.04
3 Q2017  X                               Teniposide, 50 mg..............            7035  ..............  ..............  ..............          $20.85
3 Q2018  X                               Urofollitropin, 75 I.U.........            7037  ..............  ..............  ..............           $8.24
3 Q3001  S                               Brachytherapy Seeds............            0918  ..............  ..............  ..............           $9.99
  Q9920  A                               Epoetin with hct = 20..........  ..............  ..............  ..............  ..............  ..............
  Q9921  A                               Epoetin with hct = 21..........  ..............  ..............  ..............  ..............  ..............
  Q9922  A                               Epoetin with hct = 22..........  ..............  ..............  ..............  ..............  ..............
  Q9923  A                               Epoetin with hct = 23..........  ..............  ..............  ..............  ..............  ..............
  Q9924  A                               Epoetin with hct = 24..........  ..............  ..............  ..............  ..............  ..............
  Q9925  A                               Epoetin with hct = 25..........  ..............  ..............  ..............  ..............  ..............
  Q9926  A                               Epoetin with hct = 26..........  ..............  ..............  ..............  ..............  ..............
  Q9927  A                               Epoetin with hct = 27..........  ..............  ..............  ..............  ..............  ..............
  Q9928  A                               Epoetin with hct = 28..........  ..............  ..............  ..............  ..............  ..............
  Q9929  A                               Epoetin with hct = 29..........  ..............  ..............  ..............  ..............  ..............
  Q9930  A                               Epoetin with hct = 30..........  ..............  ..............  ..............  ..............  ..............
  Q9931  A                               Epoetin with hct = 31..........  ..............  ..............  ..............  ..............  ..............
  Q9932  A                               Epoetin with hct = 32..........  ..............  ..............  ..............  ..............  ..............
  Q9933  A                               Epoetin with hct = 33..........  ..............  ..............  ..............  ..............  ..............
  Q9934  A                               Epoetin with hct = 34..........  ..............  ..............  ..............  ..............  ..............
  Q9935  A                               Epoetin with hct = 35..........  ..............  ..............  ..............  ..............  ..............
  Q9936  A                               Epoetin with hct = 36..........  ..............  ..............  ..............  ..............  ..............
  Q9937  A                               Epoetin with hct = 37..........  ..............  ..............  ..............  ..............  ..............
  Q9938  A                               Epoetin with hct = 38..........  ..............  ..............  ..............  ..............  ..............
  Q9939  A                               Epoetin with hct = 39..........  ..............  ..............  ..............  ..............  ..............
  Q9940  A                               Epoetin with hct >= 40.........  ..............  ..............  ..............  ..............  ..............
  R0070  N                               Transport portable x-ray.......  ..............  ..............  ..............  ..............  ..............
  R0075  N                               Transport port x-ray multipl...  ..............  ..............  ..............  ..............  ..............
  R0076  N                               Transport portable EKG.........  ..............  ..............  ..............  ..............  ..............
  V2020  A                               Vision svcs frames purchases...  ..............  ..............  ..............  ..............  ..............
  V2025  E                               Eyeglasses delux frames........  ..............  ..............  ..............  ..............  ..............
  V2100  A                               Lens spher single plano 4.00...  ..............  ..............  ..............  ..............  ..............
  V2101  A                               Single visn sphere 4.12-7.00...  ..............  ..............  ..............  ..............  ..............
  V2102  A                               Singl visn sphere 7.12-20.00...  ..............  ..............  ..............  ..............  ..............
  V2103  A                               Spherocylindr 4.00d/12-2.00d...  ..............  ..............  ..............  ..............  ..............
  V2104  A                               Spherocylindr 4.00d/2.12-4d....  ..............  ..............  ..............  ..............  ..............
  V2105  A                               Spherocylinder 4.00d/4.25-6d...  ..............  ..............  ..............  ..............  ..............
  V2106  A                               Spherocylinder 4.00d/>6.00d....  ..............  ..............  ..............  ..............  ..............

[[Page 18705]]

 
  V2107  A                               Spherocylinder 4.25d/12-2d.....  ..............  ..............  ..............  ..............  ..............
  V2108  A                               Spherocylinder 4.25d/2.12-4d...  ..............  ..............  ..............  ..............  ..............
  V2109  A                               Spherocylinder 4.25d/4.25-6d...  ..............  ..............  ..............  ..............  ..............
  V2110  A                               Spherocylinder 4.25d/over 6d...  ..............  ..............  ..............  ..............  ..............
  V2111  A                               Spherocylindr 7.25d/.25-2.25...  ..............  ..............  ..............  ..............  ..............
  V2112  A                               Spherocylindr 7.25d/2.25-4d....  ..............  ..............  ..............  ..............  ..............
  V2113  A                               Spherocylindr 7.25d/4.25-6d....  ..............  ..............  ..............  ..............  ..............
  V2114  A                               Spherocylinder over 12.00d.....  ..............  ..............  ..............  ..............  ..............
  V2115  A                               Lens lenticular bifocal........  ..............  ..............  ..............  ..............  ..............
  V2116  A                               Nonaspheric lens bifocal.......  ..............  ..............  ..............  ..............  ..............
  V2117  A                               Aspheric lens bifocal..........  ..............  ..............  ..............  ..............  ..............
  V2118  A                               Lens aniseikonic single........  ..............  ..............  ..............  ..............  ..............
  V2199  A                               Lens single vision not oth c...  ..............  ..............  ..............  ..............  ..............
  V2200  A                               Lens spher bifoc plano 4.00d...  ..............  ..............  ..............  ..............  ..............
  V2201  A                               Lens sphere bifocal 4.12-7.0...  ..............  ..............  ..............  ..............  ..............
  V2202  A                               Lens sphere bifocal 7.12-20....  ..............  ..............  ..............  ..............  ..............
  V2203  A                               Lens sphcyl bifocal 4.00d/.1...  ..............  ..............  ..............  ..............  ..............
  V2204  A                               Lens sphcy bifocal 4.00d/2.1...  ..............  ..............  ..............  ..............  ..............
  V2205  A                               Lens sphcy bifocal 4.00d/4.2...  ..............  ..............  ..............  ..............  ..............
  V2206  A                               Lens sphcy bifocal 4.00d/ove...  ..............  ..............  ..............  ..............  ..............
  V2207  A                               Lens sphcy bifocal 4.25-7d/....  ..............  ..............  ..............  ..............  ..............
  V2208  A                               Lens sphcy bifocal 4.25-7/2....  ..............  ..............  ..............  ..............  ..............
  V2209  A                               Lens sphcy bifocal 4.25-7/4....  ..............  ..............  ..............  ..............  ..............
  V2210  A                               Lens sphcy bifocal 4.25-7/ov...  ..............  ..............  ..............  ..............  ..............
  V2211  A                               Lens sphcy bifo 7.25-12/.25-...  ..............  ..............  ..............  ..............  ..............
  V2212  A                               Lens sphcyl bifo 7.25-12/2.2...  ..............  ..............  ..............  ..............  ..............
  V2213  A                               Lens sphcyl bifo 7.25-12/4.2...  ..............  ..............  ..............  ..............  ..............
  V2214  A                               Lens sphcyl bifocal over 12....  ..............  ..............  ..............  ..............  ..............
  V2215  A                               Lens lenticular bifocal........  ..............  ..............  ..............  ..............  ..............
  V2216  A                               Lens lenticular nonaspheric....  ..............  ..............  ..............  ..............  ..............
  V2217  A                               Lens lenticular aspheric bif...  ..............  ..............  ..............  ..............  ..............
  V2218  A                               Lens aniseikonic bifocal.......  ..............  ..............  ..............  ..............  ..............
  V2219  A                               Lens bifocal seg width over....  ..............  ..............  ..............  ..............  ..............
  V2220  A                               Lens bifocal add over 3.25d....  ..............  ..............  ..............  ..............  ..............
  V2299  A                               Lens bifocal speciality........  ..............  ..............  ..............  ..............  ..............
  V2300  A                               Lens sphere trifocal 4.00d.....  ..............  ..............  ..............  ..............  ..............
  V2301  A                               Lens sphere trifocal 4.12-7....  ..............  ..............  ..............  ..............  ..............
  V2302  A                               Lens sphere trifocal 7.12-20...  ..............  ..............  ..............  ..............  ..............
  V2303  A                               Lens sphcy trifocal 4.0/.12-...  ..............  ..............  ..............  ..............  ..............
  V2304  A                               Lens sphcy trifocal 4.0/2.25...  ..............  ..............  ..............  ..............  ..............
  V2305  A                               Lens sphcy trifocal 4.0/4.25...  ..............  ..............  ..............  ..............  ..............
  V2306  A                               Lens sphcyl trifocal 4.00/>6...  ..............  ..............  ..............  ..............  ..............
  V2307  A                               Lens sphcy trifocal 4.25-7/....  ..............  ..............  ..............  ..............  ..............
  V2308  A                               Lens sphc trifocal 4.25-7/2....  ..............  ..............  ..............  ..............  ..............
  V2309  A                               Lens sphc trifocal 4.25-7/4....  ..............  ..............  ..............  ..............  ..............
  V2310  A                               Lens sphc trifocal 4.25-7/>6...  ..............  ..............  ..............  ..............  ..............
  V2311  A                               Lens sphc trifo 7.25-12/.25-...  ..............  ..............  ..............  ..............  ..............
  V2312  A                               Lens sphc trifo 7.25-12/2.25...  ..............  ..............  ..............  ..............  ..............
  V2313  A                               Lens sphc trifo 7.25-12/4.25...  ..............  ..............  ..............  ..............  ..............
  V2314  A                               Lens sphcyl trifocal over 12...  ..............  ..............  ..............  ..............  ..............
  V2315  A                               Lens lenticular trifocal.......  ..............  ..............  ..............  ..............  ..............
  V2316  A                               Lens lenticular nonaspheric....  ..............  ..............  ..............  ..............  ..............
  V2317  A                               Lens lenticular aspheric tri...  ..............  ..............  ..............  ..............  ..............
  V2318  A                               Lens aniseikonic trifocal......  ..............  ..............  ..............  ..............  ..............
  V2319  A                               Lens trifocal seg width > 28...  ..............  ..............  ..............  ..............  ..............
  V2320  A                               Lens trifocal add over 3.25d...  ..............  ..............  ..............  ..............  ..............
  V2399  A                               Lens trifocal speciality.......  ..............  ..............  ..............  ..............  ..............
  V2410  A                               Lens variab asphericity sing...  ..............  ..............  ..............  ..............  ..............
  V2430  A                               Lens variable asphericity bi...  ..............  ..............  ..............  ..............  ..............
  V2499  A                               Variable asphericity lens......  ..............  ..............  ..............  ..............  ..............
  V2500  A                               Contact lens pmma spherical....  ..............  ..............  ..............  ..............  ..............
  V2501  A                               Cntct lens pmma-toric/prism....  ..............  ..............  ..............  ..............  ..............
  V2502  A                               Contact lens pmma bifocal......  ..............  ..............  ..............  ..............  ..............
  V2503  A                               Cntct lens pmma color vision...  ..............  ..............  ..............  ..............  ..............
  V2510  A                               Cntct gas permeable sphericl...  ..............  ..............  ..............  ..............  ..............
  V2511  A                               Cntct toric prism ballast......  ..............  ..............  ..............  ..............  ..............
  V2512  A                               Cntct lens gas permbl bifocl...  ..............  ..............  ..............  ..............  ..............
  V2513  A                               Contact lens extended wear.....  ..............  ..............  ..............  ..............  ..............
  V2520  A                               Contact lens hydrophilic.......  ..............  ..............  ..............  ..............  ..............
  V2521  A                               Cntct lens hydrophilic toric...  ..............  ..............  ..............  ..............  ..............
  V2522  A                               Cntct lens hydrophil bifocl....  ..............  ..............  ..............  ..............  ..............
  V2523  A                               Cntct lens hydrophil extend....  ..............  ..............  ..............  ..............  ..............
  V2530  A                               Contact lens gas impermeable...  ..............  ..............  ..............  ..............  ..............

[[Page 18706]]

 
  V2531  A                               Contact lens gas permeable.....  ..............  ..............  ..............  ..............  ..............
  V2599  A                               Contact lens/es other type.....  ..............  ..............  ..............  ..............  ..............
  V2600  A                               Hand held low vision aids......  ..............  ..............  ..............  ..............  ..............
  V2610  A                               Single lens spectacle mount....  ..............  ..............  ..............  ..............  ..............
  V2615  A                               Telescop/othr compound lens....  ..............  ..............  ..............  ..............  ..............
  V2623  A                               Plastic eye prosth custom......  ..............  ..............  ..............  ..............  ..............
  V2624  A                               Polishing artifical eye........  ..............  ..............  ..............  ..............  ..............
  V2625  A                               Enlargemnt of eye prosthesis...  ..............  ..............  ..............  ..............  ..............
  V2626  A                               Reduction of eye prosthesis....  ..............  ..............  ..............  ..............  ..............
  V2627  A                               Scleral cover shell............  ..............  ..............  ..............  ..............  ..............
  V2628  A                               Fabrication & fitting..........  ..............  ..............  ..............  ..............  ..............
  V2629  A                               Prosthetic eye other type......  ..............  ..............  ..............  ..............  ..............
  V2630  N                               Anter chamber intraocul lens...  ..............  ..............  ..............  ..............  ..............
  V2631  N                               Iris support intraoclr lens....  ..............  ..............  ..............  ..............  ..............
  V2632  N                               Post chmbr intraocular lens....  ..............  ..............  ..............  ..............  ..............
  V2700  A                               Balance lens...................  ..............  ..............  ..............  ..............  ..............
  V2710  A                               Glass/plastic slab off prism...  ..............  ..............  ..............  ..............  ..............
  V2715  A                               Prism lens/es..................  ..............  ..............  ..............  ..............  ..............
  V2718  A                               Fresnell prism press-on lens...  ..............  ..............  ..............  ..............  ..............
  V2730  A                               Special base curve.............  ..............  ..............  ..............  ..............  ..............
  V2740  A                               Rose tint plastic..............  ..............  ..............  ..............  ..............  ..............
  V2741  A                               Non-rose tint plastic..........  ..............  ..............  ..............  ..............  ..............
  V2742  A                               Rose tint glass................  ..............  ..............  ..............  ..............  ..............
  V2743  A                               Non-rose tint glass............  ..............  ..............  ..............  ..............  ..............
  V2744  A                               Tint photochromatic lens/es....  ..............  ..............  ..............  ..............  ..............
  V2750  A                               Anti-reflective coating........  ..............  ..............  ..............  ..............  ..............
  V2755  A                               UV lens/es.....................  ..............  ..............  ..............  ..............  ..............
  V2760  A                               Scratch resistant coating......  ..............  ..............  ..............  ..............  ..............
  V2770  A                               Occluder lens/es...............  ..............  ..............  ..............  ..............  ..............
  V2780  A                               Oversize lens/es...............  ..............  ..............  ..............  ..............  ..............
  V2781  A                               Progressive lens per lens......  ..............  ..............  ..............  ..............  ..............
  V2785  A                               Corneal tissue processing......  ..............  ..............  ..............  ..............  ..............
  V2799  A                               Miscellaneous vision service...  ..............  ..............  ..............  ..............  ..............
  V5008  E                               Hearing screening..............  ..............  ..............  ..............  ..............  ..............
  V5010  E                               Assessment for hearing aid.....  ..............  ..............  ..............  ..............  ..............
  V5011  E                               Hearing aid fitting/checking...  ..............  ..............  ..............  ..............  ..............
  V5014  E                               Hearing aid repair/modifying...  ..............  ..............  ..............  ..............  ..............
  V5020  E                               Conformity evaluation..........  ..............  ..............  ..............  ..............  ..............
  V5030  E                               Body-worn hearing aid air......  ..............  ..............  ..............  ..............  ..............
  V5040  E                               Body-worn hearing aid bone.....  ..............  ..............  ..............  ..............  ..............
  V5050  E                               Body-worn hearing aid in ear...  ..............  ..............  ..............  ..............  ..............
  V5060  E                               Behind ear hearing aid.........  ..............  ..............  ..............  ..............  ..............
  V5070  E                               Glasses air conduction.........  ..............  ..............  ..............  ..............  ..............
  V5080  E                               Glasses bone conduction........  ..............  ..............  ..............  ..............  ..............
  V5090  E                               Hearing aid dispensing fee.....  ..............  ..............  ..............  ..............  ..............
  V5100  E                               Body-worn bilat hearing aid....  ..............  ..............  ..............  ..............  ..............
  V5110  E                               Hearing aid dispensing fee.....  ..............  ..............  ..............  ..............  ..............
  V5120  E                               Body-worn binaur hearing aid...  ..............  ..............  ..............  ..............  ..............
  V5130  E                               In ear binaural hearing aid....  ..............  ..............  ..............  ..............  ..............
  V5140  E                               Behind ear binaur hearing ai...  ..............  ..............  ..............  ..............  ..............
  V5150  E                               Glasses binaural hearing aid...  ..............  ..............  ..............  ..............  ..............
  V5160  E                               Dispensing fee binaural........  ..............  ..............  ..............  ..............  ..............
  V5170  E                               Within ear cros hearing aid....  ..............  ..............  ..............  ..............  ..............
  V5180  E                               Behind ear cros hearing aid....  ..............  ..............  ..............  ..............  ..............
  V5190  E                               Glasses cros hearing aid.......  ..............  ..............  ..............  ..............  ..............
  V5200  E                               Cros hearing aid dispens fee...  ..............  ..............  ..............  ..............  ..............
  V5210  E                               In ear bicros hearing aid......  ..............  ..............  ..............  ..............  ..............
  V5220  E                               Behind ear bicros hearing ai...  ..............  ..............  ..............  ..............  ..............
  V5230  E                               Glasses bicros hearing aid.....  ..............  ..............  ..............  ..............  ..............
  V5240  E                               Dispensing fee bicros..........  ..............  ..............  ..............  ..............  ..............
  V5299  A                               Hearing service................  ..............  ..............  ..............  ..............  ..............
  V5336  E                               Repair communication device....  ..............  ..............  ..............  ..............  ..............
  V5362  A                               Speech screening...............  ..............  ..............  ..............  ..............  ..............
  V5363  A                               Language screening.............  ..............  ..............  ..............  ..............  ..............
  V5364  A                               Dysphagia screening............  ..............  ..............  ..............  ..............  ..............
--------------------------------------------------------------------------------------------------------------------------------------------------------

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

Copyright American Dental Association. All rights reserved.

\1\ Not subject to national coinsurance. Minimum unadjusted coinsurance 
is 25% of the payment rate. The payment rate is the lower of the HOPD 
payment rate or the Ambulatory Surgical Center payment.

  

\2\ Not subject to national coinsurance.

\3\ Eligible for pass-through payments. See Preamble for payment rate 
determination. See Addendum K for complete list of pass-through codes.

            Addendum C.--Proposed Hospital Outpatient Department (HOPD) Payment for Procedures by APC
----------------------------------------------------------------------------------------------------------------
                                                                                     National         Minimum
  APC      CPT/     HCPCS Description        Status        Relative     Payment     Unadjusted      Unadjusted
          HCPCS                             Indicator       Weight       Rate       Coinsurance     Coinsurance
----------------------------------------------------------------------------------------------------------------
   0001        Photochemotherapy        S                       0.47      $22.79           $8.49           $4.56

[[Page 18707]]

 
           96900  Ultraviolet light
                   therapy
           96910  Photochemotherapy
                   with UV-B
           96912  Photochemotherapy
                   with UV-A
           96913  Photochemotherapy,
                   UV-A or B
           96999  Dermatological
                   procedure
   0002  Fine needle Biopsy/Aspiration  T                       0.62      $30.06          $17.66           $6.01
           60001  Aspirate/inject
                   thyriod cyst
           88170  Fine needle
                   aspiration
           88171  Fine needle
                   aspiration
   0003  Bone Marrow Biopsy/Aspiration  T                       0.98      $47.52          $27.99           $9.50
           85095  Bone marrow
                   aspiration
           85102  Bone marrow biopsy
   0004      Level I Needle Biopsy/     T                       1.84      $89.22          $32.57          $17.84
         Aspiration Except Bone Marrow
           17999  Skin tissue
                   procedure
           19000  Drainage of breast
                   lesion
           19001  Drain breast lesion
                   add-on
           20615  Treatment of bone
                   cyst
           42400  Biopsy of salivary
                   gland
           54800  Biopsy of epididymis
           55000  Drainage of
                   hydrocele
           60100  Biopsy of thyroid
           60699  Endocrine surgery
                   procedure
   0005     Level II Needle Biopsy/     T                       5.41     $262.32         $119.75          $52.46
         Aspiration Except Bone Marrow
           19100  Biopsy of breast
           20206  Needle biopsy,
                   muscle
           32400  Needle biopsy chest
                   lining
           32405  Biopsy, lung or
                   mediastinum
           38505  Needle biopsy, lymph
                   nodes
           47000  Needle biopsy of
                   liver
           47399  Liver surgery
                   procedure
           48102  Needle biopsy,
                   pancreas
           48999  Pancreas surgery
                   procedure
           49180  Biopsy, abdominal
                   mass
           50200  Biopsy of kidney
           50390  Drainage of kidney
                   lesion
           54500  Biopsy of testis
           62269  Needle biopsy,
                   spinal cord
   0006   Level I Incision & Drainage   T                       2.00      $96.97          $33.95          $19.39
           10040  Acne surgery of skin
                   abscess
           10060  Drainage of skin
                   abscess
           10061  Drainage of skin
                   abscess
           10080  Drainage of
                   pilonidal cyst
           10120  Remove foreign body
           10160  Puncture drainage of
                   lesion
           20000  Incision of abscess
           26010  Drainage of finger
                   abscess
           69000  Drain external ear
                   lesion
           69020  Drain outer ear
                   canal lesion
   0007   Level II Incision & Drainage  T                       3.68     $178.43          $72.03          $35.69
           10081  Drainage of
                   pilonidal cyst
           10140  Drainage of hematoma/
                   fluid
           10180  Complex drainage,
                   wound
           26011  Drainage of finger
                   abscess
           69005  Drain external ear
                   lesion
   0008  Level III Incision & Drainage  T                       6.15     $298.20         $113.67          $59.64
           19020  Incision of breast
                   lesion
           20950  Fluid pressure,
                   muscle
           21501  Drain neck/chest
                   lesion
           21700  Revision of neck
                   muscle
           21720  Revision of neck
                   muscle
           21725  Revision of neck
                   muscle
           23030  Drain shoulder
                   lesion
           23031  Drain shoulder bursa
           23930  Drainage of arm
                   lesion
           23931  Drainage of arm
                   bursa
           27301  Drain thigh/knee
                   lesion
           27603  Drain lower leg
                   lesion
           28001  Drainage of bursa of
                   foot
           38300  Drainage, lymph node
                   lesion
           38305  Drainage, lymph node
                   lesion
           38999  Blood/lymph system
                   procedure
           51080  Drainage of bladder
                   abscess
           54015  Drain penis lesion

[[Page 18708]]

 
           54115  Treatment of penis
                   lesion
           55100  Drainage of scrotum
                   abscess
   0009         Nail Procedures         T                       0.74      $35.88           $9.63           $7.18
           11719  Trim nail(s)
           11720  Debride nail, 1-5
           11721  Debride nail, 6 or
                   more
           11740  Drain blood from
                   under nail
           G0127  Trim nail(s)
   0010  Level I Destruction of Lesion  T                       0.55      $26.67           $9.86           $5.33
           17000  Destroy benign/
                   premal lesion
           17003  Destroy lesions, 2-
                   14
           17110  Destruct lesion, 1-
                   14
   0011     Level II Destruction of     T                       2.72     $131.88          $50.01          $26.38
                     Lesion
           17004  Destroy lesions, 15
                   or more
           17106  Destruction of skin
                   lesions
           17107  Destruction of skin
                   lesions
           17108  Destruction of skin
                   lesions
           17111  Destruct lesion, 15
                   or more
   0012      Level I Debridement &      T                       0.53      $25.70           $9.18           $5.14
                  Destruction
           11732  Remove nail plate,
                   add-on
           11900  Injection into skin
                   lesions
           15852  Dressing change, not
                   for burn
           17340  Cryotherapy of skin
           69220  Clean out mastoid
                   cavity
   0013      Level II Debridement &     T                       0.91      $44.12          $17.66           $8.82
                  Destruction
           11300  Shave skin lesion
           11301  Shave skin lesion
           11305  Shave skin lesion
           11306  Shave skin lesion
           11310  Shave skin lesion
           11311  Shave skin lesion
           11730  Removal of nail
                   plate
           11901  Added skin lesions
                   injection
           15786  Abrasion, lesion,
                   single
           15788  Chemical peel, face,
                   epiderm
           15850  Removal of sutures
           15851  Removal of sutures
           17260  Destruction of skin
                   lesions
           17261  Destruction of skin
                   lesions
           17262  Destruction of skin
                   lesions
           17263  Destruction of skin
                   lesions
           17271  Destruction of skin
                   lesions
           17272  Destruction of skin
                   lesions
           54050  Destruction, penis
                   lesion(s)
           54056  Cryosurgery, penis
                   lesion(s)
   0014     Level III Debridement &     T                       1.50      $72.73          $24.55          $14.55
                  Destruction
           11302  Shave skin lesion
           11307  Shave skin lesion
           16025  Treatment of burn(s)
           17250  Chemical cautery,
                   tissue
           46917  Laser surgery, anal
                   lesions
   0015      Level IV Debridement &     T                       1.77      $85.82          $31.20          $17.16
                  Destruction
           11000  Debride infected
                   skin
           11001  Debride infected
                   skin add-on
           11040  Debride skin,
                   partial
           11041  Debride skin, full
           11055  Trim skin lesion
           11056  Trim skin lesions, 2
                   to 4
           11057  Trim skin lesions,
                   over 4
           11200  Removal of skin tags
           11201  Remove skin tags add-
                   on
           11303  Shave skin lesion
           11308  Shave skin lesion
           11312  Shave skin lesion
           11765  Excision of nail
                   fold, toe
           15783  Abrasion treatment
                   of skin
           15789  Chemical peel, face,
                   dermal
           16000  Initial treatment of
                   burn(s)
           16010  Treatment of burn(s)
           16020  Treatment of burn(s)
           16030  Treatment of burn(s)
           17264  Destruction of skin
                   lesions
           17270  Destruction of skin
                   lesions

[[Page 18709]]

 
           17273  Destruction of skin
                   lesions
           17274  Destruction of skin
                   lesions
           17276  Destruction of skin
                   lesions
           17280  Destruction of skin
                   lesions
           17281  Destruction of skin
                   lesions
           17282  Destruction of skin
                   lesions
           17283  Destruction of skin
                   lesions
   0016      Level V Debridement &      T                       3.53     $171.16          $74.67          $34.23
                  Destruction
           11042  Debride skin/tissue
           11043  Debride tissue/
                   muscle
           11313  Shave skin lesion
           15787  Abrasion, lesions,
                   add-on
           15792  Chemical peel,
                   nonfacial
           15793  Chemical peel,
                   nonfacial
           15810  Salabrasion
           17266  Destruction of skin
                   lesions
           17284  Destruction of skin
                   lesions
           17286  Destruction of skin
                   lesions
           17360  Skin peel therapy
           17380  Hair removal by
                   electrolysis
           46900  Destruction, anal
                   lesion(s)
           46910  Destruction, anal
                   lesion(s)
           46916  Cryosurgery, anal
                   lesion(s)
           54055  Destruction, penis
                   lesion(s)
           56501  Destruction, vulva
                   lesion(s)
   0017      Level VI Debridement &     T                      12.45     $603.66         $289.16         $120.73
                  Destruction
           11044  Debride tissue/
                   muscle/bone
           16015  Treatment of burn(s)
           46922  Excision of anal
                   lesion(s)
           46924  Destruction, anal
                   lesion(s)
           54057  Laser surg, penis
                   lesion(s)
           54060  Excision of penis
                   lesion(s)
           54065  Destruction, penis
                   lesion(s)
           56515  Destruction, vulva
                   lesion(s)
   0018    Biopsy Skin, Subcutaneous    T                       0.94      $45.58          $17.66           $9.12
           Tissue or Mucous Membrane
           11100  Biopsy of skin
                   lesion
           11101  Biopsy, skin add-on
   0019     Level I Excision/Biopsy     T                       4.00     $193.95          $78.91          $38.79
           11400  Removal of skin
                   lesion
           11401  Removal of skin
                   lesion
           11402  Removal of skin
                   lesion
           11420  Removal of skin
                   lesion
           11421  Removal of skin
                   lesion
           11422  Removal of skin
                   lesion
           11440  Removal of skin
                   lesion
           11441  Removal of skin
                   lesion
           11442  Removal of skin
                   lesion
           11600  Removal of skin
                   lesion
           11601  Removal of skin
                   lesion
           11602  Removal of skin
                   lesion
           11620  Removal of skin
                   lesion
           11621  Removal of skin
                   lesion
           11622  Removal of skin
                   lesion
           11640  Removal of skin
                   lesion
           11641  Removal of skin
                   lesion
           11642  Removal of skin
                   lesion
           11750  Removal of nail bed
           11755  Biopsy, nail unit
           11976  Removal of
                   contraceptive cap
           20220  Bone biopsy, trocar/
                   needle
           20520  Removal of foreign
                   body
           21550  Biopsy of neck/chest
           23330  Remove shoulder
                   foreign body
           24200  Removal of arm
                   foreign body
           27086  Remove hip foreign
                   body
           28190  Removal of foot
                   foreign body
           56605  Biopsy of vulva/
                   perineum
           56606  Biopsy of vulva/
                   perineum
           58999  Genital surgery
                   procedure
           69100  Biopsy of external
                   ear
   0020     Level II Excision/Biopsy    T                       6.51     $315.65         $130.53          $63.13
           10121  Remove foreign body
           11403  Removal of skin
                   lesion

[[Page 18710]]

 
           11404  Removal of skin
                   lesion
           11406  Removal of skin
                   lesion
           11423  Removal of skin
                   lesion
           11424  Removal of skin
                   lesion
           11443  Removal of skin
                   lesion
           11444  Removal of skin
                   lesion
           11603  Removal of skin
                   lesion
           11604  Removal of skin
                   lesion
           11623  Removal of skin
                   lesion
           11624  Removal of skin
                   lesion
           11643  Removal of skin
                   lesion
           11644  Removal of skin
                   lesion
           16035  Incision of burn
                   scab
           17304  Chemosurgery of skin
                   lesion
           17305  2nd stage
                   chemosurgery
           17306  3rd stage
                   chemosurgery
           17307  Followup skin lesion
                   therapy
           17310  Extensive skin
                   chemosurgery
           20200  Muscle biopsy
           20225  Bone biopsy, trocar/
                   needle
           21920  Biopsy soft tissue
                   of back
           24065  Biopsy arm/elbow
                   soft tissue
           24066  Biopsy arm/elbow
                   soft tissue
           25065  Biopsy forearm soft
                   tissues
           25075  Removal of forearm
                   lesion
           26320  Removal of implant
                   from hand
           27613  Biopsy lower leg
                   soft tissue
           28193  Removal of foot
                   foreign body
           37609  Temporal artery
                   procedure
           37799  Vascular surgery
                   procedure
           54100  Biopsy of penis
           69110  Remove external ear,
                   partial
           69145  Remove ear canal
                   lesion(s)
   0021    Level III Excision/Biopsy    T                      10.49     $508.63         $236.51         $101.73
           11606  Removal of skin
                   lesion
           11770  Removal of pilonidal
                   lesion
           20205  Deep muscle biopsy
           20670  Removal of support
                   implant
           23000  Removal of calcium
                   deposits
           23065  Biopsy shoulder
                   tissues
           23075  Removal of shoulder
                   lesion
           24075  Remove arm/elbow
                   lesion
           24201  Removal of arm
                   foreign body
           27040  Biopsy of soft
                   tissues
           27323  Biopsy, thigh soft
                   tissues
           27618  Remove lower leg
                   lesion
           28043  Excision of foot
                   lesion
           28192  Removal of foot
                   foreign body
           54105  Biopsy of penis
   0022     Level IV Excision/Biopsy    T                      12.49     $605.60         $292.94         $121.12
           11010  Debride skin, fx
           11011  Debride skin/muscle,
                   fx
           11012  Debride skin/muscle/
                   bone, fx
           11426  Removal of skin
                   lesion
           11446  Removal of skin
                   lesion
           11450  Removal, sweat gland
                   lesion
           11451  Removal, sweat gland
                   lesion
           11462  Removal, sweat gland
                   lesion
           11463  Removal, sweat gland
                   lesion
           11470  Removal, sweat gland
                   lesion
           11471  Removal, sweat gland
                   lesion
           11626  Removal of skin
                   lesion
           11646  Removal of skin
                   lesion
           11752  Remove nail bed/
                   finger tip
           11771  Removal of pilonidal
                   lesion
           11772  Removal of pilonidal
                   lesion
           11971  Remove tissue
                   expander(s)
           15780  Abrasion treatment
                   of skin
           15781  Abrasion treatment
                   of skin
           15782  Abrasion treatment
                   of skin
           15811  Salabrasion
           15838  Excise excessive
                   skin tissue
           15920  Removal of tail bone
                   ulcer

[[Page 18711]]

 
           15931  Remove sacrum
                   pressure sore
           15933  Remove sacrum
                   pressure sore
           15940  Remove hip pressure
                   sore
           15941  Remove hip pressure
                   sore
           15950  Remove thigh
                   pressure sore
           15951  Remove thigh
                   pressure sore
           15999  Removal of pressure
                   sore
           20240  Bone biopsy,
                   excisional
           20245  Bone biopsy,
                   excisional
           20525  Removal of foreign
                   body
           20680  Removal of support
                   implant
           21555  Remove lesion, neck/
                   chest
           21556  Remove lesion, neck/
                   chest
           21925  Biopsy soft tissue
                   of back
           21930  Remove lesion, back
                   or flank
           21935  Remove tumor, back
           22900  Remove abdominal
                   wall lesion
           22999  Abdomen surgery
                   procedure
           23066  Biopsy shoulder
                   tissues
           23076  Removal of shoulder
                   lesion
           23077  Remove tumor of
                   shoulder
           23331  Remove shoulder
                   foreign body
           24076  Remove arm/elbow
                   lesion
           24077  Remove tumor of arm/
                   elbow
           25066  Biopsy forearm soft
                   tissues
           25076  Removal of forearm
                   lesion
           25077  Remove tumor,
                   forearm/wrist
           26115  Removal of hand
                   lesion
           26116  Removal of hand
                   lesion
           26117  Remove tumor, hand/
                   finger
           27041  Biopsy of soft
                   tissues
           27047  Remove hip/pelvis
                   lesion
           27048  Remove hip/pelvis
                   lesion
           27049  Remove tumor, hip/
                   pelvis
           27324  Biopsy, thigh soft
                   tissues
           27327  Removal of thigh
                   lesion
           27328  Removal of thigh
                   lesion
           27329  Remove tumor, thigh/
                   knee
           27372  Removal of foreign
                   body
           27614  Biopsy lower leg
                   soft tissue
           27619  Remove lower leg
                   lesion
           69205  Clear outer ear
                   canal
   0023  Exploration Penetrating Wound  T                       1.98      $96.00          $40.37          $19.20
           20100  Explore wound, neck
           20103  Explore wound,
                   extremity
   0024       Level I Skin Repair       T                       2.43     $117.82          $44.50          $23.56
           11760  Repair of nail bed
           11762  Reconstruction of
                   nail bed
           11920  Correct skin color
                   defects
           11921  Correct skin color
                   defects
           11922  Correct skin color
                   defects
           11950  Therapy for contour
                   defects
           11951  Therapy for contour
                   defects
           11952  Therapy for contour
                   defects
           11954  Therapy for contour
                   defects
           12001  Repair superficial
                   wound(s)
           12002  Repair superficial
                   wound(s)
           12004  Repair superficial
                   wound(s)
           12005  Repair superficial
                   wound(s)
           12006  Repair superficial
                   wound(s)
           12007  Repair superficial
                   wound(s)
           12011  Repair superficial
                   wound(s)
           12013  Repair superficial
                   wound(s)
           12014  Repair superficial
                   wound(s)
           12015  Repair superficial
                   wound(s)
           12016  Repair superficial
                   wound(s)
           12017  Repair superficial
                   wound(s)
           12018  Repair superficial
                   wound(s)
           12020  Closure of split
                   wound
           12021  Closure of split
                   wound
           12031  Layer closure of
                   wound(s)
           12032  Layer closure of
                   wound(s)
           12034  Layer closure of
                   wound(s)

[[Page 18712]]

 
           12035  Layer closure of
                   wound(s)
           12036  Layer closure of
                   wound(s)
           12041  Layer closure of
                   wound(s)
           12042  Layer closure of
                   wound(s)
           12044  Layer closure of
                   wound(s)
           12045  Layer closure of
                   wound(s)
           12046  Layer closure of
                   wound(s)
           12051  Layer closure of
                   wound(s)
           12052  Layer closure of
                   wound(s)
           12053  Layer closure of
                   wound(s)
           12054  Layer closure of
                   wound(s)
           12055  Layer closure of
                   wound(s)
           12056  Layer closure of
                   wound(s)
   0025       Level II Skin Repair      T                       3.74     $181.34          $70.66          $36.27
           13100  Repair of wound or
                   lesion
           13101  Repair of wound or
                   lesion
           13102  Repair wound/lesion
                   add-on
           13120  Repair of wound or
                   lesion
           13121  Repair of wound or
                   lesion
           13122  Repair wound/lesion
                   add-on
           13131  Repair of wound or
                   lesion
           13132  Repair of wound or
                   lesion
           13133  Repair wound/lesion
                   add-on
           13151  Repair of wound or
                   lesion
           13152  Repair of wound or
                   lesion
           13153  Repair wound/lesion
                   add-on
           43870  Repair stomach
                   opening
   0026      Level III Skin Repair      T                      12.11     $587.18         $277.92         $117.44
           11960  Insert tissue
                   expander(s)
           11970  Replace tissue
                   expander
           12037  Layer closure of
                   wound(s)
           12047  Layer closure of
                   wound(s)
           12057  Layer closure of
                   wound(s)
           13150  Repair of wound or
                   lesion
           13160  Late closure of
                   wound
           14000  Skin tissue
                   rearrangement
           14001  Skin tissue
                   rearrangement
           14020  Skin tissue
                   rearrangement
           14021  Skin tissue
                   rearrangement
           14040  Skin tissue
                   rearrangement
           14041  Skin tissue
                   rearrangement
           14060  Skin tissue
                   rearrangement
           14061  Skin tissue
                   rearrangement
           14300  Skin tissue
                   rearrangement
           14350  Skin tissue
                   rearrangement
           15000  Skin graft
           15001  Skin graft add-on
           15050  Skin pinch graft
           15100  Skin split graft
           15101  Skin split graft add-
                   on
           15120  Skin split graft
           15121  Skin split graft add-
                   on
           15200  Skin full graft
           15201  Skin full graft add-
                   on
           15220  Skin full graft
           15221  Skin full graft add-
                   on
           15240  Skin full graft
           15241  Skin full graft add-
                   on
           15260  Skin full graft
           15261  Skin full graft add-
                   on
           15350  Skin homograft
           15351  Skin homograft add-
                   on
           15400  Skin heterograft
           15401  Skin heterograft add-
                   on
           15570  Form skin pedicle
                   flap
           15572  Form skin pedicle
                   flap
           15574  Form skin pedicle
                   flap
           15576  Form skin pedicle
                   flap
           15600  Skin graft
           15610  Skin graft
           15620  Skin graft
           15630  Skin graft
           15650  Transfer skin
                   pedicle flap

[[Page 18713]]

 
           15775  Hair transplant
                   punch grafts
           15776  Hair transplant
                   punch grafts
           15819  Plastic surgery,
                   neck
           15820  Revision of lower
                   eyelid
           15821  Revision of lower
                   eyelid
           15822  Revision of upper
                   eyelid
           15823  Revision of upper
                   eyelid
           15825  Removal of neck
                   wrinkles
           15829  Removal of skin
                   wrinkles
           15835  Excise excessive
                   skin tissue
           20101  Explore wound, chest
           20102  Explore wound,
                   abdomen
           20910  Remove cartilage for
                   graft
           20912  Remove cartilage for
                   graft
           20920  Removal of fascia
                   for graft
           20922  Removal of fascia
                   for graft
           20926  Removal of tissue
                   for graft
           23921  Amputation follow-up
                   surgery
           25929  Amputation follow-up
                   surgery
           33222  Revise pocket,
                   pacemaker
           33223  Revise pocket,
                   pacing-defib
           44312  Revision of
                   ileostomy
           44340  Revision of
                   colostomy
           G0168  Wound closure by
                   adhesive
           G0169  Removal tissue; no
                   anesthsia
           G0170  Skin biograft
           G0171  Skin biograft add-on
   0027       Level IV Skin Repair      T                      15.80     $766.10         $383.10         $153.22
           15732  Muscle-skin graft,
                   head/neck
           15734  Muscle-skin graft,
                   trunk
           15736  Muscle-skin graft,
                   arm
           15738  Muscle-skin graft,
                   leg
           15740  Island pedicle flap
                   graft
           15750  Neurovascular
                   pedicle graft
           15760  Composite skin graft
           15770  Derma-fat-fascia
                   graft
           15824  Removal of forehead
                   wrinkles
           15826  Removal of brow
                   wrinkles
           15828  Removal of face
                   wrinkles
           15831  Excise excessive
                   skin tissue
           15832  Excise excessive
                   skin tissue
           15833  Excise excessive
                   skin tissue
           15834  Excise excessive
                   skin tissue
           15836  Excise excessive
                   skin tissue
           15837  Excise excessive
                   skin tissue
           15839  Excise excessive
                   skin tissue
           15840  Graft for face nerve
                   palsy
           15841  Graft for face nerve
                   palsy
           15842  Graft for face nerve
                   palsy
           15845  Skin and muscle
                   repair, face
           15876  Suction assisted
                   lipectomy
           15877  Suction assisted
                   lipectomy
           15878  Suction assisted
                   lipectomy
           15879  Suction assisted
                   lipectomy
           15922  Removal of tail bone
                   ulcer
           15934  Remove sacrum
                   pressure sore
           15935  Remove sacrum
                   pressure sore
           15936  Remove sacrum
                   pressure sore
           15937  Remove sacrum
                   pressure sore
           15944  Remove hip pressure
                   sore
           15945  Remove hip pressure
                   sore
           15946  Remove hip pressure
                   sore
           15952  Remove thigh
                   pressure sore
           15953  Remove thigh
                   pressure sore
           15956  Remove thigh
                   pressure sore
           15958  Remove thigh
                   pressure sore
   0029     Incision/Excision Breast    T                      12.85     $623.06         $303.50         $124.61
           19101  Biopsy of breast
           19110  Nipple exploration
           19112  Excise breast duct
                   fistula
           19120  Removal of breast
                   lesion
           19125  Excision, breast
                   lesion
           19126  Excision, addl
                   breast lesion

[[Page 18714]]

 
           19140  Removal of breast
                   tissue
           19290  Place needle wire,
                   breast
           19291  Place needle wire,
                   breast
           19396  Design custom breast
                   implant
           19499  Breast surgery
                   procedure
   0030      Breast Reconstruction/     T                      20.19     $978.95         $523.95         $195.79
                   Mastectomy
           19160  Removal of breast
                   tissue
           19162  Remove breast
                   tissue, nodes
           19180  Removal of breast
           19182  Removal of breast
           19316  Suspension of breast
           19318  Reduction of large
                   breast
           19324  Enlarge breast
           19325  Enlarge breast with
                   implant
           19328  Removal of breast
                   implant
           19330  Removal of implant
                   material
           19340  Immediate breast
                   prosthesis
           19342  Delayed breast
                   prosthesis
           19350  Breast
                   reconstruction
           19355  Correct inverted
                   nipple(s)
           19357  Breast
                   reconstruction
           19366  Breast
                   reconstruction
           19370  Surgery of breast
                   capsule
           19371  Removal of breast
                   capsule
           19380  Revise breast
                   reconstruction
   0031        Hyperbaric Oxygen        S                       3.00     $145.46         $140.85          $29.09
           99183  Hyperbaric oxygen
                   therapy
           G0167  Hyperbaric oz tx; no
                   md reqrd
   0032      Placement Transvenous      T                       5.40     $261.83         $119.52          $52.37
           Catheters/Arterial Cutdown
           36420  Establish access to
                   vein
           36425  Establish access to
                   vein
           36488  Insertion of
                   catheter, vein
           36489  Insertion of
                   catheter, vein
           36490  Insertion of
                   catheter, vein
           36491  Insertion of
                   catheter, vein
           36493  Repositioning of cvc
           36640  Insertion catheter,
                   artery
   0033     Partial Hospitalization     P                       4.17     $202.19          $48.17          $40.44
           G0129  Partial hosp prog
                   service
           G0172  Partial hosp prog
                   service
           Q0082  Activity therapy w/
                   partial h
   0040    Arthrocentesis & Ligament/   T                       2.11     $102.31          $40.60          $20.46
                Tendon Injection
           20550  Inject tendon/
                   ligament/cyst
           20600  Drain/inject, joint/
                   bursa
           20605  Drain/inject, joint/
                   bursa
           20610  Drain/inject, joint/
                   bursa
   0041           Arthroscopy           T                      24.57   $1,191.33         $592.08         $238.27
           29800  Jaw arthroscopy/
                   surgery
           29804  Jaw arthroscopy/
                   surgery
           29815  Shoulder arthroscopy
           29819  Shoulder arthroscopy/
                   surgery
           29820  Shoulder arthroscopy/
                   surgery
           29821  Shoulder arthroscopy/
                   surgery
           29822  Shoulder arthroscopy/
                   surgery
           29823  Shoulder arthroscopy/
                   surgery
           29825  Shoulder arthroscopy/
                   surgery
           29826  Shoulder arthroscopy/
                   surgery
           29830  Elbow arthroscopy
           29834  Elbow arthroscopy/
                   surgery
           29835  Elbow arthroscopy/
                   surgery
           29836  Elbow arthroscopy/
                   surgery
           29837  Elbow arthroscopy/
                   surgery
           29838  Elbow arthroscopy/
                   surgery
           29840  Wrist arthroscopy
           29843  Wrist arthroscopy/
                   surgery
           29844  Wrist arthroscopy/
                   surgery
           29845  Wrist arthroscopy/
                   surgery
           29846  Wrist arthroscopy/
                   surgery
           29847  Wrist arthroscopy/
                   surgery
           29848  Wrist endoscopy/
                   surgery
           29860  Hip arthroscopy, dx
           29861  Hip arthroscopy/
                   surgery
           29862  Hip arthroscopy/
                   surgery

[[Page 18715]]

 
           29863  Hip arthroscopy/
                   surgery
           29870  Knee arthroscopy, dx
           29871  Knee arthroscopy/
                   drainage
           29874  Knee arthroscopy/
                   surgery
           29875  Knee arthroscopy/
                   surgery
           29876  Knee arthroscopy/
                   surgery
           29877  Knee arthroscopy/
                   surgery
           29879  Knee arthroscopy/
                   surgery
           29880  Knee arthroscopy/
                   surgery
           29881  Knee arthroscopy/
                   surgery
           29882  Knee arthroscopy/
                   surgery
           29883  Knee arthroscopy/
                   surgery
           29884  Knee arthroscopy/
                   surgery
           29886  Knee arthroscopy/
                   surgery
           29887  Knee arthroscopy/
                   surgery
           29891  Ankle arthroscopy/
                   surgery
           29894  Ankle arthroscopy/
                   surgery
           29895  Ankle arthroscopy/
                   surgery
           29897  Ankle arthroscopy/
                   surgery
           29898  Ankle arthroscopy/
                   surgery
           29909  Arthroscopy of joint
   0042      Arthroscopically-Aided     T                      29.22   $1,416.79         $804.74         $283.36
                   Procedures
           29850  Knee arthroscopy/
                   surgery
           29851  Knee arthroscopy/
                   surgery
           29855  Tibial arthroscopy/
                   surgery
           29856  Tibial arthroscopy/
                   surgery
           29885  Knee arthroscopy/
                   surgery
           29888  Knee arthroscopy/
                   surgery
           29889  Knee arthroscopy/
                   surgery
           29892  Ankle arthroscopy/
                   surgery
   0043    Closed Treatment Fracture    T                       1.64      $79.52          $25.46          $15.90
                Finger/Toe/Trunk
           21800  Treatment of rib
                   fracture
           21820  Treat sternum
                   fracture
           22305  Treat spine process
                   fracture
           22310  Treat spine fracture
           22315  Treat spine fracture
           22899  Spine surgery
                   procedure
           23500  Treat clavicle
                   fracture
           23505  Treat clavicle
                   fracture
           23520  Treat clavicle
                   dislocation
           23525  Treat clavicle
                   dislocation
           23540  Treat clavicle
                   dislocation
           23545  Treat clavicle
                   dislocation
           23570  Treat shoulder blade
                   fx
           23575  Treat shoulder blade
                   fx
           23650  Treat shoulder
                   dislocation
           23929  Shoulder surgery
                   procedure
           26700  Treat knuckle
                   dislocation
           26720  Treat finger
                   fracture, each
           26725  Treat finger
                   fracture, each
           26740  Treat finger
                   fracture, each
           26750  Treat finger
                   fracture, each
           26755  Treat finger
                   fracture, each
           26770  Treat finger
                   dislocation
           26989  Hand/finger surgery
           27200  Treat tail bone
                   fracture
           27299  Pelvis/hip joint
                   surgery
           28490  Treat big toe
                   fracture
           28495  Treat big toe
                   fracture
           28510  Treatment of toe
                   fracture
           28515  Treatment of toe
                   fracture
           28630  Treat toe
                   dislocation
           28660  Treat toe
                   dislocation
           28899  Foot/toes surgery
                   procedure
   0044    Closed Treatment Fracture/   T                       2.17     $105.22          $38.08          $21.04
         Dislocation Except Finger/Toe/
                     Trunk
           23600  Treat humerus
                   fracture
           23605  Treat humerus
                   fracture
           23620  Treat humerus
                   fracture
           23625  Treat humerus
                   fracture
           23665  Treat dislocation/
                   fracture
           23675  Treat dislocation/
                   fracture
           24500  Treat humerus
                   fracture
           24505  Treat humerus
                   fracture

[[Page 18716]]

 
           24530  Treat humerus
                   fracture
           24535  Treat humerus
                   fracture
           24560  Treat humerus
                   fracture
           24565  Treat humerus
                   fracture
           24576  Treat humerus
                   fracture
           24577  Treat humerus
                   fracture
           24600  Treat elbow
                   dislocation
           24620  Treat elbow fracture
           24640  Treat elbow
                   dislocation
           24650  Treat radius
                   fracture
           24655  Treat radius
                   fracture
           24670  Treat ulnar fracture
           24675  Treat ulnar fracture
           24999  Upper arm/elbow
                   surgery
           25500  Treat fracture of
                   radius
           25505  Treat fracture of
                   radius
           25520  Treat fracture of
                   radius
           25530  Treat fracture of
                   ulna
           25535  Treat fracture of
                   ulna
           25560  Treat fracture
                   radius & ulna
           25565  Treat fracture
                   radius & ulna
           25600  Treat fracture
                   radius/ulna
           25605  Treat fracture
                   radius/ulna
           25622  Treat wrist bone
                   fracture
           25624  Treat wrist bone
                   fracture
           25630  Treat wrist bone
                   fracture
           25635  Treat wrist bone
                   fracture
           25650  Treat wrist bone
                   fracture
           25660  Treat wrist
                   dislocation
           25675  Treat wrist
                   dislocation
           25680  Treat wrist fracture
           25690  Treat wrist
                   dislocation
           25999  Forearm or wrist
                   surgery
           26600  Treat metacarpal
                   fracture
           26605  Treat metacarpal
                   fracture
           26607  Treat metacarpal
                   fracture
           26641  Treat thumb
                   dislocation
           26645  Treat thumb fracture
           26670  Treat hand
                   dislocation
           26706  Pin knuckle
                   dislocation
           26742  Treat finger
                   fracture, each
           27193  Treat pelvic ring
                   fracture
           27220  Treat hip socket
                   fracture
           27230  Treat thigh fracture
           27238  Treat thigh fracture
           27246  Treat thigh fracture
           27250  Treat hip
                   dislocation
           27256  Treat hip
                   dislocation
           27265  Treat hip
                   dislocation
           27500  Treatment of thigh
                   fracture
           27501  Treatment of thigh
                   fracture
           27502  Treatment of thigh
                   fracture
           27503  Treatment of thigh
                   fracture
           27508  Treatment of thigh
                   fracture
           27510  Treatment of thigh
                   fracture
           27516  Treat thigh fx
                   growth plate
           27517  Treat thigh fx
                   growth plate
           27520  Treat kneecap
                   fracture
           27530  Treat knee fracture
           27532  Treat knee fracture
           27538  Treat knee
                   fracture(s)
           27550  Treat knee
                   dislocation
           27560  Treat kneecap
                   dislocation
           27599  Leg surgery
                   procedure
           27750  Treatment of tibia
                   fracture
           27752  Treatment of tibia
                   fracture
           27760  Treatment of ankle
                   fracture
           27762  Treatment of ankle
                   fracture
           27780  Treatment of fibula
                   fracture
           27781  Treatment of fibula
                   fracture
           27786  Treatment of ankle
                   fracture
           27788  Treatment of ankle
                   fracture
           27808  Treatment of ankle
                   fracture

[[Page 18717]]

 
           27810  Treatment of ankle
                   fracture
           27816  Treatment of ankle
                   fracture
           27818  Treatment of ankle
                   fracture
           27824  Treat lower leg
                   fracture
           27825  Treat lower leg
                   fracture
           27830  Treat lower leg
                   dislocation
           27840  Treat ankle
                   dislocation
           27899  Leg/ankle surgery
                   procedure
           28400  Treatment of heel
                   fracture
           28405  Treatment of heel
                   fracture
           28430  Treatment of ankle
                   fracture
           28435  Treatment of ankle
                   fracture
           28450  Treat midfoot
                   fracture, each
           28455  Treat midfoot
                   fracture, each
           28470  Treat metatarsal
                   fracture
           28475  Treat metatarsal
                   fracture
           28530  Treat sesamoid bone
                   fracture
           28540  Treat foot
                   dislocation
           28570  Treat foot
                   dislocation
           28600  Treat foot
                   dislocation
   0045  Bone/Joint Manipulation Under  T                      11.02     $534.33         $277.12         $106.87
                   Anesthesia
           22505  Manipulation of
                   spine
           23655  Treat shoulder
                   dislocation
           23700  Fixation of shoulder
           24605  Treat elbow
                   dislocation
           26675  Treat hand
                   dislocation
           26705  Treat knuckle
                   dislocation
           26775  Treat finger
                   dislocation
           27194  Treat pelvic ring
                   fracture
           27252  Treat hip
                   dislocation
           27257  Treat hip
                   dislocation
           27275  Manipulation of hip
                   joint
           27552  Treat knee
                   dislocation
           27562  Treat kneecap
                   dislocation
           27570  Fixation of knee
                   joint
           27831  Treat lower leg
                   dislocation
           27842  Treat ankle
                   dislocation
           27860  Fixation of ankle
                   joint
           28545  Treat foot
                   dislocation
           28575  Treat foot
                   dislocation
           28605  Treat foot
                   dislocation
           28635  Treat toe
                   dislocation
           28665  Treat toe
                   dislocation
   0046   Open/Percutaneous Treatment   T                      22.29   $1,080.78         $535.76         $216.16
            Fracture or Dislocation
           21336  Treat nasal septal
                   fracture
           21805  Treatment of rib
                   fracture
           23515  Treat clavicle
                   fracture
           23530  Treat clavicle
                   dislocation
           23532  Treat clavicle
                   dislocation
           23550  Treat clavicle
                   dislocation
           23552  Treat clavicle
                   dislocation
           23585  Treat scapula
                   fracture
           23615  Treat humerus
                   fracture
           23616  Treat humerus
                   fracture
           23630  Treat humerus
                   fracture
           23660  Treat shoulder
                   dislocation
           23670  Treat dislocation/
                   fracture
           23680  Treat dislocation/
                   fracture
           24515  Treat humerus
                   fracture
           24516  Treat humerus
                   fracture
           24538  Treat humerus
                   fracture
           24545  Treat humerus
                   fracture
           24546  Treat humerus
                   fracture
           24566  Treat humerus
                   fracture
           24575  Treat humerus
                   fracture
           24579  Treat humerus
                   fracture
           24582  Treat humerus
                   fracture
           24586  Treat elbow fracture
           24587  Treat elbow fracture
           24615  Treat elbow
                   dislocation
           24635  Treat elbow fracture
           24665  Treat radius
                   fracture
           24666  Treat radius
                   fracture

[[Page 18718]]

 
           24685  Treat ulnar fracture
           25515  Treat fracture of
                   radius
           25525  Treat fracture of
                   radius
           25526  Treat fracture of
                   radius
           25545  Treat fracture of
                   ulna
           25574  Treat fracture
                   radius & ulna
           25575  Treat fracture
                   radius/ulna
           25611  Treat fracture
                   radius/ulna
           25620  Treat fracture
                   radius/ulna
           25628  Treat wrist bone
                   fracture
           25645  Treat wrist bone
                   fracture
           25670  Treat wrist
                   dislocation
           25676  Treat wrist
                   dislocation
           25685  Treat wrist fracture
           25695  Treat wrist
                   dislocation
           26608  Treat metacarpal
                   fracture
           26615  Treat metacarpal
                   fracture
           26650  Treat thumb fracture
           26665  Treat thumb fracture
           26676  Pin hand dislocation
           26685  Treat hand
                   dislocation
           26686  Treat hand
                   dislocation
           26715  Treat knuckle
                   dislocation
           26727  Treat finger
                   fracture, each
           26735  Treat finger
                   fracture, each
           26746  Treat finger
                   fracture, each
           26756  Pin finger fracture,
                   each
           26765  Treat finger
                   fracture, each
           26776  Pin finger
                   dislocation
           26785  Treat finger
                   dislocation
           27202  Treat tail bone
                   fracture
           27509  Treatment of thigh
                   fracture
           27556  Treat knee
                   dislocation
           27566  Treat kneecap
                   dislocation
           27615  Remove tumor, lower
                   leg
           27756  Treatment of tibia
                   fracture
           27758  Treatment of tibia
                   fracture
           27759  Treatment of tibia
                   fracture
           27766  Treatment of ankle
                   fracture
           27784  Treatment of fibula
                   fracture
           27792  Treatment of ankle
                   fracture
           27814  Treatment of ankle
                   fracture
           27822  Treatment of ankle
                   fracture
           27823  Treatment of ankle
                   fracture
           27826  Treat lower leg
                   fracture
           27827  Treat lower leg
                   fracture
           27828  Treat lower leg
                   fracture
           27829  Treat lower leg
                   joint
           27832  Treat lower leg
                   dislocation
           27846  Treat ankle
                   dislocation
           27848  Treat ankle
                   dislocation
           28406  Treatment of heel
                   fracture
           28415  Treat heel fracture
           28420  Treat/graft heel
                   fracture
           28436  Treatment of ankle
                   fracture
           28445  Treat ankle fracture
           28456  Treat midfoot
                   fracture
           28465  Treat midfoot
                   fracture, each
           28476  Treat metatarsal
                   fracture
           28485  Treat metatarsal
                   fracture
           28496  Treat big toe
                   fracture
           28505  Treat big toe
                   fracture
           28525  Treat toe fracture
           28531  Treat sesamoid bone
                   fracture
           28546  Treat foot
                   dislocation
           28555  Repair foot
                   dislocation
           28576  Treat foot
                   dislocation
           28585  Repair foot
                   dislocation
           28606  Treat foot
                   dislocation
           28615  Repair foot
                   dislocation
           28636  Treat toe
                   dislocation
           28645  Repair toe
                   dislocation
           28666  Treat toe
                   dislocation

[[Page 18719]]

 
           28675  Repair of toe
                   dislocation
   0047       Arthroplasty without      T                      22.09   $1,071.08         $537.03         $214.22
                   Prosthesis
           24360  Reconstruct elbow
                   joint
           24365  Reconstruct head of
                   radius
           25332  Revise wrist joint
           25447  Repair wrist
                   joint(s)
           25449  Remove wrist joint
                   implant
           26530  Revise knuckle joint
           26535  Revise finger joint
           27266  Treat hip
                   dislocation
           27437  Revise kneecap
           27440  Revision of knee
                   joint
           27441  Revision of knee
                   joint
           27442  Revision of knee
                   joint
           27443  Revision of knee
                   joint
           27700  Revision of ankle
                   joint
   0048   Arthroplasty with Prosthesis  T                      29.06   $1,409.03         $725.94         $281.81
           24361  Reconstruct elbow
                   joint
           24362  Reconstruct elbow
                   joint
           24363  Replace elbow joint
           24366  Reconstruct head of
                   radius
           25441  Reconstruct wrist
                   joint
           25442  Reconstruct wrist
                   joint
           25443  Reconstruct wrist
                   joint
           25444  Reconstruct wrist
                   joint
           25445  Reconstruct wrist
                   joint
           25446  Wrist replacement
           26531  Revise knuckle with
                   implant
           26536  Revise/implant
                   finger joint
           27438  Revise kneecap with
                   implant
   0049     Level I Musculoskeletal     T                      15.04     $729.25         $356.95         $145.85
           Procedures Except Hand and
                      Foot
           20005  Incision of deep
                   abscess
           20250  Open bone biopsy
           20251  Open bone biopsy
           20650  Insert and remove
                   bone pin
           20693  Adjust bone fixation
                   device
           20694  Remove bone fixation
                   device
           20975  Electrical bone
                   stimulation
           20979  Us bone stimulation
           23100  Biopsy of shoulder
                   joint
           23140  Removal of bone
                   lesion
           23935  Drain arm/elbow bone
                   lesion
           24100  Biopsy elbow joint
                   lining
           24105  Removal of elbow
                   bursa
           24110  Remove humerus
                   lesion
           24120  Remove elbow lesion
           24310  Revision of arm
                   tendon
           24925  Amputation follow-up
                   surgery
           25000  Incision of tendon
                   sheath
           25020  Decompression of
                   forearm
           25028  Drainage of forearm
                   lesion
           25031  Drainage of forearm
                   bursa
           25035  Treat forearm bone
                   lesion
           25085  Incision of wrist
                   capsule
           25100  Biopsy of wrist
                   joint
           25110  Remove wrist tendon
                   lesion
           25115  Remove wrist/forearm
                   lesion
           25116  Remove wrist/forearm
                   lesion
           25248  Remove forearm
                   foreign body
           25295  Release wrist/
                   forearm tendon
           25907  Amputation follow-up
                   surgery
           25922  Amputate hand at
                   wrist
           26990  Drainage of pelvis
                   lesion
           26991  Drainage of pelvis
                   bursa
           27000  Incision of hip
                   tendon
           27050  Biopsy of sacroiliac
                   joint
           27052  Biopsy of hip joint
           27060  Removal of ischial
                   bursa
           27062  Remove femur lesion/
                   bursa
           27065  Removal of hip bone
                   lesion
           27087  Remove hip foreign
                   body
           27305  Incise thigh tendon
                   & fascia
           27306  Incision of thigh
                   tendon

[[Page 18720]]

 
           27307  Incision of thigh
                   tendons
           27340  Removal of kneecap
                   bursa
           27345  Removal of knee cyst
           27347  Remove knee cyst
           27380  Repair of kneecap
                   tendon
           27381  Repair/graft kneecap
                   tendon
           27385  Repair of thigh
                   muscle
           27386  Repair/graft of
                   thigh muscle
           27390  Incision of thigh
                   tendon
           27391  Incision of thigh
                   tendons
           27392  Incision of thigh
                   tendons
           27496  Decompression of
                   thigh/knee
           27497  Decompression of
                   thigh/knee
           27498  Decompression of
                   thigh/knee
           27499  Decompression of
                   thigh/knee
           27594  Amputation follow-up
                   surgery
           27600  Decompression of
                   lower leg
           27601  Decompression of
                   lower leg
           27602  Decompression of
                   lower leg
           27604  Drain lower leg
                   bursa
           27606  Incision of achilles
                   tendon
           27607  Treat lower leg bone
                   lesion
           27630  Removal of tendon
                   lesion
           27656  Repair leg fascia
                   defect
           27658  Repair of leg
                   tendon, each
           27659  Repair of leg
                   tendon, each
           27664  Repair of leg
                   tendon, each
           27675  Repair lower leg
                   tendons
           27704  Removal of ankle
                   implant
           27707  Incision of fibula
           27884  Amputation follow-up
                   surgery
           27892  Decompression of leg
           27893  Decompression of leg
           27894  Decompression of leg
           28002  Treatment of foot
                   infection
           28003  Treatment of foot
                   infection
   0050     Level II Musculoskeletal    T                      21.13   $1,024.53         $513.86         $204.91
           Procedures Except Hand and
                      Foot
           20690  Apply bone fixation
                   device
           20692  Apply bone fixation
                   device
           20900  Removal of bone for
                   graft
           20902  Removal of bone for
                   graft
           20924  Removal of tendon
                   for graft
           21502  Drain chest lesion
           21600  Partial removal of
                   rib
           21610  Partial removal of
                   rib
           23040  Exploratory shoulder
                   surgery
           23044  Exploratory shoulder
                   surgery
           23101  Shoulder joint
                   surgery
           23105  Remove shoulder
                   joint lining
           23106  Incision of
                   collarbone joint
           23107  Explore treat
                   shoulder joint
           23145  Removal of bone
                   lesion
           23146  Removal of bone
                   lesion
           23150  Removal of humerus
                   lesion
           23155  Removal of humerus
                   lesion
           23156  Removal of humerus
                   lesion
           23170  Remove collar bone
                   lesion
           23172  Remove shoulder
                   blade lesion
           23174  Remove humerus
                   lesion
           23180  Remove collar bone
                   lesion
           23182  Remove shoulder
                   blade lesion
           23184  Remove humerus
                   lesion
           23190  Partial removal of
                   scapula
           23405  Incision of tendon &
                   muscle
           23406  Incise tendon(s) &
                   muscle(s)
           24000  Exploratory elbow
                   surgery
           24006  Release elbow joint
           24101  Explore/treat elbow
                   joint
           24102  Remove elbow joint
                   lining
           24115  Remove/graft bone
                   lesion
           24116  Remove/graft bone
                   lesion
           24125  Remove/graft bone
                   lesion
           24126  Remove/graft bone
                   lesion

[[Page 18721]]

 
           24130  Removal of head of
                   radius
           24134  Removal of arm bone
                   lesion
           24136  Remove radius bone
                   lesion
           24138  Remove elbow bone
                   lesion
           24140  Partial removal of
                   arm bone
           24145  Partial removal of
                   radius
           24147  Partial removal of
                   elbow
           24160  Remove elbow joint
                   implant
           24164  Remove radius head
                   implant
           24301  Muscle/tendon
                   transfer
           24305  Arm tendon
                   lengthening
           24350  Repair of tennis
                   elbow
           24351  Repair of tennis
                   elbow
           24352  Repair of tennis
                   elbow
           24354  Repair of tennis
                   elbow
           24356  Revision of tennis
                   elbow
           24400  Revision of humerus
           24410  Revision of humerus
           24495  Decompression of
                   forearm
           25023  Decompression of
                   forearm
           25040  Explore/treat wrist
                   joint
           25101  Explore/treat wrist
                   joint
           25105  Remove wrist joint
                   lining
           25107  Remove wrist joint
                   cartilage
           25118  Excise wrist tendon
                   sheath
           25119  Partial removal of
                   ulna
           25120  Removal of forearm
                   lesion
           25125  Remove/graft forearm
                   lesion
           25126  Remove/graft forearm
                   lesion
           25130  Removal of wrist
                   lesion
           25135  Remove & graft wrist
                   lesion
           25136  Remove & graft wrist
                   lesion
           25145  Remove forearm bone
                   lesion
           25150  Partial removal of
                   ulna
           25151  Partial removal of
                   radius
           25230  Partial removal of
                   radius
           25240  Partial removal of
                   ulna
           25250  Removal of wrist
                   prosthesis
           25251  Removal of wrist
                   prosthesis
           25260  Repair forearm
                   tendon/muscle
           25263  Repair forearm
                   tendon/muscle
           25265  Repair forearm
                   tendon/muscle
           25270  Repair forearm
                   tendon/muscle
           25272  Repair forearm
                   tendon/muscle
           25274  Repair forearm
                   tendon/muscle
           25280  Revise wrist/forearm
                   tendon
           25290  Incise wrist/forearm
                   tendon
           25300  Fusion of tendons at
                   wrist
           25301  Fusion of tendons at
                   wrist
           25360  Revision of ulna
           25365  Revise radius & ulna
           25400  Repair radius or
                   ulna
           25415  Repair radius & ulna
           27001  Incision of hip
                   tendon
           27003  Incision of hip
                   tendon
           27066  Removal of hip bone
                   lesion
           27067  Remove/graft hip
                   bone lesion
           27080  Removal of tail bone
           27097  Revision of hip
                   tendon
           27098  Transfer tendon to
                   pelvis
           27310  Exploration of knee
                   joint
           27330  Biopsy, knee joint
                   lining
           27331  Explore/treat knee
                   joint
           27332  Removal of knee
                   cartilage
           27333  Removal of knee
                   cartilage
           27334  Remove knee joint
                   lining
           27335  Remove knee joint
                   lining
           27350  Removal of kneecap
           27355  Remove femur lesion
           27356  Remove femur lesion/
                   graft
           27357  Remove femur lesion/
                   graft
           27358  Remove femur lesion/
                   fixation
           27360  Partial removal, leg
                   bone(s)

[[Page 18722]]

 
           27393  Lengthening of thigh
                   tendon
           27394  Lengthening of thigh
                   tendons
           27396  Transplant of thigh
                   tendon
           27403  Repair of knee
                   cartilage
           27425  Lateral retinacular
                   release
           27610  Explore/treat ankle
                   joint
           27612  Exploration of ankle
                   joint
           27620  Explore/treat ankle
                   joint
           27625  Remove ankle joint
                   lining
           27626  Remove ankle joint
                   lining
           27635  Remove lower leg
                   bone lesion
           27637  Remove/graft leg
                   bone lesion
           27638  Remove/graft leg
                   bone lesion
           27641  Partial removal of
                   fibula
           27665  Repair of leg
                   tendon, each
           27676  Repair lower leg
                   tendons
           27680  Release of lower leg
                   tendon
           27681  Release of lower leg
                   tendons
           27685  Revision of lower
                   leg tendon
           27686  Revise lower leg
                   tendons
           27687  Revision of calf
                   tendon
           27695  Repair of ankle
                   ligament
           27696  Repair of ankle
                   ligaments
           27698  Repair of ankle
                   ligament
           27709  Incision of tibia &
                   fibula
           27730  Repair of tibia
                   epiphysis
           27732  Repair of fibula
                   epiphysis
           27734  Repair lower leg
                   epiphyses
           27740  Repair of leg
                   epiphyses
           27889  Amputation of foot
                   at ankle
   0051    Level III Musculoskeletal    T                      27.76   $1,346.00         $675.24         $269.20
           Procedures Except Hand and
                      Foot
           20150  Excise epiphyseal
                   bar
           23020  Release shoulder
                   joint
           23120  Partial removal,
                   collar bone
           23130  Remove shoulder
                   bone, part
           23415  Release of shoulder
                   ligament
           23480  Revision of collar
                   bone
           23485  Revision of collar
                   bone
           23490  Reinforce clavicle
           23491  Reinforce shoulder
                   bones
           23800  Fusion of shoulder
                   joint
           23802  Fusion of shoulder
                   joint
           24155  Removal of elbow
                   joint
           24320  Repair of arm tendon
           24330  Revision of arm
                   muscles
           24331  Revision of arm
                   muscles
           24340  Repair of biceps
                   tendon
           24341  Repair arm tendon/
                   muscle
           24342  Repair of ruptured
                   tendon
           24420  Revision of humerus
           24430  Repair of humerus
           24435  Repair humerus with
                   graft
           24470  Revision of elbow
                   joint
           24498  Reinforce humerus
           24800  Fusion of elbow
                   joint
           24802  Fusion/graft of
                   elbow joint
           25310  Transplant forearm
                   tendon
           25312  Transplant forearm
                   tendon
           25315  Revise palsy hand
                   tendon(s)
           25316  Revise palsy hand
                   tendon(s)
           25320  Repair/revise wrist
                   joint
           25335  Realignment of hand
           25337  Reconstruct ulna/
                   radioulnar
           25350  Revision of radius
           25355  Revision of radius
           25370  Revise radius or
                   ulna
           25375  Revise radius & ulna
           25425  Repair/graft radius
                   or ulna
           25426  Repair/graft radius
                   & ulna
           25440  Repair/graft wrist
                   bone
           25450  Revision of wrist
                   joint
           25455  Revision of wrist
                   joint
           25490  Reinforce radius

[[Page 18723]]

 
           25491  Reinforce ulna
           25492  Reinforce radius and
                   ulna
           25800  Fusion of wrist
                   joint
           25805  Fusion/graft of
                   wrist joint
           25810  Fusion/graft of
                   wrist joint
           25830  Fusion, radioulnar
                   jnt/ulna
           27033  Exploration of hip
                   joint
           27100  Transfer of
                   abdominal muscle
           27105  Transfer of spinal
                   muscle
           27110  Transfer of
                   iliopsoas muscle
           27111  Transfer of
                   iliopsoas muscle
           27395  Lengthening of thigh
                   tendons
           27397  Transplants of thigh
                   tendons
           27400  Revise thigh muscles/
                   tendons
           27405  Repair of knee
                   ligament
           27407  Repair of knee
                   ligament
           27409  Repair of knee
                   ligaments
           27418  Repair degenerated
                   kneecap
           27420  Revision of unstable
                   kneecap
           27422  Revision of unstable
                   kneecap
           27424  Revision/removal of
                   kneecap
           27430  Revision of thigh
                   muscles
           27435  Incision of knee
                   joint
           27640  Partial removal of
                   tibia
           27647  Extensive ankle/heel
                   surgery
           27650  Repair achilles
                   tendon
           27652  Repair/graft
                   achilles tendon
           27654  Repair of achilles
                   tendon
           27690  Revise lower leg
                   tendon
           27691  Revise lower leg
                   tendon
           27692  Revise additional
                   leg tendon
           27705  Incision of tibia
           27742  Repair of leg
                   epiphyses
           27745  Reinforce tibia
           27870  Fusion of ankle
                   joint
           27871  Fusion of
                   tibiofibular joint
   0052     Level IV Musculoskeletal    T                      36.16   $1,753.29         $930.91         $350.66
           Procedures Except Hand and
                      Foot
           23410  Repair of tendon(s)
           23412  Repair of tendon(s)
           23420  Repair of shoulder
           23430  Repair biceps tendon
           23450  Repair shoulder
                   capsule
           23455  Repair shoulder
                   capsule
           23460  Repair shoulder
                   capsule
           23462  Repair shoulder
                   capsule
           23465  Repair shoulder
                   capsule
           23466  Repair shoulder
                   capsule
           24935  Revision of
                   amputation
           27427  Reconstruction, knee
           27428  Reconstruction, knee
           27429  Reconstruction, knee
   0053   Level I Hand Musculoskeletal  T                      11.32     $548.87         $253.49         $109.77
                   Procedures
           25111  Remove wrist tendon
                   lesion
           25112  Reremove wrist
                   tendon lesion
           25820  Fusion of hand bones
           26020  Drain hand tendon
                   sheath
           26025  Drainage of palm
                   bursa
           26030  Drainage of palm
                   bursa(s)
           26034  Treat hand bone
                   lesion
           26035  Decompress fingers/
                   hand
           26037  Decompress fingers/
                   hand
           26055  Incise finger tendon
                   sheath
           26060  Incision of finger
                   tendon
           26070  Explore/treat hand
                   joint
           26075  Explore/treat finger
                   joint
           26080  Explore/treat finger
                   joint
           26100  Biopsy hand joint
                   lining
           26105  Biopsy finger joint
                   lining
           26110  Biopsy finger joint
                   lining
           26130  Remove wrist joint
                   lining
           26140  Revise finger joint,
                   each
           26145  Tendon excision,
                   palm/finger
           26160  Remove tendon sheath
                   lesion

[[Page 18724]]

 
           26170  Removal of palm
                   tendon, each
           26180  Removal of finger
                   tendon
           26185  Remove finger bone
           26200  Remove hand bone
                   lesion
           26210  Removal of finger
                   lesion
           26215  Remove/graft finger
                   lesion
           26230  Partial removal of
                   hand bone
           26235  Partial removal,
                   finger bone
           26236  Partial removal,
                   finger bone
           26250  Extensive hand
                   surgery
           26260  Extensive finger
                   surgery
           26261  Extensive finger
                   surgery
           26262  Partial removal of
                   finger
           26410  Repair hand tendon
           26418  Repair finger tendon
           26432  Repair finger tendon
           26433  Repair finger tendon
           26437  Realignment of
                   tendons
           26440  Release palm/finger
                   tendon
           26445  Release hand/finger
                   tendon
           26450  Incision of palm
                   tendon
           26455  Incision of finger
                   tendon
           26460  Incise hand/finger
                   tendon
           26471  Fusion of finger
                   tendons
           26474  Fusion of finger
                   tendons
           26476  Tendon lengthening
           26477  Tendon shortening
           26478  Lengthening of hand
                   tendon
           26479  Shortening of hand
                   tendon
           26500  Hand tendon
                   reconstruction
           26508  Release thumb
                   contracture
           26520  Release knuckle
                   contracture
           26525  Release finger
                   contracture
           26540  Repair hand joint
           26542  Repair hand joint
                   with graft
           26560  Repair of web finger
           26587  Reconstruct extra
                   finger
           26593  Release muscles of
                   hand
           26951  Amputation of finger/
                   thumb
           26952  Amputation of finger/
                   thumb
   0054  Level II Hand Musculoskeletal  T                      19.66     $953.26         $472.33         $190.65
                   Procedures
           25210  Removal of wrist
                   bone
           25215  Removal of wrist
                   bones
           25825  Fuse hand bones with
                   graft
           26040  Release palm
                   contracture
           26045  Release palm
                   contracture
           26121  Release palm
                   contracture
           26123  Release palm
                   contracture
           26125  Release palm
                   contracture
           26135  Revise finger joint,
                   each
           26205  Remove/graft bone
                   lesion
           26255  Extensive hand
                   surgery
           26350  Repair finger/hand
                   tendon
           26352  Repair/graft hand
                   tendon
           26356  Repair finger/hand
                   tendon
           26357  Repair finger/hand
                   tendon
           26358  Repair/graft hand
                   tendon
           26370  Repair finger/hand
                   tendon
           26372  Repair/graft hand
                   tendon
           26373  Repair finger/hand
                   tendon
           26390  Revise hand/finger
                   tendon
           26392  Repair/graft hand
                   tendon
           26412  Repair/graft hand
                   tendon
           26415  Excision, hand/
                   finger tendon
           26416  Graft hand or finger
                   tendon
           26420  Repair/graft finger
                   tendon
           26426  Repair finger/hand
                   tendon
           26428  Repair/graft finger
                   tendon
           26434  Repair/graft finger
                   tendon
           26442  Release palm &
                   finger tendon
           26449  Release forearm/hand
                   tendon
           26480  Transplant hand
                   tendon
           26483  Transplant/graft
                   hand tendon

[[Page 18725]]

 
           26485  Transplant palm
                   tendon
           26489  Transplant/graft
                   palm tendon
           26490  Revise thumb tendon
           26492  Tendon transfer with
                   graft
           26494  Hand tendon/muscle
                   transfer
           26496  Revise thumb tendon
           26497  Finger tendon
                   transfer
           26498  Finger tendon
                   transfer
           26499  Revision of finger
           26502  Hand tendon
                   reconstruction
           26504  Hand tendon
                   reconstruction
           26510  Thumb tendon
                   transfer
           26516  Fusion of knuckle
                   joint
           26517  Fusion of knuckle
                   joints
           26518  Fusion of knuckle
                   joints
           26541  Repair hand joint
                   with graft
           26545  Reconstruct finger
                   joint
           26546  Repair nonunion hand
           26548  Reconstruct finger
                   joint
           26550  Construct thumb
                   replacement
           26555  Positional change of
                   finger
           26561  Repair of web finger
           26562  Repair of web finger
           26565  Correct metacarpal
                   flaw
           26567  Correct finger
                   deformity
           26568  Lengthen metacarpal/
                   finger
           26580  Repair hand
                   deformity
           26585  Repair finger
                   deformity
           26590  Repair finger
                   deformity
           26591  Repair muscles of
                   hand
           26596  Excision
                   constricting tissue
           26597  Release of scar
                   contracture
           26820  Thumb fusion with
                   graft
           26841  Fusion of thumb
           26842  Thumb fusion with
                   graft
           26843  Fusion of hand joint
           26844  Fusion/graft of hand
                   joint
           26850  Fusion of knuckle
           26852  Fusion of knuckle
                   with graft
           26860  Fusion of finger
                   joint
           26861  Fusion of finger
                   jnt, add-on
           26862  Fusion/graft of
                   finger joint
           26863  Fuse/graft added
                   joint
           26910  Amputate metacarpal
                   bone
   0055   Level I Foot Musculoskeletal  T                      15.47     $750.10         $355.34         $150.02
                   Procedures
           27605  Incision of achilles
                   tendon
           28005  Treat foot bone
                   lesion
           28008  Incision of foot
                   fascia
           28010  Incision of toe
                   tendon
           28011  Incision of toe
                   tendons
           28020  Exploration of foot
                   joint
           28022  Exploration of foot
                   joint
           28024  Exploration of toe
                   joint
           28045  Excision of foot
                   lesion
           28046  Resection of tumor,
                   foot
           28050  Biopsy of foot joint
                   lining
           28052  Biopsy of foot joint
                   lining
           28054  Biopsy of toe joint
                   lining
           28080  Removal of foot
                   lesion
           28086  Excise foot tendon
                   sheath
           28088  Excise foot tendon
                   sheath
           28090  Removal of foot
                   lesion
           28092  Removal of toe
                   lesions
           28100  Removal of ankle/
                   heel lesion
           28104  Removal of foot
                   lesion
           28108  Removal of toe
                   lesions
           28111  Part removal of
                   metatarsal
           28112  Part removal of
                   metatarsal
           28113  Part removal of
                   metatarsal
           28114  Removal of
                   metatarsal heads
           28116  Revision of foot
           28118  Removal of heel bone
           28119  Removal of heel spur

[[Page 18726]]

 
           28120  Part removal of
                   ankle/heel
           28122  Partial removal of
                   foot bone
           28124  Partial removal of
                   toe
           28126  Partial removal of
                   toe
           28130  Removal of ankle
                   bone
           28140  Removal of
                   metatarsal
           28150  Removal of toe
           28153  Partial removal of
                   toe
           28160  Partial removal of
                   toe
           28171  Extensive foot
                   surgery
           28173  Extensive foot
                   surgery
           28175  Extensive foot
                   surgery
           28200  Repair of foot
                   tendon
           28208  Repair of foot
                   tendon
           28210  Repair/graft of foot
                   tendon
           28220  Release of foot
                   tendon
           28222  Release of foot
                   tendons
           28225  Release of foot
                   tendon
           28226  Release of foot
                   tendons
           28230  Incision of foot
                   tendon(s)
           28232  Incision of toe
                   tendon
           28234  Incision of foot
                   tendon
           28240  Release of big toe
           28270  Release of foot
                   contracture
           28272  Release of toe
                   joint, each
           28280  Fusion of toes
           28285  Repair of hammertoe
           28286  Repair of hammertoe
           28310  Revision of big toe
           28312  Revision of toe
           28313  Repair deformity of
                   toe
           28315  Removal of sesamoid
                   bone
           28340  Resect enlarged toe
                   tissue
           28341  Resect enlarged toe
           28737  Revision of foot
                   bones
           28750  Fusion of big toe
                   joint
           28755  Fusion of big toe
                   joint
           28810  Amputation toe &
                   metatarsal
           28820  Amputation of toe
           28825  Partial amputation
                   of toe
           29893  Scope, plantar
                   fasciotomy
   0056  Level II Foot Musculoskeletal  T                      17.30     $838.83         $405.81         $167.77
                   Procedures
           28060  Partial removal,
                   foot fascia
           28062  Removal of foot
                   fascia
           28070  Removal of foot
                   joint lining
           28072  Removal of foot
                   joint lining
           28102  Remove/graft foot
                   lesion
           28103  Remove/graft foot
                   lesion
           28106  Remove/graft foot
                   lesion
           28107  Remove/graft foot
                   lesion
           28202  Repair/graft of foot
                   tendon
           28238  Revision of foot
                   tendon
           28250  Revision of foot
                   fascia
           28260  Release of midfoot
                   joint
           28261  Revision of foot
                   tendon
           28262  Revision of foot and
                   ankle
           28264  Release of midfoot
                   joint
           28288  Partial removal of
                   foot bone
           28289  Repair hallux
                   rigidus
           28300  Incision of heel
                   bone
           28302  Incision of ankle
                   bone
           28304  Incision of midfoot
                   bones
           28305  Incise/graft midfoot
                   bones
           28306  Incision of
                   metatarsal
           28307  Incision of
                   metatarsal
           28308  Incision of
                   metatarsal
           28309  Incision of
                   metatarsals
           28320  Repair of foot bones
           28322  Repair of
                   metatarsals
           28344  Repair extra toe(s)
           28345  Repair webbed toe(s)
           28360  Reconstruct cleft
                   foot
           28705  Fusion of foot bones

[[Page 18727]]

 
           28715  Fusion of foot bones
           28725  Fusion of foot bones
           28730  Fusion of foot bones
           28735  Fusion of foot bones
           28740  Fusion of foot bones
           28760  Fusion of big toe
                   joint
   0057        Bunion Procedures        T                      21.00   $1,018.23         $496.65         $203.65
           28110  Part removal of
                   metatarsal
           28290  Correction of bunion
           28292  Correction of bunion
           28293  Correction of bunion
           28294  Correction of bunion
           28296  Correction of bunion
           28297  Correction of bunion
           28298  Correction of bunion
           28299  Correction of bunion
   0058    Level I Strapping and Cast   S                       1.09      $52.85          $19.27          $10.57
                  Application
           29505  Application, long
                   leg splint
           29515  Application lower
                   leg splint
           29520  Strapping of hip
           29530  Strapping of knee
           29540  Strapping of ankle
           29550  Strapping of toes
           29580  Application of paste
                   boot
           29590  Application of foot
                   splint
           29700  Removal/revision of
                   cast
           29705  Removal/revision of
                   cast
           29710  Removal/revision of
                   cast
           29715  Removal/revision of
                   cast
           29720  Repair of body cast
           29730  Windowing of cast
           29740  Wedging of cast
           29750  Wedging of clubfoot
                   cast
           29799  Casting/strapping
                   procedure
   0059   Level II Strapping and Cast   S                       1.74      $84.37          $29.59          $16.87
                  Application
           29000  Application of body
                   cast
           29010  Application of body
                   cast
           29015  Application of body
                   cast
           29020  Application of body
                   cast
           29025  Application of body
                   cast
           29035  Application of body
                   cast
           29040  Application of body
                   cast
           29044  Application of body
                   cast
           29046  Application of body
                   cast
           29049  Application of
                   figure eight
           29055  Application of
                   shoulder cast
           29058  Application of
                   shoulder cast
           29065  Application of long
                   arm cast
           29075  Application of
                   forearm cast
           29085  Apply hand/wrist
                   cast
           29105  Apply long arm
                   splint
           29125  Apply forearm splint
           29126  Apply forearm splint
           29130  Application of
                   finger splint
           29131  Application of
                   finger splint
           29200  Strapping of chest
           29220  Strapping of low
                   back
           29240  Strapping of
                   shoulder
           29260  Strapping of elbow
                   or wrist
           29280  Strapping of hand or
                   finger
           29305  Application of hip
                   cast
           29325  Application of hip
                   casts
           29345  Application of long
                   leg cast
           29355  Application of long
                   leg cast
           29358  Apply long leg cast
                   brace
           29365  Application of long
                   leg cast
           29405  Apply short leg cast
           29425  Apply short leg cast
           29435  Apply short leg cast
           29440  Addition of walker
                   to cast
           29445  Apply rigid leg cast
           29450  Application of leg
                   cast
   0060       Manipulation Therapy      S                       0.77      $37.34           $7.80           $7.47

[[Page 18728]]

 
           98925  Osteopathic
                   manipulation
           98926  Osteopathic
                   manipulation
           98927  Osteopathic
                   manipulation
           98928  Osteopathic
                   manipulation
           98929  Osteopathic
                   manipulation
           98940  Chiropractic
                   manipulation
           98941  Chiropractic
                   manipulation
           98942  Chiropractic
                   manipulation
   0070       Thoracentesis/Lavage      T                       3.64     $176.49          $79.60          $35.30
                   Procedures
           32000  Drainage of chest
           32002  Treatment of
                   collapsed lung
           32005  Treat lung lining
                   chemically
           32020  Insertion of chest
                   tube
           32420  Puncture/clear lung
           32960  Therapeutic
                   pneumothorax
           32999  Chest surgery
                   procedure
           33010  Drainage of heart
                   sac
           33011  Repeat drainage of
                   heart sac
           33999  Cardiac surgery
                   procedure
           49080  Puncture, peritoneal
                   cavity
           49081  Removal of abdominal
                   fluid
   0071     Level I Endoscopy Upper     T                       0.55      $26.67          $14.22           $5.33
                     Airway
           31231  Nasal endoscopy, dx
           31575  Diagnostic
                   laryngoscopy
           92511  Nasopharyngoscopy
   0072     Level II Endoscopy Upper    T                       1.26      $61.09          $41.52          $12.22
                     Airway
           31233  Nasal/sinus
                   endoscopy, dx
           31505  Diagnostic
                   laryngoscopy
           31511  Remove foreign body,
                   larynx
           31520  Diagnostic
                   laryngoscopy
           31700  Insertion of airway
                   catheter
           31720  Clearance of airways
   0073    Level III Endoscopy Upper    T                       4.11     $199.28          $91.07          $39.86
                     Airway
           31513  Injection into vocal
                   cord
           31577  Remove foreign body,
                   larynx
           31579  Diagnostic
                   laryngoscopy
           31717  Bronchial brush
                   biopsy
           31730  Intro, windpipe wire/
                   tube
   0074     Level IV Endoscopy Upper    T                      13.61     $659.91         $347.54         $131.98
                     Airway
           31235  Nasal/sinus
                   endoscopy, dx
           31237  Nasal/sinus
                   endoscopy, surg
           31238  Nasal/sinus
                   endoscopy, surg
           31240  Nasal/sinus
                   endoscopy, surg
           31510  Laryngoscopy with
                   biopsy
           31512  Removal of larynx
                   lesion
           31515  Laryngoscopy for
                   aspiration
           31525  Diagnostic
                   laryngoscopy
           31526  Diagnostic
                   laryngoscopy
           31528  Laryngoscopy and
                   dilatation
           31529  Laryngoscopy and
                   dilatation
           31576  Laryngoscopy with
                   biopsy
           31578  Removal of larynx
                   lesion
   0075     Level V Endoscopy Upper     T                      18.55     $899.44         $467.29         $179.89
                     Airway
           31239  Nasal/sinus
                   endoscopy, surg
           31254  Revision of ethmoid
                   sinus
           31255  Removal of ethmoid
                   sinus
           31256  Exploration
                   maxillary sinus
           31267  Endoscopy, maxillary
                   sinus
           31276  Sinus endoscopy,
                   surgical
           31287  Nasal/sinus
                   endoscopy, surg
           31288  Nasal/sinus
                   endoscopy, surg
           31527  Laryngoscopy for
                   treatment
           31530  Operative
                   laryngoscopy
           31531  Operative
                   laryngoscopy
           31535  Operative
                   laryngoscopy
           31536  Operative
                   laryngoscopy
           31540  Operative
                   laryngoscopy
           31541  Operative
                   laryngoscopy
           31560  Operative
                   laryngoscopy
           31561  Operative
                   laryngoscopy
           31570  Laryngoscopy with
                   injection
           31571  Laryngoscopy with
                   injection
           96570  Photodynamic tx, 30
                   min

[[Page 18729]]

 
           96571  Photodynamic tx,
                   addl 15 min
   0076      Endoscopy Lower Airway     T                       8.06     $390.81         $197.05          $78.16
           31615  Visualization of
                   windpipe
           31622  Dx bronchoscope/wash
           31623  Dx bronchoscope/
                   brush
           31624  Dx bronchoscope/
                   lavage
           31625  Bronchoscopy with
                   biopsy
           31628  Bronchoscopy with
                   biopsy
           31629  Bronchoscopy with
                   biopsy
           31630  Bronchoscopy with
                   repair
           31631  Bronchoscopy with
                   dilation
           31635  Remove foreign body,
                   airway
           31640  Bronchoscopy &
                   remove lesion
           31641  Bronchoscopy, treat
                   blockage
           31643  Diag bronchoscope/
                   catheter
           31645  Bronchoscopy, clear
                   airways
           31646  Bronchoscopy,
                   reclear airway
           31656  Bronchoscopy, inj
                   for x-ray
           31899  Airways surgical
                   procedure
           32601  Thoracoscopy,
                   diagnostic
           32602  Thoracoscopy,
                   diagnostic
           32603  Thoracoscopy,
                   diagnostic
           32604  Thoracoscopy,
                   diagnostic
           32605  Thoracoscopy,
                   diagnostic
           32606  Thoracoscopy,
                   diagnostic
           39400  Visualization of
                   chest
   0077   Level I Pulmonary Treatment   S                       0.43      $20.85          $12.62           $4.17
           94640  Airway inhalation
                   treatment
           94650  Pressure breathing
                   (IPPB)
           94651  Pressure breathing
                   (IPPB)
           94664  Aerosol or vapor
                   inhalations
           94665  Aerosol or vapor
                   inhalations
           94667  Chest wall
                   manipulation
           94668  Chest wall
                   manipulation
   0078   Level II Pulmonary Treatment  S                       1.34      $64.97          $29.13          $12.99
           94642  Aerosol inhalation
                   treatment
   0079    Ventilation Initiation and   S                       3.18     $154.19         $107.70          $30.84
                   Management
           94656  Initial ventilator
                   mgmt
           94657  Continued ventilator
                   mgmt
           94660  Pos airway pressure,
                   CPAP
           94662  Neg press
                   ventilation, cnp
   0080        Diagnostic Cardiac       T                      25.77   $1,249.51         $713.89         $249.90
                Catheterization
           93501  Right heart
                   catheterization
           93503  Insert/place heart
                   catheter
           93505  Biopsy of heart
                   lining
           93510  Left heart
                   catheterization
           93511  Left heart
                   catheterization
           93514  Left heart
                   catheterization
           93524  Left heart
                   catheterization
           93526  Rt & Lt heart
                   catheters
           93527  Rt & Lt heart
                   catheters
           93528  Rt & Lt heart
                   catheters
           93529  Rt, Lt heart
                   catheterization
           93530  Rt heart cath,
                   congenital
           93531  R & l heart cath,
                   congenital
           93532  R & l heart cath,
                   congenital
           93533  R & l heart cath,
                   congenital
           93536  Insert circulation
                   assi
   0081   Non-Coronary Angioplasty or   T                      19.36     $938.71         $434.25         $187.74
                  Atherectomy
           35180  Repair blood vessel
                   lesion
           35184  Repair blood vessel
                   lesion
           35190  Repair blood vessel
                   lesion
           35201  Repair blood vessel
                   lesion
           35206  Repair blood vessel
                   lesion
           35226  Repair blood vessel
                   lesion
           35231  Repair blood vessel
                   lesion
           35236  Repair blood vessel
                   lesion
           35256  Repair blood vessel
                   lesion
           35261  Repair blood vessel
                   lesion
           35266  Repair blood vessel
                   lesion
           35286  Repair blood vessel
                   lesion
           35321  Rechanneling of
                   artery
           35459  Repair arterial
                   blockage

[[Page 18730]]

 
           35460  Repair venous
                   blockage
           35470  Repair arterial
                   blockage
           35471  Repair arterial
                   blockage
           35472  Repair arterial
                   blockage
           35473  Repair arterial
                   blockage
           35474  Repair arterial
                   blockage
           35475  Repair arterial
                   blockage
           35476  Repair venous
                   blockage
           35484  Atherectomy, open
           35485  Atherectomy, open
           35490  Atherectomy,
                   percutaneous
           35491  Atherectomy,
                   percutaneous
           35492  Atherectomy,
                   percutaneous
           35493  Atherectomy,
                   percutaneous
           35494  Atherectomy,
                   percutaneous
           35495  Atherectomy,
                   percutaneous
           35500  Harvest vein for
                   bypass
           37204  Transcatheter
                   occlusion
           37205  Transcatheter stent
           37206  Transcatheter stent
                   add-on
           37207  Transcatheter stent
           37208  Transcatheter stent
                   add-on
           37209  Exchange arterial
                   catheter
           37250  Iv us first vessel
                   add-on
           37251  Iv us each add
                   vessel add-on
           37565  Ligation of neck
                   vein
           37600  Ligation of neck
                   artery
   0082       Coronary Atherectomy      T                      40.34   $1,955.97         $859.56         $391.19
           92995  Coronary atherectomy
           92996  Coronary atherectomy
                   add-on
   0083      Coronary Angiosplasty      T                      45.79   $2,220.22       $1,322.95         $444.04
           92980  Insert intracoronary
                   stent
           92981  Insert intracoronary
                   stent
           92982  Coronary artery
                   dilation
           92984  Coronary artery
                   dilation
   0084    Level I Electrophysiologic   S                      10.70     $518.81         $177.79         $103.76
                   Evaluation
           93640  Evaluation heart
                   device
           93641  Electrophysiology
                   evaluation
           93642  Electrophysiology
                   evaluation
   0085   Level II Electrophysiologic   S                      27.06   $1,312.06         $654.48         $262.41
                   Evaluation
           93619  Electrophysiology
                   evaluation
           93620  Electrophysiology
                   evaluation
           93621  Electrophysiology
                   evaluation
           93622  Electrophysiology
                   evaluation
   0086   Ablate Heart Dysrhythm Focus  S                      47.62   $2,308.95       $1,265.37         $461.79
           93650  Ablate heart
                   dysrhythm focus
           93651  Ablate heart
                   dysrhythm focus
           93652  Ablate heart
                   dysrhythm focus
   0087    Cardiac Electrophysiologic   S                       9.53     $462.08         $214.72          $92.42
               Recording/Mapping
           93600  Bundle of His
                   recording
           93602  Intra-atrial
                   recording
           93603  Right ventricular
                   recording
           93607  Left ventricular
                   recording
           93609  Mapping of
                   tachycardia
           93610  Intra-atrial pacing
           93612  Intraventricular
                   pacing
           93615  Esophageal recording
           93616  Esophageal recording
           93618  Heart rhythm pacing
           93623  Stimulation, pacing
                   heart
           93624  Electrophysiologic
                   study
           93631  Heart pacing,
                   mapping
   0088           Thrombectomy          T                      26.49   $1,284.42         $678.68         $256.88
           34101  Removal of artery
                   clot
           34111  Removal of arm
                   artery clot
           34201  Removal of artery
                   clot
           34203  Removal of leg
                   artery clot
           34471  Removal of vein clot
           34490  Removal of vein clot
           34501  Repair valve,
                   femoral vein
           34510  Transposition of
                   vein valve
           34520  Cross-over vein
                   graft
           34530  Leg vein fusion

[[Page 18731]]

 
           35188  Repair blood vessel
                   lesion
           35207  Repair blood vessel
                   lesion
           35875  Removal of clot in
                   graft
           35876  Removal of clot in
                   graft
           35879  Revise graft w/vein
           35881  Revise graft w/vein
           36821  Av fusion direct any
                   site
           36825  Artery-vein graft
           36830  Artery-vein graft
           36831  Av fistula excision
           36832  Av fistula revision
           36833  Av fistula revision
           G0159  Perc declot dialysis
                   graft
   0089  Level I Implantation/Removal/  T                       6.49     $314.68         $130.07          $62.94
          Revision of Pacemaker, AICD
               or Vascular Device
           33210  Insertion of heart
                   electrode
           33211  Insertion of heart
                   electrode
           33220  Revise eltrd pacing-
                   defib
           33241  Remove pulse
                   generator
           36261  Revision of infusion
                   pump
           36262  Removal of infusion
                   pump
           36299  Vessel injection
                   procedure
           36531  Revision of infusion
                   pump
           36532  Removal of infusion
                   pump
           36534  Revision of access
                   device
           36535  Removal of access
                   device
           37203  Transcatheter
                   retrieval
   0090  Level II Implantation/Removal/ T                      20.96   $1,016.29         $573.04         $203.26
          Revision of Pacemaker, AICD
               or Vascular Device
           33206  Insertion of heart
                   pacemaker
           33207  Insertion of heart
                   pacemaker
           33208  Insertion of heart
                   pacemaker
           33212  Insertion of pulse
                   generator
           33213  Insertion of pulse
                   generator
           33214  Upgrade of pacemaker
                   system
           33216  Revise eltrd pacing-
                   defib
           33217  Revise eltrd pacing-
                   defib
           33218  Revise eltrd pacing-
                   defib
           33233  Removal of pacemaker
                   system
           33234  Removal of pacemaker
                   system
           33235  Removal pacemaker
                   electrode
           33240  Insert pulse
                   generator
           33244  Remove eltrd,
                   transven
           33249  Eltrd/insert pace-
                   defib
           36860  External cannula
                   declotting
           36861  Cannula declotting
   0091    Level I Vascular Ligation    T                      14.79     $717.12         $348.23         $143.42
           30915  Ligation, nasal
                   sinus artery
           37605  Ligation of neck
                   artery
           37606  Ligation of neck
                   artery
           37615  Ligation of neck
                   artery
           37650  Revision of major
                   vein
           37700  Revise leg vein
           37760  Revision of leg
                   veins
           37780  Revision of leg vein
           37785  Revise secondary
                   varicosity
   0092    Level II Vascular Ligation   T                      20.21     $979.92         $505.37         $195.98
           30920  Ligation, upper jaw
                   artery
           37607  Ligation of a-v
                   fistula
           37720  Removal of leg vein
           37730  Removal of leg veins
           37735  Removal of leg veins/
                   lesion
   0093     Vascular Repair/Fistula     T                      17.95     $870.34         $422.33         $174.07
                  Construction
           36260  Insertion of
                   infusion pump
           36530  Insertion of
                   infusion pump
           36533  Insertion of access
                   device
           36800  Insertion of cannula
           36810  Insertion of cannula
           36815  Insertion of cannula
           36819  Av fusion by basilic
                   vein
           36835  Artery to vein shunt
   0094        Resuscitation and        S                       4.51     $218.68         $105.29          $43.74
                 Cardioversion
           31500  Insert emergency
                   airway
           92950  Heart/lung
                   resuscitation cpr
           92953  Temporary external
                   pacing

[[Page 18732]]

 
           92960  Cardioversion
                   electric, ext
           92961  Cardioversion,
                   electric, int
           99440  Newborn
                   resuscitation
   0095      Cardiac Rehabilitation     S                       0.64      $31.03          $16.98           $6.21
           93797  Cardiac rehab
           93798  Cardiac rehab/
                   monitor
   0096  Non-Invasive Vascular Studies  S                       2.06      $99.88          $61.48          $19.98
           93721  Plethysmography
                   tracing
           93740  Temperature gradient
                   studies
           93799  Cardiovascular
                   procedure
           93875  Extracranial study
           93922  Extremity study
           93923  Extremity study
           93924  Extremity study
           93965  Extremity study
   0097    Cardiovascular Stress Test   S                       1.62      $78.55          $62.40          $15.71
           93017  Cardiovascular
                   stress test
           93024  Cardiac drug stress
                   test
   0098     Injection of Sclerosing     T                       1.19      $57.70          $20.88          $11.54
                    Solution
           36468  Injection(s), spider
                   veins
           36469  Injection(s), spider
                   veins
           36470  Injection therapy of
                   vein
           36471  Injection therapy of
                   veins
           45520  Treatment of rectal
                   prolapse
   0099  Continuous Cardiac Monitoring  S                       0.38      $18.43          $14.68           $3.69
           93012  Transmission of ecg
           93270  ECG recording
           93278  ECG/signal-averaged
           G0005  ECG 24 hour
                   recording
           G0015  Post symptom ECG
                   tracing
   0100          Continuous ECG         S                       1.70      $82.43          $71.57          $16.49
           93225  ECG monitor/record,
                   24 hrs
           93226  ECG monitor/report,
                   24 hrs
           93231  Ecg monitor/record,
                   24 hrs
           93232  ECG monitor/report,
                   24 hrs
           93236  ECG monitor/report,
                   24 hrs
           93268  ECG record/review
           93271  Ecg/monitoring and
                   analysis
           93724  Analyze pacemaker
                   system
           G0004  ECG transm phys
                   review & int
           G0006  ECG transmission &
                   analysis
   0101      Tilt Table Evaluation      S                       4.47     $216.74         $128.84          $43.35
           93660  Tilt table
                   evaluation
   0102      Electronic Analysis of     S                       0.45      $21.82          $12.62           $4.36
            Pacemakers/other Devices
           62367  Analyze spine
                   infusion pump
           62368  Analyze spine
                   infusion pump
           93727  Analyze ilr system
           93731  Analyze pacemaker
                   system
           93732  Analyze pacemaker
                   system
           93733  Telephone analy,
                   pacemaker
           93734  Analyze pacemaker
                   system
           93735  Analyze pacemaker
                   system
           93736  Telephone analy,
                   pacemaker
           93737  Analyze cardio/
                   defibrillator
           93738  Analyze cardio/
                   defibrillator
           93741  Analyze ht pace
                   device sngl
           93742  Analyze ht pace
                   device sngl
           93743  Analyze ht pace
                   device dual
           93744  Analyze ht pace
                   device dual
           95970  Analyze neurostim,
                   no prog
           95971  Analyze neurostim,
                   simple
           95972  Analyze neurostim,
                   complex
           95973  Analyze neurostim,
                   complex
           95974  Cranial neurostim,
                   complex
           95975  Cranial neurostim,
                   complex
   0109    Bone Marrow Harvesting and   S                       4.13     $200.25          $40.05          $40.05
             Bone Marrow/Stem Cell
                   Transplant
           38230  Bone marrow
                   collection
           38240  Bone marrow/stem
                   transplant
           38241  Bone marrow/stem
                   transplant
   0110           Transfusion           S                       5.83     $282.68         $122.73          $56.54
           36430  Blood transfusion
                   service
           36440  Blood transfusion
                   service
           36450  Exchange transfusion
                   service

[[Page 18733]]

 
           36455  Exchange transfusion
                   service
           36460  Transfusion service,
                   fetal
   0111      Blood Product Exchange     S                      14.17     $687.06         $300.74         $137.41
           36520  Plasma and/or cell
                   exchange
           36521  Apheresis w/adsorp/
                   reinfuse
           38231  Stem cell collection
   0112   Extracorporeal Photopheresis  S                      39.60   $1,920.09         $663.65         $384.02
           36522  Photopheresis
   0113    Excision Lymphatic System    T                      13.89     $673.49         $326.55         $134.70
           38308  Incision of lymph
                   channels
           38500  Biopsy/removal,
                   lymph nodes
           38510  Biopsy/removal,
                   lymph nodes
           38520  Biopsy/removal,
                   lymph nodes
           38525  Biopsy/removal,
                   lymph nodes
           38530  Biopsy/removal,
                   lymph nodes
           38550  Removal, neck/armpit
                   lesion
   0114     Thyroid/Lymphadenectomy     T                      19.56     $948.41         $493.78         $189.68
                   Procedures
           38542  Explore deep
                   node(s), neck
           38555  Removal, neck/armpit
                   lesion
           38720  Removal of lymph
                   nodes, neck
           38740  Remove armpit lymph
                   nodes
           38745  Remove armpit lymph
                   nodes
           38760  Remove groin lymph
                   nodes
           60200  Remove thyroid
                   lesion
           60210  Partial thyroid
                   excision
           60220  Partial removal of
                   thyroid
           60225  Partial removal of
                   thyroid
           60240  Removal of thyroid
           60280  Remove thyroid duct
                   lesion
           60281  Remove thyroid duct
                   lesion
   0116   Chemotherapy Administration   S                       2.34     $113.46          $22.69          $22.69
           by Other Technique Except
                    Infusion
           Q0083  Chemo by other than
                   infusion
   0117   Chemotherapy Administration   S                       1.84      $89.22          $71.80          $17.84
                by Infusion Only
           Q0084  Chemotherapy by
                   infusion
   0118   Chemotherapy Administration   S                       2.90     $140.61          $72.03          $28.12
           by Both Infusion and Other
                   Technique
           Q0085  Chemo by both
                   infusion and o
   0120     Infusion Therapy Except     S                       1.66      $80.49          $42.67          $16.10
                  Chemotherapy
           36680  Insert needle, bone
                   cavity
           Q0081  Infusion ther other
                   than che
   0121     Level I Tube changes and    T                       2.36     $114.43          $52.53          $22.89
                 Repositioning
           31502  Change of windpipe
                   airway
           43760  Change gastrostomy
                   tube
           43761  Reposition
                   gastrostomy tube
           43999  Stomach surgery
                   procedure
           47530  Revise/reinsert bile
                   tube
           47999  Bile tract surgery
                   procedure
           49999  Abdomen surgery
                   procedure
           50688  Change of ureter
                   tube
           51705  Change of bladder
                   tube
           51710  Change of bladder
                   tube
           62194  Replace/irrigate
                   catheter
           62225  Replace/irrigate
                   catheter
   0122    Level II Tube changes and    T                       5.04     $244.37         $114.93          $48.88
                 Repositioning
           47525  Change bile duct
                   catheter
           50398  Change kidney tube
   0123    Level III Tube changes and   T                      13.89     $673.49         $350.75         $134.70
                 Repositioning
           49422  Remove perm cannula/
                   catheter
           49429  Removal of shunt
   0130       Level I Laparoscopy       T                      25.36   $1,229.63         $659.53         $245.93
           38129  Laparoscope proc,
                   spleen
           38589  Laparoscope proc,
                   lymphatic
           43289  Laparoscope proc,
                   esoph
           43659  Laparoscope proc,
                   stom
           44209  Laparoscope proc,
                   intestine
           44970  Laparoscopy,
                   appendectomy
           44979  Laparoscope proc,
                   app
           47560  Laparoscopy w/
                   cholangio
           47561  Laparo w/cholangio/
                   biopsy
           47579  Laparoscope proc,
                   biliary
           49320  Diag laparo separate
                   proc
           49321  Laparoscopy, biopsy
           49322  Laparoscopy,
                   aspiration
           49323  Laparo drain
                   lymphocele

[[Page 18734]]

 
           49329  Laparo proc, abdm/
                   per/oment
           50549  Laparoscope proc,
                   renal
           54699  Laparoscope proc,
                   testis
           55559  Laparo proc,
                   spermatic cord
           58679  Laparo proc, oviduct-
                   ovary
           59898  Laparo proc, ob care/
                   deliver
           60659  Laparo proc,
                   endocrine
   0131       Level II Laparoscopy      T                      41.81   $2,027.24       $1,089.88         $405.45
           38120  Laparoscopy,
                   splenectomy
           38570  Laparoscopy, lymph
                   node biop
           38572  Laparoscopy,
                   lymphadenectomy
           43653  Laparoscopy,
                   gastrostomy
           44200  Laparoscopy,
                   enterolysis
           44201  Laparoscopy,
                   jejunostomy
           47562  Laparoscopic
                   cholecystectomy
           47563  Laparo
                   cholecystectomy/
                   graph
           47564  Laparo
                   cholecystectomy/
                   explr
           47570  Laparo
                   cholecystoenterosto
                   my
           49650  Laparo hernia repair
                   initial
           49651  Laparo hernia repair
                   recur
           49659  Laparo proc, hernia
                   repair
           50541  Laparo ablate renal
                   cyst
           50544  Laparoscopy,
                   pyeloplasty
           50945  Laparoscopy
                   ureterolithotomy
           51990  Laparo urethral
                   suspension
           54690  Laparoscopy,
                   orchiectomy
           55550  Laparo ligate
                   spermatic vein
           58551  Laparoscopy, remove
                   myoma
           58660  Laparoscopy, lysis
           58661  Laparoscopy, remove
                   adnexa
           58662  Laparoscopy, excise
                   lesions
           58670  Laparoscopy, tubal
                   cautery
           58671  Laparoscopy, tubal
                   block
           58672  Laparoscopy,
                   fimbrioplasty
           58673  Laparoscopy,
                   salpingostomy
           59150  Treat ectopic
                   pregnancy
           59151  Treat ectopic
                   pregnancy
   0132      Level III Laparoscopy      T                      48.91   $2,371.50       $1,239.22         $474.30
           38571  Laparoscopy,
                   lymphadenectomy
           43280  Laparoscopy,
                   fundoplasty
           43651  Laparoscopy, vagus
                   nerve
           43652  Laparoscopy, vagus
                   nerve
           50548  Laparo-asst remove k/
                   ureter
           51992  Laparo sling
                   operation
           54692  Laparoscopy,
                   orchiopexy
           58550  Laparo-asst vag
                   hysterectomy
   0140   Esophageal Dilation without   T                       4.74     $229.83         $107.24          $45.97
                   Endoscopy
           43450  Dilate esophagus
           43453  Dilate esophagus
           43456  Dilate esophagus
           43458  Dilate esophagus
           43499  Esophagus surgery
                   procedure
   0141       Upper GI Procedures       T                       7.15     $346.68         $184.67          $69.34
           43200  Esophagus endoscopy
           43202  Esophagus endoscopy,
                   biopsy
           43204  Esophagus endoscopy
                   & inject
           43205  Esophagus endoscopy/
                   ligation
           43215  Esophagus endoscopy
           43216  Esophagus endoscopy/
                   lesion
           43217  Esophagus endoscopy
           43219  Esophagus endoscopy
           43220  Esoph endoscopy,
                   dilation
           43226  Esoph endoscopy,
                   dilation
           43227  Esoph endoscopy,
                   repair
           43228  Esoph endoscopy,
                   ablation
           43234  Upper GI endoscopy,
                   exam
           43235  Uppr gi endoscopy,
                   diagnosis
           43239  Upper GI endoscopy,
                   biopsy
           43241  Upper GI endoscopy
                   with tube
           43243  Upper gi endoscopy &
                   inject
           43244  Upper GI endoscopy/
                   ligation
           43245  Operative upper GI
                   endoscopy
           43246  Place gastrostomy
                   tube

[[Page 18735]]

 
           43247  Operative upper GI
                   endoscopy
           43248  Uppr gi endoscopy/
                   guide wire
           43249  Esoph endoscopy,
                   dilation
           43250  Upper GI endoscopy/
                   tumor
           43251  Operative upper GI
                   endoscopy
           43255  Operative upper GI
                   endoscopy
           43258  Operative upper GI
                   endoscopy
           43259  Endoscopic
                   ultrasound exam
           43600  Biopsy of stomach
           43750  Place gastrostomy
                   tube
           43830  Place gastrostomy
                   tube
           43831  Place gastrostomy
                   tube
           44100  Biopsy of bowel
   0142    Small Intestine Endoscopy    T                       7.45     $361.23         $162.42          $72.25
           44360  Small bowel
                   endoscopy
           44361  Small bowel
                   endoscopy/biopsy
           44363  Small bowel
                   endoscopy
           44364  Small bowel
                   endoscopy
           44365  Small bowel
                   endoscopy
           44366  Small bowel
                   endoscopy
           44369  Small bowel
                   endoscopy
           44372  Small bowel
                   endoscopy
           44373  Small bowel
                   endoscopy
           44376  Small bowel
                   endoscopy
           44377  Small bowel
                   endoscopy/biopsy
           44378  Small bowel
                   endoscopy
           44380  Small bowel
                   endoscopy
           44382  Small bowel
                   endoscopy
           44799  Intestine surgery
                   procedure
   0143        Lower GI Endoscopy       T                       7.98     $386.93         $199.12          $77.39
           44385  Endoscopy of bowel
                   pouch
           44386  Endoscopy, bowel
                   pouch/biop
           44388  Colon endoscopy
           44389  Colonoscopy with
                   biopsy
           44390  Colonoscopy for
                   foreign body
           44391  Colonoscopy for
                   bleeding
           44392  Colonoscopy &
                   polypectomy
           44393  Colonoscopy, lesion
                   removal
           44394  Colonoscopy w/snare
           45355  Surgical colonoscopy
           45378  Diagnostic
                   colonoscopy
           45379  Colonoscopy
           45380  Colonoscopy and
                   biopsy
           45382  Colonoscopy/control
                   bleeding
           45383  Lesion removal
                   colonoscopy
           45384  Colonoscopy
           45385  Lesion removal
                   colonoscopy
   0144       Diagnostic Anoscopy       T                       2.23     $108.13          $49.32          $21.63
           46604  Anoscopy and
                   dilation
           46608  Anoscopy/remove for
                   body
   0145       Therapeutic Anoscopy      T                       7.46     $361.71         $179.39          $72.34
           46606  Anoscopy and biopsy
           46610  Anoscopy/remove
                   lesion
           46611  Anoscopy
           46612  Anoscopy/remove
                   lesions
           46614  Anoscopy/control
                   bleeding
           46615  Anoscopy
   0146      Level I Sigmoidoscopy      T                       2.83     $137.22          $65.15          $27.44
           45300  Proctosigmoidoscopy
           45303  Proctosigmoidoscopy
           45305  Proctosigmoidoscopy
                   & biopsy
           45307  Proctosigmoidoscopy
           45317  Proctosigmoidoscopy
           45330  Diagnostic
                   sigmoidoscopy
           45331  Sigmoidoscopy and
                   biopsy
           45332  Sigmoidoscopy
   0147      Level II Sigmoidoscopy     T                       6.26     $303.53         $149.11          $60.71
           45308  Proctosigmoidoscopy
           45309  Proctosigmoidoscopy
           45315  Proctosigmoidoscopy
           45320  Proctosigmoidoscopy
           45321  Proctosigmoidoscopy
           45333  Sigmoidoscopy &
                   polypectomy

[[Page 18736]]

 
           45334  Sigmoidoscopy for
                   bleeding
           45337  Sigmoidoscopy &
                   decompress
           45338  Sigmoidoscopy
           45339  Sigmoidoscopy
   0148  Level I Anal/Rectal Procedure  T                       2.34     $113.46          $43.59          $22.69
           45005  Drainage of rectal
                   abscess
           45900  Reduction of rectal
                   prolapse
           45915  Remove rectal
                   obstruction
           45999  Rectum surgery
                   procedure
           46040  Incision of rectal
                   abscess
           46050  Incision of anal
                   abscess
           46070  Incision of anal
                   septum
           46083  Incise external
                   hemorrhoid
           46221  Ligation of
                   hemorrhoid(s)
           46320  Removal of
                   hemorrhoid clot
           46500  Injection into
                   hemorrhoids
           46934  Destruction of
                   hemorrhoids
           46935  Destruction of
                   hemorrhoids
           46945  Ligation of
                   hemorrhoids
           46946  Ligation of
                   hemorrhoids
   0149       Level II Anal/Rectal      T                      12.86     $623.54         $293.06         $124.71
                   Procedure
           45000  Drainage of pelvic
                   abscess
           45020  Drainage of rectal
                   abscess
           45100  Biopsy of rectum
           45905  Dilation of anal
                   sphincter
           45910  Dilation of rectal
                   narrowing
           46030  Removal of rectal
                   marker
           46080  Incision of anal
                   sphincter
           46210  Removal of anal
                   crypt
           46220  Removal of anal tab
           46230  Removal of anal tabs
           46754  Removal of suture
                   from anus
           46936  Destruction of
                   hemorrhoids
           46940  Treatment of anal
                   fissure
           46942  Treatment of anal
                   fissure
           46999  Anus surgery
                   procedure
   0150      Level III Anal/Rectal      T                      17.68     $857.25         $437.12         $171.45
                   Procedure
           45108  Removal of anorectal
                   lesion
           45150  Excision of rectal
                   stricture
           45160  Excision of rectal
                   lesion
           45170  Excision of rectal
                   lesion
           45190  Destruction, rectal
                   tumor
           45500  Repair of rectum
           45505  Repair of rectum
           45560  Repair of rectocele
           46045  Incision of rectal
                   abscess
           46060  Incision of rectal
                   abscess
           46200  Removal of anal
                   fissure
           46211  Removal of anal
                   crypts
           46250  Hemorrhoidectomy
           46255  Hemorrhoidectomy
           46257  Remove hemorrhoids &
                   fissure
           46258  Remove hemorrhoids &
                   fistula
           46260  Hemorrhoidectomy
           46261  Remove hemorrhoids &
                   fissure
           46262  Remove hemorrhoids &
                   fistula
           46270  Removal of anal
                   fistula
           46275  Removal of anal
                   fistula
           46280  Removal of anal
                   fistula
           46285  Removal of anal
                   fistula
           46288  Repair anal fistula
           46700  Repair of anal
                   stricture
           46750  Repair of anal
                   sphincter
           46753  Reconstruction of
                   anus
           46760  Repair of anal
                   sphincter
           46761  Repair of anal
                   sphincter
           46762  Implant artificial
                   sphincter
           46937  Cryotherapy of
                   rectal lesion
           46938  Cryotherapy of
                   rectal lesion
   0151      Endoscopic Retrograde      T                      10.53     $510.57         $245.46         $102.11
           Cholangio-Pancreatography
                     (ERCP)
           43260  Endo
                   cholangiopancreatog
                   raph
           43261  Endo
                   cholangiopancreatog
                   raph
           43262  Endo
                   cholangiopancreatog
                   raph

[[Page 18737]]

 
           43263  Endo
                   cholangiopancreatog
                   raph
           43264  Endo
                   cholangiopancreatog
                   raph
           43265  Endo
                   cholangiopancreatog
                   raph
           43267  Endo
                   cholangiopancreatog
                   raph
           43268  Endo
                   cholangiopancreatog
                   raph
           43269  Endo
                   cholangiopancreatog
                   raph
           43271  Endo
                   cholangiopancreatog
                   raph
           43272  Endo
                   cholangiopancreatog
                   raph
   0152       Percutaneous Biliary      T                       8.22     $398.56         $207.38          $79.71
             Endoscopic Procedures
           47510  Insert catheter,
                   bile duct
           47511  Insert bile duct
                   drain
           47552  Biliary endoscopy
                   thru skin
           47553  Biliary endoscopy
                   thru skin
           47554  Biliary endoscopy
                   thru skin
           47555  Biliary endoscopy
                   thru skin
           47556  Biliary endoscopy
                   thru skin
           47630  Remove bile duct
                   stone
   0153     Peritoneal and Abdominal    T                      19.62     $951.32         $496.31         $190.26
                   Procedures
           49085  Remove abdomen
                   foreign body
           49250  Excision of
                   umbilicus
           49420  Insert abdominal
                   drain
           49421  Insert abdominal
                   drain
           49423  Exchange drainage
                   catheter
           49426  Revise abdomen-
                   venous shunt
   0154   Hernia/Hydrocele Procedures   T                      22.43   $1,087.57         $556.98         $217.51
           49495  Repair inguinal
                   hernia, init
           49496  Repair inguinal
                   hernia, init
           49500  Repair inguinal
                   hernia
           49501  Repair inguinal
                   hernia, init
           49505  Repair inguinal
                   hernia
           49507  Repair inguinal
                   hernia
           49520  Rerepair inguinal
                   hernia
           49521  Repair inguinal
                   hernia, rec
           49525  Repair inguinal
                   hernia
           49540  Repair lumbar hernia
           49550  Repair femoral
                   hernia
           49553  Repair femoral
                   hernia, init
           49555  Repair femoral
                   hernia
           49557  Repair femoral
                   hernia, recur
           49560  Repair abdominal
                   hernia
           49561  Repair incisional
                   hernia
           49565  Rerepair abdominal
                   hernia
           49566  Repair incisional
                   hernia
           49568  Hernia repair w/mesh
           49570  Repair epigastric
                   hernia
           49572  Repair epigastric
                   hernia
           49580  Repair umbilical
                   hernia
           49582  Repair umbilical
                   hernia
           49585  Repair umbilical
                   hernia
           49587  Repair umbilical
                   hernia
           49590  Repair abdominal
                   hernia
           49600  Repair umbilical
                   lesion
           51500  Removal of bladder
                   cyst
           54530  Removal of testis
           54550  Exploration for
                   testis
           54640  Suspension of testis
           55040  Removal of hydrocele
           55041  Removal of
                   hydroceles
           55535  Revise spermatic
                   cord veins
           55540  Revise hernia &
                   sperm veins
 2 0157   Colorectal Cancer Screening:  S                       1.79      $86.79                          $17.36
                  Barium Enema
           G0106  Colon CA screen;
                   barium enema
           G0120  Colon ca scrn;
                   barium enema
 1 0158   Colorectal Cancer Screening:  S                       7.98     $386.93                          $96.73
                  Colonoscopy
           G0104  CA screen; flexi
                   sigmoidscope
 1 0159   Colorectal Cancer Screening:  S                       7.98     $137.22                          $34.31
             Flexible Sigmoidoscopy
           G0105  Colorectal scrn; hi
                   risk ind
   0160  Level I Cystourethroscopy and  T                       5.43     $263.28         $110.11          $52.66
              other Genitourinary
                   Procedures
           50392  Insert kidney drain
           50393  Insert ureteral tube
           50395  Create passage to
                   kidney
           52000  Cystoscopy
           52265  Cystoscopy and
                   treatment

[[Page 18738]]

 
   0161    Level II Cystourethroscopy   T                      10.94     $530.45         $249.36         $106.09
            and other Genitourinary
                   Procedures
           50551  Kidney endoscopy
           50553  Kidney endoscopy
           50555  Kidney endoscopy &
                   biopsy
           50557  Kidney endoscopy &
                   treatment
           50559  Renal endoscopy/
                   radiotracer
           50561  Kidney endoscopy &
                   treatment
           52005  Cystoscopy & ureter
                   catheter
           52007  Cystoscopy and
                   biopsy
           52010  Cystoscopy & duct
                   catheter
           52204  Cystoscopy
           52214  Cystoscopy and
                   treatment
           52224  Cystoscopy and
                   treatment
           52260  Cystoscopy and
                   treatment
           52270  Cystoscopy & revise
                   urethra
           52275  Cystoscopy & revise
                   urethra
           52276  Cystoscopy and
                   treatment
           52281  Cystoscopy and
                   treatment
           52283  Cystoscopy and
                   treatment
           52285  Cystoscopy and
                   treatment
           52290  Cystoscopy and
                   treatment
           52300  Cystoscopy and
                   treatment
           52301  Cystoscopy and
                   treatment
           52305  Cystoscopy and
                   treatment
           52310  Cystoscopy and
                   treatment
           52315  Cystoscopy and
                   treatment
           52327  Cystoscopy, inject
                   material
           52510  Dilation prostatic
                   urethra
           53605  Dilate urethra
                   stricture
   0162   Level III Cystourethroscopy   T                      17.49     $848.04         $427.49         $169.61
            and other Genitourinary
                   Procedures
           50951  Endoscopy of ureter
           50953  Endoscopy of ureter
           50955  Ureter endoscopy &
                   biopsy
           50957  Ureter endoscopy &
                   treatment
           50959  Ureter endoscopy &
                   tracer
           50961  Ureter endoscopy &
                   treatment
           51020  Incise & treat
                   bladder
           51030  Incise & treat
                   bladder
           51040  Incise & drain
                   bladder
           51045  Incise bladder/drain
                   ureter
           51050  Removal of bladder
                   stone
           51065  Removal of ureter
                   stone
           51520  Removal of bladder
                   lesion
           51880  Repair of bladder
                   opening
           52234  Cystoscopy and
                   treatment
           52235  Cystoscopy and
                   treatment
           52250  Cystoscopy and
                   radiotracer
           52277  Cystoscopy and
                   treatment
           52282  Cystoscopy, implant
                   stent
           52317  Remove bladder stone
           52318  Remove bladder stone
           52320  Cystoscopy and
                   treatment
           52325  Cystoscopy, stone
                   removal
           52330  Cystoscopy and
                   treatment
           52332  Cystoscopy and
                   treatment
           52334  Create passage to
                   kidney
           52335  Endoscopy of urinary
                   tract
           52336  Cystoscopy, stone
                   removal
           52337  Cystoscopy, stone
                   removal
           52338  Cystoscopy and
                   treatment
           52339  Cystoscopy and
                   treatment
           52340  Cystoscopy and
                   treatment
           52450  Incision of prostate
           52500  Revision of bladder
                   neck
           52606  Control postop
                   bleeding
           52640  Relieve bladder
                   contracture
           52700  Drainage of prostate
                   abscess
           55720  Drainage of prostate
                   abscess
           55725  Drainage of prostate
                   abscess
           55859  Percut/needle
                   insert, pros
   0163    Level IV Cystourethroscopy   T                      28.98   $1,405.16         $792.58         $281.03
            and other Genitourinary
                   Procedures
           50080  Removal of kidney
                   stone
           50081  Removal of kidney
                   stone

[[Page 18739]]

 
           52240  Cystoscopy and
                   treatment
           52601  Prostatectomy (TURP)
           52612  Prostatectomy, first
                   stage
           52614  Prostatectomy,
                   second stage
           52620  Remove residual
                   prostate
           52630  Remove prostate
                   regrowth
           52647  Laser surgery of
                   prostate
           52648  Laser surgery of
                   prostate
   0164     Level I Urinary and Anal    T                       2.17     $105.23          $33.03          $21.05
                   Procedures
           51005  Drainage of bladder
           51700  Irrigation of
                   bladder
           51736  Urine flow
                   measurement
           51741  Electro-
                   uroflowmetry, first
           51784  Anal/urinary muscle
                   study
           51785  Anal/urinary muscle
                   study
           51795  Urine voiding
                   pressure study
           51797  Intraabdominal
                   pressure test
           53600  Dilate urethra
                   stricture
           53601  Dilate urethra
                   stricture
           53621  Dilate urethra
                   stricture
           53660  Dilation of urethra
           53661  Dilation of urethra
           53675  Insert urinary
                   catheter
           54235  Penile injection
           54240  Penis study
           55899  Genital surgery
                   procedure
   0165    Level II Urinary and Anal    T                       3.89     $188.61          $91.76          $37.72
                   Procedures
           50396  Measure kidney
                   pressure
           50686  Measure ureter
                   pressure
           51000  Drainage of bladder
           51010  Drainage of bladder
           51720  Treatment of bladder
                   lesion
           51725  Simple
                   cystometrogram
           51726  Complex
                   cystometrogram
           51772  Urethra pressure
                   profile
           51792  Urinary reflex study
           53620  Dilate urethra
                   stricture
           53899  Urology surgery
                   procedure
           54200  Treatment of penis
                   lesion
           54220  Treatment of penis
                   lesion
           54231  Dynamic
                   cavernosometry
           54250  Penis study
           54450  Preputial stretching
           91122  Anal pressure record
   0166   Level I Urethral Procedures   T                      10.17     $493.11         $218.73          $98.62
           53000  Incision of urethra
           53010  Incision of urethra
           53020  Incision of urethra
           53025  Incision of urethra
           53040  Drainage of urethra
                   abscess
           53060  Drainage of urethra
                   abscess
           53080  Drainage of urinary
                   leakage
           53200  Biopsy of urethra
           53250  Removal of urethra
                   gland
           53260  Treatment of urethra
                   lesion
           53265  Treatment of urethra
                   lesion
           53275  Repair of urethra
                   defect
           53442  Remove perineal
                   prosthesis
           53502  Repair of urethra
                   injury
           53510  Repair of urethra
                   injury
           53665  Dilation of urethra
           54000  Slitting of prepuce
           54001  Slitting of prepuce
   0167   Level II Urethral Procedures  T                      21.06   $1,021.14         $555.84         $204.23
           51715  Endoscopic injection/
                   implant
           53270  Removal of urethra
                   gland
           53505  Repair of urethra
                   injury
   0168  Level III Urethral Procedures  T                      24.94   $1,209.27         $536.11         $241.85
           53210  Removal of urethra
           53215  Removal of urethra
           53220  Treatment of urethra
                   lesion
           53230  Removal of urethra
                   lesion
           53235  Removal of urethra
                   lesion

[[Page 18740]]

 
           53240  Surgery for urethra
                   pouch
           53400  Revise urethra,
                   stage 1
           53405  Revise urethra,
                   stage 2
           53410  Reconstruction of
                   urethra
           53420  Reconstruct urethra,
                   stage 1
           53425  Reconstruct urethra,
                   stage 2
           53430  Reconstruction of
                   urethra
           53447  Remove artificial
                   sphincter
           53449  Correct artificial
                   sphincter
           53450  Revision of urethra
           53460  Revision of urethra
           53515  Repair of urethra
                   injury
           53520  Repair of urethra
                   defect
   0169           Lithotripsy           T                      46.72   $2,265.32       $1,384.20         $453.06
           50590  Fragmenting of
                   kidney stone
   0170   Dialysis for Other Than ESRD  S                       6.68     $323.89          $72.26          $64.78
                    Patients
           90935  Hemodialysis, one
                   evaluation
           90945  Dialysis, one
                   evaluation
   0180           Circumcision          T                      13.62     $660.39         $304.87         $132.08
           54150  Circumcision
           54152  Circumcision
           54160  Circumcision
           54161  Circumcision
   0181        Penile Procedures        T                      32.37   $1,569.53         $906.36         $313.91
           37790  Penile venous
                   occlusion
           54110  Treatment of penis
                   lesion
           54111  Treat penis lesion,
                   graft
           54112  Treat penis lesion,
                   graft
           54120  Partial removal of
                   penis
           54205  Treatment of penis
                   lesion
           54300  Revision of penis
           54304  Revision of penis
           54308  Reconstruction of
                   urethra
           54312  Reconstruction of
                   urethra
           54316  Reconstruction of
                   urethra
           54318  Reconstruction of
                   urethra
           54322  Reconstruction of
                   urethra
           54324  Reconstruction of
                   urethra
           54326  Reconstruction of
                   urethra
           54328  Revise penis/urethra
           54340  Secondary urethral
                   surgery
           54344  Secondary urethral
                   surgery
           54348  Secondary urethral
                   surgery
           54352  Reconstruct urethra/
                   penis
           54360  Penis plastic
                   surgery
           54380  Repair penis
           54385  Repair penis
           54402  Remove penis
                   prosthesis
           54407  Remove multi-comp
                   prosthesis
           54409  Revise penis
                   prosthesis
           54420  Revision of penis
           54435  Revision of penis
           54440  Repair of penis
   0182       Insertion of Penile       T                      52.11   $2,526.66       $1,525.05         $505.33
                   Prosthesis
           53440  Correct bladder
                   function
           53445  Correct urine flow
                   control
           54400  Insert semi-rigid
                   prosthesis
           54401  Insert self-contd
                   prosthesis
           54405  Insert multi-comp
                   prosthesis
   0183   Testes/Epididymis Procedures  T                      18.26     $885.37         $448.94         $177.07
           54505  Biopsy of testis
           54510  Removal of testis
                   lesion
           54520  Removal of testis
           54600  Reduce testis
                   torsion
           54620  Suspension of testis
           54660  Revision of testis
           54670  Repair testis injury
           54680  Relocation of
                   testis(es)
           54700  Drainage of scrotum
           54820  Exploration of
                   epididymis
           54830  Remove epididymis
                   lesion
           54840  Remove epididymis
                   lesion
           54860  Removal of
                   epididymis

[[Page 18741]]

 
           54861  Removal of
                   epididymis
           54900  Fusion of spermatic
                   ducts
           54901  Fusion of spermatic
                   ducts
           55060  Repair of hydrocele
           55110  Explore scrotum
           55120  Removal of scrotum
                   lesion
           55150  Removal of scrotum
           55175  Revision of scrotum
           55180  Revision of scrotum
           55200  Incision of sperm
                   duct
           55250  Removal of sperm
                   duct(s)
           55400  Repair of sperm duct
           55450  Ligation of sperm
                   duct
           55500  Removal of hydrocele
           55520  Removal of sperm
                   cord lesion
           55530  Revise spermatic
                   cord veins
           55680  Remove sperm pouch
                   lesion
   0184         Prostate Biopsy         T                       4.94     $239.53         $122.96          $47.91
           55700  Biopsy of prostate
           55705  Biopsy of prostate
   0190      Surgical Hysteroscopy      T                      17.85     $865.49         $443.89         $173.10
           58558  Hysteroscopy, biopsy
           58559  Hysteroscopy, lysis
           58560  Hysteroscopy, resect
                   septum
           58561  Hysteroscopy, remove
                   myoma
           58562  Hysteroscopy, remove
                   fb
           58563  Hysteroscopy,
                   ablation
           58578  Laparo proc, uterus
           58579  Hysteroscope
                   procedure
   0191   Level I Female Reproductive   T                       1.19      $57.70          $17.43          $11.54
                   Procedures
           57160  Insert pessary/other
                   device
           57170  Fitting of diaphragm/
                   cap
           57452  Examination of
                   vagina
           58100  Biopsy of uterus
                   lining
           58301  Remove intrauterine
                   device
           58555  Hysteroscopy, dx,
                   sep proc
           59200  Insert cervical
                   dilator
           Q0091  Obtaining screen pap
                   smear
   0192   Level II Female Reproductive  T                       2.38     $115.40          $35.33          $23.08
                   Procedures
           56405  I & D of vulva/
                   perineum
           56420  Drainage of gland
                   abscess
           57100  Biopsy of vagina
           57150  Treat vagina
                   infection
           57180  Treat vaginal
                   bleeding
           57454  Vagina examination &
                   biopsy
           57505  Endocervical
                   curettage
           57511  Cryocautery of
                   cervix
           99170  Anogenital exam,
                   child
   0193  Level III Female Reproductive  T                       8.93     $432.99         $171.13          $86.60
                   Procedures
           56441  Lysis of labial
                   lesion(s)
           56720  Incision of hymen
           57020  Drainage of pelvic
                   fluid
           57460  Cervix excision
           57500  Biopsy of cervix
           57510  Cauterization of
                   cervix
           57513  Laser surgery of
                   cervix
           57800  Dilation of cervical
                   canal
   0194   Level IV Female Reproductive  T                      16.21     $785.98         $395.94         $157.20
                   Procedures
           56440  Surgery for vulva
                   lesion
           56700  Partial removal of
                   hymen
           56740  Remove vagina gland
                   lesion
           56800  Repair of vagina
           56810  Repair of perineum
           57000  Exploration of
                   vagina
           57010  Drainage of pelvic
                   abscess
           57061  Destruction vagina
                   lesion(s)
           57065  Destruction vagina
                   lesion(s)
           57105  Biopsy of vagina
           57106  Remove vagina wall,
                   partial
           57107  Remove vagina
                   tissue, part
           57109  Vaginectomy partial
                   w/nodes
           57130  Remove vagina lesion
           57135  Remove vagina lesion

[[Page 18742]]

 
           57200  Repair of vagina
           57210  Repair vagina/
                   perineum
           57230  Repair of urethral
                   lesion
           57400  Dilation of vagina
           57410  Pelvic examination
           57415  Remove vaginal
                   foreign body
           57520  Conization of cervix
           57700  Revision of cervix
           57720  Revision of cervix
           58345  Reopen fallopian
                   tube
           58350  Reopen fallopian
                   tube
           58970  Retrieval of oocyte
           59300  Episiotomy or
                   vaginal repair
           59320  Revision of cervix
           59871  Remove cerclage
                   suture
   0195   Level V Female Reproductive   T                      18.68     $905.74         $483.80         $181.15
                   Procedures
           56620  Partial removal of
                   vulva
           56625  Complete removal of
                   vulva
           57220  Revision of urethra
           57240  Repair bladder &
                   vagina
           57250  Repair rectum &
                   vagina
           57260  Repair of vagina
           57265  Extensive repair of
                   vagina
           57268  Repair of bowel
                   bulge
           57284  Repair paravaginal
                   defect
           57288  Repair bladder
                   defect
           57289  Repair bladder &
                   vagina
           57291  Construction of
                   vagina
           57300  Repair rectum-vagina
                   fistula
           57522  Conization of cervix
           57530  Removal of cervix
           57550  Removal of residual
                   cervix
           57555  Remove cervix/repair
                   vagina
           57556  Remove cervix,
                   repair bowel
           58145  Removal of uterus
                   lesion
           58800  Drainage of ovarian
                   cyst(s)
           58820  Drain ovary abscess,
                   open
           58900  Biopsy of ovary(s)
           58920  Partial removal of
                   ovary(s)
           58925  Removal of ovarian
                   cyst(s)
   0196      Dilatation & Curettage     T                      14.47     $701.61         $357.98         $140.32
           57820  D & c of residual
                   cervix
           58120  Dilation and
                   curettage
           59160  D & c after delivery
   0197      Infertility Procedures     T                       2.40     $116.37          $49.55          $23.27
           55870  Electroejaculation
           58321  Artificial
                   insemination
           58322  Artificial
                   insemination
           58323  Sperm washing
           58974  Transfer of embryo
           58976  Transfer of embryo
   0198   Pregnancy and Neonatal Care   T                       1.34      $64.97          $33.03          $12.99
                   Procedures
           59000  Amniocentesis
           59012  Fetal cord puncture,
                   prenatal
           59015  Chorion biopsy
           59020  Fetal contract
                   stress test
           59025  Fetal non-stress
                   test
           59030  Fetal scalp blood
                   sample
           59050  Fetal monitor w/
                   report
           59899  Maternity care
                   procedure
   0199         Vaginal Delivery        T                      11.20     $543.06         $157.83         $108.61
           59409  Obstetrical care
           59412  Antepartum
                   manipulation
           59414  Deliver placenta
           59612  Vbac delivery only
   0200       Therapeutic Abortion      T                      13.89     $673.49         $373.23         $134.70
           59840  Abortion
           59841  Abortion
   0201       Spontaneous Abortion      T                      13.00     $630.33         $329.65         $126.07
           59812  Treatment of
                   miscarriage
           59820  Care of miscarriage
           59821  Treatment of
                   miscarriage
           59870  Evacuate mole of
                   uterus

[[Page 18743]]

 
   0210            Spinal Tap           T                       3.00     $145.46          $62.40          $29.09
           62270  Spinal fluid tap,
                   diagnostic
           62272  Drain spinal fluid
   0211      Level I Nervous System     T                       3.32     $160.98          $74.78          $32.20
                   Injections
           64400  Injection for nerve
                   block
           64402  Injection for nerve
                   block
           64405  Injection for nerve
                   block
           64408  Injection for nerve
                   block
           64410  Injection for nerve
                   block
           64412  Injection for nerve
                   block
           64413  Injection for nerve
                   block
           64415  Injection for nerve
                   block
           64417  Injection for nerve
                   block
           64418  Injection for nerve
                   block
           64420  Injection for nerve
                   block
           64421  Injection for nerve
                   block
           64425  Injection for nerve
                   block
           64430  Injection for nerve
                   block
           64435  Injection for nerve
                   block
           64445  Injection for nerve
                   block
           64450  Injection for nerve
                   block
           64470  Inj paravertebral c/
                   t
           64472  Inj paravertebral c/
                   t add-on
           64475  Inj paravertebral l/
                   s
           64476  Inj paravertebral l/
                   s add-on
           64479  Inj foramen epidural
                   c/t
           64480  Inj foramen epidural
                   add-on
           64483  Inj foramen epidural
                   l/s
           64484  Inj foramen epidural
                   add-on
           64505  Injection for nerve
                   block
           64508  Injection for nerve
                   block
           64510  Injection for nerve
                   block
           64520  Injection for nerve
                   block
           64530  Injection for nerve
                   block
           64600  Injection treatment
                   of nerve
           64605  Injection treatment
                   of nerve
           64610  Injection treatment
                   of nerve
           64612  Destroy nerve, face
                   muscle
           64613  Destroy nerve, spine
                   muscle
           64620  Injection treatment
                   of nerve
           64622  Destr paravertebrl
                   nerve l/s
           64623  Destr paravertebral
                   n add-on
           64626  Destr paravertebrl
                   nerve c/t
           64627  Destr paravertebral
                   n add-on
           64630  Injection treatment
                   of nerve
           64640  Injection treatment
                   of nerve
           64680  Injection treatment
                   of nerve
           64999  Nervous system
                   surgery
   0212     Level II Nervous System     T                       3.64     $176.49          $88.78          $35.30
                   Injections
           61000  Remove cranial
                   cavity fluid
           61001  Remove cranial
                   cavity fluid
           61020  Remove brain cavity
                   fluid
           61026  Injection into brain
                   canal
           61050  Remove brain canal
                   fluid
           61055  Injection into brain
                   canal
           61070  Brain canal shunt
                   procedure
           62263  Lysis epidural
                   adhesions
           62268  Drain spinal cord
                   cyst
           62273  Treat epidural spine
                   lesion
           62280  Treat spinal cord
                   lesion
           62281  Treat spinal cord
                   lesion
           62282  Treat spinal canal
                   lesion
           62292  Injection into disk
                   lesion
           62294  Injection into
                   spinal artery
           62310  Inject spine c/t
           62311  Inject spine l/s
                   (cd)
           62318  Inject spine w/cath,
                   c/t
           62319  Inject spine w/cath
                   l/s (cd)
   0213     Extended EEG Studies and    S                      11.15     $540.63         $290.42         $108.13
                 Sleep Studies
           95805  Multiple sleep
                   latency test
           95806  Sleep study,
                   unattended
           95807  Sleep study,
                   attended
           95808  Polysomnography, 1-3

[[Page 18744]]

 
           95810  Polysomnography, 4
                   or more
           95811  Polysomnography w/
                   cpap
           95812  Electroencephalogram
                   (EEG)
           95813  Electroencephalogram
                   (EEG)
           95827  Night
                   electroencephalogra
                   m
           95951  EEG monitoring/
                   videorecord
           95953  EEG monitoring/
                   computer
           95954  EEG monitoring/
                   giving drugs
           95958  EEG monitoring/
                   function test
   0214       Electroencephalogram      S                       2.32     $112.49          $58.50          $22.50
           95816  Electroencephalogram
                   (EEG)
           95819  Electroencephalogram
                   (EEG)
           95822  Sleep
                   electroencephalogra
                   m
           95824  Electroencephalograp
                   hy
           95829  Surgery
                   electrocorticogram
           95955  EEG during surgery
   0215     Level I Nerve and Muscle    S                       1.15      $55.76          $30.05          $11.15
                     Tests
           95857  Tensilon test
           95858  Tensilon test &
                   myogram
           95860  Muscle test, one
                   limb
           95861  Muscle test, two
                   limbs
           95864  Muscle test, 4 limbs
           95869  Muscle test, thor
                   paraspinal
           95870  Muscle test,
                   nonparaspinal
           95872  Muscle test, one
                   fiber
           95900  Motor nerve
                   conduction test
           95903  Motor nerve
                   conduction test
           95904  Sense/mixed n
                   conduction tst
           95933  Blink reflex test
           95934  H-reflex test
           95937  Neuromuscular
                   junction test
   0216    Level II Nerve and Muscle    S                       2.87     $139.16          $64.69          $27.83
                     Tests
           92275  Electroretinography
           92585  Auditory evoked
                   potential
           95863  Muscle test, 3 limbs
           95867  Muscle test, head or
                   neck
           95868  Muscle test, head or
                   neck
           95921  Autonomic nerv
                   function test
           95922  Autonomic nerv
                   function test
           95923  Autonomic nerv
                   function test
           95925  Somatosensory
                   testing
           95926  Somatosensory
                   testing
           95927  Somatosensory
                   testing
           95930  Visual evoked
                   potential test
           95936  H-reflex test
   0217    Level III Nerve and Muscle   S                       5.87     $284.62         $156.68          $56.92
                     Tests
           95875  Limb exercise test
           95950  Ambulatory eeg
                   monitoring
   0220     Level I Nerve Procedures    T                      13.96     $676.88         $326.21         $135.38
           27315  Partial removal,
                   thigh nerve
           27320  Partial removal,
                   thigh nerve
           28030  Removal of foot
                   nerve
           28035  Decompression of
                   tibia nerve
           61790  Treat trigeminal
                   nerve
           62287  Percutaneous
                   diskectomy
           63600  Remove spinal cord
                   lesion
           63610  Stimulation of
                   spinal cord
           63615  Remove lesion of
                   spinal cord
           64702  Revise finger/toe
                   nerve
           64704  Revise hand/foot
                   nerve
           64708  Revise arm/leg nerve
           64712  Revision of sciatic
                   nerve
           64713  Revision of arm
                   nerve(s)
           64714  Revise low back
                   nerve(s)
           64716  Revision of cranial
                   nerve
           64718  Revise ulnar nerve
                   at elbow
           64719  Revise ulnar nerve
                   at wrist
           64721  Carpal tunnel
                   surgery
           64722  Relieve pressure on
                   nerve(s)
           64726  Release foot/toe
                   nerve
           64727  Internal nerve
                   revision
           64732  Incision of brow
                   nerve
           64734  Incision of cheek
                   nerve

[[Page 18745]]

 
           64736  Incision of chin
                   nerve
           64738  Incision of jaw
                   nerve
           64740  Incision of tongue
                   nerve
           64742  Incision of facial
                   nerve
           64744  Incise nerve, back
                   of head
           64746  Incise diaphragm
                   nerve
           64761  Incision of pelvis
                   nerve
           64771  Sever cranial nerve
           64772  Incision of spinal
                   nerve
           64774  Remove skin nerve
                   lesion
           64776  Remove digit nerve
                   lesion
           64778  Digit nerve surgery
                   add-on
           64782  Remove limb nerve
                   lesion
           64783  Limb nerve surgery
                   add-on
           64784  Remove nerve lesion
           64787  Implant nerve end
           64788  Remove skin nerve
                   lesion
           64790  Removal of nerve
                   lesion
           64795  Biopsy of nerve
   0221    Level II Nerve Procedures    T                      18.36     $890.22         $463.62         $178.04
           64786  Remove sciatic nerve
                   lesion
           64792  Removal of nerve
                   lesion
           64831  Repair of digit
                   nerve
           64832  Repair nerve add-on
           64834  Repair of hand or
                   foot nerve
           64835  Repair of hand or
                   foot nerve
           64836  Repair of hand or
                   foot nerve
           64837  Repair nerve add-on
           64840  Repair of leg nerve
           64856  Repair/transpose
                   nerve
           64857  Repair arm/leg nerve
           64858  Repair sciatic nerve
           64859  Nerve surgery
           64861  Repair of arm nerves
           64862  Repair of low back
                   nerves
           64864  Repair of facial
                   nerve
           64865  Repair of facial
                   nerve
           64870  Fusion of facial/
                   other nerve
           64872  Subsequent repair of
                   nerve
           64874  Repair & revise
                   nerve add-on
           64876  Repair nerve/shorten
                   bone
           64885  Nerve graft, head or
                   neck
           64886  Nerve graft, head or
                   neck
           64890  Nerve graft, hand or
                   foot
           64891  Nerve graft, hand or
                   foot
           64892  Nerve graft, arm or
                   leg
           64893  Nerve graft, arm or
                   leg
           64895  Nerve graft, hand or
                   foot
           64896  Nerve graft, hand or
                   foot
           64897  Nerve graft, arm or
                   leg
           64898  Nerve graft, arm or
                   leg
           64901  Nerve graft add-on
           64902  Nerve graft add-on
           64905  Nerve pedicle
                   transfer
           64907  Nerve pedicle
                   transfer
   0222   Implantation of Neurological  T                      25.48   $1,235.45         $780.07         $247.09
                     Device
           61215  Insert brain-fluid
                   device
           61885  Implant neurostim
                   one array
           62360  Insert spine
                   infusion device
           62361  Implant spine
                   infusion pump
           62362  Implant spine
                   infusion pump
           63685  Implant
                   neuroreceiver
           64590  Implant
                   neuroreceiver
   0223     Level I Revision/Removal    T                       6.34     $307.41         $153.24          $61.48
              Neurological Device
           62350  Implant spinal canal
                   cath
           62355  Remove spinal canal
                   catheter
           63746  Removal of spinal
                   shunt
   0224    Level II Revision/Removal    T                      15.94     $772.88         $374.61         $154.58
              Neurological Device
           62230  Replace/revise brain
                   shunt
           62365  Remove spine
                   infusion device
           63650  Implant
                   neuroelectrodes
           63660  Revise/remove
                   neuroelectrode
           63688  Revise/remove
                   neuroreceiver

[[Page 18746]]

 
           63744  Revision of spinal
                   shunt
   0225         Implantation of         T                       3.43     $166.31          $64.46          $33.26
           Neurostimulator Electrodes
           64553  Implant
                   neuroelectrodes
           64555  Implant
                   neuroelectrodes
           64560  Implant
                   neuroelectrodes
           64565  Implant
                   neuroelectrodes
           64573  Implant
                   neuroelectrodes
           64575  Implant
                   neuroelectrodes
           64577  Implant
                   neuroelectrodes
           64580  Implant
                   neuroelectrodes
           64585  Revise/remove
                   neuroelectrode
           64595  Revise/remove
                   neuroreceiver
   0230        Level I Eye Tests        S                       0.98      $47.52          $22.48           $9.50
           68200  Treat eyelid by
                   injection
           92020  Special eye
                   evaluation
           92060  Special eye
                   evaluation
           92065  Orthoptic/pleoptic
                   training
           92081  Visual field
                   examination(s)
           92082  Visual field
                   examination(s)
           92083  Visual field
                   examination(s)
           92120  Tonography & eye
                   evaluation
           92130  Water provocation
                   tonography
           92225  Special eye exam,
                   initial
           92250  Eye exam with photos
           92260  Ophthalmoscopy/
                   dynamometry
           92265  Eye muscle
                   evaluation
           92270  Electro-oculography
           92283  Color vision
                   examination
           92285  Eye photography
           92330  Fitting of
                   artificial eye
           92499  Eye service or
                   procedure
   0231        Level II Eye Tests       S                       2.64     $128.01          $59.87          $25.60
           65205  Remove foreign body
                   from eye
           65210  Remove foreign body
                   from eye
           65220  Remove foreign body
                   from eye
           65222  Remove foreign body
                   from eye
           65430  Corneal smear
           67350  Biopsy eye muscle
           67500  Inject/treat eye
                   socket
           68110  Remove eyelid lining
                   lesion
           68761  Close tear duct
                   opening
           68801  Dilate tear duct
                   opening
           68810  Probe nasolacrimal
                   duct
           68840  Explore/irrigate
                   tear ducts
           68899  Tear duct system
                   surgery
           92018  New eye exam &
                   treatment
           92019  Eye exam & treatment
           92135  Opthalmic dx imaging
           92140  Glaucoma provocative
                   tests
           92226  Special eye exam,
                   subsequent
           92230  Eye exam with photos
           92235  Eye exam with photos
           92240  Icg angiography
           92284  Dark adaptation eye
                   exam
           92286  Internal eye
                   photography
           92287  Internal eye
                   photography
   0232   Level I Anterior Segment Eye  T                       6.04     $292.86         $134.66          $58.57
           65235  Remove foreign body
                   from eye
           65272  Repair of eye wound
           65286  Repair of eye wound
           65400  Removal of eye
                   lesion
           65436  Curette/treat cornea
           65450  Treatment of corneal
                   lesion
           65772  Correction of
                   astigmatism
           65800  Drainage of eye
           65820  Relieve inner eye
                   pressure
           65880  Incise inner eye
                   adhesions
           65900  Remove eye lesion
           66020  Injection treatment
                   of eye
           66030  Injection treatment
                   of eye
           66500  Incision of iris
           66505  Incision of iris
           66625  Removal of iris

[[Page 18747]]

 
           66700  Destruction, ciliary
                   body
           66710  Destruction, ciliary
                   body
           66720  Destruction, ciliary
                   body
           66820  Incision, secondary
                   cataract
           66830  Removal of lens
                   lesion
           67880  Revision of eyelid
           68100  Biopsy of eyelid
                   lining
   0233  Level II Anterior Segment Eye  T                      13.79     $668.64         $331.60         $133.73
           65275  Repair of eye wound
           65280  Repair of eye wound
           65410  Biopsy of cornea
           65420  Removal of eye
                   lesion
           65426  Removal of eye
                   lesion
           65775  Correction of
                   astigmatism
           65805  Drainage of eye
           65810  Drainage of eye
           65815  Drainage of eye
           65865  Incise inner eye
                   adhesions
           65870  Incise inner eye
                   adhesions
           65875  Incise inner eye
                   adhesions
           65920  Remove implant from
                   eye
           65930  Remove blood clot
                   from eye
           66130  Remove eye lesion
           66150  Glaucoma surgery
           66250  Follow-up surgery of
                   eye
           66600  Remove iris and
                   lesion
           66605  Removal of iris
           66630  Removal of iris
           66635  Removal of iris
           66680  Repair iris &
                   ciliary body
           66682  Repair iris &
                   ciliary body
           66740  Destruction, ciliary
                   body
           66825  Reposition
                   intraocular lens
           68130  Remove eyelid lining
                   lesion
           68330  Revise eyelid lining
   0234    Level III Anterior Segment   T                      20.64   $1,000.77         $502.16         $200.15
                 Eye Procedures
           65285  Repair of eye wound
           65850  Incision of eye
           66155  Glaucoma surgery
           66160  Glaucoma surgery
           66165  Glaucoma surgery
           66170  Glaucoma surgery
           66172  Incision of eye
           66180  Implant eye shunt
           66185  Revise eye shunt
           66225  Repair/graft eye
                   lesion
           68360  Revise eyelid lining
           68362  Revise eyelid lining
   0235  Level I Posterior Segment Eye  T                       2.94     $142.55          $78.91          $28.51
                   Procedures
           67141  Treatment of retina
           67208  Treatment of retinal
                   lesion
           67227  Treatment of retinal
                   lesion
   0236    Level II Posterior Segment   T                       6.70     $324.86         $147.96          $64.97
                 Eye Procedures
           66220  Repair eye lesion
           67028  Injection eye drug
           67030  Incise inner eye
                   strands
           67101  Repair detached
                   retina
           67110  Repair detached
                   retina
           67115  Release encircling
                   material
           67120  Remove eye implant
                   material
   0237   Level III Posterior Segment   T                      33.96   $1,646.62         $852.68         $329.32
                 Eye Procedures
           65260  Remove foreign body
                   from eye
           65265  Remove foreign body
                   from eye
           67005  Partial removal of
                   eye fluid
           67010  Partial removal of
                   eye fluid
           67015  Release of eye fluid
           67025  Replace eye fluid
           67027  Implant eye drug
                   system
           67036  Removal of inner eye
                   fluid
           67038  Strip retinal
                   membrane
           67039  Laser treatment of
                   retina
           67040  Laser treatment of
                   retina
           67107  Repair detached
                   retina

[[Page 18748]]

 
           67108  Repair detached
                   retina
           67112  Rerepair detached
                   retina
           67121  Remove eye implant
                   material
           67218  Treatment of retinal
                   lesion
           67220  Treatment of choroid
                   lesion
           67255  Reinforce/graft eye
                   wall
   0238    Level I Repair and Plastic   T                       2.80     $135.76          $58.96          $27.15
                 Eye Procedures
           67345  Destroy nerve of eye
                   muscle
           67505  Inject/treat eye
                   socket
           67700  Drainage of eyelid
                   abscess
           67800  Remove eyelid lesion
           67805  Remove eyelid
                   lesions
           67810  Biopsy of eyelid
           67820  Revise eyelashes
           67825  Revise eyelashes
           67938  Remove eyelid
                   foreign body
           68400  Incise/drain tear
                   gland
           68440  Incise tear duct
                   opening
           68705  Revise tear duct
                   opening
           68760  Close tear duct
                   opening
   0239   Level II Repair and Plastic   T                       6.26     $303.53         $123.42          $60.71
                 Eye Procedures
           65435  Curette/treat cornea
           67415  Aspiration, orbital
                   contents
           67515  Inject/treat eye
                   socket
           67599  Orbit surgery
                   procedure
           67710  Incision of eyelid
           67801  Remove eyelid
                   lesions
           67830  Revise eyelashes
           67840  Remove eyelid lesion
           67850  Treat eyelid lesion
           67875  Closure of eyelid by
                   suture
           67915  Repair eyelid defect
           67922  Repair eyelid defect
           68040  Treatment of eyelid
                   lesions
           68115  Remove eyelid lining
                   lesion
           68135  Remove eyelid lining
                   lesion
           68399  Eyelid lining
                   surgery
   0240   Level III Repair and Plastic  T                      13.47     $653.12         $315.31         $130.62
                 Eye Procedures
           65125  Revise ocular
                   implant
           65175  Removal of ocular
                   implant
           65270  Repair of eye wound
           65600  Revision of cornea
           67250  Reinforce eye wall
           67715  Incision of eyelid
                   fold
           67808  Remove eyelid
                   lesion(s)
           67835  Revise eyelashes
           67882  Revision of eyelid
           67900  Repair brow defect
           67901  Repair eyelid defect
           67902  Repair eyelid defect
           67903  Repair eyelid defect
           67904  Repair eyelid defect
           67906  Repair eyelid defect
           67908  Repair eyelid defect
           67909  Revise eyelid defect
           67911  Revise eyelid defect
           67914  Repair eyelid defect
           67916  Repair eyelid defect
           67917  Repair eyelid defect
           67921  Repair eyelid defect
           67923  Repair eyelid defect
           67924  Repair eyelid defect
           67930  Repair eyelid wound
           67935  Repair eyelid wound
           67950  Revision of eyelid
           67961  Revision of eyelid
           67966  Revision of eyelid
           67975  Reconstruction of
                   eyelid
           67999  Revision of eyelid
           68020  Incise/drain eyelid
                   lining
           68320  Revise/graft eyelid
                   lining
           68340  Separate eyelid
                   adhesions
           68420  Incise/drain tear
                   sac

[[Page 18749]]

 
           68510  Biopsy of tear gland
           68525  Biopsy of tear sac
           68530  Clearance of tear
                   duct
           68770  Close tear system
                   fistula
           68811  Probe nasolacrimal
                   duct
           68815  Probe nasolacrimal
                   duct
   0241   Level IV Repair and Plastic   T                      16.60     $804.89         $384.47         $160.98
                 Eye Procedures
           65093  Revise eye with
                   implant
           65130  Insert ocular
                   implant
           65135  Insert ocular
                   implant
           65150  Revise ocular
                   implant
           67400  Explore/biopsy eye
                   socket
           67405  Explore/drain eye
                   socket
           67412  Explore/treat eye
                   socket
           67413  Explore/treat eye
                   socket
           67560  Revise eye socket
                   implant
           67971  Reconstruction of
                   eyelid
           67973  Reconstruction of
                   eyelid
           67974  Reconstruction of
                   eyelid
           68326  Revise/graft eyelid
                   lining
           68328  Revise/graft eyelid
                   lining
           68335  Revise/graft eyelid
                   lining
           68500  Removal of tear
                   gland
           68505  Partial removal,
                   tear gland
           68520  Removal of tear sac
           68540  Remove tear gland
                   lesion
           68700  Repair tear ducts
           68745  Create tear duct
                   drain
   0242    Level V Repair and Plastic   T                      23.70   $1,149.14         $597.36         $229.83
                 Eye Procedures
           65091  Revise eye
           65101  Removal of eye
           65103  Remove eye/insert
                   implant
           65105  Remove eye/attach
                   implant
           65110  Removal of eye
           65112  Remove eye/revise
                   socket
           65114  Remove eye/revise
                   socket
           65140  Attach ocular
                   implant
           65155  Reinsert ocular
                   implant
           67414  Explr/decompress eye
                   socket
           67420  Explore/treat eye
                   socket
           67430  Explore/treat eye
                   socket
           67440  Explore/drain eye
                   socket
           67445  Explr/decompress eye
                   socket
           67450  Explore/biopsy eye
                   socket
           67550  Insert eye socket
                   implant
           67570  Decompress optic
                   nerve
           68325  Revise/graft eyelid
                   lining
           68550  Remove tear gland
                   lesion
           68720  Create tear sac
                   drain
           68750  Create tear duct
                   drain
   0243   Strabismus/Muscle Procedures  T                      17.99     $872.28         $431.39         $174.46
           65290  Repair of eye socket
                   wound
           67311  Revise eye muscle
           67312  Revise two eye
                   muscles
           67314  Revise eye muscle
           67316  Revise two eye
                   muscles
           67318  Revise eye muscle(s)
           67320  Revise eye muscle(s)
                   add-on
           67331  Eye surgery follow-
                   up add-on
           67332  Rerevise eye muscles
                   add-on
           67334  Revise eye muscle w/
                   suture
           67335  Eye suture during
                   surgery
           67340  Revise eye muscle
                   add-on
           67343  Release eye tissue
           67399  Eye muscle surgery
                   procedure
   0244        Corneal Transplant       T                      32.88   $1,594.26         $851.42         $318.85
           65710  Corneal transplant
           65730  Corneal transplant
           65750  Corneal transplant
           65755  Corneal transplant
           65770  Revise cornea with
                   implant
   0245   Cataract Procedures without   T                      26.55   $1,287.33         $623.85         $257.47
                   IOL Insert
           66840  Removal of lens
                   material

[[Page 18750]]

 
           66850  Removal of lens
                   material
           66852  Removal of lens
                   material
           66920  Extraction of lens
           66930  Extraction of lens
           66940  Extraction of lens
   0246   Cataract Procedures with IOL  T                      26.55   $1,287.33         $623.85         $257.47
                     Insert
           66983  Remove cataract/
                   insert lens
           66984  Remove cataract/
                   insert lens
           66985  Insert lens
                   prosthesis
           66986  Exchange lens
                   prosthesis
   0247   Laser Eye Procedures Except   T                       4.89     $237.10         $112.86          $47.42
                    Retinal
           65855  Laser surgery of eye
           65860  Incise inner eye
                   adhesions
           66761  Revision of iris
           66762  Revision of iris
           66770  Removal of inner eye
                   lesion
           66821  After cataract laser
                   surgery
           66999  Eye surgery
                   procedure
           67031  Laser surgery, eye
                   strands
   0248     Laser Retinal Procedures    T                       4.19     $203.16          $94.05          $40.63
           67105  Repair detached
                   retina
           67145  Treatment of retina
           67210  Treatment of retinal
                   lesion
           67228  Treatment of retinal
                   lesion
           67299  Eye surgery
                   procedure
   0250   Nasal Cauterization/Packing   T                       2.21     $107.16          $38.54          $21.43
           30901  Control of nosebleed
           30903  Control of nosebleed
           30905  Control of nosebleed
           30906  Repeat control of
                   nosebleed
           42960  Control throat
                   bleeding
           42970  Control nose/throat
                   bleeding
   0251      Level I ENT Procedures     T                       1.68      $81.46          $27.99          $16.29
           21450  Treat lower jaw
                   fracture
           21480  Reset dislocated jaw
           30000  Drainage of nose
                   lesion
           30020  Drainage of nose
                   lesion
           30300  Remove nasal foreign
                   body
           30560  Release of nasal
                   adhesions
           30999  Nasal surgery
                   procedure
           31000  Irrigation,
                   maxillary sinus
           40800  Drainage of mouth
                   lesion
           40804  Removal, foreign
                   body, mouth
           40806  Incision of lip fold
           40808  Biopsy of mouth
                   lesion
           40818  Excise oral mucosa
                   for graft
           40830  Repair mouth
                   laceration
           41005  Drainage of mouth
                   lesion
           41009  Drainage of mouth
                   lesion
           41250  Repair tongue
                   laceration
           41599  Tongue and mouth
                   surgery
           41800  Drainage of gum
                   lesion
           42000  Drainage mouth roof
                   lesion
           42180  Repair palate
           42280  Preparation, palate
                   mold
           42299  Palate/uvula surgery
           42310  Drainage of salivary
                   gland
           42320  Drainage of salivary
                   gland
           42700  Drainage of tonsil
                   abscess
           42809  Remove pharynx
                   foreign body
           69400  Inflate middle ear
                   canal
           92502  Ear and throat
                   examination
   0252     Level II ENT Procedures     T                       5.18     $251.16         $114.24          $50.23
           20500  Injection of sinus
                   tract
           21400  Treat eye socket
                   fracture
           21493  Treat hyoid bone
                   fracture
           21494  Treat hyoid bone
                   fracture
           21899  Neck/chest surgery
                   procedure
           30100  Intranasal biopsy
           30124  Removal of nose
                   lesion
           30210  Nasal sinus therapy
           30220  Insert nasal septal
                   button
           30801  Cauterization, inner
                   nose

[[Page 18751]]

 
           31002  Irrigation, sphenoid
                   sinus
           31299  Sinus surgery
                   procedure
           40490  Biopsy of lip
           40801  Drainage of mouth
                   lesion
           40805  Removal, foreign
                   body, mouth
           40812  Excise/repair mouth
                   lesion
           40819  Excise lip or cheek
                   fold
           40899  Mouth surgery
                   procedure
           41015  Drainage of mouth
                   lesion
           41100  Biopsy of tongue
           41108  Biopsy of floor of
                   mouth
           41820  Excision, gum, each
                   quadrant
           41821  Excision of gum flap
           42100  Biopsy roof of mouth
           42140  Excision of uvula
           42325  Create salivary cyst
                   drain
           42326  Create salivary cyst
                   drain
           42330  Removal of salivary
                   stone
           42650  Dilation of salivary
                   duct
           42660  Dilation of salivary
                   duct
           42800  Biopsy of throat
           42999  Throat surgery
                   procedure
           69399  Outer ear surgery
                   procedure
           69405  Catheterize middle
                   ear canal
           69410  Inset middle ear
                   (baffle)
           69420  Incision of eardrum
           69424  Remove ventilating
                   tube
           69433  Create eardrum
                   opening
           69979  Temporal bone
                   surgery
   0253     Level III ENT Procedures    T                      12.02     $582.81         $284.00         $116.56
           21031  Remove exostosis,
                   mandible
           21032  Remove exostosis,
                   maxilla
           21040  Removal of jaw bone
                   lesion
           21085  Prepare face/oral
                   prosthesis
           21089  Prepare face/oral
                   prosthesis
           21282  Revision of eyelid
           21295  Revision of jaw
                   muscle/bone
           21299  Cranio/maxillofacial
                   surgery
           21300  Treatment of skull
                   fracture
           21310  Treatment of nose
                   fracture
           21315  Treatment of nose
                   fracture
           21320  Treatment of nose
                   fracture
           21325  Treatment of nose
                   fracture
           21337  Treat nasal septal
                   fracture
           21401  Treat eye socket
                   fracture
           21440  Treat dental ridge
                   fracture
           21452  Treat lower jaw
                   fracture
           21485  Reset dislocated jaw
           21497  Interdental wiring
           21499  Head surgery
                   procedure
           30110  Removal of nose
                   polyp(s)
           30115  Removal of nose
                   polyp(s)
           30117  Removal of
                   intranasal lesion
           30120  Revision of nose
           30130  Removal of turbinate
                   bones
           30140  Removal of turbinate
                   bones
           30200  Injection treatment
                   of nose
           30310  Remove nasal foreign
                   body
           30320  Remove nasal foreign
                   body
           30802  Cauterization, inner
                   nose
           30930  Therapy, fracture of
                   nose
           31020  Exploration,
                   maxillary sinus
           31585  Treat larynx
                   fracture
           31599  Larynx surgery
                   procedure
           31612  Puncture/clear
                   windpipe
           31820  Closure of windpipe
                   lesion
           40500  Partial excision of
                   lip
           40520  Partial excision of
                   lip
           40650  Repair lip
           40652  Repair lip
           40799  Lip surgery
                   procedure
           40810  Excision of mouth
                   lesion
           40814  Excise/repair mouth
                   lesion

[[Page 18752]]

 
           40816  Excision of mouth
                   lesion
           40820  Treatment of mouth
                   lesion
           40831  Repair mouth
                   laceration
           41000  Drainage of mouth
                   lesion
           41006  Drainage of mouth
                   lesion
           41007  Drainage of mouth
                   lesion
           41008  Drainage of mouth
                   lesion
           41010  Incision of tongue
                   fold
           41016  Drainage of mouth
                   lesion
           41017  Drainage of mouth
                   lesion
           41018  Drainage of mouth
                   lesion
           41105  Biopsy of tongue
           41110  Excision of tongue
                   lesion
           41112  Excision of tongue
                   lesion
           41113  Excision of tongue
                   lesion
           41115  Excision of tongue
                   fold
           41116  Excision of mouth
                   lesion
           41251  Repair tongue
                   laceration
           41252  Repair tongue
                   laceration
           41500  Fixation of tongue
           41510  Tongue to lip
                   surgery
           41520  Reconstruction,
                   tongue fold
           41805  Removal foreign
                   body, gum
           41806  Removal foreign
                   body, jawbone
           41822  Excision of gum
                   lesion
           41823  Excision of gum
                   lesion
           41825  Excision of gum
                   lesion
           41826  Excision of gum
                   lesion
           41827  Excision of gum
                   lesion
           41828  Excision of gum
                   lesion
           41830  Removal of gum
                   tissue
           41850  Treatment of gum
                   lesion
           41870  Gum graft
           41872  Repair gum
           41874  Repair tooth socket
           41899  Dental surgery
                   procedure
           42104  Excision lesion,
                   mouth roof
           42106  Excision lesion,
                   mouth roof
           42160  Treatment mouth roof
                   lesion
           42260  Repair nose to lip
                   fistula
           42281  Insertion, palate
                   prosthesis
           42300  Drainage of salivary
                   gland
           42305  Drainage of salivary
                   gland
           42335  Removal of salivary
                   stone
           42340  Removal of salivary
                   stone
           42405  Biopsy of salivary
                   gland
           42408  Excision of salivary
                   cyst
           42409  Drainage of salivary
                   cyst
           42450  Excise sublingual
                   gland
           42600  Closure of salivary
                   fistula
           42665  Ligation of salivary
                   duct
           42699  Salivary surgery
                   procedure
           42720  Drainage of throat
                   abscess
           42802  Biopsy of throat
           42804  Biopsy of upper nose/
                   throat
           42806  Biopsy of upper nose/
                   throat
           42808  Excise pharynx
                   lesion
           42810  Excision of neck
                   cyst
           42900  Repair throat wound
           42972  Control nose/throat
                   bleeding
           60000  Drain thyroid/tongue
                   cyst
           69105  Biopsy of external
                   ear canal
           69120  Removal of external
                   ear
           69222  Clean out mastoid
                   cavity
           69421  Incision of eardrum
           69436  Create eardrum
                   opening
           69440  Exploration of
                   middle ear
           69540  Remove ear lesion
           69610  Repair of eardrum
           69620  Repair of eardrum
           69799  Middle ear surgery
                   procedure
           69949  Inner ear surgery
                   procedure
   0254     Level IV ENT Procedures     T                      12.45     $603.66         $272.41         $120.73

[[Page 18753]]

 
           21010  Incision of jaw
                   joint
           21015  Resection of facial
                   tumor
           21030  Removal of face bone
                   lesion
           21076  Prepare face/oral
                   prosthesis
           21110  Interdental fixation
           21120  Reconstruction of
                   chin
           21121  Reconstruction of
                   chin
           21122  Reconstruction of
                   chin
           21123  Reconstruction of
                   chin
           21125  Augmentation, lower
                   jaw bone
           21137  Reduction of
                   forehead
           21181  Contour cranial bone
                   lesion
           21235  Ear cartilage graft
           21296  Revision of jaw
                   muscle/bone
           21330  Treatment of nose
                   fracture
           21335  Treatment of nose
                   fracture
           21338  Treat nasoethmoid
                   fracture
           21339  Treat nasoethmoid
                   fracture
           21345  Treat nose/jaw
                   fracture
           21421  Treat mouth roof
                   fracture
           21445  Treat dental ridge
                   fracture
           21451  Treat lower jaw
                   fracture
           21454  Treat lower jaw
                   fracture
           30118  Removal of
                   intranasal lesion
           30430  Revision of nose
           30630  Repair nasal septum
                   defect
           31040  Exploration behind
                   upper jaw
           31070  Exploration of
                   frontal sinus
           31600  Incision of windpipe
           31601  Incision of windpipe
           31603  Incision of windpipe
           31605  Incision of windpipe
           31610  Incision of windpipe
           31611  Surgery/speech
                   prosthesis
           31613  Repair windpipe
                   opening
           31825  Repair of windpipe
                   defect
           31830  Revise windpipe scar
           40510  Partial excision of
                   lip
           40525  Reconstruct lip with
                   flap
           40527  Reconstruct lip with
                   flap
           40530  Partial removal of
                   lip
           40654  Repair lip
           40840  Reconstruction of
                   mouth
           40842  Reconstruction of
                   mouth
           40843  Reconstruction of
                   mouth
           41114  Excision of tongue
                   lesion
           42107  Excision lesion,
                   mouth roof
           42145  Repair palate,
                   pharynx/uvula
           42235  Repair palate
           42500  Repair salivary duct
           42950  Reconstruction of
                   throat
           42955  Surgical opening of
                   throat
           43020  Incision of
                   esophagus
           69140  Remove ear canal
                   lesion(s)
           69300  Revise external ear
           69650  Release middle ear
                   bone
   0256      Level V ENT Procedures     T                      25.40   $1,231.57         $623.05         $246.31
           21025  Excision of bone,
                   lower jaw
           21026  Excision of facial
                   bone(s)
           21029  Contour of face bone
                   lesion
           21034  Removal of face bone
                   lesion
           21041  Removal of jaw bone
                   lesion
           21044  Removal of jaw bone
                   lesion
           21050  Removal of jaw joint
           21060  Remove jaw joint
                   cartilage
           21070  Remove coronoid
                   process
           21077  Prepare face/oral
                   prosthesis
           21079  Prepare face/oral
                   prosthesis
           21080  Prepare face/oral
                   prosthesis
           21081  Prepare face/oral
                   prosthesis
           21082  Prepare face/oral
                   prosthesis
           21083  Prepare face/oral
                   prosthesis
           21084  Prepare face/oral
                   prosthesis

[[Page 18754]]

 
           21086  Prepare face/oral
                   prosthesis
           21087  Prepare face/oral
                   prosthesis
           21088  Prepare face/oral
                   prosthesis
           21100  Maxillofacial
                   fixation
           21127  Augmentation, lower
                   jaw bone
           21138  Reduction of
                   forehead
           21139  Reduction of
                   forehead
           21198  Reconstruct lower
                   jaw bone
           21206  Reconstruct upper
                   jaw bone
           21208  Augmentation of
                   facial bones
           21209  Reduction of facial
                   bones
           21210  Face bone graft
           21215  Lower jaw bone graft
           21230  Rib cartilage graft
           21240  Reconstruction of
                   jaw joint
           21242  Reconstruction of
                   jaw joint
           21243  Reconstruction of
                   jaw joint
           21244  Reconstruction of
                   lower jaw
           21245  Reconstruction of
                   jaw
           21246  Reconstruction of
                   jaw
           21248  Reconstruction of
                   jaw
           21249  Reconstruction of
                   jaw
           21260  Revise eye sockets
           21261  Revise eye sockets
           21263  Revise eye sockets
           21267  Revise eye sockets
           21270  Augmentation, cheek
                   bone
           21275  Revision,
                   orbitofacial bones
           21280  Revision of eyelid
           21340  Treatment of nose
                   fracture
           21355  Treat cheek bone
                   fracture
           21406  Treat eye socket
                   fracture
           21407  Treat eye socket
                   fracture
           21453  Treat lower jaw
                   fracture
           21461  Treat lower jaw
                   fracture
           21462  Treat lower jaw
                   fracture
           21465  Treat lower jaw
                   fracture
           21470  Treat lower jaw
                   fracture
           21490  Repair dislocated
                   jaw
           30125  Removal of nose
                   lesion
           30150  Partial removal of
                   nose
           30160  Removal of nose
           30400  Reconstruction of
                   nose
           30410  Reconstruction of
                   nose
           30420  Reconstruction of
                   nose
           30435  Revision of nose
           30450  Revision of nose
           30460  Revision of nose
           30462  Revision of nose
           30520  Repair of nasal
                   septum
           30540  Repair nasal defect
           30545  Repair nasal defect
           30580  Repair upper jaw
                   fistula
           30600  Repair mouth/nose
                   fistula
           30620  Intranasal
                   reconstruction
           31030  Exploration,
                   maxillary sinus
           31032  Explore sinus,
                   remove polyps
           31050  Exploration,
                   sphenoid sinus
           31051  Sphenoid sinus
                   surgery
           31075  Exploration of
                   frontal sinus
           31080  Removal of frontal
                   sinus
           31081  Removal of frontal
                   sinus
           31084  Removal of frontal
                   sinus
           31085  Removal of frontal
                   sinus
           31086  Removal of frontal
                   sinus
           31087  Removal of frontal
                   sinus
           31090  Exploration of
                   sinuses
           31200  Removal of ethmoid
                   sinus
           31201  Removal of ethmoid
                   sinus
           31205  Removal of ethmoid
                   sinus
           31300  Removal of larynx
                   lesion
           31320  Diagnostic incision,
                   larynx
           31375  Partial removal of
                   larynx

[[Page 18755]]

 
           31400  Revision of larynx
           31420  Removal of
                   epiglottis
           31580  Revision of larynx
           31586  Treat larynx
                   fracture
           31588  Revision of larynx
           31590  Reinnervate larynx
           31595  Larynx nerve surgery
           31614  Repair windpipe
                   opening
           31750  Repair of windpipe
           31755  Repair of windpipe
           40700  Repair cleft lip/
                   nasal
           40701  Repair cleft lip/
                   nasal
           40702  Repair cleft lip/
                   nasal
           40720  Repair cleft lip/
                   nasal
           40761  Repair cleft lip/
                   nasal
           40844  Reconstruction of
                   mouth
           40845  Reconstruction of
                   mouth
           41120  Partial removal of
                   tongue
           42120  Remove palate/lesion
           42182  Repair palate
           42200  Reconstruct cleft
                   palate
           42205  Reconstruct cleft
                   palate
           42210  Reconstruct cleft
                   palate
           42215  Reconstruct cleft
                   palate
           42220  Reconstruct cleft
                   palate
           42225  Reconstruct cleft
                   palate
           42226  Lengthening of
                   palate
           42227  Lengthening of
                   palate
           42410  Excise parotid gland/
                   lesion
           42415  Excise parotid gland/
                   lesion
           42420  Excise parotid gland/
                   lesion
           42425  Excise parotid gland/
                   lesion
           42440  Excise submaxillary
                   gland
           42505  Repair salivary duct
           42507  Parotid duct
                   diversion
           42508  Parotid duct
                   diversion
           42509  Parotid duct
                   diversion
           42510  Parotid duct
                   diversion
           42725  Drainage of throat
                   abscess
           42815  Excision of neck
                   cyst
           42844  Extensive surgery of
                   throat
           42890  Partial removal of
                   pharynx
           42892  Revision of
                   pharyngeal walls
           42962  Control throat
                   bleeding
           60500  Explore parathyroid
                   glands
           61330  Decompress eye
                   socket
           69310  Rebuild outer ear
                   canal
           69320  Rebuild outer ear
                   canal
           69450  Eardrum revision
           69501  Mastoidectomy
           69505  Remove mastoid
                   structures
           69511  Extensive mastoid
                   surgery
           69530  Extensive mastoid
                   surgery
           69550  Remove ear lesion
           69552  Remove ear lesion
           69601  Mastoid surgery
                   revision
           69602  Mastoid surgery
                   revision
           69603  Mastoid surgery
                   revision
           69604  Mastoid surgery
                   revision
           69605  Mastoid surgery
                   revision
           69631  Repair eardrum
                   structures
           69632  Rebuild eardrum
                   structures
           69633  Rebuild eardrum
                   structures
           69635  Repair eardrum
                   structures
           69636  Rebuild eardrum
                   structures
           69637  Rebuild eardrum
                   structures
           69641  Revise middle ear &
                   mastoid
           69642  Revise middle ear &
                   mastoid
           69643  Revise middle ear &
                   mastoid
           69644  Revise middle ear &
                   mastoid
           69645  Revise middle ear &
                   mastoid
           69646  Revise middle ear &
                   mastoid
           69660  Revise middle ear
                   bone

[[Page 18756]]

 
           69661  Revise middle ear
                   bone
           69662  Revise middle ear
                   bone
           69666  Repair middle ear
                   structures
           69667  Repair middle ear
                   structures
           69670  Remove mastoid air
                   cells
           69676  Remove middle ear
                   nerve
           69700  Close mastoid
                   fistula
           69711  Remove/repair
                   hearing aid
           69720  Release facial nerve
           69725  Release facial nerve
           69740  Repair facial nerve
           69745  Repair facial nerve
           69801  Incise inner ear
           69802  Incise inner ear
           69805  Explore inner ear
           69806  Explore inner ear
           69820  Establish inner ear
                   window
           69840  Revise inner ear
                   window
           69905  Remove inner ear
           69910  Remove inner ear &
                   mastoid
           69915  Incise inner ear
                   nerve
           69955  Release facial nerve
           69960  Release inner ear
                   canal
   0257     Implantation of Cochlear    T                     115.31   $5,591.04       $3,498.58       $1,118.21
                     Device
           69930  Implant cochlear
                   device
   0258  Tonsil and Adenoid Procedures  T                      18.62     $902.83         $462.81         $180.57
           42820  Remove tonsils and
                   adenoids
           42821  Remove tonsils and
                   adenoids
           42825  Removal of tonsils
           42826  Removal of tonsils
           42830  Removal of adenoids
           42831  Removal of adenoids
           42835  Removal of adenoids
           42836  Removal of adenoids
           42860  Excision of tonsil
                   tags
           42870  Excision of lingual
                   tonsil
   0260    Level I Plain Film Except    X                       0.79      $38.30          $22.02           $7.66
                     Teeth
           70030  X-ray eye for
                   foreign body
           70100  X-ray exam of jaw
           70110  X-ray exam of jaw
           70120  X-ray exam of
                   mastoids
           70130  X-ray exam of
                   mastoids
           70140  X-ray exam of facial
                   bones
           70150  X-ray exam of facial
                   bones
           70160  X-ray exam of nasal
                   bones
           70190  X-ray exam of eye
                   sockets
           70200  X-ray exam of eye
                   sockets
           70210  X-ray exam of
                   sinuses
           70220  X-ray exam of
                   sinuses
           70240  X-ray exam,
                   pituitary saddle
           70250  X-ray exam of skull
           70328  X-ray exam of jaw
                   joint
           70330  X-ray exam of jaw
                   joints
           70350  X-ray head for
                   orthodontia
           70355  Panoramic x-ray of
                   jaws
           70360  X-ray exam of neck
           70380  X-ray exam of
                   salivary gland
           71010  Chest x-ray
           71015  Chest x-ray
           71020  Chest x-ray
           71021  Chest x-ray
           71022  Chest x-ray
           71030  Chest x-ray
           71035  Chest x-ray
           71100  X-ray exam of ribs
           71101  X-ray exam of ribs/
                   chest
           71110  X-ray exam of ribs
           71120  X-ray exam of
                   breastbone
           71130  X-ray exam of
                   breastbone
           72020  X-ray exam of spine
           72040  X-ray exam of neck
                   spine
           72069  X-ray exam of trunk
                   spine
           72070  X-ray exam of
                   thoracic spine

[[Page 18757]]

 
           72072  X-ray exam of
                   thoracic spine
           72074  X-ray exam of
                   thoracic spine
           72080  X-ray exam of trunk
                   spine
           72090  X-ray exam of trunk
                   spine
           72100  X-ray exam of lower
                   spine
           72120  X-ray exam of lower
                   spine
           72170  X-ray exam of pelvis
           72190  X-ray exam of pelvis
           72200  X-ray exam
                   sacroiliac joints
           72202  X-ray exam
                   sacroiliac joints
           72220  X-ray exam of
                   tailbone
           73000  X-ray exam of collar
                   bone
           73010  X-ray exam of
                   shoulder blade
           73020  X-ray exam of
                   shoulder
           73030  X-ray exam of
                   shoulder
           73050  X-ray exam of
                   shoulders
           73060  X-ray exam of
                   humerus
           73070  X-ray exam of elbow
           73080  X-ray exam of elbow
           73090  X-ray exam of
                   forearm
           73092  X-ray exam of arm,
                   infant
           73100  X-ray exam of wrist
           73110  X-ray exam of wrist
           73120  X-ray exam of hand
           73130  X-ray exam of hand
           73140  X-ray exam of
                   finger(s)
           73500  X-ray exam of hip
           73510  X-ray exam of hip
           73520  X-ray exam of hips
           73540  X-ray exam of pelvis
                   & hips
           73550  X-ray exam of thigh
           73560  X-ray exam of knee,
                   1 or 2
           73562  X-ray exam of knee,
                   3
           73564  X-ray exam, knee, 4
                   or more
           73565  X-ray exam of knees
           73590  X-ray exam of lower
                   leg
           73600  X-ray exam of ankle
           73610  X-ray exam of ankle
           73620  X-ray exam of foot
           73630  X-ray exam of foot
           73650  X-ray exam of heel
           73660  X-ray exam of toe(s)
           74000  X-ray exam of
                   abdomen
           74010  X-ray exam of
                   abdomen
           74020  X-ray exam of
                   abdomen
           74710  X-ray measurement of
                   pelvis
           76010  X-ray, nose to
                   rectum
           76040  X-rays, bone
                   evaluation
           76066  Joint(s) survey,
                   single film
           76098  X-ray exam, breast
                   specimen
           76150  X-ray exam, dry
                   process
           76499  Radiographic
                   procedure
           77417  Radiology port
                   film(s)
   0261    Level II Plain Film Except   X                       1.38      $66.91          $38.77          $13.38
          Teeth Including Bone Density
                  Measurement
           70134  X-ray exam of middle
                   ear
           70260  X-ray exam of skull
           71111  X-ray exam of ribs/
                   chest
           72010  X-ray exam of spine
           72050  X-ray exam of neck
                   spine
           72052  X-ray exam of neck
                   spine
           72110  X-ray exam of lower
                   spine
           72114  X-ray exam of lower
                   spine
           73530  X-ray exam of hip
           73592  X-ray exam of leg,
                   infant
           74022  X-ray exam series,
                   abdomen
           76006  X-ray stress view
           76020  X-rays for bone age
           76061  X-rays, bone survey
           76062  X-rays, bone survey
           76065  X-rays, bone
                   evaluation
           76075  Dual energy x-ray
                   study
           76076  Dual energy x-ray
                   study
           76078  Photodensitometry

[[Page 18758]]

 
           76100  X-ray exam of body
                   section
           76120  Cinematic x-rays
           76125  Cinematic x-rays add-
                   on
           78350  Bone mineral, single
                   photon
           G0130  Single energy x-ray
                   study
           G0131  CT scan, bone
                   density study
           G0132  CT scan, bone
                   density study
   0262       Plain Film of Teeth       X                       0.40      $19.39          $10.90           $3.88
           70300  X-ray exam of teeth
           70310  X-ray exam of teeth
           70320  Full mouth x-ray of
                   teeth
   0263      Level I Miscellaneous      X                       1.68      $81.46          $45.88          $16.29
              Radiology Procedures
           70170  X-ray exam of tear
                   duct
           70373  Contrast x-ray of
                   larynx
           70390  X-ray exam of
                   salivary duct
           71040  Contrast x-ray of
                   bronchi
           71060  Contrast x-ray of
                   bronchi
           74190  X-ray exam of
                   peritoneum
           74305  X-ray bile ducts/
                   pancreas
           76080  X-ray exam of
                   fistula
           76086  X-ray of mammary
                   duct
           76088  X-ray of mammary
                   ducts
           76096  X-ray of needle
                   wire, breast
           76101  Complex body section
                   x-ray
   0264      Level II Miscellaneous     X                       3.83     $185.71         $108.97          $37.14
              Radiology Procedures
           74320  Contrast x-ray of
                   bile ducts
           74328  X-ray bile duct
                   endoscopy
           74329  X-ray for pancreas
                   endoscopy
           74330  X-ray bile/panc
                   endoscopy
           74350  X-ray guide, stomach
                   tube
           74355  X-ray guide,
                   intestinal tube
           74470  X-ray exam of kidney
                   lesion
           74740  X-ray, female
                   genital tract
           74742  X-ray, fallopian
                   tube
           75801  Lymph vessel x-ray,
                   arm/leg
           75803  Lymph vessel x-ray,
                   arms/legs
           75805  Lymph vessel x-ray,
                   trunk
           75807  Lymph vessel x-ray,
                   trunk
           75809  Nonvascular shunt, x-
                   ray
           75898  Follow-up angiogram
           76095  Stereotactic breast
                   biopsy
           76102  Complex body section
                   x-rays
   0265  Level I Diagnostic Ultrasound  S                       1.17      $56.73          $38.08          $11.35
                Except Vascular
           76513  Echo exam of eye,
                   water bath
           76529  Echo exam of eye
           76536  Echo exam of head
                   and neck
           76645  Echo exam of
                   breast(s)
           76810  Echo exam of
                   pregnant uterus
           76815  Echo exam of
                   pregnant uterus
           76816  Echo exam follow-up/
                   repeat
           76857  Echo exam of pelvis
           76970  Ultrasound exam
                   follow-up
           76977  Us bone density
                   measure
           G0050  Residual urine by
                   ultrasound
   0266       Level II Diagnostic       S                       1.79      $86.79          $57.35          $17.36
           Ultrasound Except Vascular
           76506  Echo exam of head
           76511  Echo exam of eye
           76512  Echo exam of eye
           76516  Echo exam of eye
           76519  Echo exam of eye
           76604  Echo exam of chest
           76700  Echo exam of abdomen
           76705  Echo exam of abdomen
           76770  Echo exam abdomen
                   back wall
           76775  Echo exam abdomen
                   back wall
           76778  Echo exam kidney
                   transplant
           76800  Echo exam spinal
                   canal
           76805  Echo exam of
                   pregnant uterus
           76818  Fetal biophysical
                   profile
           76830  Echo exam,
                   transvaginal
           76831  Echo exam, uterus
           76856  Echo exam of pelvis
           76870  Echo exam of scrotum

[[Page 18759]]

 
           76872  Echo exam,
                   transrectal
           76873  Echograp trans r,
                   pros study
           76880  Echo exam of
                   extremity
           76885  Echo exam, infant
                   hips
           76886  Echo exam, infant
                   hips
           76975  GI endoscopic
                   ultrasound
           76986  Echo exam at surgery
           76999  Echo examination
                   procedure
   0267       Vascular Ultrasound       S                       2.72     $131.88          $80.06          $26.38
           93880  Extracranial study
           93882  Extracranial study
           93886  Intracranial study
           93888  Intracranial study
           93925  Lower extremity
                   study
           93926  Lower extremity
                   study
           93930  Upper extremity
                   study
           93931  Upper extremity
                   study
           93970  Extremity study
           93971  Extremity study
           93975  Vascular study
           93976  Vascular study
           93978  Vascular study
           93979  Vascular study
           93980  Penile vascular
                   study
           93981  Penile vascular
                   study
           93990  Doppler flow testing
   0268    Guidance Under Ultrasound    X                       2.23     $108.13          $69.51          $21.63
           76930  Echo guide for heart
                   sac tap
           76932  Echo guide for heart
                   biopsy
           76934  Echo guide for chest
                   tap
           76936  Echo guide for
                   artery repair
           76938  Echo exam for
                   drainage
           76941  Echo guide for
                   transfusion
           76942  Echo guide for
                   biopsy
           76945  Echo guide, villus
                   sampling
           76946  Echo guide for
                   amniocentesis
           76948  Echo guide, ova
                   aspiration
           76950  Echo guidance
                   radiotherapy
           76960  Echo guidance
                   radiotherapy
           76965  Echo guidance
                   radiotherapy
           G0161  Echo guide for cryo
                   probes
   0269      Echocardiogram Except      S                       4.40     $213.34         $114.01          $42.67
                Transesophageal
           76825  Echo exam of fetal
                   heart
           76826  Echo exam of fetal
                   heart
           76827  Echo exam of fetal
                   heart
           76828  Echo exam of fetal
                   heart
           93303  Echo transthoracic
           93304  Echo transthoracic
           93307  Echo exam of heart
           93308  Echo exam of heart
           93320  Doppler echo exam,
                   heart
           93321  Doppler echo exam,
                   heart
           93325  Doppler color flow
                   add-on
           93350  Echo transthoracic
   0270         Transesophageal         S                       5.55     $269.10         $150.26          $53.82
                 Echocardiogram
           93312  Echo transesophageal
           93313  Echo transesophageal
           93315  Echo transesophageal
           93316  Echo transesophageal
   0271           Mammography           S                       0.70      $33.94          $19.50           $6.79
           76090  Mammogram, one
                   breast
           76091  Mammogram, both
                   breasts
   0272       Level I Fluoroscopy       X                       1.40      $67.88          $39.00          $13.58
           70371  Speech evaluation,
                   complex
           71023  Chest x-ray and
                   fluoroscopy
           71034  Chest x-ray and
                   fluoroscopy
           74340  X-ray guide for GI
                   tube
           76000  Fluoroscope
                   examination
           76003  Needle localization
                   by x-ray
   0273       Level II Fluoroscopy      X                       2.49     $120.73          $61.02          $24.15
           70370  Throat x-ray &
                   fluoroscopy
           71036  X-ray guidance for
                   biopsy
           71090  X-ray & pacemaker
                   insertion

[[Page 18760]]

 
           75989  Abscess drainage
                   under x-ray
           76001  Fluoroscope exam,
                   extensive
           76005  Fluoroguide for
                   spine inject
   0274           Myelography           S                       4.83     $234.19         $128.12          $46.84
           70010  Contrast x-ray of
                   brain
           70015  Contrast x-ray of
                   brain
           72240  Contrast x-ray of
                   neck spine
           72255  Contrast x-ray,
                   thorax spine
           72265  Contrast x-ray,
                   lower spine
           72270  Contrast x-ray of
                   spine
           72275  Epidurography
           72285  X-ray c/t spine disk
           72295  X-ray of lower spine
                   disk
   0275           Arthrography          S                       2.74     $132.85          $72.26          $26.57
           70332  X-ray exam of jaw
                   joint
           73040  Contrast x-ray of
                   shoulder
           73085  Contrast x-ray of
                   elbow
           73115  Contrast x-ray of
                   wrist
           73525  Contrast x-ray of
                   hip
           73542  X-ray exam,
                   sacroiliac joint
           73580  Contrast x-ray of
                   knee joint
           73615  Contrast x-ray of
                   ankle
   0276   Level I Digestive Radiology   S                       1.79      $86.79          $49.78          $17.36
           74210  Contrst x-ray exam
                   of throat
           74220  Contrast x-ray,
                   esophagus
           74230  Cinema x-ray, throat/
                   esoph
           74240  X-ray exam, upper gi
                   tract
           74241  X-ray exam, upper gi
                   tract
           74246  Contrst x-ray uppr
                   gi tract
           74247  Contrst x-ray uppr
                   gi tract
           74250  X-ray exam of small
                   bowel
           74270  Contrast x-ray exam
                   of colon
           74283  Contrast x-ray exam
                   of colon
           74290  Contrast x-ray,
                   gallbladder
           74291  Contrast x-rays,
                   gallbladder
   0277   Level II Digestive Radiology  S                       2.47     $119.76          $69.28          $23.95
           74245  X-ray exam, upper gi
                   tract
           74249  Contrst x-ray uppr
                   gi tract
           74251  X-ray exam of small
                   bowel
           74260  X-ray exam of small
                   bowel
           74280  Contrast x-ray exam
                   of colon
   0278       Diagnostic Urography      S                       2.85     $138.19          $81.67          $27.64
           74400  Contrst x-ray,
                   urinary tract
           74410  Contrst x-ray,
                   urinary tract
           74415  Contrst x-ray,
                   urinary tract
           74420  Contrst x-ray,
                   urinary tract
           74425  Contrst x-ray,
                   urinary tract
           74430  Contrast x-ray,
                   bladder
           74440  X-ray, male genital
                   tract
           74445  X-ray exam of penis
           74450  X-ray, urethra/
                   bladder
           74455  X-ray, urethra/
                   bladder
           74775  X-ray exam of
                   perineum
   0279        Level I Diagnostic       S                       6.30     $305.47         $174.57          $61.09
           Angiography and Venography
                Except Extremity
           75660  Artery x-rays, head
                   & neck
           75662  Artery x-rays, head
                   & neck
           75685  Artery x-rays, spine
           75705  Artery x-rays, spine
           75741  Artery x-rays, lung
           75746  Artery x-rays, lung
           75756  Artery x-rays, chest
           75810  Vein x-ray, spleen/
                   liver
           75825  Vein x-ray, trunk
           75827  Vein x-ray, chest
           75831  Vein x-ray, kidney
           75833  Vein x-ray, kidneys
           75840  Vein x-ray, adrenal
                   gland
           75842  Vein x-ray, adrenal
                   glands
           75860  Vein x-ray, neck
           75870  Vein x-ray, skull
           75872  Vein x-ray, skull
           75880  Vein x-ray, eye
                   socket
           75885  Vein x-ray, liver

[[Page 18761]]

 
           75889  Vein x-ray, liver
           75891  Vein x-ray, liver
   0280       Level II Diagnostic       S                      14.98     $726.34         $380.12         $145.27
           Angiography and Venography
                Except Extremity
           75600  Contrast x-ray exam
                   of aorta
           75605  Contrast x-ray exam
                   of aorta
           75625  Contrast x-ray exam
                   of aorta
           75630  X-ray aorta, leg
                   arteries
           75650  Artery x-rays, head
                   & neck
           75658  Artery x-rays, arm
           75665  Artery x-rays, head
                   & neck
           75671  Artery x-rays, head
                   & neck
           75676  Artery x-rays, neck
           75680  Artery x-rays, neck
           75710  Artery x-rays, arm/
                   leg
           75716  Artery x-rays, arms/
                   legs
           75722  Artery x-rays,
                   kidney
           75724  Artery x-rays,
                   kidneys
           75726  Artery x-rays,
                   abdomen
           75731  Artery x-rays,
                   adrenal gland
           75733  Artery x-rays,
                   adrenals
           75736  Artery x-rays,
                   pelvis
           75743  Artery x-rays, lungs
           75774  Artery x-ray, each
                   vessel
           75887  Vein x-ray, liver
   0281     Venography of Extremity     S                       4.40     $213.34         $115.16          $42.67
           75790  Visualize A-V shunt
           75820  Vein x-ray, arm/leg
           75822  Vein x-ray, arms/
                   legs
   0282    Level I Computerized Axial   S                       2.38     $115.40          $94.51          $23.08
                   Tomography
           70486  Cat scan of face/jaw
           76370  CAT scan for therapy
                   guide
           76375  3d/holograph
                   reconstr add-on
           76380  CAT scan follow-up
                   study
   0283   Level II Computerized Axial   S                       4.89     $237.10         $179.39          $47.42
                   Tomography
           70450  CAT scan of head or
                   brain
           70460  Contrast CAT scan of
                   head
           70470  Contrast CAT scans
                   of head
           70480  CAT scan of skull
           70481  Contrast CAT scan of
                   skull
           70482  Contrast CAT scans
                   of skull
           70487  Contrast CAT scan,
                   face/jaw
           70488  Contrast cat scans,
                   face/jaw
           70490  CAT scan of neck
                   tissue
           70491  Contrast CAT of neck
                   tissue
           70492  Contrast CAT of neck
                   tissue
           71250  Cat scan of chest
           71260  Contrast CAT scan of
                   chest
           71270  Contrast CAT scans
                   of chest
           72125  CAT scan of neck
                   spine
           72126  Contrast CAT scan of
                   neck
           72127  Contrast CAT scans
                   of neck
           72128  CAT scan of thorax
                   spine
           72129  Contrast CAT scan of
                   thorax
           72130  Contrast CAT scans
                   of thorax
           72131  CAT scan of lower
                   spine
           72132  Contrast CAT of
                   lower spine
           72133  Contrst cat scans,
                   low spine
           72192  CAT scan of pelvis
           72193  Contrast CAT scan of
                   pelvis
           72194  Contrast CAT scans
                   of pelvis
           73200  CAT scan of arm
           73201  Contrast CAT scan of
                   arm
           73202  Contrast CAT scans
                   of arm
           73700  CAT scan of leg
           73701  Contrast CAT scan of
                   leg
           73702  Contrast CAT scans
                   of leg
           74150  CAT scan of abdomen
           74160  Contrast CAT scan of
                   abdomen
           74170  Contrast CAT scans,
                   abdomen
           76355  CAT scan for
                   localization
           76360  CAT scan for needle
                   biopsy
           76365  CAT scan for cyst
                   aspiration
   0284    Magnetic Resonance Imaging   S                       8.02     $388.87         $257.39          $77.77

[[Page 18762]]

 
           70336  Magnetic image, jaw
                   joint
           70540  Magnetic image, face/
                   neck
           70541  Magnetic image, head
                   (MRA)
           70551  Magnetic image,
                   brain (MRI)
           70552  Magnetic image,
                   brain (MRI)
           70553  Magnetic image,
                   brain (mri)
           71550  Magnetic image,
                   chest (mri)
           72141  Magnetic image, neck
                   spine
           72142  Magnetic image, neck
                   spine
           72146  Magnetic image,
                   chest spine
           72147  Magnetic image,
                   chest spine
           72148  Magnetic image,
                   lumbar spine
           72149  Magnetic image,
                   lumbar spine
           72156  Magnetic image, neck
                   spine
           72157  Magnetic image,
                   chest spine
           72158  Magnetic image,
                   lumbar spine
           72196  Magnetic image,
                   pelvis
           73220  Magnetic image, arm/
                   hand
           73221  Magnetic image,
                   joint of arm
           73720  Magnetic image, leg/
                   foot
           73721  Magnetic image,
                   joint of leg
           74181  Magnetic image/
                   abdomen (mri)
           75552  Magnetic image,
                   myocardium
           75553  Magnetic image,
                   myocardium
           75554  Cardiac MRI/function
           75555  Cardiac MRI/limited
                   study
           76093  Magnetic image,
                   breast
           76094  Magnetic image, both
                   breasts
           76390  Mr spectroscopy
           76400  Magnetic image, bone
                   marrow
   0285   Positron Emission Tomography  S                      15.06     $730.22         $415.21         $146.04
                     (PET)
           G0030  PET imaging prev PET
                   single
           G0031  PET imaging prev PET
                   multple
           G0032  PET follow SPECT
                   78464 singl
           G0033  PET follow SPECT
                   78464 mult
           G0034  PET follow SPECT
                   76865 singl
           G0035  PET follow SPECT
                   78465 mult
           G0036  PET follow cornry
                   angio sing
           G0037  PET follow cornry
                   angio mult
           G0038  PET follow myocard
                   perf sing
           G0039  PET follow myocard
                   perf mult
           G0040  PET follow stress
                   echo singl
           G0041  PET follow stress
                   echo mult
           G0042  PET follow
                   ventriculogm sing
           G0043  PET follow
                   ventriculogm mult
           G0044  PET following rest
                   ECG singl
           G0045  PET following rest
                   ECG mult
           G0046  PET follow stress
                   ECG singl
           G0047  PET follow stress
                   ECG mult
   0286         Myocardial Scans        S                       7.28     $352.99         $200.04          $70.60
           78460  Heart muscle blood,
                   single
           78461  Heart muscle blood,
                   multiple
           78464  Heart image (3d),
                   single
           78465  Heart image (3d),
                   multiple
           78472  Gated heart, planar,
                   single
           78473  Gated heart,
                   multiple
           78478  Heart wall motion
                   add-on
           78480  Heart function add-
                   on
           78481  Heart first pass,
                   single
           78483  Heart first pass,
                   multiple
   0290   Standard Non-Imaging Nuclear  S                       1.94      $94.06          $55.51          $18.81
                    Medicine
           78000  Thyroid, single
                   uptake
           78001  Thyroid, multiple
                   uptakes
           78003  Thyroid suppress/
                   stimul
           78010  Thyroid imaging
           78011  Thyroid imaging with
                   flow
           78099  Endocrine nuclear
                   procedure
           78199  Blood/lymph nuclear
                   exam
           78270  Vit B-12 absorption
                   exam
           78271  Vit B-12 absorp
                   exam, IF
           78282  GI protein loss exam
           78299  GI nuclear procedure
           78399  Musculoskeletal
                   nuclear exam

[[Page 18763]]

 
   0291    Level I Diagnostic Nuclear   S                       3.15     $152.73          $93.14          $30.55
         Medicine Excluding Myocardial
                     Scans
           78006  Thyroid imaging with
                   uptake
           78007  Thyroid image, mult
                   uptakes
           78015  Thyroid met imaging
           78102  Bone marrow imaging,
                   ltd
           78110  Plasma volume,
                   single
           78111  Plasma volume,
                   multiple
           78120  Red cell mass,
                   single
           78121  Red cell mass,
                   multiple
           78185  Spleen imaging
           78190  Platelet survival,
                   kinetics
           78191  Platelet survival
           78201  Liver imaging
           78202  Liver imaging with
                   flow
           78215  Liver and spleen
                   imaging
           78216  Liver & spleen image/
                   flow
           78230  Salivary gland
                   imaging
           78231  Serial salivary
                   imaging
           78232  Salivary gland
                   function exam
           78258  Esophageal motility
                   study
           78261  Gastric mucosa
                   imaging
           78262  Gastroesophageal
                   reflux exam
           78272  Vit B-12 absorp,
                   combined
           78290  Meckel's divert exam
           78300  Bone imaging,
                   limited area
           78445  Vascular flow
                   imaging
           78455  Venous thrombosis
                   study
           78456  Acute venous
                   thrombus image
           78457  Venous thrombosis
                   imaging
           78458  Ven thrombosis
                   images, bilat
           78580  Lung perfusion
                   imaging
           78591  Vent image, 1
                   breath, 1 proj
           78599  Respiratory nuclear
                   exam
           78605  Brain imaging,
                   complete
           78610  Brain flow imaging
                   only
           78660  Nuclear exam of tear
                   flow
           78700  Kidney imaging,
                   static
           78701  Kidney imaging with
                   flow
           78715  Renal vascular flow
                   exam
           78725  Kidney function
                   study
           78730  Urinary bladder
                   retention
           78740  Ureteral reflux
                   study
           78760  Testicular imaging
           78761  Testicular imaging/
                   flow
           78999  Nuclear diagnostic
                   exam
   0292   Level II Diagnostic Nuclear   S                       4.36     $211.40         $126.63          $42.28
         Medicine Excluding Myocardial
                     Scans
           78016  Thyroid met imaging/
                   studies
           78018  Thyroid met imaging,
                   body
           78020  Thyroid met uptake
           78070  Parathyroid nuclear
                   imaging
           78075  Adrenal nuclear
                   imaging
           78103  Bone marrow imaging,
                   mult
           78104  Bone marrow imaging,
                   body
           78122  Blood volume
           78130  Red cell survival
                   study
           78135  Red cell survival
                   kinetics
           78140  Red cell
                   sequestration
           78160  Plasma iron turnover
           78162  Iron absorption exam
           78170  Red cell iron
                   utilization
           78172  Total body iron
                   estimation
           78195  Lymph system imaging
           78205  Liver imaging (3D)
           78206  Liver image (3d) w/
                   flow
           78220  Liver function study
           78223  Hepatobiliary
                   imaging
           78264  Gastric emptying
                   study
           78278  Acute GI blood loss
                   imaging
           78291  Leveen/shunt patency
                   exam
           78305  Bone imaging,
                   multiple areas
           78306  Bone imaging, whole
                   body
           78315  Bone imaging, 3
                   phase
           78320  Bone imaging (3D)

[[Page 18764]]

 
           78414  Non-imaging heart
                   function
           78428  Cardiac shunt
                   imaging
           78466  Heart infarct image
           78468  Heart infarct image
                   (ef)
           78469  Heart infarct image
                   (3D)
           78499  Cardiovascular
                   nuclear exam
           78584  Lung V/Q image
                   single breath
           78585  Lung V/Q imaging
           78586  Aerosol lung image,
                   single
           78587  Aerosol lung image,
                   multiple
           78588  Perfusion lung image
           78593  Vent image, 1 proj,
                   gas
           78594  Vent image, mult
                   proj, gas
           78596  Lung differential
                   function
           78600  Brain imaging, ltd
                   static
           78601  Brain imaging, ltd w/
                   flow
           78606  Brain imaging, compl
                   w/flow
           78607  Brain imaging (3D)
           78615  Cerebral blood flow
                   imaging
           78630  Cerebrospinal fluid
                   scan
           78635  CSF ventriculography
           78645  CSF shunt evaluation
           78647  Cerebrospinal fluid
                   scan
           78650  CSF leakage imaging
           78699  Nervous system
                   nuclear exam
           78704  Imaging renogram
           78707  Kidney flow/function
                   image
           78708  Kidney flow/function
                   image
           78709  Kidney flow/function
                   image
           78710  Kidney imaging (3D)
           78799  Genitourinary
                   nuclear exam
           78800  Tumor imaging,
                   limited area
           78801  Tumor imaging, mult
                   areas
           78802  Tumor imaging, whole
                   body
           78803  Tumor imaging (3D)
           78805  Abscess imaging, ltd
                   area
           78806  Abscess imaging,
                   whole body
           78807  Nuclear localization/
                   abscess
   0294   Level I Therapeutic Nuclear   S                       5.13     $248.74         $144.06          $49.75
                    Medicine
           79000  Init hyperthyroid
                   therapy
           79001  Repeat hyperthyroid
                   therapy
           79020  Thyroid ablation
           79030  Thyroid ablation,
                   carcinoma
           79035  Thyroid metastatic
                   therapy
           79100  Hematopoetic nuclear
                   therapy
           79300  Interstitial nuclear
                   therapy
           79440  Nuclear joint
                   therapy
           79999  Nuclear medicine
                   therapy
   0295   Level II Therapeutic Nuclear  S                      19.85     $962.47         $609.17         $192.49
                    Medicine
           79200  Intracavitary
                   nuclear trmt
           79400  Nonhemato nuclear
                   therapy
           79420  Intravascular
                   nuclear ther
   0296       Level I Therapeutic       S                       3.57     $173.10         $100.25          $34.62
             Radiologic Procedures
           74235  Remove esophagus
                   obstruction
           74327  X-ray bile stone
                   removal
           74360  X-ray guide, GI
                   dilation
           74485  X-ray guide, GU
                   dilation
           75984  X-ray control
                   catheter change
           78494  Heart image, spect
           78496  Heart first pass add-
                   on
   0297       Level II Therapeutic      S                       6.13     $297.23         $172.51          $59.45
             Radiologic Procedures
           74363  X-ray, bile duct
                   dilation
           74475  X-ray control, cath
                   insert
           74480  X-ray control, cath
                   insert
           75894  X-rays, transcath
                   therapy
           75896  X-rays, transcath
                   therapy
           75980  Contrast x-ray exam
                   bile duct
           75982  Contrast x-ray exam
                   bile duct
   0300    Level I Radiation Therapy    S                       1.98      $96.00          $47.72          $19.20
           77401  Radiation treatment
                   delivery
           77402  Radiation treatment
                   delivery
           77403  Radiation treatment
                   delivery
           77404  Radiation treatment
                   delivery

[[Page 18765]]

 
           77406  Radiation treatment
                   delivery
           77407  Radiation treatment
                   delivery
           77408  Radiation treatment
                   delivery
           77409  Radiation treatment
                   delivery
           77414  Radiation treatment
                   delivery
           77789  Radioelement
                   application
   0301    Level II Radiation Therapy   S                       2.21     $107.16          $52.53          $21.43
           77411  Radiation treatment
                   delivery
           77412  Radiation treatment
                   delivery
           77413  Radiation treatment
                   delivery
           77416  Radiation treatment
                   delivery
           77520  Proton beam delivery
           77523  Proton beam delivery
           77750  Infuse radioactive
                   materials
   0302   Level III Radiation Therapy   S                       8.21     $398.08         $216.55          $79.62
           77470  Special radiation
                   treatment
           G0173  Stereotactic, one
                   session
           G0174  Stereotactic, mult
                   session
   0303  Treatment Device Construction  X                       2.83     $137.22          $69.28          $27.44
           77332  Radiation treatment
                   aid(s)
           77333  Radiation treatment
                   aid(s)
           77334  Radiation treatment
                   aid(s)
   0304  Level I Therapeutic Radiation  X                       1.49      $72.25          $41.52          $14.45
             Treatment Preparation
           77280  Set radiation
                   therapy field
           77300  Radiation therapy
                   dose plan
           77305  Radiation therapy
                   dose plan
           77310  Radiation therapy
                   dose plan
           77331  Special radiation
                   dosimetry
   0305       Level II Therapeutic      X                       4.06     $196.86          $97.50          $39.37
              Radiation Treatment
                  Preparation
           77285  Set radiation
                   therapy field
           77290  Set radiation
                   therapy field
           77315  Radiation therapy
                   dose plan
           77321  Radiation therapy
                   port plan
           77326  Radiation therapy
                   dose plan
           77327  Radiation therapy
                   dose plan
           77328  Radiation therapy
                   dose plan
   0310      Level III Therapeutic      X                      13.98     $677.85         $339.05         $135.57
              Radiation Treatment
                  Preparation
           77295  Set radiation
                   therapy field
   0311    Radiation Physics Services   X                       1.32      $64.00          $31.66          $12.80
           77336  Radiation physics
                   consult
           77370  Radiation physics
                   consult
           77399  External radiation
                   dosimetry
   0312    Radioelement Applications    S                       4.09     $198.31         $109.65          $39.66
           77761  Radioelement
                   application
           77762  Radioelement
                   application
           77763  Radioelement
                   application
           77776  Radioelement
                   application
           77777  Radioelement
                   application
           77778  Radioelement
                   application
   0313          Brachytherapy          S                       7.89     $382.56         $164.02          $76.51
           77781  High intensity
                   brachytherapy
           77782  High intensity
                   brachytherapy
           77783  High intensity
                   brachytherapy
           77784  High intensity
                   brachytherapy
           77799  Radium/radioisotope
                   therapy
   0314      Hyperthermic Therapies     S                       5.88     $285.10         $150.95          $57.02
           77600  Hyperthermia
                   treatment
           77605  Hyperthermia
                   treatment
           77610  Hyperthermia
                   treatment
           77615  Hyperthermia
                   treatment
           77620  Hyperthermia
                   treatment
   0320    Electroconvulsive Therapy    S                       3.68     $178.43          $80.06          $35.69
           90870  Electroconvulsive
                   therapy
           90871  Electroconvulsive
                   therapy
   0321      Biofeedback and Other      S                       1.26      $61.09          $29.25          $12.22
                    Training
           90901  Biofeedback train,
                   any meth
           90911  Biofeedback peri/uro/
                   rectal
   0322         Brief Individual        S                       1.32      $64.00          $14.22          $12.80
                 Psychotherapy
           90804  Psytx, office, 20-30
                   min
           90805  Psytx, off, 20-30
                   min w/e&m
           90810  Intac psytx, off, 20-
                   30 min
           90811  Intac psytx, 20-30,
                   w/e&m
           90816  Psytx, hosp, 20-30
                   min

[[Page 18766]]

 
           90817  Psytx, hosp, 20-30
                   min w/e&m
           90823  Intac psytx, hosp,
                   20-30 min
           90824  Intac psytx, hsp 20-
                   30 w/e&m
           90899  Psychiatric service/
                   therapy
   0323       Extended Individual       S                       1.85      $89.70          $22.48          $17.94
                 Psychotherapy
           90801  Psy dx interview
           90802  Intac psy dx
                   interview
           90806  Psytx, off, 45-50
                   min
           90807  Psytx, off, 45-50
                   min w/e&m
           90808  Psytx, office, 75-80
                   min
           90809  Psytx, off, 75-80, w/
                   e&m
           90812  Intac psytx, off, 45-
                   50 min
           90813  Intac psytx, 45-50
                   min w/e&m
           90814  Intac psytx, off, 75-
                   80 min
           90815  Intac psytx, 75-80 w/
                   e&m
           90818  Psytx, hosp, 45-50
                   min
           90819  Psytx, hosp, 45-50
                   min w/e&m
           90821  Psytx, hosp, 75-80
                   min
           90822  Psytx, hosp, 75-80
                   min w/e&m
           90826  Intac psytx, hosp,
                   45-50 min
           90827  Intac psytx, hsp 45-
                   50 w/e&m
           90828  Intac psytx, hosp,
                   75-80 min
           90829  Intac psytx, hsp 75-
                   80 w/e&m
           90845  Psychoanalysis
           90865  Narcosynthesis
           90880  Hypnotherapy
   0324       Family Psychotherapy      S                       1.87      $90.67          $20.19          $18.13
           90846  Family psytx w/o
                   patient
           90847  Family psytx w/
                   patient
   0325       Group Psychotherapy       S                       1.55      $75.16          $19.96          $15.03
           90849  Multiple family
                   group psytx
           90853  Group psychotherapy
           90857  Intac group psytx
   0330        Dental Procedures        S                       1.51      $73.22          $14.64          $14.64
           D0150  Comprehensve oral
                   evaluation
           D0240  Intraoral occlusal
                   film
           D0250  Extraoral first film
           D0260  Extraoral ea
                   additional film
           D0270  Dental bitewing
                   single film
           D0272  Dental bitewings two
                   films
           D0274  Dental bitewings
                   four films
           D0460  Pulp vitality test
           D0501  Histopathologic
                   examinations
           D0502  Other oral pathology
                   procedu
           D0999  Unspecified
                   diagnostic proce
           D1510  Space maintainer fxd
                   unilat
           D1515  Fixed bilat space
                   maintainer
           D1520  Remove unilat space
                   maintain
           D1525  Remove bilat space
                   maintain
           D1550  Recement space
                   maintainer
           D2970  Temporary-fractured
                   tooth
           D2999  Dental unspec
                   restorative pr
           D3460  Endodontic
                   endosseous implan
           D3999  Endodontic procedure
           D4260  Osseous surgery per
                   quadrant
           D4263  Bone replce graft
                   first site
           D4264  Bone replce graft
                   each add
           D4270  Pedicle soft tissue
                   graft pr
           D4271  Free soft tissue
                   graft proc
           D4273  Subepithelial tissue
                   graft
           D4355  Full mouth
                   debridement
           D4381  Localized chemo
                   delivery
           D5911  Facial moulage
                   sectional
           D5912  Facial moulage
                   complete
           D5983  Radiation applicator
           D5984  Radiation shield
           D5985  Radiation cone
                   locator
           D5987  Commissure splint
           D6920  Dental connector bar
           D7110  Oral surgery single
                   tooth
           D7120  Each add tooth
                   extraction
           D7130  Tooth root removal
           D7210  Rem imp tooth w
                   mucoper flp

[[Page 18767]]

 
           D7220  Impact tooth remov
                   soft tiss
           D7230  Impact tooth remov
                   part bony
           D7240  Impact tooth remov
                   comp bony
           D7241  Impact tooth rem
                   bony w/comp
           D7250  Tooth root removal
           D7260  Oral antral fistula
                   closure
           D7291  Transseptal
                   fiberotomy
           D7940  Reshaping bone
                   orthognathic
           D9630  Other drugs/
                   medicaments
           D9930  Treatment of
                   complications
           D9940  Dental occlusal
                   guard
           D9950  Occlusion analysis
           D9951  Limited occlusal
                   adjustment
           D9952  Complete occlusal
                   adjustment
   0340    Minor Ancillary Procedures   X                       1.04      $50.43          $12.85          $10.09
           69200  Clear outer ear
                   canal
           69210  Remove impacted ear
                   wax
   0341         Immunology Tests        X                       0.13       $6.30           $3.67           $1.26
           86485  Skin test, candida
           86490  Coccidioidomycosis
                   skin test
           86510  Histoplasmosis skin
                   test
           86580  TB intradermal test
           86585  TB tine test
           86586  Skin test, unlisted
   0342        Level I Pathology        X                       0.26      $12.61           $8.03           $2.52
           85060  Blood smear
                   interpretation
           88160  Cytopath smear,
                   other source
           88199  Cytopathology
                   procedure
           88300  Surgical path, gross
           88302  Tissue exam by
                   pathologist
           88311  Decalcify tissue
           88313  Special stains
           88319  Enzyme
                   histochemistry
           88321  Microslide
                   consultation
           88399  Surgical pathology
                   procedure
   0343        Level II Pathology       X                       0.45      $21.82          $12.16           $4.36
           80500  Lab pathology
                   consultation
           80502  Lab pathology
                   consultation
           86077  Physician blood bank
                   service
           88104  Cytopathology,
                   fluids
           88106  Cytopathology,
                   fluids
           88107  Cytopathology,
                   fluids
           88108  Cytopath,
                   concentrate tech
           88125  Forensic
                   cytopathology
           88161  Cytopath smear,
                   other source
           88162  Cytopath smear,
                   other source
           88172  Evaluation of smear
           88173  Interpretation of
                   smear
           88304  Tissue exam by
                   pathologist
           88305  Tissue exam by
                   pathologist
           88312  Special stains
           88314  Histochemical stain
           88318  Chemical
                   histochemistry
           88323  Microslide
                   consultation
           88325  Comprehensive review
                   of data
           88329  Pathology consult in
                   surgery
           88331  Pathology consult in
                   surgery
           88332  Pathology consult in
                   surgery
           88346  Immunofluorescent
                   study
           88362  Nerve teasing
                   preparations
           89399  Pathology lab
                   procedure
           G0025  Collagen skin test
                   kit
   0344       Level III Pathology       X                       0.79      $38.30          $23.63           $7.66
           85097  Bone marrow
                   interpretation
           86078  Physician blood bank
                   service
           86079  Physician blood bank
                   service
           88180  Cell marker study
           88182  Cell marker study
           88307  Tissue exam by
                   pathologist
           88309  Tissue exam by
                   pathologist
           88342  Immunocytochemistry
           88347  Immunofluorescent
                   study
           88348  Electron microscopy

[[Page 18768]]

 
           88349  Scanning electron
                   microscopy
           88355  Analysis, skeletal
                   muscle
           88356  Analysis, nerve
           88358  Analysis, tumor
           88365  Tissue hybridization
           89350  Sputum specimen
                   collection
           89360  Collect sweat for
                   test
 2 0354   Administration of Influenza   X                       0.13       $6.19  ..............  ..............
                    Vaccine
           G0008  Admin influenza
                   virus vac
           Q0034  Admin of influenza
                   vaccine
   0355      Level I Immunizations      X                       0.19       $9.21           $5.05           $1.84
           90645  Hib vaccine, hboc,
                   im
           90646  Hib vaccine, prp-d,
                   im
           90647  Hib vaccine, prp-
                   omp, im
           90648  Hib vaccine, prp-t,
                   im
           90657  Flu vaccine, 6-35
                   mo, im
           90658  Flu vaccine, 3 yrs,
                   im
           90659  Flu vaccine, whole,
                   im
           90660  Flu vaccine, nasal
           90700  Dtap vaccine, im
           90702  Dt vaccine, im
           90704  Mumps vaccine, sc
           90713  Poliovirus, ipv, sc
           90716  Chicken pox vaccine,
                   sc
           90720  Dtp/hib vaccine, im
           90721  Dtap/hib vaccine, im
           90727  Plague vaccine, im
           90732  Pneumococcal
                   vaccine, adult
           90749  Vaccine toxoid
   0356      Level II Immunizations     X                       0.36      $17.46           $4.82           $3.49
           90371  Hep b ig, im
           90389  Tetanus ig, im
           90396  Varicella-zoster ig,
                   im
           90476  Adenovirus vaccine,
                   type 4
           90477  Adenovirus vaccine,
                   type 7
           90585  Bcg vaccine, percut
           90586  Bcg vaccine,
                   intravesical
           90632  Hep a vaccine, adult
                   im
           90633  Hep a vacc, ped/
                   adol, 2 dose
           90634  Hep a vacc, ped/
                   adol, 3 dose
           90680  Rotovirus vaccine,
                   oral
           90690  Typhoid vaccine,
                   oral
           90691  Typhoid vaccine, im
           90692  Typhoid vaccine, h-
                   p, sc/id
           90693  Typhoid vaccine,
                   akd, sc
           90701  Dtp vaccine, im
           90703  Tetanus vaccine, im
           90707  Mmr vaccine, sc
           90710  Mmrv vaccine, sc
           90712  Oral poliovirus
                   vaccine
           90717  Yellow fever
                   vaccine, sc
           90718  Td vaccine, im
           90744  Hep b vaccine, ped/
                   adol, im
           90746  Hep b vaccine,
                   adult, im
           90747  Hep b vaccine, ill
                   pat, im
   0357     Level III Immunizations     X                       1.85      $89.70          $38.31          $17.94
           90287  Botulinum antitoxin
           90296  Diphtheria antitoxin
           90375  Rabies ig, im/sc
           90376  Rabies ig, heat
                   treated
           90378  Rsv ig, im
           90379  Rsv ig, iv
           90384  Rh ig, full-dose, im
           90385  Rh ig, minidose, im
           90386  Rh ig, iv
           90393  Vaccina ig, im
           90581  Anthrax vaccine, sc
           90636  Hep a/hep b vacc,
                   adult im
           90665  Lyme disease
                   vaccine, im
           90669  Pneumococcal
                   vaccine, ped
           90675  Rabies vaccine, im
           90676  Rabies vaccine, id
           90705  Measles vaccine, sc

[[Page 18769]]

 
           90719  Diphtheria vaccine,
                   im
           90733  Meningococcal
                   vaccine, sc
           90735  Encephalitis
                   vaccine, sc
   0358      Level IV Immunizations     X                       6.98     $338.44         $126.74          $67.69
           90706  Rubella vaccine, sc
           90708  Measles-rubella
                   vaccine, sc
           90709  Rubella & mumps
                   vaccine, sc
           90725  Cholera vaccine,
                   injectable
           90748  Hep b/hib vaccine,
                   im
   0359            Injections           X                       0.96      $46.55           $9.31           $9.31
           90782  Injection, sc/im
           90783  Injection, ia
           90784  Injection, iv
           90788  Injection of
                   antibiotic
           90799  Ther/prophylactic/dx
                   inject
   0360     Level I Alimentary Tests    X                       1.38      $66.91          $34.75          $13.38
           89105  Sample intestinal
                   contents
           89130  Sample stomach
                   contents
           89132  Sample stomach
                   contents
           89135  Sample stomach
                   contents
           89136  Sample stomach
                   contents
           89140  Sample stomach
                   contents
           91030  Acid perfusion of
                   esophagus
           91055  Gastric intubation
                   for smear
           91065  Breath hydrogen test
           91100  Pass intestine
                   bleeding tube
           91105  Gastric intubation
                   treatment
           91299  Gastroenterology
                   procedure
   0361    Level II Alimentary Tests    X                       3.53     $171.16          $88.09          $34.23
           89100  Sample intestinal
                   contents
           89141  Sample stomach
                   contents
           91000  Esophageal
                   intubation
           91010  Esophagus motility
                   study
           91011  Esophagus motility
                   study
           91012  Esophagus motility
                   study
           91020  Gastric motility
           91032  Esophagus, acid
                   reflux test
           91033  Prolonged acid
                   reflux test
           91052  Gastric analysis
                   test
           91060  Gastric saline load
                   test
           95075  Ingestion challenge
                   test
   0362      Fitting of Vision Aids     X                       0.51      $24.73           $9.63           $4.95
           92311  Contact lens fitting
           92312  Contact lens fitting
           92313  Contact lens fitting
           92315  Prescription of
                   contact lens
           92316  Prescription of
                   contact lens
           92317  Prescription of
                   contact lens
           92325  Modification of
                   contact lens
           92326  Replacement of
                   contact lens
           92352  Special spectacles
                   fitting
           92353  Special spectacles
                   fitting
           92354  Special spectacles
                   fitting
           92355  Special spectacles
                   fitting
           92358  Eye prosthesis
                   service
           92371  Repair & adjust
                   spectacles
   0363  Otorhinolaryngologic Function  X                       2.83     $137.22          $53.22          $27.44
                     Tests
           92512  Nasal function
                   studies
           92516  Facial nerve
                   function test
           92520  Laryngeal function
                   studies
           92541  Spontaneous
                   nystagmus test
           92542  Positional nystagmus
                   test
           92543  Caloric vestibular
                   test
           92544  Optokinetic
                   nystagmus test
           92545  Oscillating tracking
                   test
           92546  Sinusoidal
                   rotational test
           92547  Supplemental
                   electrical test
           92548  Posturography
           92584  Electrocochleography
           92587  Evoked auditory test
           92588  Evoked auditory test
   0364        Level I Audiometry       X                       0.68      $32.97          $13.31           $6.59
           92552  Pure tone
                   audiometry, air

[[Page 18770]]

 
           92553  Audiometry, air &
                   bone
           92555  Speech threshold
                   audiometry
           92556  Speech audiometry,
                   complete
           92567  Tympanometry
           92599  ENT procedure/
                   service
   0365       Level II Audiometry       X                       1.47      $71.28          $22.48          $14.26
           92557  Comprehensive
                   hearing test
           92561  Bekesy audiometry,
                   diagnosis
           92562  Loudness balance
                   test
           92563  Tone decay hearing
                   test
           92564  Sisi hearing test
           92565  Stenger test, pure
                   tone
           92568  Acoustic reflex
                   testing
           92569  Acoustic reflex
                   decay test
           92571  Filtered speech
                   hearing test
           92572  Staggered spondaic
                   word test
           92573  Lombard test
           92575  Sensorineural acuity
                   test
           92576  Synthetic sentence
                   test
           92577  Stenger test, speech
           92579  Visual audiometry
                   (vra)
           92582  Conditioning play
                   audiometry
           92583  Select picture
                   audiometry
           92589  Auditory function
                   test(s)
           92596  Ear protector
                   evaluation
   0366     Electrocardiogram (ECG)     X                       0.38      $18.43          $15.60           $3.69
           93005  Electrocardiogram,
                   tracing
           93041  Rhythm ECG, tracing
           Q0035  Cardiokymography
   0367      Level I Pulmonary Test     X                       0.83      $40.24          $20.65           $8.05
           94010  Breathing capacity
                   test
           94200  Lung function test
                   (MBC/MVV)
           94250  Expired gas
                   collection
           94375  Respiratory flow
                   volume loop
           94400  CO2 breathing
                   response curve
           94450  Hypoxia response
                   curve
           94680  Exhaled air
                   analysis, o2
           94690  Exhaled air analysis
           94720  Monoxide diffusing
                   capacity
           94770  Exhaled carbon
                   dioxide test
           94799  Pulmonary service/
                   procedure
   0368     Level II Pulmonary Tests    X                       1.66      $80.49          $42.44          $16.10
           94060  Evaluation of
                   wheezing
           94240  Residual lung
                   capacity
           94260  Thoracic gas volume
           94350  Lung nitrogen
                   washout curve
           94360  Measure airflow
                   resistance
           94370  Breath airway
                   closing volume
           94620  Pulmonary stress
                   test/simple
           94681  Exhaled air
                   analysis, o2/co2
           94725  Membrane diffusion
                   capacity
           94750  Pulmonary compliance
                   study
   0369    Level III Pulmonary Tests    X                       2.34     $113.46          $58.50          $22.69
           94014  Patient recorded
                   spirometry
           94015  Patient recorded
                   spirometry
           94016  Review patient
                   spirometry
           94070  Evaluation of
                   wheezing
           94621  Pulm stress test/
                   complex
           94772  Breath recording,
                   infant
           95070  Bronchial allergy
                   tests
           95071  Bronchial allergy
                   tests
   0370          Allergy Tests          X                       0.57      $27.64          $11.81           $5.53
           95004  Allergy skin tests
           95010  Sensitivity skin
                   tests
           95015  Sensitivity skin
                   tests
           95024  Allergy skin tests
           95027  Skin end point
                   titration
           95028  Allergy skin tests
           95044  Allergy patch tests
           95052  Photo patch test
           95056  Photosensitivity
                   tests
           95060  Eye allergy tests
           95065  Nose allergy test

[[Page 18771]]

 
           95078  Provocative testing
           95180  Rapid
                   desensitization
           95199  Allergy immunology
                   services
   0371        Allergy Injections       X                       0.32      $15.52           $3.67           $3.10
           95115  Immunotherapy, one
                   injection
           95117  Immunotherapy
                   injections
           95144  Antigen therapy
                   services
           95145  Antigen therapy
                   services
           95146  Antigen therapy
                   services
           95147  Antigen therapy
                   services
           95148  Antigen therapy
                   services
           95149  Antigen therapy
                   services
           95165  Antigen therapy
                   services
           95170  Antigen therapy
                   services
   0372      Therapeutic Phlebotomy     X                       0.43      $20.85          $10.09           $4.17
           99195  Phlebotomy
   0373    Neuropsychological Testing   X                       3.21     $155.64          $44.96          $31.13
           96100  Psychological
                   testing
           96105  Assessment of
                   aphasia
           96110  Developmental test,
                   lim
           96111  Developmental test,
                   extend
           96115  Neurobehavior status
                   exam
           96117  Neuropsych test
                   battery
   0374   Monitoring Psychiatric Drugs  X                       1.17      $56.73          $13.08          $11.35
           90862  Medication
                   management
           M0064  Visit for drug
                   monitoring
   0600     Low Level Clinic Visits     V                       0.98      $47.52           $9.50           $9.50
           99201  Office/outpatient
                   visit, new
           99202  Office/outpatient
                   visit, new
           99211  Office/outpatient
                   visit, est
           99212  Office/outpatient
                   visit, est
           99241  Office consultation
           99242  Office consultation
           99271  Confirmatory
                   consultation
           99272  Confirmatory
                   consultation
   0601     Mid Level Clinic Visits     V                       1.00      $48.49           $9.70           $9.70
           92002  Eye exam, new
                   patient
           92012  Eye exam established
                   pat
           99203  Office/outpatient
                   visit, new
           99213  Office/outpatient
                   visit, est
           99243  Office consultation
           99273  Confirmatory
                   consultation
           G0101  CA screen; pelvic/
                   breast exam
   0602     High Level Clinic Visits    V                       1.66      $80.49          $16.29          $16.10
           92004  Eye exam, new
                   patient
           92014  Eye exam & treatment
           99204  Office/outpatient
                   visit, new
           99205  Office/outpatient
                   visit, new
           99214  Office/outpatient
                   visit, est
           99215  Office/outpatient
                   visit, est
           99244  Office consultation
           99245  Office consultation
           99274  Confirmatory
                   consultation
           99275  Confirmatory
                   consultation
   0603      Interdisciplinary Team     V                       1.66      $80.49          $16.29          $16.10
                   Conference
  G0175   Multidisciplinary team visit
   0610    Low Level Emergency Visits   V                       1.34      $64.97          $20.65          $12.99
           99281  Emergency dept visit
           99282  Emergency dept visit
   0611    Mid Level Emergency Visits   V                       2.11     $102.31          $36.47          $20.46
           99283  Emergency dept visit
   0612   High Level Emergency Visits   V                       3.19     $154.67          $54.14          $30.93
           99284  Emergency dept visit
           99285  Emergency dept visit
   0620          Critical Care          S                       8.60     $416.99         $152.78          $83.40
           99291  Critical care, first
                   hour
 3 0701            Strontium            X                                                                 $84.76
           A9600  Strontium-89
                   chloride
 3 0702             Samariam            X                                                                $139.06
           A9605  Samarium sm153
                   lexidronamm
 3 0704       Satumomab Pendetide       X                                                                 $63.13
           A4642  Satumomab pendetide
                   per dose
 3 0705         Tc99 Tetrofosmin        X                                                                 $71.08

[[Page 18772]]

 
           A9502  Technetium TC99M
                   tetrofosmin
 3 0725        Leucovorin Calcium       X                                                                  $1.07
           J0640  Leucovorin calcium
                   injection
 3 0726    Dexrazoxane Hydrochloride    X                                                                 $18.81
           J1190  Dexrazoxane HCl
                   injection
 3 0727      Injection, Etidronate      X                                                                  $9.31
                    Disodium
           J1436  Etidronate disodium
                   inj
 3 0728        Filgrastim (G-CSF)       X                                                                 $25.21
           J1440  Filgrastim 300 mcg
                   injection
 3 0730       Pamidronate Disodium      X                                                                 $30.93
           J2430  Pamidronate disodium/
                   30 MG
 3 0731      Sargramostim (GM-CSF)      X                                                                 $16.97
           J2820  Sargramostim
                   injection
 3 0732              Mesna              X                                                                  $2.42
           J9209  Mesna injection
 3 0733          Epoetin Alpha          X                                                                  $1.75
           Q0136  Non esrd epoetin
                   alpha inj
 3 0750    Dolasetron Mesylate 10 mg    X                                                                  $1.94
           J1260  Dolasetron mesylate
 3 0754        Metoclopramide HCL       X                                                                  $0.19
           J2765  Metoclopramide hcl
                   injection
 3 0755     Thiethylperazine Maleate    X                                                                  $0.68
           J3280  Thiethylperazine
                   maleate inj
 3 0761      Oral Substitute for IV     X                                                                  $0.10
                   Antiemtic
           Q0163  Diphenhydramine HCl
                   50mg
           Q0164  Prochlorperazine
                   maleate 5mg
           Q0169  Promethazine HCl
                   12.5mg oral
           Q0171  Chlorpromazine HCl
                   10mg oral
           Q0173  Trimethobenzamide
                   HCl 250mg
           Q0174  Thiethylperazine
                   maleate10mg
           Q0175  Perphenazine 4mg
                   oral
           Q0177  Hydroxyzine pamoate
                   25mg
 3 0762            Dronabinol           X                                                                  $0.48
           Q0167  Dronabinol 2.5mg
                   oral
 3 0763    Dolasetron Mesylate 100 mg   X                                                                  $8.53
                      Oral
           Q0180  Dolasetron mesylate
                   oral
 3 0764     Granisetron HCL, 100 mcg    X                                                                  $2.33
           J1626  Granisetron HCl
                   injection
 3 0765    Granisetron HCL, 1mg Oral    X                                                                  $3.20
           Q0166  Granisetron HCl 1 mg
                   oral
 3 0768  Ondansetron Hydrochloride per  X                                                                  $0.87
                 1 mg Injection
           J2405  Ondansetron hcl
                   injection
 3 0769   Ondansetron Hydrochloride 8   X                                                                  $2.62
                    mg oral
           Q0179  Ondansetron HCl 8mg
                   oral
 3 0800   Leuprolide Acetate per 3.75   X                                                                 $68.56
                       mg
           J1950  Leuprolide acetate/
                   3.75 MG
 3 0801         Cyclophosphamide        X                                                                   $.19
           J8530  Cyclophosphamide
                   oral 25 MG
 3 0802            Etoposide            X                                                                  $3.10
           J8560  Etoposide oral 50 MG
 3 0803            Melphalan            X                                                                  $0.19
           J8600  Melphalan oral 2 MG
 3 0807   Aldesleukin single use vial   X                                                                 $65.07
           J9015  Aldesleukin/single
                   use vial
 3 0809   BCG (Intravesical) one vial   X                                                                 $19.78
           J9031  Bcg live
                   intravesical vac
 3 0810    Goserelin Acetate Implant,   X                                                                 $59.74
                   per 3.6 mg
           J9202  Goserelin acetate
                   implant
 3 0811        Carboplatin 50 mg        X                                                                 $13.96
           J9045  Carboplatin
                   injection
 3 0812        Carmustine 100 mg        X                                                                 $10.57
           J9050  Carmus bischl nitro
                   inj
 3 0813         Cisplatin 10 mg         X                                                                  $4.56
           J9060  Cisplatin 10 MG
                   injeciton
 3 0814    Asparaginase, 10,000 units   X                                                                  $8.34
           J9020  Asparaginase
                   injection
 3 0815     Cyclophosphamide 100 mg     X                                                                  $0.48
           J9070  Cyclophosphamide 100
                   MG inj
 3 0816  Cyclophosphamide, Lyophilized  X                                                                  $1.16
                     100 mg
           J9093  Cyclophosphamide
                   lyophilized
 3 0817         Cytrabine 100 mg        X                                                                  $0.68
           J9100  Cytarabine hcl 100
                   MG inj
 3 0818       Dactinomycin 0.5 mg       X                                                                  $1.75

[[Page 18773]]

 
           J9120  Dactinomycin
                   actinomycin d
 3 0819        Dacarbazine 100 mg       X                                                                  $1.26
           J9130  Dacarbazine 10 MG
                   inj
 3 0820      Daunorubicin HCI 10 mg     X                                                                 $11.64
           J9150  Daunorubicin
 3 0821      Daunorubicin Citrate,      X                                                                  $7.76
          Liposomal Formulation, 10 mg
           J9151  Daunorubicin citrate
                   liposom
 3 0822  Diethylstibestrol Diphosphate  X                                                                  $2.13
                     250 mg
           J9165  Diethylstilbestrol
                   injection
 3 0823         Docetaxel 20 mg         X                                                                 $34.72
           J9170  Docetaxel
 3 0824         Etoposide 10 mg         X                                                                   $.58
           J9181  Etoposide 10 MG inj
 3 0826     Methotrexate Oral 2.5 mg    X                                                                   $.29
           J8610  Methotrexate oral
                   2.5 MG
 3 0827        Floxuridine 500 mg       X                                                                 $18.81
           J9200  Floxuridine
                   injection
 3 0828      Gemcitabine HCL 200 mg     X                                                                  $9.31
           J9201  Gemcitabine HCl
 3 0830         Irinotecan 20 mg        X                                                                 $14.16
           J9206  Irinotecan injection
 3 0831      Ifosfamide per 1 gram      X                                                                 $13.58
           J9208  Ifosfomide injection
 3 0832  Idarubicin Hydrochloride 5 mg  X                                                                 $46.45
           J9211  Idarubicin hcl
                   injeciton
 3 0833      Interferon Alfacon-1,      X                                                                  $0.19
               Recombinant, 1 mcg
           J9212  Interferon alfacon-1
 3 0834       Interferon, Alfa-2A,      X                                                                  $3.20
          Recombinant 3 million units
           J9213  Interferon alfa-2a
                   inj
 3 0836       Interferon, Alfa-2B,      X                                                                  $1.36
          Recombinant, 1 million units
           J9214  Interferon alfa-2b
                   inj
 3 0838     Interferon, Gamma 1-B, 3    X                                                                 $22.79
                 million units
           J9216  Interferon gamma 1-b
                   inj
 3 0839    Mechlorethamine HCI 10 mg    X                                                                  $1.65
           J9230  Mechlorethamine hcl
                   inj
 3 0840       Melphalan HCI 50 mg       X                                                                 $44.71
           J9245  Inj melphalan
                   hydrochl 50 MG
 3 0841     Methotrexate Sodium 5 mg    X                                                                   $.10
           J9250  Methotrexate sodium
                   inj
 3 0842   Fludarabine Phosphate 50 mg   X                                                                 $30.84
           J9185  Fludarabine
                   phosphate inj
 3 0843   Pegaspargase per single dose  X                                                                $178.72
                      vial
           J9266  Pegaspargase/singl
                   dose vial
 3 0844        Pentostatin 10 mg        X                                                                $133.73
           J9268  Pentostatin
                   injection
 3 0847      Doxorubicin HCL 10 mg      X                                                                  $2.81
           J9000  Doxorubic hcl 10 MG
                   vl chemo
 3 0849        Rituximab, 100 mg        X                                                                 $51.40
           J9310  Rituximab cancer
                   treatment
 3 0850        Streptozocin 1 gm        X                                                                 $14.64
           J9320  Streptozocin
                   injection
 3 0851          Thiotepa 15 mg         X                                                                  $9.50
           J9340  Thiotepa injection
 3 0852          Topotecan 4 mg         X                                                                 $73.22
           J9350  Topotecan
 3 0853     Vinblastine Sulfate 1 mg    X                                                                   $.39
           J9360  Vinblastine sulfate
                   inj
 3 0854     Vincristine Sulfate 1 mg    X                                                                  $2.23
           J9370  Vincristine sulfate
                   1 MG inj
 3 0855   Vinorelbine Tartrate per 10   X                                                                  $9.60
                       mg
           J9390  Vinorelbine tartrate/
                   10 mg
 3 0856      Porfimer Sodium 75 mg      X                                                                 $34.62
           J9600  Porfimer sodium
 3 0857    Bleomycin Sulfate 15 units   X                                                                 $48.29
           J9040  Bleomycin sulfate
                   injection
 3 0858         Cladribine, 1mg         X                                                                  $8.24
           J9065  Inj cladribine per 1
                   MG
 3 0859           Fluorouracil          X                                                                  $0.19
           J9190  Fluorouracil
                   injection
 3 0860        Plicamycin 2.5 mg        X                                                                  $1.36
           J9270  Plicamycin
                   (mithramycin) inj
 3 0861      Leuprolide Acetate 1 mg    X                                                                 $19.39
           J9218  Leuprolide acetate
                   injeciton

[[Page 18774]]

 
 3 0862          Mitomycin, 5mg         X                                                                 $19.88
           J9280  Mitomycin 5 MG inj
 3 0863         Paclitaxel, 30mg        X                                                                 $30.16
           J9265  Paclitaxel injection
 3 0864    Mitoxantrone HCl, per 5mg    X                                                                 $25.80
           J9293  Mitoxantrone
                   hydrochl/5 MG
 3 0865   Interferon alfa-N3, 250,000   X                                                                  $1.07
                       IU
           J9215  Interferon alfa-n3
                   inj
 3 0884     Rho (D) Immune Globulin,    X                                                                  $3.78
              Human one dose pack
           J2790  Rho d immune
                   globulin inj
 2 0886     Azathioprine, 50 mg oral    X                       0.02        $.97                           $0.19
           J7500  Azathioprine oral
                   50mg
 2 0887   Azathioprine, Parenteral 100  X                       1.40      $67.88                          $13.58
            mg, 20 ml each injection
           J7501  Azathioprine
                   parenteral
 2 0888    Cyclosporine, Oral 100 mg    X                       0.08       $3.88                           $0.78
           J7502  Cyclosporine oral
                   100 mg
 2 0889     Cyclosporine, Parenteral    X                       0.36      $17.46                           $3.49
           J7516  Cyclosporin
                   parenteral 250mg
 2 0890  Lymphocyte Immune Globulin 50  X                       3.79     $183.77                          $36.75
                mg/ml, 5 ml each
           J7504  Lymphocyte immune
                   globulin
 2 0891     Tacrolimus per 1 mg oral    X                       3.15     $152.73                          $30.55
           J7507  Tacrolimus oral per
                   1 MG
 3 0892  Daclizumab, Parenteral, 25 mg  X                                                                 $54.11
           J7913  Daclizumab,
                   Parenteral, 25 m
 3 0900  Injection, Alglucerase per 10  X                                                                  $5.14
                     units
           J0205  Alglucerase
                   injection
 3 0901       Alpha I, Proteinase       X                                                                 $15.22
           Inhibitor, Human per 10mg
           J0256  Alpha 1 proteinase
                   inhibitor
 3 0902   Botulinum Toxin, Type A per   X                                                                 $56.05
                      unit
           J0585  Botulinum toxin a
                   per unit
 3 0903       CMV Immune Globulin       X                                                                 $54.11
           J0850  Cytomegalovirus imm
                   IV/vial
 3 0905    Immune Globulin per 500 mg   X                                                                  $6.40
           J1561  Immune globulin 500
                   mg
 3 0906       RSV Immune Globulin       X                                                                 $85.53
           J1565  RSV-ivig
 2 0907    Ganciclovir Sodium 500 mg    X                       0.51      $24.73                           $4.95
                   injection
           J1570  Ganciclovir sodium
                   injection
 2 0908     Tetanus Immune Globulin,    X                       0.90      $43.64                           $8.73
             Human, up to 250 units
           J1670  Tetanus immune
                   globulin inj
 3 0909    Interferon Beta-1a 33 mcg    X                                                                 $28.70
           J1825  Interferon beta-1a
 3 0910    Interferon Beta-1b 0.25 mg   X                                                                  $8.44
           J1830  Interferon beta-1b/
                   .25 MG
 2 0911   Streptokinase per 250,000 iu  X                       1.64      $79.69                          $15.94
           J2995  Inj streptokinase/
                   250000 IU
 3 0913   Ganciclovir 4.5 mg, Implant   X                                                                $701.51
           J7310  Ganciclovir long act
                   implant
 2 0914     Reteplase, 37.6 mg (Two     X                      38.20   $1,852.21                         $370.44
               Single Use Vials)
           J2994  Reteplase double
                   bolus
 2 0915   Alteplase recombinant, 10mg   X                       5.85     $283.70                          $56.74
           J2996  Alteplase
                   recombinant inj
 3 0916      Imiglucerase per unit      X                                                                  $0.58
           J1785  Injection
                   imiglucerase/unit
 2 0917  Dipyridamole, 10 mg/Adenosine  X                       0.36      $17.46                           $3.49
                      6MG
           J0150  Injection adenosine
                   6 MG
           J1245  Dipyridamole
                   injection
 3 0918     Brachytherapy Seeds, Any    S                                                                  $9.99
                   type, Each
           Q3001  Brachytherapy Seeds
 3 0925   Factor VIII (Antihemophilic   X                                                                  $0.19
             Factor, Human) per iu
           J7190  Factor viii
 3 0926   Factor VIII (Antihemophilic   X                                                                  $0.19
            Factor, Porcine) per iu
           J7191  Factor VIII
                   (porcine)
 3 0927   Factor VIII (Antihemophilic   X                                                                  $0.19
          Factor, Recombinant) per iu
           J7192  Factor viii
                   recombinant
 3 0928        Factor IX, Complex       X                                                                  $0.08
           J7194  Factor ix complex
 3 0929    Other Hemophilia Clotting    X                                                                  $0.27
                 Factors per iu
           J7198  Anti-inhibitor
           Q0187  Factor viia
                   recombinant
 3 0930   Antithrombin III (Human) per  X                                                                  $0.19
                       iu
           J7197  Antithrombin iii
                   injection
 3 0931    Factor IX (Antihemophilic    X                                                                  $0.04
             Factor, Purified, Non-
                  Recombinant)

[[Page 18775]]

 
           Q0160  Factor IX non-
                   recombinant
 3 0932    Factor IX (Antihemophilic    X                                                                  $0.10
              Factor, Recombinant)
           Q0161  Factor IX
                   recombinant
 2 0949     Plasma, Pooled Multiple     S                       3.49     $169.22                          $33.84
            Donor, Solvent/Detergent
                Treated, Frozen
           P9023  Frozen plasma,
                   pooled, sd
 2 0950  Blood (Whole) For Transfusion  S                       2.08     $101.02                          $20.20
           P9010  Whole blood for
                   transfusion
 2 0952         Cryoprecipitate         S                       0.70      $33.92                           $6.78
           P9012  Cryoprecipitate each
                   unit
 2 0953         Fibrinogen Unit         S                       0.48      $23.27                           $4.65
           P9013  Unit/s blood
                   fibrinogen
 2 0954       Leukocyte Poor Blood      S                       2.83     $137.21                          $27.44
           P9016  Leukocyte poor
                   blood, unit
 2 0955       Plasma, Fresh Frozen      S                       2.26     $109.35                          $21.87
           P9017  One donor fresh
                   frozn plasma
 2 0956     Plasma Protein Fraction     S                       1.26      $61.09                          $12.22
           P9018  Plasma protein
                   fract, unit
 2 0957       Platelet Concentrate      S                       0.98      $47.46                           $9.49
           P9019  Platelet concentrate
                   unit
 2 0958       Platelet Rich Plasma      S                       1.16      $56.25                          $11.25
           P9020  Platelet rich plasma
                   unit
 2 0959         Red Blood Cells         S                       2.04      $99.04                          $19.81
           P9021  Red blood cells unit
 2 0960      Washed Red Blood Cells     S                       3.81     $184.53                          $36.91
           P9022  Washed red blood
                   cells unit
 2 0961  Infusion, Albumin (Human) 5%,  X                       2.77     $134.31                          $26.86
                     500 ml
           Q0156  Human albumin 5%
 2 0962    Infusion, Albumin (Human)    X                       1.38      $66.91                          $13.38
                   25%, 50 ml
           Q0157  Human albumin 25%
 2 0970  New Technology - Level I ($0-  T                       0.52      $25.21                           $5.04
                      $50)
           78268  Breath test
                   analysis, c-14
 2 0971    New Technology - Level II    S                       1.55      $75.16                          $15.03
                   ($50-$100)
           78267  Breath tst attain/
                   anal c-14
 2 0972    New Technology - Level III   T                       3.09     $149.83                          $29.97
                  ($100-$200)
           G0166  Extrnl counterpulse,
                   per tx
 2 0980    New Technology - Level XI    S                      38.67   $1,875.00                         $375.00
                 ($1750-$2000)
           53850  Prostatic microwave
                   thermotx
           53852  Prostatic rf
                   thermotx
           G0125  Lung image (PET)
           G0126  Lung image (PET)
                   staging
           G0163  Pet for rec of
                   colorectal ca
           G0164  Pet for lymphoma
                   staging
           G0165  Pet, rec of melanoma/
                   met ca
 3 7000        Amifostine, 500 mg       X                                                                 $41.99
           J0207  Amifostine
 3 7001  Amphotericin B lipid complex,  X                                                                 $12.12
                   50 mg, Inj
           J0286  Amphotericin B lipid
                   complex
 3 7002       Clonidine, HCl, 1 MG      X                                                                  $4.17
           J0735  Clonidine
                   hydrochloride
 3 7003    Epoprostenol, 0.5 MG, inj    X                                                                  $2.23
           J1325  Epoprostenol
                   injection
 3 7004   Immune globulin intravenous   X                                                                 $45.48
                 human 5g, inj
           J1562  Immune globulin 5
                   gms
 3 7005     Gonadorelin hcI, 100 mcg    X                                                                  $9.12
           J1620  Gonadorelin hydroch/
                   100 mcg
 2 7007  Milrinone lacetate, per 5 ml,  X                       0.47      $22.79                           $4.56
                      inj
           J2260  Inj milrinone
                   lactate/5 ML
 3 7010   Morphine sulfate concentrate  X                                                                   $.68
         (preservative free) per 10 mg
           J2275  Morphine sulfate
                   injection
 3 7011      Oprelevekin, inj, 5 mg     X                                                                 $30.35
           J2355  Oprelvekin injection
 3 7012   Pentamidine isethionate, 300  X                                                                  $8.73
                       mg
           J2545  Pentamidine
                   isethionte/300mg
 3 7014   Fentanyl citrate, inj, up to  X                                                                   $.19
                      2 ml
           J3010  Fentanyl citrate
                   injeciton
 3 7015       Busulfan, oral 2 mg       X                                                                  $0.19
           J8510  Oral busulfan
 3 7019      Aprotinin, 10,000 kiu      X                                                                  $2.42
           Q2003  Aprotinin, 10,000
                   kiu
 3 7021  Baclofen, intrathecal, 50 mcg  X                                                                  $0.10
           J0476  Baclofen intrathecal
                   trial
 3 7022   Elliotts B Solution, per ml   X                                                                 $19.20
           Q2002  Elliot's B solution

[[Page 18776]]

 
 3 7023      Treatment for bladder      X                                                                  $4.46
          calculi, I.e. Renacidin per
                     500 ml
           Q2004  Treatment for
                   bladder calcul
 3 7024        Corticorelin ovine       X                                                                 $45.77
               triflutate, 0.1 mg
           Q2005  Corticorelin ovine
                   triflutat
 3 7025   Digoxin immune FAB (Ovine),   X                                                                 $14.06
                     10 mg
           Q2006  Digoxin immune FAB
                   (Ovine),
 3 7026   Ethanolamine oleate, 1000 ml  X                                                                  $2.13
           Q2007  Ethanolamine oleate,
                   1000 ml
 3 7027        Fomepizole, 1.5 G        X                                                                $141.29
           Q2008  Fomepizole, 1.5 G
 3 7028       Fosphenytoin, 50 mg       X                                                                  $0.78
           Q2009  Fosphenytoin, 50 mg
 3 7029    Glatiramer acetate, 25 mg    X                                                                  $3.59
           Q2010  Glatiramer acetate,
                   25 mgeny
 3 7030           Hemin, 1 mg           X                                                                  $0.10
           Q2011  Hemin, 1 mg
 3 7031   Octreotide Acetate, 500 mcg   X                                                                  $5.43
           J2352  Octreotide acetate
                   injection
 3 7032    Sermorelin acetate, 0.5 mg   X                                                                 $53.34
           Q2014  Sermorelin acetate,
                   0.5 mg
 3 7033          Somatrem, 5 mg         X                                                                 $28.03
           Q2015  Somatrem, 5 mg
 3 7034         Somatropin, 1 mg        X                                                                  $5.04
           Q2016  Somatropin, 1 mg
 3 7035        Teniposide, 50 mg        X                                                                 $20.85
           Q2017  Teniposide, 50 mg
 2 7036   Urokinase, inj, IV, 250,000   X                       0.73      $35.40                           $7.08
                      I.U.
           J3365  Urokinase 250,000 IU
                   inj
 3 7037     Urofollitropin, 75 I.U.     X                                                                  $8.24
           Q2018  Urofollitropin, 75
                   I.U.
 3 7038       Muromonab-CD3, 5 mg       X                                                                 $89.60
           J7505  Monoclonal
                   antibodies
 3 7039  Pegademase bovine inj 25 I.U.  X                                                                  $1.16
           Q2012  Pegademase bovine
                   inj 25 I.U
 3 7040   Pentastarch 10% inj, 100 ml   X                                                                  $2.04
           Q2013  Pentastarch 10% inj,
                   100 ml
 2 7041      Tirofiban HCL, 0.5 mg      X                       0.02        $.97                           $0.19
           J3245  Tirofiban
                   hydrochloride
 3 7042    Capecitabine, oral 150 mg    X                                                                  $0.19
           J8520  Capecitabine, oral,
                   150 mg
 3 7043        Infliximab, 10 MG        X                                                                  $6.89
           J1745  Infliximab injection
 3 7045     Trimetrexate Glucoronate    X                                                                  $8.15
           J3305  Inj trimetrexate
                   glucoronate
 3 7046     Doxorubicin Hcl Liposome    X                                                                 $39.18
           J9001  Doxorubicin hcl
                   liposome inj
----------------------------------------------------------------------------------------------------------------

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

Copyright American Dental Association. All rights reserved.

 

 

 

 

           Addendum D.--1996 HCPC Codes Used To Calculate Pay
------------------------------------------------------------------------
                                                            Termination
                        CPT/HCPCS                              Date
------------------------------------------------------------------------
00420...................................................      12/31/1999
01000...................................................      12/31/1999
01110...................................................      12/31/1999
01240...................................................      12/31/1999
01300...................................................      12/31/1999
01460...................................................      12/31/1999
01600...................................................      12/31/1999
01700...................................................      12/31/1999
01800...................................................      12/31/1999
01900...................................................      12/31/1999
01902...................................................      12/31/1999
11050...................................................      12/31/1997
11051...................................................      12/31/1997
11052...................................................      12/31/1997
11700...................................................      12/31/1996
11701...................................................      12/31/1996
11710...................................................      12/31/1996
11711...................................................      12/31/1996
11731...................................................      12/31/1998
13300...................................................      12/31/1999
15580...................................................      12/31/1999
15625...................................................      12/31/1999
15755...................................................      12/31/1996
16040...................................................      12/31/1998
16041...................................................      12/31/1998
16042...................................................      12/31/1998
17001...................................................      12/31/1997
17002...................................................      12/31/1997
17010...................................................      12/31/1997
17100...................................................      12/31/1997
17101...................................................      12/31/1997
17102...................................................      12/31/1997
17104...................................................      12/31/1997
17105...................................................      12/31/1997
17200...................................................      12/31/1997
17201...................................................      12/31/1997
20960...................................................      12/31/1996
20971...................................................      12/31/1996
25330...................................................      12/31/1996
25331...................................................      12/31/1996
26552...................................................      12/31/1996
26557...................................................      12/31/1996
26558...................................................      12/31/1996
26559...................................................      12/31/1996
32001...................................................      12/31/1999
33242...................................................      12/31/1999
33247...................................................      12/31/1999
42880...................................................      12/31/1996

[[Page 18777]]

 
53640...................................................      12/31/1996
56300...................................................      12/31/1999
56301...................................................      12/31/1999
56302...................................................      12/31/1999
56303...................................................      12/31/1999
56304...................................................      12/31/1999
56305...................................................      12/31/1999
56306...................................................      12/31/1999
56307...................................................      12/31/1999
56308...................................................      12/31/1999
56309...................................................      12/31/1999
56310...................................................      12/31/1999
56311...................................................      12/31/1999
56312...................................................      12/31/1999
56313...................................................      12/31/1999
56314...................................................      12/31/1999
56315...................................................      12/31/1999
56316...................................................      12/31/1999
56317...................................................      12/31/1999
56318...................................................      12/31/1999
56320...................................................      12/31/1999
56321...................................................      12/31/1999
56322...................................................      12/31/1999
56323...................................................      12/31/1999
56324...................................................      12/31/1999
56340...................................................      12/31/1999
56341...................................................      12/31/1999
56342...................................................      12/31/1999
56343...................................................      12/31/1999
56344...................................................      12/31/1999
56345...................................................      12/31/1999
56346...................................................      12/31/1999
56347...................................................      12/31/1999
56348...................................................      12/31/1999
56349...................................................      12/31/1999
56350...................................................      12/31/1999
56351...................................................      12/31/1999
56352...................................................      12/31/1999
56353...................................................      12/31/1999
56354...................................................      12/31/1999
56355...................................................      12/31/1999
56356...................................................      12/31/1999
56360...................................................      12/31/1996
56361...................................................      12/31/1996
56362...................................................      12/31/1999
56363...................................................      12/31/1999
56399...................................................      12/31/1999
57108...................................................      12/31/1998
61106...................................................      12/31/1998
61130...................................................      12/31/1998
61712...................................................      12/31/1998
61855...................................................      12/31/1999
61865...................................................      12/31/1999
62274...................................................      12/31/1999
62275...................................................      12/31/1999
62276...................................................      12/31/1999
62277...................................................      12/31/1999
62278...................................................      12/31/1999
62279...................................................      12/31/1999
62288...................................................      12/31/1999
62289...................................................      12/31/1999
62298...................................................      12/31/1999
63690...................................................      12/31/1998
63691...................................................      12/31/1998
64440...................................................      12/31/1999
64441...................................................      12/31/1999
64442...................................................      12/31/1999
64443...................................................      12/31/1999
64830...................................................      12/31/1998
68800...................................................      12/31/1996
68820...................................................      12/31/1996
68825...................................................      12/31/1996
68830...................................................      12/31/1996
71038...................................................      12/31/1998
74405...................................................      12/31/1998
77380...................................................      12/31/1999
77381...................................................      12/31/1999
77419...................................................      12/31/1999
77420...................................................      12/31/1999
77425...................................................      12/31/1999
77430...................................................      12/31/1999
78017...................................................      12/31/1998
78726...................................................      12/31/1997
78727...................................................      12/31/1997
80002...................................................      12/31/1997
80003...................................................      12/31/1997
80004...................................................      12/31/1997
80005...................................................      12/31/1997
80006...................................................      12/31/1997
80007...................................................      12/31/1997
80008...................................................      12/31/1997
80009...................................................      12/31/1997
80010...................................................      12/31/1997
80011...................................................      12/31/1997
80012...................................................      12/31/1997
80016...................................................      12/31/1997
80018...................................................      12/31/1997
80019...................................................      12/31/1997
80049...................................................      12/31/1999
80054...................................................      12/31/1999
80058...................................................      12/31/1999
80059...................................................      12/31/1999
80091...................................................      12/31/1999
80092...................................................      12/31/1999
82130...................................................      12/31/1998
82250...................................................      12/31/1998
83019...................................................      12/31/1998
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85029...................................................      12/31/1998
85030...................................................      12/31/1998
86287...................................................      12/31/1997
86289...................................................      12/31/1997
86290...................................................      12/31/1997
86291...................................................      12/31/1997
86293...................................................      12/31/1997
86295...................................................      12/31/1997
86296...................................................      12/31/1997
86299...................................................      12/31/1997
86302...................................................      12/31/1997
86303...................................................      12/31/1997
86306...................................................      12/31/1997
86311...................................................      12/31/1997
86313...................................................      12/31/1997
86315...................................................      12/31/1997
86588...................................................      12/31/1999
87178...................................................      12/31/1997
87179...................................................      12/31/1997
88151...................................................      12/31/1997
88156...................................................      12/31/1998
88157...................................................      12/31/1997
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88260...................................................      12/31/1998
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90714...................................................      12/31/1998
90724...................................................      12/31/1998
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90745...................................................      12/31/1999
90820...................................................      12/31/1997
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90843...................................................      12/31/1997
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90900...................................................      12/31/1996
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90904...................................................      12/31/1996
90906...................................................      12/31/1996
90908...................................................      12/31/1996
90910...................................................      12/31/1996
90915...................................................      12/31/1996
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93208...................................................      12/31/1996
93209...................................................      12/31/1996
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94160...................................................      12/31/1996
97122...................................................      12/31/1998
97250...................................................      12/31/1998
97260...................................................      12/31/1998
97261...................................................      12/31/1998
97265...................................................      12/31/1998
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97521...................................................      12/31/1996
99351...................................................      12/31/1997
99352...................................................      12/31/1997
99353...................................................      12/31/1997
99376...................................................      12/31/1997
A2000...................................................      12/31/1997
A4190...................................................      12/31/1996
A4200...................................................      12/31/1996
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A4203...................................................      12/31/1996
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A4205...................................................      12/31/1996
A4363...................................................      12/31/1999
A4581...................................................      12/31/1996
A4610...................................................      12/31/1996
D0471...................................................      12/31/1999
D2210...................................................      12/31/1999
D2810...................................................      12/31/1999
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E1350...................................................      12/31/1996
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E1402...................................................      12/31/1999
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E1404...................................................      12/31/1999
G0051...................................................      12/31/1997
G0052...................................................      12/31/1997
G0053...................................................      12/31/1997
G0054...................................................      09/30/1996
G0055...................................................      09/30/1996
G0056...................................................      09/30/1996
G0057...................................................      09/30/1996
G0058...................................................      12/31/1997
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G0100...................................................      12/31/1997
G0133...................................................      12/31/1998
H5300...................................................      12/31/1997
J1625...................................................      12/31/1997
J1760...................................................      12/31/1999
J1770...................................................      12/31/1999
J1780...................................................      12/31/1999
J2050...................................................      12/31/1996
J3005...................................................      12/31/1997
J7140...................................................      12/31/1996
J7150...................................................      12/31/1996
J7196...................................................      12/31/1999
J7503...................................................      12/31/1999
J9010...................................................      12/31/1996
K0109...................................................      09/30/1999
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K0124...................................................      12/31/1996
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K0140...................................................      03/31/1997
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K0262...................................................      12/31/1996
K0263...................................................      12/31/1996
K0264...................................................      12/31/1996
K0265...................................................      12/31/1996
K0266...................................................      12/31/1996
K0271...................................................      06/30/1996
K0272...................................................      06/30/1996
K0273...................................................      06/30/1996
K0274...................................................      06/30/1996
K0275...................................................      06/30/1996
K0276...................................................      06/30/1996
K0277...................................................      12/31/1999
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K0284...................................................      12/31/1999
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K0400...................................................      12/31/1999
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K0453...................................................      12/31/1998
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K0506...................................................      12/31/1999
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K0527...................................................      12/31/1999
K0528...................................................      12/31/1999
K0530...................................................      12/31/1999
L4200...................................................      12/31/1996
L4310...................................................      12/31/1998
L4320...................................................      12/31/1998
L4390...................................................      12/31/1998
L7160...................................................      12/31/1996
L7165...................................................      12/31/1996
L8605...................................................      12/31/1997
L8611...................................................      12/31/1997
L8615...................................................      12/31/1997
L8616...................................................      12/31/1997
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L8618...................................................      12/31/1997
L8620...................................................      12/31/1997
L8621...................................................      12/31/1997
L8622...................................................      12/31/1997
L8623...................................................      12/31/1997
L8624...................................................      12/31/1997
L8625...................................................      12/31/1997
L8626...................................................      12/31/1997
L8627...................................................      12/31/1997
L8628...................................................      12/31/1997
L8629...................................................      12/31/1997
L8640...................................................      12/31/1997
L8655...................................................      12/31/1997
L8656...................................................      12/31/1997
L8657...................................................      12/31/1997
L8680...................................................      12/31/1997
L8690...................................................      12/31/1997
L9999...................................................      12/31/1996
M0005...................................................      12/31/1997
M0006...................................................      12/31/1997
M0007...................................................      12/31/1997
M0008...................................................      12/31/1997
M0101...................................................      12/31/1998
P9014...................................................      12/31/1998
P9015...................................................      12/31/1998
P9610...................................................      12/31/1998
Q0068...................................................      12/31/1999
Q0103...................................................      12/31/1997
Q0104...................................................      12/31/1997
Q0109...................................................      12/31/1997
Q0110...................................................      12/31/1997
Q0116...................................................      09/30/1996
Q0132...................................................      12/31/1999
Q0158...................................................      12/31/1997
Q0159...................................................      12/31/1998
Q0162...................................................      12/31/1998
Q0182...................................................      12/31/1998
------------------------------------------------------------------------

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

Copyright American Dental Association. All rights reserved.

 

 

 

 

 Addendum E.--CPT Codes Which Would Be Paid Only As Inpatient Procedures
------------------------------------------------------------------------
  CPT/
 HCPCS      HOPD  Status  Indicator               Description
------------------------------------------------------------------------
  00174  C                             Anesth, pharyngeal surgery
  00176  C                             Anesth, pharyngeal surgery
  00192  C                             Anesth, facial bone surgery
  00214  C                             Anesth, skull drainage
  00215  C                             Anesth, skull fracture
  00404  C                             Anesth, surgery of breast
  00406  C                             Anesth, surgery of breast
  00452  C                             Anesth, surgery of shoulder
  00474  C                             Anesth, surgery of rib(s)
  00524  C                             Anesth, chest drainage
  00530  C                             Anesth, pacemaker insertion
  00540  C                             Anesth, chest surgery
  00542  C                             Anesth, release of lung
  00544  C                             Anesth, chest lining removal
  00546  C                             Anesth, lung, chest wall surg
  00560  C                             Anesth, open heart surgery
  00562  C                             Anesth, open heart surgery
  00580  C                             Anesth heart/lung transplant
  00604  C                             Anesth, surgery of vertebra
  00622  C                             Anesth, removal of nerves
  00632  C                             Anesth, removal of nerves
  00634  C                             Anesth for chemonucleolysis
  00670  C                             Anesth, spine, cord surgery
  00792  C                             Anesth, part liver removal
  00794  C                             Anesth, pancreas removal
  00796  C                             Anesth, for liver transplant
  00802  C                             Anesth, fat layer removal
  00844  C                             Anesth, pelvis surgery
  00846  C                             Anesth, hysterectomy
  00848  C                             Anesth, pelvic organ surg
  00850  C                             Anesth, cesarean section
  00855  C                             Anesth, hysterectomy
  00857  C                             Analgesia, labor & c-section
  00864  C                             Anesth, removal of bladder
  00865  C                             Anesth, removal of prostate
  00866  C                             Anesth, removal of adrenal
  00868  C                             Anesth, kidney transplant
  00882  C                             Anesth, major vein ligation
  00884  C                             Anesth, major vein revision
  00904  C                             Anesth, perineal surgery
  00908  C                             Anesth, removal of prostate
  00928  C                             Anesth, removal of testis
  00932  C                             Anesth, amputation of penis
  00934  C                             Anesth, penis, nodes removal
  00936  C                             Anesth, penis, nodes removal
  00944  C                             Anesth, vaginal hysterectomy
  00955  C                             Analgesia, vaginal delivery
  01140  C                             Anesth, amputation at pelvis
  01150  C                             Anesth, pelvic tumor surgery
  01190  C                             Anesth, pelvis nerve removal
  01212  C                             Anesth, hip disarticulation
  01214  C                             Anesth, replacement of hip
  01232  C                             Anesth, amputation of femur
  01234  C                             Anesth, radical femur surg
  01272  C                             Anesth, femoral artery surg
  01274  C                             Anesth, femoral embolectomy
  01402  C                             Anesth, replacement of knee
  01404  C                             Anesth, amputation at knee
  01442  C                             Anesth, knee artery surg
  01444  C                             Anesth, knee artery repair
  01486  C                             Anesth, ankle replacement
  01502  C                             Anesth, lwr leg embolectomy
  01632  C                             Anesth, surgery of shoulder
  01634  C                             Anesth, shoulder joint amput
  01636  C                             Anesth, forequarter amput
  01638  C                             Anesth, shoulder replacement
  01652  C                             Anesth, shoulder vessel surg
  01654  C                             Anesth, shoulder vessel surg
  01656  C                             Anesth, arm-leg vessel surg
  01756  C                             Anesth, radical humerus surg
  01772  C                             Anesth, uppr arm embolectomy
  01782  C                             Anesth, uppr arm vein repair
  01842  C                             Anesth, lwr arm embolectomy
  01852  C                             Anesth, lwr arm vein repair
  01904  C                             Anesth, skull x-ray inject
  01990  C                             Support for organ donor
  15756  C                             Free muscle flap, microvasc
  15757  C                             Free skin flap, microvasc
  15758  C                             Free fascial flap, microvasc
  19200  C                             Removal of breast
  19220  C                             Removal of breast
  19240  C                             Removal of breast
  19260  C                             Removal of chest wall lesion
  19271  C                             Revision of chest wall
  19272  C                             Extensive chest wall surgery
  19361  C                             Breast reconstruction
  19364  C                             Breast reconstruction
  19367  C                             Breast reconstruction
  19368  C                             Breast reconstruction
  19369  C                             Breast reconstruction
  20660  C                             Apply, remove fixation device
  20661  C                             Application of head brace
  20662  C                             Application of pelvis brace
  20663  C                             Application of thigh brace
  20664  C                             Halo brace application
  20802  C                             Replantation, arm, complete
  20805  C                             Replant, forearm, complete

[[Page 18780]]

 
  20808  C                             Replantation hand, complete
  20816  C                             Replantation digit, complete
  20822  C                             Replantation digit, complete
  20824  C                             Replantation thumb, complete
  20827  C                             Replantation thumb, complete
  20838  C                             Replantation foot, complete
  20930  C                             Spinal bone allograft
  20931  C                             Spinal bone allograft
  20936  C                             Spinal bone autograft
  20937  C                             Spinal bone autograft
  20938  C                             Spinal bone autograft
  20955  C                             Fibula bone graft, microvasc
  20956  C                             Iliac bone graft, microvasc
  20957  C                             Mt bone graft, microvasc
  20962  C                             Other bone graft, microvasc
  20969  C                             Bone/skin graft, microvasc
  20970  C                             Bone/skin graft, iliac crest
  20972  C                             Bone/skin graft, metatarsal
  20973  C                             Bone/skin graft, great toe
  21045  C                             Extensive jaw surgery
  21141  C                             Reconstruct midface, lefort
  21142  C                             Reconstruct midface, lefort
  21143  C                             Reconstruct midface, lefort
  21145  C                             Reconstruct midface, lefort
  21146  C                             Reconstruct midface, lefort
  21147  C                             Reconstruct midface, lefort
  21150  C                             Reconstruct midface, lefort
  21151  C                             Reconstruct midface, lefort
  21154  C                             Reconstruct midface, lefort
  21155  C                             Reconstruct midface, lefort
  21159  C                             Reconstruct midface, lefort
  21160  C                             Reconstruct midface, lefort
  21172  C                             Reconstruct orbit/forehead
  21175  C                             Reconstruct orbit/forehead
  21179  C                             Reconstruct entire forehead
  21180  C                             Reconstruct entire forehead
  21182  C                             Reconstruct cranial bone
  21183  C                             Reconstruct cranial bone
  21184  C                             Reconstruct cranial bone
  21188  C                             Reconstruction of midface
  21193  C                             Reconstruct lower jaw bone
  21194  C                             Reconstruct lower jaw bone
  21195  C                             Reconstruct lower jaw bone
  21196  C                             Reconstruct lower jaw bone
  21247  C                             Reconstruct lower jaw bone
  21255  C                             Reconstruct lower jaw bone
  21256  C                             Reconstruction of orbit
  21268  C                             Revise eye sockets
  21343  C                             Treatment of sinus fracture
  21344  C                             Treatment of sinus fracture
  21346  C                             Treat nose/jaw fracture
  21347  C                             Treat nose/jaw fracture
  21348  C                             Treat nose/jaw fracture
  21356  C                             Treat cheek bone fracture
  21360  C                             Treat cheek bone fracture
  21365  C                             Treat cheek bone fracture
  21366  C                             Treat cheek bone fracture
  21385  C                             Treat eye socket fracture
  21386  C                             Treat eye socket fracture
  21387  C                             Treat eye socket fracture
  21390  C                             Treat eye socket fracture
  21395  C                             Treat eye socket fracture
  21408  C                             Treat eye socket fracture
  21422  C                             Treat mouth roof fracture
  21423  C                             Treat mouth roof fracture
  21431  C                             Treat craniofacial fracture
  21432  C                             Treat craniofacial fracture
  21433  C                             Treat craniofacial fracture
  21435  C                             Treat craniofacial fracture
  21436  C                             Treat craniofacial fracture
  21495  C                             Treat hyoid bone fracture
  21510  C                             Drainage of bone lesion
  21557  C                             Remove tumor, neck/chest
  21615  C                             Removal of rib
  21616  C                             Removal of rib and nerves
  21620  C                             Partial removal of sternum
  21627  C                             Sternal debridement
  21630  C                             Extensive sternum surgery
  21632  C                             Extensive sternum surgery
  21705  C                             Revision of neck muscle/rib
  21740  C                             Reconstruction of sternum
  21750  C                             Repair of sternum separation
  21810  C                             Treatment of rib fracture(s)
  21825  C                             Treat sternum fracture
  22100  C                             Remove part of neck vertebra
  22101  C                             Remove part, thorax vertebra
  22102  C                             Remove part, lumbar vertebra
  22103  C                             Remove extra spine segment
  22110  C                             Remove part of neck vertebra
  22112  C                             Remove part, thorax vertebra
  22114  C                             Remove part, lumbar vertebra
  22116  C                             Remove extra spine segment
  22210  C                             Revision of neck spine
  22212  C                             Revision of thorax spine
  22214  C                             Revision of lumbar spine
  22216  C                             Revise, extra spine segment
  22220  C                             Revision of neck spine
  22222  C                             Revision of thorax spine
  22224  C                             Revision of lumbar spine
  22226  C                             Revise, extra spine segment
  22318  C                             Treat odontoid fx w/o graft
  22319  C                             Treat odontoid fx w/graft
  22325  C                             Treat spine fracture
  22326  C                             Treat neck spine fracture
  22327  C                             Treat thorax spine fracture
  22328  C                             Treat each add spine fx
  22548  C                             Neck spine fusion
  22554  C                             Neck spine fusion
  22556  C                             Thorax spine fusion
  22558  C                             Lumbar spine fusion
  22585  C                             Additional spinal fusion
  22590  C                             Spine & skull spinal fusion
  22595  C                             Neck spinal fusion
  22600  C                             Neck spine fusion
  22610  C                             Thorax spine fusion
  22612  C                             Lumbar spine fusion
  22614  C                             Spine fusion, extra segment
  22630  C                             Lumbar spine fusion
  22632  C                             Spine fusion, extra segment
  22800  C                             Fusion of spine
  22802  C                             Fusion of spine
  22804  C                             Fusion of spine
  22808  C                             Fusion of spine
  22810  C                             Fusion of spine
  22812  C                             Fusion of spine
  22818  C                             Kyphectomy, 1-2 segments
  22819  C                             Kyphectomy, 3 or more
  22830  C                             Exploration of spinal fusion
  22840  C                             Insert spine fixation device
  22841  C                             Insert spine fixation device
  22842  C                             Insert spine fixation device
  22843  C                             Insert spine fixation device
  22844  C                             Insert spine fixation device
  22845  C                             Insert spine fixation device
  22846  C                             Insert spine fixation device
  22847  C                             Insert spine fixation device
  22848  C                             Insert pelv fixation device
  22849  C                             Reinsert spinal fixation
  22850  C                             Remove spine fixation device
  22851  C                             Apply spine prosth device
  22852  C                             Remove spine fixation device
  22855  C                             Remove spine fixation device
  23035  C                             Drain shoulder bone lesion
  23125  C                             Removal of collar bone
  23195  C                             Removal of head of humerus
  23200  C                             Removal of collar bone
  23210  C                             Removal of shoulder blade
  23220  C                             Partial removal of humerus
  23221  C                             Partial removal of humerus
  23222  C                             Partial removal of humerus
  23332  C                             Remove shoulder foreign body
  23395  C                             Muscle transfer, shoulder/arm
  23397  C                             Muscle transfers
  23400  C                             Fixation of shoulder blade
  23440  C                             Remove/transplant tendon
  23470  C                             Reconstruct shoulder joint
  23472  C                             Reconstruct shoulder joint
  23900  C                             Amputation of arm & girdle
  23920  C                             Amputation at shoulder joint
  24149  C                             Radical resection of elbow
  24150  C                             Extensive humerus surgery
  24151  C                             Extensive humerus surgery
  24152  C                             Extensive radius surgery
  24153  C                             Extensive radius surgery
  24900  C                             Amputation of upper arm
  24920  C                             Amputation of upper arm
  24930  C                             Amputation follow-up surgery
  24931  C                             Amputate upper arm & implant
  24940  C                             Revision of upper arm
  25170  C                             Extensive forearm surgery
  25390  C                             Shorten radius or ulna
  25391  C                             Lengthen radius or ulna
  25392  C                             Shorten radius & ulna
  25393  C                             Lengthen radius & ulna
  25405  C                             Repair/graft radius or ulna
  25420  C                             Repair/graft radius & ulna
  25900  C                             Amputation of forearm
  25905  C                             Amputation of forearm
  25909  C                             Amputation follow-up surgery
  25915  C                             Amputation of forearm
  25920  C                             Amputate hand at wrist
  25924  C                             Amputation follow-up surgery
  25927  C                             Amputation of hand
  25931  C                             Amputation follow-up surgery
  26551  C                             Great toe-hand transfer
  26553  C                             Single transfer, toe-hand
  26554  C                             Double transfer, toe-hand
  26556  C                             Toe joint transfer
  26992  C                             Drainage of bone lesion
  27005  C                             Incision of hip tendon
  27006  C                             Incision of hip tendons
  27025  C                             Incision of hip/thigh fascia
  27030  C                             Drainage of hip joint
  27035  C                             Denervation of hip joint
  27036  C                             Excision of hip joint/muscle
  27054  C                             Removal of hip joint lining
  27070  C                             Partial removal of hip bone
  27071  C                             Partial removal of hip bone
  27075  C                             Extensive hip surgery
  27076  C                             Extensive hip surgery
  27077  C                             Extensive hip surgery
  27078  C                             Extensive hip surgery
  27079  C                             Extensive hip surgery
  27090  C                             Removal of hip prosthesis
  27091  C                             Removal of hip prosthesis
  27120  C                             Reconstruction of hip socket
  27122  C                             Reconstruction of hip socket
  27125  C                             Partial hip replacement
  27130  C                             Total hip replacement
  27132  C                             Total hip replacement
  27134  C                             Revise hip joint replacement
  27137  C                             Revise hip joint replacement
  27138  C                             Revise hip joint replacement
  27140  C                             Transplant femur ridge
  27146  C                             Incision of hip bone
  27147  C                             Revision of hip bone

[[Page 18781]]

 
  27151  C                             Incision of hip bones
  27156  C                             Revision of hip bones
  27158  C                             Revision of pelvis
  27161  C                             Incision of neck of femur
  27165  C                             Incision/fixation of femur
  27170  C                             Repair/graft femur head/neck
  27175  C                             Treat slipped epiphysis
  27176  C                             Treat slipped epiphysis
  27177  C                             Treat slipped epiphysis
  27178  C                             Treat slipped epiphysis
  27179  C                             Revise head/neck of femur
  27181  C                             Treat slipped epiphysis
  27185  C                             Revision of femur epiphysis
  27187  C                             Reinforce hip bones
  27215  C                             Treat pelvic fracture(s)
  27216  C                             Treat pelvic ring fracture
  27217  C                             Treat pelvic ring fracture
  27218  C                             Treat pelvic ring fracture
  27222  C                             Treat hip socket fracture
  27226  C                             Treat hip wall fracture
  27227  C                             Treat hip fracture(s)
  27228  C                             Treat hip fracture(s)
  27232  C                             Treat thigh fracture
  27235  C                             Treat thigh fracture
  27236  C                             Treat thigh fracture
  27240  C                             Treat thigh fracture
  27244  C                             Treat thigh fracture
  27245  C                             Treat thigh fracture
  27248  C                             Treat thigh fracture
  27253  C                             Treat hip dislocation
  27254  C                             Treat hip dislocation
  27258  C                             Treat hip dislocation
  27259  C                             Treat hip dislocation
  27280  C                             Fusion of sacroiliac joint
  27282  C                             Fusion of pubic bones
  27284  C                             Fusion of hip joint
  27286  C                             Fusion of hip joint
  27290  C                             Amputation of leg at hip
  27295  C                             Amputation of leg at hip
  27303  C                             Drainage of bone lesion
  27365  C                             Extensive leg surgery
  27445  C                             Revision of knee joint
  27446  C                             Revision of knee joint
  27447  C                             Total knee replacement
  27448  C                             Incision of thigh
  27450  C                             Incision of thigh
  27454  C                             Realignment of thigh bone
  27455  C                             Realignment of knee
  27457  C                             Realignment of knee
  27465  C                             Shortening of thigh bone
  27466  C                             Lengthening of thigh bone
  27468  C                             Shorten/lengthen thighs
  27470  C                             Repair of thigh
  27472  C                             Repair/graft of thigh
  27475  C                             Surgery to stop leg growth
  27477  C                             Surgery to stop leg growth
  27479  C                             Surgery to stop leg growth
  27485  C                             Surgery to stop leg growth
  27486  C                             Revise/replace knee joint
  27487  C                             Revise/replace knee joint
  27488  C                             Removal of knee prosthesis
  27495  C                             Reinforce thigh
  27506  C                             Treatment of thigh fracture
  27507  C                             Treatment of thigh fracture
  27511  C                             Treatment of thigh fracture
  27513  C                             Treatment of thigh fracture
  27514  C                             Treatment of thigh fracture
  27519  C                             Treat thigh fx growth plate
  27524  C                             Treat kneecap fracture
  27535  C                             Treat knee fracture
  27536  C                             Treat knee fracture
  27540  C                             Treat knee fracture
  27557  C                             Treat knee dislocation
  27558  C                             Treat knee dislocation
  27580  C                             Fusion of knee
  27590  C                             Amputate leg at thigh
  27591  C                             Amputate leg at thigh
  27592  C                             Amputate leg at thigh
  27596  C                             Amputation follow-up surgery
  27598  C                             Amputate lower leg at knee
  27645  C                             Extensive lower leg surgery
  27646  C                             Extensive lower leg surgery
  27702  C                             Reconstruct ankle joint
  27703  C                             Reconstruction, ankle joint
  27712  C                             Realignment of lower leg
  27715  C                             Revision of lower leg
  27720  C                             Repair of tibia
  27722  C                             Repair/graft of tibia
  27724  C                             Repair/graft of tibia
  27725  C                             Repair of lower leg
  27727  C                             Repair of lower leg
  27880  C                             Amputation of lower leg
  27881  C                             Amputation of lower leg
  27882  C                             Amputation of lower leg
  27886  C                             Amputation follow-up surgery
  27888  C                             Amputation of foot at ankle
  28800  C                             Amputation of midfoot
  28805  C                             Amputation thru metatarsal
  31225  C                             Removal of upper jaw
  31230  C                             Removal of upper jaw
  31290  C                             Nasal/sinus endoscopy, surg
  31291  C                             Nasal/sinus endoscopy, surg
  31292  C                             Nasal/sinus endoscopy, surg
  31293  C                             Nasal/sinus endoscopy, surg
  31294  C                             Nasal/sinus endoscopy, surg
  31360  C                             Removal of larynx
  31365  C                             Removal of larynx
  31367  C                             Partial removal of larynx
  31368  C                             Partial removal of larynx
  31370  C                             Partial removal of larynx
  31380  C                             Partial removal of larynx
  31382  C                             Partial removal of larynx
  31390  C                             Removal of larynx & pharynx
  31395  C                             Reconstruct larynx & pharynx
  31582  C                             Revision of larynx
  31584  C                             Treat larynx fracture
  31587  C                             Revision of larynx
  31725  C                             Clearance of airways
  31760  C                             Repair of windpipe
  31766  C                             Reconstruction of windpipe
  31770  C                             Repair/graft of bronchus
  31775  C                             Reconstruct bronchus
  31780  C                             Reconstruct windpipe
  31781  C                             Reconstruct windpipe
  31785  C                             Remove windpipe lesion
  31786  C                             Remove windpipe lesion
  31800  C                             Repair of windpipe injury
  31805  C                             Repair of windpipe injury
  32035  C                             Exploration of chest
  32036  C                             Exploration of chest
  32095  C                             Biopsy through chest wall
  32100  C                             Exploration/biopsy of chest
  32110  C                             Explore/repair chest
  32120  C                             Re-exploration of chest
  32124  C                             Explore chest free adhesions
  32140  C                             Removal of lung lesion(s)
  32141  C                             Remove/treat lung lesions
  32150  C                             Removal of lung lesion(s)
  32151  C                             Remove lung foreign body
  32160  C                             Open chest heart massage
  32200  C                             Drain, open, lung lesion
  32201  C                             Drain, percut, lung lesion
  32215  C                             Treat chest lining
  32220  C                             Release of lung
  32225  C                             Partial release of lung
  32310  C                             Removal of chest lining
  32320  C                             Free/remove chest lining
  32402  C                             Open biopsy chest lining
  32440  C                             Removal of lung
  32442  C                             Sleeve pneumonectomy
  32445  C                             Removal of lung
  32480  C                             Partial removal of lung
  32482  C                             Bilobectomy
  32484  C                             Segmentectomy
  32486  C                             Sleeve lobectomy
  32488  C                             Completion pneumonectomy
  32491  C                             Lung volume reduction
  32500  C                             Partial removal of lung
  32501  C                             Repair bronchus add-on
  32520  C                             Remove lung & revise chest
  32522  C                             Remove lung & revise chest
  32525  C                             Remove lung & revise chest
  32540  C                             Removal of lung lesion
  32650  C                             Thoracoscopy, surgical
  32651  C                             Thoracoscopy, surgical
  32652  C                             Thoracoscopy, surgical
  32653  C                             Thoracoscopy, surgical
  32654  C                             Thoracoscopy, surgical
  32655  C                             Thoracoscopy, surgical
  32656  C                             Thoracoscopy, surgical
  32657  C                             Thoracoscopy, surgical
  32658  C                             Thoracoscopy, surgical
  32659  C                             Thoracoscopy, surgical
  32660  C                             Thoracoscopy, surgical
  32661  C                             Thoracoscopy, surgical
  32662  C                             Thoracoscopy, surgical
  32663  C                             Thoracoscopy, surgical
  32664  C                             Thoracoscopy, surgical
  32665  C                             Thoracoscopy, surgical
  32800  C                             Repair lung hernia
  32810  C                             Close chest after drainage
  32815  C                             Close bronchial fistula
  32820  C                             Reconstruct injured chest
  32850  C                             Donor pneumonectomy
  32851  C                             Lung transplant, single
  32852  C                             Lung transplant with bypass
  32853  C                             Lung transplant, double
  32854  C                             Lung transplant with bypass
  32900  C                             Removal of rib(s)
  32905  C                             Revise & repair chest wall
  32906  C                             Revise & repair chest wall
  32940  C                             Revision of lung
  32997  C                             Total lung lavage
  33015  C                             Incision of heart sac
  33020  C                             Incision of heart sac
  33025  C                             Incision of heart sac
  33030  C                             Partial removal of heart sac
  33031  C                             Partial removal of heart sac
  33050  C                             Removal of heart sac lesion
  33120  C                             Removal of heart lesion
  33130  C                             Removal of heart lesion
  33140  C                             Heart revascularize (tmr)
  33200  C                             Insertion of heart pacemaker
  33201  C                             Insertion of heart pacemaker
  33236  C                             Remove electrode/thoracotomy
  33237  C                             Remove electrode/thoracotomy
  33238  C                             Remove electrode/thoracotomy
  33243  C                             Remove eltrd/thoracotomy
  33245  C                             Insert epic eltrd pace-defib
  33246  C                             Insert epic eltrd/generator
  33250  C                             Ablate heart dysrhythm focus
  33251  C                             Ablate heart dysrhythm focus
  33253  C                             Reconstruct atria

[[Page 18782]]

 
  33261  C                             Ablate heart dysrhythm focus
  33282  C                             Implant pat-active ht record
  33284  C                             Remove pat-active ht record
  33300  C                             Repair of heart wound
  33305  C                             Repair of heart wound
  33310  C                             Exploratory heart surgery
  33315  C                             Exploratory heart surgery
  33320  C                             Repair major blood vessel(s)
  33321  C                             Repair major vessel
  33322  C                             Repair major blood vessel(s)
  33330  C                             Insert major vessel graft
  33332  C                             Insert major vessel graft
  33335  C                             Insert major vessel graft
  33400  C                             Repair of aortic valve
  33401  C                             Valvuloplasty, open
  33403  C                             Valvuloplasty, w/cp bypass
  33404  C                             Prepare heart-aorta conduit
  33405  C                             Replacement of aortic valve
  33406  C                             Replacement of aortic valve
  33410  C                             Replacement of aortic valve
  33411  C                             Replacement of aortic valve
  33412  C                             Replacement of aortic valve
  33413  C                             Replacement of aortic valve
  33414  C                             Repair of aortic valve
  33415  C                             Revision, subvalvular tissue
  33416  C                             Revise ventricle muscle
  33417  C                             Repair of aortic valve
  33420  C                             Revision of mitral valve
  33422  C                             Revision of mitral valve
  33425  C                             Repair of mitral valve
  33426  C                             Repair of mitral valve
  33427  C                             Repair of mitral valve
  33430  C                             Replacement of mitral valve
  33460  C                             Revision of tricuspid valve
  33463  C                             Valvuloplasty, tricuspid
  33464  C                             Valvuloplasty, tricuspid
  33465  C                             Replace tricuspid valve
  33468  C                             Revision of tricuspid valve
  33470  C                             Revision of pulmonary valve
  33471  C                             Valvotomy, pulmonary valve
  33472  C                             Revision of pulmonary valve
  33474  C                             Revision of pulmonary valve
  33475  C                             Replacement, pulmonary valve
  33476  C                             Revision of heart chamber
  33478  C                             Revision of heart chamber
  33496  C                             Repair, prosth valve clot
  33500  C                             Repair heart vessel fistula
  33501  C                             Repair heart vessel fistula
  33502  C                             Coronary artery correction
  33503  C                             Coronary artery graft
  33504  C                             Coronary artery graft
  33505  C                             Repair artery w/tunnel
  33506  C                             Repair artery, translocation
  33510  C                             CABG, vein, single
  33511  C                             CABG, vein, two
  33512  C                             CABG, vein, three
  33513  C                             CABG, vein, four
  33514  C                             CABG, vein, five
  33516  C                             Cabg, vein, six or more
  33517  C                             CABG, artery-vein, single
  33518  C                             CABG, artery-vein, two
  33519  C                             CABG, artery-vein, three
  33521  C                             CABG, artery-vein, four
  33522  C                             CABG, artery-vein, five
  33523  C                             Cabg, art-vein, six or more
  33530  C                             Coronary artery, bypass/reop
  33533  C                             CABG, arterial, single
  33534  C                             CABG, arterial, two
  33535  C                             CABG, arterial, three
  33536  C                             Cabg, arterial, four or more
  33542  C                             Removal of heart lesion
  33545  C                             Repair of heart damage
  33572  C                             Open coronary endarterectomy
  33600  C                             Closure of valve
  33602  C                             Closure of valve
  33606  C                             Anastomosis/artery-aorta
  33608  C                             Repair anomaly w/conduit
  33610  C                             Repair by enlargement
  33611  C                             Repair double ventricle
  33612  C                             Repair double ventricle
  33615  C                             Repair, simple fontan
  33617  C                             Repair, modified fontan
  33619  C                             Repair single ventricle
  33641  C                             Repair heart septum defect
  33645  C                             Revision of heart veins
  33647  C                             Repair heart septum defects
  33660  C                             Repair of heart defects
  33665  C                             Repair of heart defects
  33670  C                             Repair of heart chambers
  33681  C                             Repair heart septum defect
  33684  C                             Repair heart septum defect
  33688  C                             Repair heart septum defect
  33690  C                             Reinforce pulmonary artery
  33692  C                             Repair of heart defects
  33694  C                             Repair of heart defects
  33697  C                             Repair of heart defects
  33702  C                             Repair of heart defects
  33710  C                             Repair of heart defects
  33720  C                             Repair of heart defect
  33722  C                             Repair of heart defect
  33730  C                             Repair heart-vein defect(s)
  33732  C                             Repair heart-vein defect
  33735  C                             Revision of heart chamber
  33736  C                             Revision of heart chamber
  33737  C                             Revision of heart chamber
  33750  C                             Major vessel shunt
  33755  C                             Major vessel shunt
  33762  C                             Major vessel shunt
  33764  C                             Major vessel shunt & graft
  33766  C                             Major vessel shunt
  33767  C                             Major vessel shunt
  33770  C                             Repair great vessels defect
  33771  C                             Repair great vessels defect
  33774  C                             Repair great vessels defect
  33775  C                             Repair great vessels defect
  33776  C                             Repair great vessels defect
  33777  C                             Repair great vessels defect
  33778  C                             Repair great vessels defect
  33779  C                             Repair great vessels defect
  33780  C                             Repair great vessels defect
  33781  C                             Repair great vessels defect
  33786  C                             Repair arterial trunk
  33788  C                             Revision of pulmonary artery
  33800  C                             Aortic suspension
  33802  C                             Repair vessel defect
  33803  C                             Repair vessel defect
  33813  C                             Repair septal defect
  33814  C                             Repair septal defect
  33820  C                             Revise major vessel
  33822  C                             Revise major vessel
  33824  C                             Revise major vessel
  33840  C                             Remove aorta constriction
  33845  C                             Remove aorta constriction
  33851  C                             Remove aorta constriction
  33852  C                             Repair septal defect
  33853  C                             Repair septal defect
  33860  C                             Ascending aortic graft
  33861  C                             Ascending aortic graft
  33863  C                             Ascending aortic graft
  33870  C                             Transverse aortic arch graft
  33875  C                             Thoracic aortic graft
  33877  C                             Thoracoabdominal graft
  33910  C                             Remove lung artery emboli
  33915  C                             Remove lung artery emboli
  33916  C                             Surgery of great vessel
  33917  C                             Repair pulmonary artery
  33918  C                             Repair pulmonary atresia
  33919  C                             Repair pulmonary atresia
  33920  C                             Repair pulmonary atresia
  33922  C                             Transect pulmonary artery
  33924  C                             Remove pulmonary shunt
  33930  C                             Removal of donor heart/lung
  33935  C                             Transplantation, heart/lung
  33940  C                             Removal of donor heart
  33945  C                             Transplantation of heart
  33960  C                             External circulation assist
  33961  C                             External circulation assist
  33968  C                             Remove aortic assist device
  33970  C                             Aortic circulation assist
  33971  C                             Aortic circulation assist
  33973  C                             Insert balloon device
  33974  C                             Remove intra-aortic balloon
  33975  C                             Implant ventricular device
  33976  C                             Implant ventricular device
  33977  C                             Remove ventricular device
  33978  C                             Remove ventricular device
  34001  C                             Removal of artery clot
  34051  C                             Removal of artery clot
  34151  C                             Removal of artery clot
  34401  C                             Removal of vein clot
  34421  C                             Removal of vein clot
  34451  C                             Removal of vein clot
  34502  C                             Reconstruct vena cava
  35001  C                             Repair defect of artery
  35002  C                             Repair artery rupture, neck
  35005  C                             Repair defect of artery
  35011  C                             Repair defect of artery
  35013  C                             Repair artery rupture, arm
  35021  C                             Repair defect of artery
  35022  C                             Repair artery rupture, chest
  35045  C                             Repair defect of arm artery
  35081  C                             Repair defect of artery
  35082  C                             Repair artery rupture, aorta
  35091  C                             Repair defect of artery
  35092  C                             Repair artery rupture, aorta
  35102  C                             Repair defect of artery
  35103  C                             Repair artery rupture, groin
  35111  C                             Repair defect of artery
  35112  C                             Repair artery rupture, spleen
  35121  C                             Repair defect of artery
  35122  C                             Repair artery rupture, belly
  35131  C                             Repair defect of artery
  35132  C                             Repair artery rupture, groin
  35141  C                             Repair defect of artery
  35142  C                             Repair artery rupture, thigh
  35151  C                             Repair defect of artery
  35152  C                             Repair artery rupture, knee
  35161  C                             Repair defect of artery
  35162  C                             Repair artery rupture
  35182  C                             Repair blood vessel lesion
  35189  C                             Repair blood vessel lesion
  35211  C                             Repair blood vessel lesion
  35216  C                             Repair blood vessel lesion
  35221  C                             Repair blood vessel lesion
  35241  C                             Repair blood vessel lesion
  35246  C                             Repair blood vessel lesion
  35251  C                             Repair blood vessel lesion
  35271  C                             Repair blood vessel lesion
  35276  C                             Repair blood vessel lesion
  35281  C                             Repair blood vessel lesion
  35301  C                             Rechanneling of artery
  35311  C                             Rechanneling of artery
  35331  C                             Rechanneling of artery
  35341  C                             Rechanneling of artery
  35351  C                             Rechanneling of artery

[[Page 18783]]

 
  35355  C                             Rechanneling of artery
  35361  C                             Rechanneling of artery
  35363  C                             Rechanneling of artery
  35371  C                             Rechanneling of artery
  35372  C                             Rechanneling of artery
  35381  C                             Rechanneling of artery
  35390  C                             Reoperation, carotid add-on
  35400  C                             Angioscopy
  35450  C                             Repair arterial blockage
  35452  C                             Repair arterial blockage
  35454  C                             Repair arterial blockage
  35456  C                             Repair arterial blockage
  35458  C                             Repair arterial blockage
  35480  C                             Atherectomy, open
  35481  C                             Atherectomy, open
  35482  C                             Atherectomy, open
  35483  C                             Atherectomy, open
  35501  C                             Artery bypass graft
  35506  C                             Artery bypass graft
  35507  C                             Artery bypass graft
  35508  C                             Artery bypass graft
  35509  C                             Artery bypass graft
  35511  C                             Artery bypass graft
  35515  C                             Artery bypass graft
  35516  C                             Artery bypass graft
  35518  C                             Artery bypass graft
  35521  C                             Artery bypass graft
  35526  C                             Artery bypass graft
  35531  C                             Artery bypass graft
  35533  C                             Artery bypass graft
  35536  C                             Artery bypass graft
  35541  C                             Artery bypass graft
  35546  C                             Artery bypass graft
  35548  C                             Artery bypass graft
  35549  C                             Artery bypass graft
  35551  C                             Artery bypass graft
  35556  C                             Artery bypass graft
  35558  C                             Artery bypass graft
  35560  C                             Artery bypass graft
  35563  C                             Artery bypass graft
  35565  C                             Artery bypass graft
  35566  C                             Artery bypass graft
  35571  C                             Artery bypass graft
  35582  C                             Vein bypass graft
  35583  C                             Vein bypass graft
  35585  C                             Vein bypass graft
  35587  C                             Vein bypass graft
  35601  C                             Artery bypass graft
  35606  C                             Artery bypass graft
  35612  C                             Artery bypass graft
  35616  C                             Artery bypass graft
  35621  C                             Artery bypass graft
  35623  C                             Bypass graft, not vein
  35626  C                             Artery bypass graft
  35631  C                             Artery bypass graft
  35636  C                             Artery bypass graft
  35641  C                             Artery bypass graft
  35642  C                             Artery bypass graft
  35645  C                             Artery bypass graft
  35646  C                             Artery bypass graft
  35650  C                             Artery bypass graft
  35651  C                             Artery bypass graft
  35654  C                             Artery bypass graft
  35656  C                             Artery bypass graft
  35661  C                             Artery bypass graft
  35663  C                             Artery bypass graft
  35665  C                             Artery bypass graft
  35666  C                             Artery bypass graft
  35671  C                             Artery bypass graft
  35681  C                             Composite bypass graft
  35682  C                             Composite bypass graft
  35683  C                             Composite bypass graft
  35691  C                             Arterial transposition
  35693  C                             Arterial transposition
  35694  C                             Arterial transposition
  35695  C                             Arterial transposition
  35700  C                             Reoperation, bypass graft
  35701  C                             Exploration, carotid artery
  35721  C                             Exploration, femoral artery
  35741  C                             Exploration popliteal artery
  35761  C                             Exploration of artery/vein
  35800  C                             Explore neck vessels
  35820  C                             Explore chest vessels
  35840  C                             Explore abdominal vessels
  35860  C                             Explore limb vessels
  35870  C                             Repair vessel graft defect
  35901  C                             Excision, graft, neck
  35903  C                             Excision, graft, extremity
  35905  C                             Excision, graft, thorax
  35907  C                             Excision, graft, abdomen
  36510  C                             Insertion of catheter, vein
  36550  C                             Declot vascular device
  36660  C                             Insertion catheter, artery
  36822  C                             Insertion of cannula(s)
  36823  C                             Insertion of cannula(s)
  36834  C                             Repair A-V aneurysm
  37140  C                             Revision of circulation
  37145  C                             Revision of circulation
  37160  C                             Revision of circulation
  37180  C                             Revision of circulation
  37181  C                             Splice spleen/kidney veins
  37195  C                             Thrombolytic therapy, stroke
  37200  C                             Transcatheter biopsy
  37201  C                             Transcatheter therapy infuse
  37202  C                             Transcatheter therapy infuse
  37616  C                             Ligation of chest artery
  37617  C                             Ligation of abdomen artery
  37620  C                             Revision of major vein
  37660  C                             Revision of major vein
  37788  C                             Revascularization, penis
  38100  C                             Removal of spleen, total
  38101  C                             Removal of spleen, partial
  38102  C                             Removal of spleen, total
  38115  C                             Repair of ruptured spleen
  38380  C                             Thoracic duct procedure
  38381  C                             Thoracic duct procedure
  38382  C                             Thoracic duct procedure
  38562  C                             Removal, pelvic lymph nodes
  38564  C                             Removal, abdomen lymph nodes
  38700  C                             Removal of lymph nodes, neck
  38724  C                             Removal of lymph nodes, neck
  38746  C                             Remove thoracic lymph nodes
  38747  C                             Remove abdominal lymph nodes
  38765  C                             Remove groin lymph nodes
  38770  C                             Remove pelvis lymph nodes
  38780  C                             Remove abdomen lymph nodes
  39000  C                             Exploration of chest
  39010  C                             Exploration of chest
  39200  C                             Removal chest lesion
  39220  C                             Removal chest lesion
  39499  C                             Chest procedure
  39501  C                             Repair diaphragm laceration
  39502  C                             Repair paraesophageal hernia
  39503  C                             Repair of diaphragm hernia
  39520  C                             Repair of diaphragm hernia
  39530  C                             Repair of diaphragm hernia
  39531  C                             Repair of diaphragm hernia
  39540  C                             Repair of diaphragm hernia
  39541  C                             Repair of diaphragm hernia
  39545  C                             Revision of diaphragm
  39560  C                             Resect diaphragm, simple
  39561  C                             Resect diaphragm, complex
  39599  C                             Diaphragm surgery procedure
  41130  C                             Partial removal of tongue
  41135  C                             Tongue and neck surgery
  41140  C                             Removal of tongue
  41145  C                             Tongue removal, neck surgery
  41150  C                             Tongue, mouth, jaw surgery
  41153  C                             Tongue, mouth, neck surgery
  41155  C                             Tongue, jaw, & neck surgery
  42426  C                             Excise parotid gland/lesion
  42842  C                             Extensive surgery of throat
  42845  C                             Extensive surgery of throat
  42894  C                             Revision of pharyngeal walls
  42953  C                             Repair throat, esophagus
  42961  C                             Control throat bleeding
  42971  C                             Control nose/throat bleeding
  43030  C                             Throat muscle surgery
  43045  C                             Incision of esophagus
  43100  C                             Excision of esophagus lesion
  43101  C                             Excision of esophagus lesion
  43107  C                             Removal of esophagus
  43108  C                             Removal of esophagus
  43112  C                             Removal of esophagus
  43113  C                             Removal of esophagus
  43116  C                             Partial removal of esophagus
  43117  C                             Partial removal of esophagus
  43118  C                             Partial removal of esophagus
  43121  C                             Partial removal of esophagus
  43122  C                             Parital removal of esophagus
  43123  C                             Partial removal of esophagus
  43124  C                             Removal of esophagus
  43130  C                             Removal of esophagus pouch
  43135  C                             Removal of esophagus pouch
  43300  C                             Repair of esophagus
  43305  C                             Repair esophagus and fistula
  43310  C                             Repair of esophagus
  43312  C                             Repair esophagus and fistula
  43320  C                             Fuse esophagus & stomach
  43324  C                             Revise esophagus & stomach
  43325  C                             Revise esophagus & stomach
  43326  C                             Revise esophagus & stomach
  43330  C                             Repair of esophagus
  43331  C                             Repair of esophagus
  43340  C                             Fuse esophagus & intestine
  43341  C                             Fuse esophagus & intestine
  43350  C                             Surgical opening, esophagus
  43351  C                             Surgical opening, esophagus
  43352  C                             Surgical opening, esophagus
  43360  C                             Gastrointestinal repair
  43361  C                             Gastrointestinal repair
  43400  C                             Ligate esophagus veins
  43401  C                             Esophagus surgery for veins
  43405  C                             Ligate/staple esophagus
  43410  C                             Repair esophagus wound
  43415  C                             Repair esophagus wound
  43420  C                             Repair esophagus opening
  43425  C                             Repair esophagus opening
  43460  C                             Pressure treatment esophagus
  43496  C                             Free jejunum flap, microvasc
  43500  C                             Surgical opening of stomach
  43501  C                             Surgical repair of stomach
  43502  C                             Surgical repair of stomach
  43510  C                             Surgical opening of stomach
  43520  C                             Incision of pyloric muscle
  43605  C                             Biopsy of stomach
  43610  C                             Excision of stomach lesion
  43611  C                             Excision of stomach lesion
  43620  C                             Removal of stomach
  43621  C                             Removal of stomach
  43622  C                             Removal of stomach
  43631  C                             Removal of stomach, partial
  43632  C                             Removal of stomach, partial

[[Page 18784]]

 
  43633  C                             Removal of stomach, partial
  43634  C                             Removal of stomach, partial
  43635  C                             Removal of stomach, partial
  43638  C                             Removal of stomach, partial
  43639  C                             Removal of stomach, partial
  43640  C                             Vagotomy & pylorus repair
  43641  C                             Vagotomy & pylorus repair
  43800  C                             Reconstruction of pylorus
  43810  C                             Fusion of stomach and bowel
  43820  C                             Fusion of stomach and bowel
  43825  C                             Fusion of stomach and bowel
  43832  C                             Place gastrostomy tube
  43840  C                             Repair of stomach lesion
  43842  C                             Gastroplasty for obesity
  43843  C                             Gastroplasty for obesity
  43846  C                             Gastric bypass for obesity
  43847  C                             Gastric bypass for obesity
  43848  C                             Revision gastroplasty
  43850  C                             Revise stomach-bowel fusion
  43855  C                             Revise stomach-bowel fusion
  43860  C                             Revise stomach-bowel fusion
  43865  C                             Revise stomach-bowel fusion
  43880  C                             Repair stomach-bowel fistula
  44005  C                             Freeing of bowel adhesion
  44010  C                             Incision of small bowel
  44015  C                             Insert needle cath bowel
  44020  C                             Exploration of small bowel
  44021  C                             Decompress small bowel
  44025  C                             Incision of large bowel
  44050  C                             Reduce bowel obstruction
  44055  C                             Correct malrotation of bowel
  44110  C                             Excision of bowel lesion(s)
  44111  C                             Excision of bowel lesion(s)
  44120  C                             Removal of small intestine
  44121  C                             Removal of small intestine
  44125  C                             Removal of small intestine
  44130  C                             Bowel to bowel fusion
  44139  C                             Mobilization of colon
  44140  C                             Partial removal of colon
  44141  C                             Partial removal of colon
  44143  C                             Partial removal of colon
  44144  C                             Partial removal of colon
  44145  C                             Partial removal of colon
  44146  C                             Partial removal of colon
  44147  C                             Partial removal of colon
  44150  C                             Removal of colon
  44151  C                             Removal of colon/ileostomy
  44152  C                             Removal of colon/ileostomy
  44153  C                             Removal of colon/ileostomy
  44155  C                             Removal of colon/ileostomy
  44156  C                             Removal of colon/ileostomy
  44160  C                             Removal of colon
  44202  C                             Laparo, resect intestine
  44300  C                             Open bowel to skin
  44310  C                             Ileostomy/jejunostomy
  44314  C                             Revision of ileostomy
  44316  C                             Devise bowel pouch
  44320  C                             Colostomy
  44322  C                             Colostomy with biopsies
  44345  C                             Revision of colostomy
  44346  C                             Revision of colostomy
  44500  C                             Intro, gastrointestinal tube
  44602  C                             Suture, small intestine
  44603  C                             Suture, small intestine
  44604  C                             Suture, large intestine
  44605  C                             Repair of bowel lesion
  44615  C                             Intestinal stricturoplasty
  44620  C                             Repair bowel opening
  44625  C                             Repair bowel opening
  44626  C                             Repair bowel opening
  44640  C                             Repair bowel-skin fistula
  44650  C                             Repair bowel fistula
  44660  C                             Repair bowel-bladder fistula
  44661  C                             Repair bowel-bladder fistula
  44680  C                             Surgical revision, intestine
  44700  C                             Suspend bowel w/prosthesis
  44800  C                             Excision of bowel pouch
  44820  C                             Excision of mesentery lesion
  44850  C                             Repair of mesentery
  44899  C                             Bowel surgery procedure
  44900  C                             Drain app abscess, open
  44901  C                             Drain app abscess, percut
  44950  C                             Appendectomy
  44955  C                             Appendectomy add-on
  44960  C                             Appendectomy
  45110  C                             Removal of rectum
  45111  C                             Partial removal of rectum
  45112  C                             Removal of rectum
  45113  C                             Partial proctectomy
  45114  C                             Partial removal of rectum
  45116  C                             Partial removal of rectum
  45119  C                             Remove rectum w/reservoir
  45120  C                             Removal of rectum
  45121  C                             Removal of rectum and colon
  45123  C                             Partial proctectomy
  45126  C                             Pelvic exenteration
  45130  C                             Excision of rectal prolapse
  45135  C                             Excision of rectal prolapse
  45540  C                             Correct rectal prolapse
  45541  C                             Correct rectal prolapse
  45550  C                             Repair rectum/remove sigmoid
  45562  C                             Exploration/repair of rectum
  45563  C                             Exploration/repair of rectum
  45800  C                             Repair rect/bladder fistula
  45805  C                             Repair fistula w/colostomy
  45820  C                             Repair rectourethral fistula
  45825  C                             Repair fistula w/colostomy
  46705  C                             Repair of anal stricture
  46715  C                             Repair of anovaginal fistula
  46716  C                             Repair of anovaginal fistula
  46730  C                             Construction of absent anus
  46735  C                             Construction of absent anus
  46740  C                             Construction of absent anus
  46742  C                             Repair of imperforated anus
  46744  C                             Repair of cloacal anomaly
  46746  C                             Repair of cloacal anomaly
  46748  C                             Repair of cloacal anomaly
  46751  C                             Repair of anal sphincter
  47001  C                             Needle biopsy, liver add-on
  47010  C                             Open drainage, liver lesion
  47011  C                             Percut drain, liver lesion
  47015  C                             Inject/aspirate liver cyst
  47100  C                             Wedge biopsy of liver
  47120  C                             Partial removal of liver
  47122  C                             Extensive removal of liver
  47125  C                             Partial removal of liver
  47130  C                             Partial removal of liver
  47133  C                             Removal of donor liver
  47134  C                             Partial removal, donor liver
  47135  C                             Transplantation of liver
  47136  C                             Transplantation of liver
  47300  C                             Surgery for liver lesion
  47350  C                             Repair liver wound
  47360  C                             Repair liver wound
  47361  C                             Repair liver wound
  47362  C                             Repair liver wound
  47400  C                             Incision of liver duct
  47420  C                             Incision of bile duct
  47425  C                             Incision of bile duct
  47460  C                             Incise bile duct sphincter
  47480  C                             Incision of gallbladder
  47490  C                             Incision of gallbladder
  47550  C                             Bile duct endoscopy add-on
  47600  C                             Removal of gallbladder
  47605  C                             Removal of gallbladder
  47610  C                             Removal of gallbladder
  47612  C                             Removal of gallbladder
  47620  C                             Removal of gallbladder
  47700  C                             Exploration of bile ducts
  47701  C                             Bile duct revision
  47711  C                             Excision of bile duct tumor
  47712  C                             Excision of bile duct tumor
  47715  C                             Excision of bile duct cyst
  47716  C                             Fusion of bile duct cyst
  47720  C                             Fuse gallbladder & bowel
  47721  C                             Fuse upper gi structures
  47740  C                             Fuse gallbladder & bowel
  47741  C                             Fuse gallbladder & bowel
  47760  C                             Fuse bile ducts and bowel
  47765  C                             Fuse liver ducts & bowel
  47780  C                             Fuse bile ducts and bowel
  47785  C                             Fuse bile ducts and bowel
  47800  C                             Reconstruction of bile ducts
  47801  C                             Placement, bile duct support
  47802  C                             Fuse liver duct & intestine
  47900  C                             Suture bile duct injury
  48000  C                             Drainage of abdomen
  48001  C                             Placement of drain, pancreas
  48005  C                             Resect/debride pancreas
  48020  C                             Removal of pancreatic stone
  48100  C                             Biopsy of pancreas
  48120  C                             Removal of pancreas lesion
  48140  C                             Partial removal of pancreas
  48145  C                             Partial removal of pancreas
  48146  C                             Pancreatectomy
  48148  C                             Removal of pancreatic duct
  48150  C                             Partial removal of pancreas
  48152  C                             Pancreatectomy
  48153  C                             Pancreatectomy
  48154  C                             Pancreatectomy
  48155  C                             Removal of pancreas
  48180  C                             Fuse pancreas and bowel
  48400  C                             Injection, intraop add-on
  48500  C                             Surgery of pancreas cyst
  48510  C                             Drain pancreatic pseudocyst
  48511  C                             Drain pancreatic pseudocyst
  48520  C                             Fuse pancreas cyst and bowel
  48540  C                             Fuse pancreas cyst and bowel
  48545  C                             Pancreatorrhaphy
  48547  C                             Duodenal exclusion
  48556  C                             Removal, allograft pancreas
  49000  C                             Exploration of abdomen
  49002  C                             Reopening of abdomen
  49010  C                             Exploration behind abdomen
  49020  C                             Drain abdominal abscess
  49021  C                             Drain abdominal abscess
  49040  C                             Drain, open, abdom abscess
  49041  C                             Drain, percut, abdom abscess
  49060  C                             Drain, open, retrop abscess
  49061  C                             Drain, percut, retroper absc
  49062  C                             Drain to peritoneal cavity
  49200  C                             Removal of abdominal lesion
  49201  C                             Removal of abdominal lesion
  49215  C                             Excise sacral spine tumor
  49220  C                             Multiple surgery, abdomen
  49255  C                             Removal of omentum
  49425  C                             Insert abdomen-venous drain
  49428  C                             Ligation of shunt
  49605  C                             Repair umbilical lesion
  49606  C                             Repair umbilical lesion
  49610  C                             Repair umbilical lesion
  49611  C                             Repair umbilical lesion
  49900  C                             Repair of abdominal wall
  49905  C                             Omental flap
  49906  C                             Free omental flap, microvasc
  50010  C                             Exploration of kidney

[[Page 18785]]

 
  50020  C                             Renal abscess, open drain
  50021  C                             Renal abscess, percut drain
  50040  C                             Drainage of kidney
  50045  C                             Exploration of kidney
  50060  C                             Removal of kidney stone
  50065  C                             Incision of kidney
  50070  C                             Incision of kidney
  50075  C                             Removal of kidney stone
  50100  C                             Revise kidney blood vessels
  50120  C                             Exploration of kidney
  50125  C                             Explore and drain kidney
  50130  C                             Removal of kidney stone
  50135  C                             Exploration of kidney
  50205  C                             Biopsy of kidney
  50220  C                             Removal of kidney
  50225  C                             Removal of kidney
  50230  C                             Removal of kidney
  50234  C                             Removal of kidney & ureter
  50236  C                             Removal of kidney & ureter
  50240  C                             Partial removal of kidney
  50280  C                             Removal of kidney lesion
  50290  C                             Removal of kidney lesion
  50300  C                             Removal of donor kidney
  50320  C                             Removal of donor kidney
  50340  C                             Removal of kidney
  50360  C                             Transplantation of kidney
  50365  C                             Transplantation of kidney
  50370  C                             Remove transplanted kidney
  50380  C                             Reimplantation of kidney
  50400  C                             Revision of kidney/ureter
  50405  C                             Revision of kidney/ureter
  50500  C                             Repair of kidney wound
  50520  C                             Close kidney-skin fistula
  50525  C                             Repair renal-abdomen fistula
  50526  C                             Repair renal-abdomen fistula
  50540  C                             Revision of horseshoe kidney
  50546  C                             Laparoscopic nephrectomy
  50547  C                             Laparo removal donor kidney
  50570  C                             Kidney endoscopy
  50572  C                             Kidney endoscopy
  50574  C                             Kidney endoscopy & biopsy
  50575  C                             Kidney endoscopy
  50576  C                             Kidney endoscopy & treatment
  50578  C                             Renal endoscopy/radiotracer
  50580  C                             Kidney endoscopy & treatment
  50600  C                             Exploration of ureter
  50605  C                             Insert ureteral support
  50610  C                             Removal of ureter stone
  50620  C                             Removal of ureter stone
  50630  C                             Removal of ureter stone
  50650  C                             Removal of ureter
  50660  C                             Removal of ureter
  50700  C                             Revision of ureter
  50715  C                             Release of ureter
  50722  C                             Release of ureter
  50725  C                             Release/revise ureter
  50727  C                             Revise ureter
  50728  C                             Revise ureter
  50740  C                             Fusion of ureter & kidney
  50750  C                             Fusion of ureter & kidney
  50760  C                             Fusion of ureters
  50770  C                             Splicing of ureters
  50780  C                             Reimplant ureter in bladder
  50782  C                             Reimplant ureter in bladder
  50783  C                             Reimplant ureter in bladder
  50785  C                             Reimplant ureter in bladder
  50800  C                             Implant ureter in bowel
  50810  C                             Fusion of ureter & bowel
  50815  C                             Urine shunt to bowel
  50820  C                             Construct bowel bladder
  50825  C                             Construct bowel bladder
  50830  C                             Revise urine flow
  50840  C                             Replace ureter by bowel
  50845  C                             Appendico-vesicostomy
  50860  C                             Transplant ureter to skin
  50900  C                             Repair of ureter
  50920  C                             Closure ureter/skin fistula
  50930  C                             Closure ureter/bowel fistula
  50940  C                             Release of ureter
  50970  C                             Ureter endoscopy
  50972  C                             Ureter endoscopy & catheter
  50974  C                             Ureter endoscopy & biopsy
  50976  C                             Ureter endoscopy & treatment
  50978  C                             Ureter endoscopy & tracer
  50980  C                             Ureter endoscopy & treatment
  51060  C                             Removal of ureter stone
  51525  C                             Removal of bladder lesion
  51530  C                             Removal of bladder lesion
  51535  C                             Repair of ureter lesion
  51550  C                             Partial removal of bladder
  51555  C                             Partial removal of bladder
  51565  C                             Revise bladder & ureter(s)
  51570  C                             Removal of bladder
  51575  C                             Removal of bladder & nodes
  51580  C                             Remove bladder/revise tract
  51585  C                             Removal of bladder & nodes
  51590  C                             Remove bladder/revise tract
  51595  C                             Remove bladder/revise tract
  51596  C                             Remove bladder/create pouch
  51597  C                             Removal of pelvic structures
  51800  C                             Revision of bladder/urethra
  51820  C                             Revision of urinary tract
  51840  C                             Attach bladder/urethra
  51841  C                             Attach bladder/urethra
  51845  C                             Repair bladder neck
  51860  C                             Repair of bladder wound
  51865  C                             Repair of bladder wound
  51900  C                             Repair bladder/vagina lesion
  51920  C                             Close bladder-uterus fistula
  51925  C                             Hysterectomy/bladder repair
  51940  C                             Correction of bladder defect
  51960  C                             Revision of bladder & bowel
  51980  C                             Construct bladder opening
  53085  C                             Drainage of urinary leakage
  53415  C                             Reconstruction of urethra
  53443  C                             Reconstruction of urethra
  54125  C                             Removal of penis
  54130  C                             Remove penis & nodes
  54135  C                             Remove penis & nodes
  54332  C                             Revise penis/urethra
  54336  C                             Revise penis/urethra
  54390  C                             Repair penis and bladder
  54430  C                             Revision of penis
  54535  C                             Extensive testis surgery
  54560  C                             Exploration for testis
  54650  C                             Orchiopexy (Fowler-Stephens)
  55600  C                             Incise sperm duct pouch
  55605  C                             Incise sperm duct pouch
  55650  C                             Remove sperm duct pouch
  55801  C                             Removal of prostate
  55810  C                             Extensive prostate surgery
  55812  C                             Extensive prostate surgery
  55815  C                             Extensive prostate surgery
  55821  C                             Removal of prostate
  55831  C                             Removal of prostate
  55840  C                             Extensive prostate surgery
  55842  C                             Extensive prostate surgery
  55845  C                             Extensive prostate surgery
  55860  C                             Surgical exposure, prostate
  55862  C                             Extensive prostate surgery
  55865  C                             Extensive prostate surgery
  56630  C                             Extensive vulva surgery
  56631  C                             Extensive vulva surgery
  56632  C                             Extensive vulva surgery
  56633  C                             Extensive vulva surgery
  56634  C                             Extensive vulva surgery
  56637  C                             Extensive vulva surgery
  56640  C                             Extensive vulva surgery
  56805  C                             Repair clitoris
  57110  C                             Remove vagina wall, complete
  57111  C                             Remove vagina tissue, compl
  57112  C                             Vaginectomy w/nodes, compl
  57120  C                             Closure of vagina
  57270  C                             Repair of bowel pouch
  57280  C                             Suspension of vagina
  57282  C                             Repair of vaginal prolapse
  57292  C                             Construct vagina with graft
  57305  C                             Repair rectum-vagina fistula
  57307  C                             Fistula repair & colostomy
  57308  C                             Fistula repair, transperine
  57310  C                             Repair urethrovaginal lesion
  57311  C                             Repair urethrovaginal lesion
  57320  C                             Repair bladder-vagina lesion
  57330  C                             Repair bladder-vagina lesion
  57335  C                             Repair vagina
  57531  C                             Removal of cervix, radical
  57540  C                             Removal of residual cervix
  57545  C                             Remove cervix/repair pelvis
  58140  C                             Removal of uterus lesion
  58150  C                             Total hysterectomy
  58152  C                             Total hysterectomy
  58180  C                             Partial hysterectomy
  58200  C                             Extensive hysterectomy
  58210  C                             Extensive hysterectomy
  58240  C                             Removal of pelvis contents
  58260  C                             Vaginal hysterectomy
  58262  C                             Vaginal hysterectomy
  58263  C                             Vaginal hysterectomy
  58267  C                             Hysterectomy & vagina repair
  58270  C                             Hysterectomy & vagina repair
  58275  C                             Hysterectomy/revise vagina
  58280  C                             Hysterectomy/revise vagina
  58285  C                             Extensive hysterectomy
  58400  C                             Suspension of uterus
  58410  C                             Suspension of uterus
  58520  C                             Repair of ruptured uterus
  58540  C                             Revision of uterus
  58600  C                             Division of fallopian tube
  58605  C                             Division of fallopian tube
  58611  C                             Ligate oviduct(s) add-on
  58615  C                             Occlude fallopian tube(s)
  58700  C                             Removal of fallopian tube
  58720  C                             Removal of ovary/tube(s)
  58740  C                             Revise fallopian tube(s)
  58750  C                             Repair oviduct
  58752  C                             Revise ovarian tube(s)
  58760  C                             Remove tubal obstruction
  58770  C                             Create new tubal opening
  58805  C                             Drainage of ovarian cyst(s)
  58822  C                             Drain ovary abscess, percut
  58823  C                             Drain pelvic abscess, percut
  58825  C                             Transposition, ovary(s)
  58940  C                             Removal of ovary(s)
  58943  C                             Removal of ovary(s)
  58950  C                             Resect ovarian malignancy
  58951  C                             Resect ovarian malignancy
  58952  C                             Resect ovarian malignancy
  58960  C                             Exploration of abdomen
  59100  C                             Remove uterus lesion
  59120  C                             Treat ectopic pregnancy
  59121  C                             Treat ectopic pregnancy
  59130  C                             Treat ectopic pregnancy
  59135  C                             Treat ectopic pregnancy
  59136  C                             Treat ectopic pregnancy
  59140  C                             Treat ectopic pregnancy
  59325  C                             Revision of cervix

[[Page 18786]]

 
  59350  C                             Repair of uterus
  59514  C                             Cesarean delivery only
  59525  C                             Remove uterus after cesarean
  59620  C                             Attempted vbac delivery only
  59830  C                             Treat uterus infection
  59850  C                             Abortion
  59851  C                             Abortion
  59852  C                             Abortion
  59855  C                             Abortion
  59856  C                             Abortion
  59857  C                             Abortion
  59866  C                             Abortion (mpr)
  60212  C                             Parital thyroid excision
  60252  C                             Removal of thyroid
  60254  C                             Extensive thyroid surgery
  60260  C                             Repeat thyroid surgery
  60270  C                             Removal of thyroid
  60271  C                             Removal of thyroid
  60502  C                             Re-explore parathyroids
  60505  C                             Explore parathyroid glands
  60512  C                             Autotransplant parathyroid
  60520  C                             Removal of thymus gland
  60521  C                             Removal of thymus gland
  60522  C                             Removal of thymus gland
  60540  C                             Explore adrenal gland
  60545  C                             Explore adrenal gland
  60600  C                             Remove carotid body lesion
  60605  C                             Remove carotid body lesion
  60650  C                             Laparoscopy adrenalectomy
  61105  C                             Twist drill hole
  61107  C                             Drill skull for implantation
  61108  C                             Drill skull for drainage
  61120  C                             Burr hole for puncture
  61140  C                             Pierce skull for biopsy
  61150  C                             Pierce skull for drainage
  61151  C                             Pierce skull for drainage
  61154  C                             Pierce skull & remove clot
  61156  C                             Pierce skull for drainage
  61210  C                             Pierce skull, implant device
  61250  C                             Pierce skull & explore
  61253  C                             Pierce skull & explore
  61304  C                             Open skull for exploration
  61305  C                             Open skull for exploration
  61312  C                             Open skull for drainage
  61313  C                             Open skull for drainage
  61314  C                             Open skull for drainage
  61315  C                             Open skull for drainage
  61320  C                             Open skull for drainage
  61321  C                             Open skull for drainage
  61332  C                             Explore/biopsy eye socket
  61333  C                             Explore orbit/remove lesion
  61334  C                             Explore orbit/remove object
  61340  C                             Relieve cranial pressure
  61343  C                             Incise skull (press relief)
  61345  C                             Relieve cranial pressure
  61440  C                             Incise skull for surgery
  61450  C                             Incise skull for surgery
  61458  C                             Incise skull for brain wound
  61460  C                             Incise skull for surgery
  61470  C                             Incise skull for surgery
  61480  C                             Incise skull for surgery
  61490  C                             Incise skull for surgery
  61500  C                             Removal of skull lesion
  61501  C                             Remove infected skull bone
  61510  C                             Removal of brain lesion
  61512  C                             Remove brain lining lesion
  61514  C                             Removal of brain abscess
  61516  C                             Removal of brain lesion
  61518  C                             Removal of brain lesion
  61519  C                             Remove brain lining lesion
  61520  C                             Removal of brain lesion
  61521  C                             Removal of brain lesion
  61522  C                             Removal of brain abscess
  61524  C                             Removal of brain lesion
  61526  C                             Removal of brain lesion
  61530  C                             Removal of brain lesion
  61531  C                             Implant brain electrodes
  61533  C                             Implant brain electrodes
  61534  C                             Removal of brain lesion
  61535  C                             Remove brain electrodes
  61536  C                             Removal of brain lesion
  61538  C                             Removal of brain tissue
  61539  C                             Removal of brain tissue
  61541  C                             Incision of brain tissue
  61542  C                             Removal of brain tissue
  61543  C                             Removal of brain tissue
  61544  C                             Remove & treat brain lesion
  61545  C                             Excision of brain tumor
  61546  C                             Removal of pituitary gland
  61548  C                             Removal of pituitary gland
  61550  C                             Release of skull seams
  61552  C                             Release of skull seams
  61556  C                             Incise skull/sutures
  61557  C                             Incise skull/sutures
  61558  C                             Excision of skull/sutures
  61559  C                             Excision of skull/sutures
  61563  C                             Excision of skull tumor
  61564  C                             Excision of skull tumor
  61570  C                             Remove foreign body, brain
  61571  C                             Incise skull for brain wound
  61575  C                             Skull base/brainstem surgery
  61576  C                             Skull base/brainstem surgery
  61580  C                             Craniofacial approach, skull
  61581  C                             Craniofacial approach, skull
  61582  C                             Craniofacial approach, skull
  61583  C                             Craniofacial approach, skull
  61584  C                             Orbitocranial approach/skull
  61585  C                             Orbitocranial approach/skull
  61586  C                             Resect nasopharynx, skull
  61590  C                             Infratemporal approach/skull
  61591  C                             Infratemporal approach/skull
  61592  C                             Orbitocranial approach/skull
  61595  C                             Transtemporal approach/skull
  61596  C                             Transcochlear approach/skull
  61597  C                             Transcondylar approach/skull
  61598  C                             Transpetrosal approach/skull
  61600  C                             Resect/excise cranial lesion
  61601  C                             Resect/excise cranial lesion
  61605  C                             Resect/excise cranial lesion
  61606  C                             Resect/excise cranial lesion
  61607  C                             Resect/excise cranial lesion
  61608  C                             Resect/excise cranial lesion
  61609  C                             Transect artery, sinus
  61610  C                             Transect artery, sinus
  61611  C                             Transect artery, sinus
  61612  C                             Transect artery, sinus
  61613  C                             Remove aneurysm, sinus
  61615  C                             Resect/excise lesion, skull
  61616  C                             Resect/excise lesion, skull
  61618  C                             Repair dura
  61619  C                             Repair dura
  61624  C                             Occlusion/embolization cath
  61626  C                             Occlusion/embolization cath
  61680  C                             Intracranial vessel surgery
  61682  C                             Intracranial vessel surgery
  61684  C                             Intracranial vessel surgery
  61686  C                             Intracranial vessel surgery
  61690  C                             Intracranial vessel surgery
  61692  C                             Intracranial vessel surgery
  61700  C                             Inner skull vessel surgery
  61702  C                             Inner skull vessel surgery
  61703  C                             Clamp neck artery
  61705  C                             Revise circulation to head
  61708  C                             Revise circulation to head
  61710  C                             Revise circulation to head
  61711  C                             Fusion of skull arteries
  61720  C                             Incise skull/brain surgery
  61735  C                             Incise skull/brain surgery
  61750  C                             Incise skull/brain biopsy
  61751  C                             Brain biopsy w/ct/mr guide
  61760  C                             Implant brain electrodes
  61770  C                             Incise skull for treatment
  61791  C                             Treat trigeminal tract
  61795  C                             Brain surgery using computer
  61850  C                             Implant neuroelectrodes
  61860  C                             Implant neuroelectrodes
  61862  C                             Implant neurostimul, subcort
  61870  C                             Implant neuroelectrodes
  61875  C                             Implant neuroelectrodes
  61880  C                             Revise/remove neuroelectrode
  61886  C                             Implant neurostim arrays
  61888  C                             Revise/remove neuroreceiver
  62000  C                             Treat skull fracture
  62005  C                             Treat skull fracture
  62010  C                             Treatment of head injury
  62100  C                             Repair brain fluid leakage
  62115  C                             Reduction of skull defect
  62116  C                             Reduction of skull defect
  62117  C                             Reduction of skull defect
  62120  C                             Repair skull cavity lesion
  62121  C                             Incise skull repair
  62140  C                             Repair of skull defect
  62141  C                             Repair of skull defect
  62142  C                             Remove skull plate/flap
  62143  C                             Replace skull plate/flap
  62145  C                             Repair of skull & brain
  62146  C                             Repair of skull with graft
  62147  C                             Repair of skull with graft
  62180  C                             Establish brain cavity shunt
  62190  C                             Establish brain cavity shunt
  62192  C                             Establish brain cavity shunt
  62200  C                             Establish brain cavity shunt
  62201  C                             Establish brain cavity shunt
  62220  C                             Establish brain cavity shunt
  62223  C                             Establish brain cavity shunt
  62256  C                             Remove brain cavity shunt
  62258  C                             Replace brain cavity shunt
  62351  C                             Implant spinal canal cath
  63001  C                             Removal of spinal lamina
  63003  C                             Removal of spinal lamina
  63005  C                             Removal of spinal lamina
  63011  C                             Removal of spinal lamina
  63012  C                             Removal of spinal lamina
  63015  C                             Removal of spinal lamina
  63016  C                             Removal of spinal lamina
  63017  C                             Removal of spinal lamina
  63020  C                             Neck spine disk surgery
  63030  C                             Low back disk surgery
  63035  C                             Spinal disk surgery add-on
  63040  C                             Neck spine disk surgery
  63042  C                             Low back disk surgery
  63045  C                             Removal of spinal lamina
  63046  C                             Removal of spinal lamina
  63047  C                             Removal of spinal lamina
  63048  C                             Remove spinal lamina add-on
  63055  C                             Decompress spinal cord
  63056  C                             Decompress spinal cord
  63057  C                             Decompress spine cord add-on
  63064  C                             Decompress spinal cord
  63066  C                             Decompress spine cord add-on
  63075  C                             Neck spine disk surgery
  63076  C                             Neck spine disk surgery
  63077  C                             Spine disk surgery, thorax
  63078  C                             Spine disk surgery, thorax

[[Page 18787]]

 
  63081  C                             Removal of vertebral body
  63082  C                             Remove vertebral body add-on
  63085  C                             Removal of vertebral body
  63086  C                             Remove vertebral body add-on
  63087  C                             Removal of vertebral body
  63088  C                             Remove vertebral body add-on
  63090  C                             Removal of vertebral body
  63091  C                             Remove vertebral body add-on
  63170  C                             Incise spinal cord tract(s)
  63172  C                             Drainage of spinal cyst
  63173  C                             Drainage of spinal cyst
  63180  C                             Revise spinal cord ligaments
  63182  C                             Revise spinal cord ligaments
  63185  C                             Incise spinal column/nerves
  63190  C                             Incise spinal column/nerves
  63191  C                             Incise spinal column/nerves
  63194  C                             Incise spinal column & cord
  63195  C                             Incise spinal column & cord
  63196  C                             Incise spinal column & cord
  63197  C                             Incise spinal column & cord
  63198  C                             Incise spinal column & cord
  63199  C                             Incise spinal column & cord
  63200  C                             Release of spinal cord
  63250  C                             Revise spinal cord vessels
  63251  C                             Revise spinal cord vessels
  63252  C                             Revise spinal cord vessels
  63265  C                             Excise intraspinal lesion
  63266  C                             Excise intraspinal lesion
  63267  C                             Excise intraspinal lesion
  63268  C                             Excise intraspinal lesion
  63270  C                             Excise intraspinal lesion
  63271  C                             Excise intraspinal lesion
  63272  C                             Excise intraspinal lesion
  63273  C                             Excise intraspinal lesion
  63275  C                             Biopsy/excise spinal tumor
  63276  C                             Biopsy/excise spinal tumor
  63277  C                             Biopsy/excise spinal tumor
  63278  C                             Biopsy/excise spinal tumor
  63280  C                             Biopsy/excise spinal tumor
  63281  C                             Biopsy/excise spinal tumor
  63282  C                             Biopsy/excise spinal tumor
  63283  C                             Biopsy/excise spinal tumor
  63285  C                             Biopsy/excise spinal tumor
  63286  C                             Biopsy/excise spinal tumor
  63287  C                             Biopsy/excise spinal tumor
  63290  C                             Biopsy/excise spinal tumor
  63300  C                             Removal of vertebral body
  63301  C                             Removal of vertebral body
  63302  C                             Removal of vertebral body
  63303  C                             Removal of vertebral body
  63304  C                             Removal of vertebral body
  63305  C                             Removal of vertebral body
  63306  C                             Removal of vertebral body
  63307  C                             Removal of vertebral body
  63308  C                             Remove vertebral body add-on
  63655  C                             Implant neuroelectrodes
  63700  C                             Repair of spinal herniation
  63702  C                             Repair of spinal herniation
  63704  C                             Repair of spinal herniation
  63706  C                             Repair of spinal herniation
  63707  C                             Repair spinal fluid leakage
  63709  C                             Repair spinal fluid leakage
  63710  C                             Graft repair of spine defect
  63740  C                             Install spinal shunt
  63741  C                             Install spinal shunt
  64752  C                             Incision of vagus nerve
  64755  C                             Incision of stomach nerves
  64760  C                             Incision of vagus nerve
  64763  C                             Incise hip/thigh nerve
  64766  C                             Incise hip/thigh nerve
  64802  C                             Remove sympathetic nerves
  64804  C                             Remove sympathetic nerves
  64809  C                             Remove sympathetic nerves
  64818  C                             Remove sympathetic nerves
  64820  C                             Remove sympathetic nerves
  64866  C                             Fusion of facial/other nerve
  64868  C                             Fusion of facial/other nerve
  65273  C                             Repair of eye wound
  69150  C                             Extensive ear canal surgery
  69155  C                             Extensive ear/neck surgery
  69502  C                             Mastoidectomy
  69535  C                             Remove part of temporal bone
  69554  C                             Remove ear lesion
  69950  C                             Incise inner ear nerve
  69970  C                             Remove inner ear lesion
  74300  C                             X-ray bile ducts/pancreas
  74301  C                             X-rays at surgery add-on
  75900  C                             Arterial catheter exchange
  75940  C                             X-ray placement, vein filter
  75945  C                             Intravascular us
  75946  C                             Intravascular us add-on
  75960  C                             Transcatheter intro, stent
  75961  C                             Retrieval, broken catheter
  75962  C                             Repair arterial blockage
  75964  C                             Repair artery blockage, each
  75966  C                             Repair arterial blockage
  75968  C                             Repair artery blockage, each
  75970  C                             Vascular biopsy
  75978  C                             Repair venous blockage
  75992  C                             Atherectomy, x-ray exam
  75993  C                             Atherectomy, x-ray exam
  75994  C                             Atherectomy, x-ray exam
  75995  C                             Atherectomy, x-ray exam
  75996  C                             Atherectomy, x-ray exam
  92970  C                             Cardioassist, internal
  92971  C                             Cardioassist, external
  92975  C                             Dissolve clot, heart vessel
  92977  C                             Dissolve clot, heart vessel
  92978  C                             Intravasc us, heart add-on
  92979  C                             Intravasc us, heart add-on
  92986  C                             Revision of aortic valve
  92987  C                             Revision of mitral valve
  92990  C                             Revision of pulmonary valve
  92992  C                             Revision of heart chamber
  92993  C                             Revision of heart chamber
  92997  C                             Pul art balloon repr, percut
  92998  C                             Pul art balloon repr, percut
  94652  C                             Pressure breathing (IPPB)
  94762  C                             Measure blood oxygen level
  95920  C                             Intraop nerve test add-on
  95961  C                             Electrode stimulation, brain
  95962  C                             Electrode stim, brain add-on
  99190  C                             Special pump services
  99191  C                             Special pump services
  99192  C                             Special pump services
  99234  C                             Observ/hosp same date
  99235  C                             Observ/hosp same date
  99236  C                             Observ/hosp same date
  99251  C                             Initial inpatient consult
  99252  C                             Initial inpatient consult
  99253  C                             Initial inpatient consult
  99254  C                             Initial inpatient consult
  99255  C                             Initial inpatient consult
  99261  C                             Follow-up inpatient consult
  99262  C                             Follow-up inpatient consult
  99263  C                             Follow-up inpatient consult
  99295  C                             Neonatal critical care
  99296  C                             Neonatal critical care
  99297  C                             Neonatal critical care
  99298  C                             Neonatal critical care
  99356  C                             Prolonged service, inpatient
  99357  C                             Prolonged service, inpatient
  99433  C                             Normal newborn care/hospital
  G0160  C                             Cryo. ablation, prostate
------------------------------------------------------------------------

 
 

 

 

 

 

 

  Federal Register / Vol. 65, No. 68 / Friday, April 7, 2000 / Rules 
and Regulations  

              Addendum F.--Status Indicators: How Various Services Are Treated Under Outpatient PPS
----------------------------------------------------------------------------------------------------------------
       Indicator                  Service                                      Status
----------------------------------------------------------------------------------------------------------------
A......................  Pulmonary Rehabilitation   Not Paid Under PPS
                          Clinical Trial.
C......................  Inpatient Procedures.....  Admit Patient; Bill as Inpatient
A......................  Durable Medical            DMEPOS Fee Schedule
                          Equipment, Prosthetics
                          and.
E......................  Non-Covered Items and      Non-paid
                          Services.
A......................  Physical, Occupational     Rehabilitation Fee Schedule
                          and SpeechTherapy.
A......................  Ambulance................  Ambulance Fee Schedule
A......................  EPO for ESRD Patients....  National Rate
A......................  Clinical Diagnostic        Laboratory Fee Schedule
                          Laboratory Services.
A......................  Physican Services for      Not Paid Under PPS
                          ESRD Patients.
A......................  Screening Mammography....  National Rate
N......................  Incidental Services,       Packaged
                          packaged into APC Rat.
P......................  Partial Hospitalization..  Paid Per Diem APC
S......................  Significant Procedure,     Paid
                          Not Discounted When.
T......................  Procedure, Multiple When   Paid
                          Discount Applies.
V......................  Visit to Clinic or         Paid
                          Emergency Department.
X......................  Ancillary Service........  Paid
----------------------------------------------------------------------------------------------------------------


[[Page 18788]]


              Addendum G.--Service Mix Indices by Hospital
------------------------------------------------------------------------
                            Hospital                                SMI
------------------------------------------------------------------------
010001..........................................................    3.13
010004..........................................................    1.77
010005..........................................................    2.17
010006..........................................................    3.08
010007..........................................................    1.70
010008..........................................................    1.86
010009..........................................................    1.69
010010..........................................................    2.44
010011..........................................................    2.56
010012..........................................................    2.21
010015..........................................................    2.29
010016..........................................................    2.55
010018..........................................................    6.45
010019..........................................................    2.41
010021..........................................................    1.74
010022..........................................................    2.02
010023..........................................................    2.85
010024..........................................................    2.88
010025..........................................................    2.14
010027..........................................................    1.10
010029..........................................................    3.22
010031..........................................................    2.04
010032..........................................................    1.28
010033..........................................................    1.53
010034..........................................................    2.69
010035..........................................................    3.05
010036..........................................................    2.72
010038..........................................................    4.48
010039..........................................................    2.19
010040..........................................................    2.62
010043..........................................................    2.32
010044..........................................................    2.21
010045..........................................................    2.00
010046..........................................................    2.09
010047..........................................................    1.67
010049..........................................................    3.06
010050..........................................................    1.93
010051..........................................................    1.60
010052..........................................................    1.60
010053..........................................................    2.00
010054..........................................................    1.88
010055..........................................................    2.86
010056..........................................................    2.70
010058..........................................................    1.25
010059..........................................................    1.90
010061..........................................................    2.62
010062..........................................................    1.81
010064..........................................................    3.43
010065..........................................................    2.41
010066..........................................................    1.42
010068..........................................................    1.39
010069..........................................................    2.34
010072..........................................................    2.61
010073..........................................................    2.61
010078..........................................................    2.55
010079..........................................................    2.52
010080..........................................................    1.08
010083..........................................................    2.25
010084..........................................................    4.17
010087..........................................................    2.71
010089..........................................................    2.61
010090..........................................................    2.43
010091..........................................................    1.63
010092..........................................................    2.55
010094..........................................................    2.50
010095..........................................................    1.50
010097..........................................................    2.07
010098..........................................................    1.75
010099..........................................................    2.14
010100..........................................................    2.79
010101..........................................................    2.38
010102..........................................................    1.32
010103..........................................................    2.38
010104..........................................................    2.66
010108..........................................................    1.95
010109..........................................................    2.24
010110..........................................................    1.20
010112..........................................................    1.87
010113..........................................................    2.85
010114..........................................................    2.48
010115..........................................................    1.47
010118..........................................................    2.56
010119..........................................................    2.13
010120..........................................................    2.04
010123..........................................................    3.11
010124..........................................................    3.42
010125..........................................................    1.44
010126..........................................................    2.11
010127..........................................................    3.32
010128..........................................................    1.40
010129..........................................................    1.84
010130..........................................................    1.67
010131..........................................................    2.80
010134..........................................................    1.56
010137..........................................................    1.57
010138..........................................................    1.32
010139..........................................................    2.72
010143..........................................................    2.02
010144..........................................................    2.70
010145..........................................................    1.61
010146..........................................................    3.10
010148..........................................................    1.94
010149..........................................................    2.84
010150..........................................................    2.15
010152..........................................................    2.14
010155..........................................................    1.63
013025..........................................................    1.64
013027..........................................................    1.11
013028..........................................................    0.93
013300..........................................................    1.48
014002..........................................................    1.41
020001..........................................................    2.78
020002..........................................................    2.30
020004..........................................................    1.92
020005..........................................................    1.07
020006..........................................................    2.04
020007..........................................................    0.87
020008..........................................................    2.33
020009..........................................................    1.05
020010..........................................................    0.58
020011..........................................................    1.02
020012..........................................................    3.41
020013..........................................................    1.89
020014..........................................................    1.78
020017..........................................................    3.41
020024..........................................................    1.84
020025..........................................................    1.06
024001..........................................................    1.65
030001..........................................................    2.73
030002..........................................................    2.64
030003..........................................................    2.15
030004..........................................................    0.86
030006..........................................................    2.79
030007..........................................................    2.55
030009..........................................................    1.43
030010..........................................................    2.87
030011..........................................................    3.75
030012..........................................................    1.90
030013..........................................................    2.56
030014..........................................................    3.09
030016..........................................................    1.86
030017..........................................................    2.92
030018..........................................................    3.33
030019..........................................................    2.49
030022..........................................................    1.73
030023..........................................................    2.74
030024..........................................................    3.70
030025..........................................................    1.79
030027..........................................................    1.63
030030..........................................................    3.06
030033..........................................................    2.60
030034..........................................................    1.39
030035..........................................................    3.18
030036..........................................................    2.49
030037..........................................................    4.59
030038..........................................................    3.33
030040..........................................................    1.99
030041..........................................................    1.30
030043..........................................................    2.57
030044..........................................................    2.07
030047..........................................................    1.68
030049..........................................................    0.78
030054..........................................................    0.83
030055..........................................................    2.47
030059..........................................................    2.66
030060..........................................................    2.25
030061..........................................................    2.09
030062..........................................................    2.47
030064..........................................................    2.59
030065..........................................................    3.18
030067..........................................................    1.59
030068..........................................................    2.56
030069..........................................................    3.02
030080..........................................................    2.74
030083..........................................................    2.58
030085..........................................................    2.55
030086..........................................................    2.27
030087..........................................................    3.66
030088..........................................................    2.22
030089..........................................................    2.78
030092..........................................................    2.94
030093..........................................................    1.63
030094..........................................................    2.11
030095..........................................................    3.28
030099..........................................................    2.09
033025..........................................................    1.82
033026..........................................................    2.18
033028..........................................................    1.64
034004..........................................................    1.58
034008..........................................................    3.05
034009..........................................................    1.55
034010..........................................................    1.55
034013..........................................................    1.57
034019..........................................................    1.52
040001..........................................................    2.42
040002..........................................................    2.24
040003..........................................................    1.98
040004..........................................................    3.62
040005..........................................................    2.05
040007..........................................................    4.24
040008..........................................................    1.31
040010..........................................................    3.21
040011..........................................................    2.11
040014..........................................................    2.81
040015..........................................................    1.77
040016..........................................................    2.02
040017..........................................................    2.57
040018..........................................................    2.87
040019..........................................................    2.10
040020..........................................................    3.01
040021..........................................................    3.28
040022..........................................................    2.43
040024..........................................................    1.80

[[Page 18789]]

 
040025..........................................................    1.76
040026..........................................................    2.63
040027..........................................................    3.19
040028..........................................................    2.17
040029..........................................................    3.57
040030..........................................................    1.37
040032..........................................................    0.92
040035..........................................................    1.17
040036..........................................................    3.29
040037..........................................................    2.01
040039..........................................................    2.51
040040..........................................................    1.35
040041..........................................................    3.36
040042..........................................................    2.13
040044..........................................................    1.40
040045..........................................................    1.65
040047..........................................................    1.77
040048..........................................................    2.46
040050..........................................................    2.88
040051..........................................................    2.07
040053..........................................................    1.60
040054..........................................................    3.26
040055..........................................................    2.81
040058..........................................................    2.42
040060..........................................................    1.45
040062..........................................................    2.58
040064..........................................................    1.41
040066..........................................................    3.53
040067..........................................................    1.19
040070..........................................................    1.77
040072..........................................................    2.31
040074..........................................................    2.91
040075..........................................................    1.74
040076..........................................................    1.79
040077..........................................................    1.77
040078..........................................................    2.74
040080..........................................................    1.87
040081..........................................................    0.93
040082..........................................................    1.77
040084..........................................................    3.12
040085..........................................................    1.90
040088..........................................................    3.29
040090..........................................................    1.43
040091..........................................................    1.73
040093..........................................................    1.37
040100..........................................................    2.39
040105..........................................................    1.29
040106..........................................................    2.06
040107..........................................................    1.59
040109..........................................................    2.02
040114..........................................................    5.13
040116..........................................................    2.93
040118..........................................................    2.82
040119..........................................................    3.14
040124..........................................................    2.53
040126..........................................................    1.95
040132..........................................................    0.96
043026..........................................................    1.30
043027..........................................................    0.85
043028..........................................................    1.17
043029..........................................................    1.86
043031..........................................................    0.82
043032..........................................................    3.76
043300..........................................................    1.57
044004..........................................................    1.54
044005..........................................................    1.57
044006..........................................................    1.64
044010..........................................................    1.65
044012..........................................................    1.59
050002..........................................................    2.06
050006..........................................................    2.44
050007..........................................................    2.29
050009..........................................................    2.97
050013..........................................................    3.22
050014..........................................................    2.86
050015..........................................................    2.38
050016..........................................................    2.13
050017..........................................................    5.03
050018..........................................................    2.55
050021..........................................................    2.26
050022..........................................................    2.85
050024..........................................................    2.28
050025..........................................................    2.34
050026..........................................................    2.34
050028..........................................................    2.52
050029..........................................................    2.32
050030..........................................................    1.88
050032..........................................................    3.20
050033..........................................................    2.24
050036..........................................................    2.67
050038..........................................................    1.49
050039..........................................................    2.85
050042..........................................................    3.26
050043..........................................................    2.85
050045..........................................................    3.17
050046..........................................................    2.32
050047..........................................................    3.05
050051..........................................................    1.60
050054..........................................................    1.75
050055..........................................................    1.93
050056..........................................................    3.46
050057..........................................................    3.51
050058..........................................................    2.74
050060..........................................................    2.11
050061..........................................................    5.22
050063..........................................................    2.75
050065..........................................................    2.53
050066..........................................................    2.43
050067..........................................................    1.93
050068..........................................................    2.71
050069..........................................................    2.78
050077..........................................................    3.23
050078..........................................................    2.67
050079..........................................................    2.20
050080..........................................................    2.13
050081..........................................................    1.14
050082..........................................................    2.90
050084..........................................................    2.44
050088..........................................................    1.44
050089..........................................................    2.10
050090..........................................................    2.52
050091..........................................................    2.57
050092..........................................................    1.87
050093..........................................................    3.76
050095..........................................................    3.98
050096..........................................................    3.94
050097..........................................................    3.79
050099..........................................................    2.27
050100..........................................................    2.75
050101..........................................................    2.80
050102..........................................................    2.14
050103..........................................................    3.29
050104..........................................................    2.27
050107..........................................................    2.69
050108..........................................................    2.76
050109..........................................................    2.26
050110..........................................................    3.28
050111..........................................................    5.30
050112..........................................................    2.67
050113..........................................................    1.35
050114..........................................................    2.76
050115..........................................................    2.18
050116..........................................................    2.99
050117..........................................................    3.02
050118..........................................................    2.63
050121..........................................................    3.26
050122..........................................................    2.54
050124..........................................................    2.32
050125..........................................................    3.20
050126..........................................................    2.94
050127..........................................................    2.04
050128..........................................................    2.45
050129..........................................................    2.73
050131..........................................................    2.45
050132..........................................................    2.98
050133..........................................................    2.08
050135..........................................................    1.59
050136..........................................................    2.67
050144..........................................................    2.46
050145..........................................................    2.76
050146..........................................................    1.41
050148..........................................................    2.31
050149..........................................................    2.40
050150..........................................................    2.44
050152..........................................................    2.31
050153..........................................................    2.58
050155..........................................................    2.14
050158..........................................................    3.58
050159..........................................................    1.48
050167..........................................................    1.42
050168..........................................................    3.40
050169..........................................................    2.78
050170..........................................................    2.83
050172..........................................................    1.89
050173..........................................................    2.82
050174..........................................................    3.38
050175..........................................................    3.37
050177..........................................................    1.89
050179..........................................................    2.63
050180..........................................................    2.32
050183..........................................................    1.30
050186..........................................................    1.96
050188..........................................................    3.77
050189..........................................................    2.48
050191..........................................................    2.69
050192..........................................................    1.60
050193..........................................................    1.89
050194..........................................................    2.70
050195..........................................................    2.38
050196..........................................................    2.39
050197..........................................................    2.76
050204..........................................................    3.22
050205..........................................................    2.35
050207..........................................................    3.48
050208..........................................................    2.09
050211..........................................................    2.71
050213..........................................................    1.28
050214..........................................................    2.05
050215..........................................................    3.07
050217..........................................................    2.15
050219..........................................................    1.98
050222..........................................................    2.61
050224..........................................................    2.71
050225..........................................................    2.28
050226..........................................................    2.85
050228..........................................................    1.17
050230..........................................................    2.91
050231..........................................................    3.44
050232..........................................................    2.92
050233..........................................................    3.37
050234..........................................................    1.67
050235..........................................................    2.64
050236..........................................................    2.17

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050238..........................................................    2.14
050239..........................................................    2.64
050240..........................................................    2.66
050241..........................................................    2.55
050242..........................................................    2.23
050243..........................................................    2.05
050245..........................................................    1.24
050248..........................................................    1.49
050251..........................................................    2.23
050253..........................................................    2.29
050254..........................................................    3.23
050256..........................................................    1.39
050257..........................................................    1.90
050260..........................................................    1.38
050261..........................................................    2.11
050262..........................................................    2.22
050264..........................................................    2.24
050267..........................................................    2.80
050270..........................................................    2.61
050272..........................................................    2.14
050274..........................................................    1.56
050276..........................................................    1.32
050277..........................................................    2.59
050278..........................................................    2.70
050279..........................................................    1.93
050280..........................................................    2.70
050281..........................................................    3.99
050282..........................................................    2.17
050283..........................................................    1.16
050286..........................................................    1.02
050289..........................................................    2.76
050290..........................................................    2.40
050291..........................................................    1.73
050292..........................................................    1.41
050293..........................................................    1.42
050295..........................................................    2.63
050296..........................................................    2.45
050298..........................................................    2.08
050299..........................................................    3.08
050300..........................................................    2.95
050301..........................................................    2.95
050302..........................................................    2.87
050305..........................................................    2.12
050307..........................................................    3.67
050308..........................................................    2.42
050309..........................................................    3.00
050310..........................................................    2.96
050312..........................................................    2.71
050313..........................................................    3.15
050315..........................................................    1.20
050317..........................................................    1.84
050320..........................................................    1.26
050324..........................................................    3.46
050325..........................................................    1.73
050327..........................................................    2.36
050328..........................................................    2.69
050329..........................................................    1.93
050331..........................................................    2.12
050333..........................................................    1.10
050334..........................................................    3.36
050335..........................................................    1.34
050336..........................................................    2.48
050337..........................................................    1.78
050342..........................................................    2.84
050343..........................................................    3.36
050348..........................................................    1.87
050349..........................................................    1.17
050350..........................................................    2.25
050351..........................................................    3.35
050352..........................................................    2.05
050353..........................................................    2.61
050355..........................................................    0.98
050357..........................................................    2.47
050359..........................................................    3.58
050360..........................................................    3.42
050366..........................................................    2.09
050367..........................................................    1.90
050369..........................................................    2.41
050377..........................................................    0.95
050378..........................................................    2.89
050379..........................................................    1.56
050380..........................................................    3.91
050382..........................................................    2.62
050388..........................................................    1.03
050390..........................................................    2.90
050391..........................................................    2.02
050392..........................................................    1.48
050393..........................................................    2.93
050394..........................................................    3.37
050396..........................................................    4.28
050397..........................................................    1.44
050401..........................................................    2.30
050404..........................................................    1.55
050406..........................................................    1.36
050407..........................................................    2.93
050410..........................................................    1.05
050414..........................................................    2.65
050417..........................................................    3.03
050418..........................................................    1.29
050419..........................................................    2.69
050420..........................................................    2.12
050421..........................................................    2.38
050423..........................................................    2.49
050424..........................................................    2.95
050426..........................................................    2.60
050427..........................................................    0.76
050430..........................................................    1.38
050431..........................................................    3.90
050432..........................................................    2.60
050433..........................................................    1.55
050434..........................................................    1.37
050435..........................................................    2.38
050436..........................................................    1.58
050438..........................................................    2.65
050440..........................................................    1.53
050441..........................................................    2.19
050443..........................................................    1.62
050444..........................................................    2.31
050446..........................................................    1.43
050447..........................................................    1.60
050448..........................................................    3.14
050454..........................................................    1.78
050455..........................................................    3.70
050456..........................................................    5.49
050457..........................................................    2.23
050459..........................................................    2.44
050468..........................................................    1.71
050469..........................................................    1.68
050470..........................................................    2.22
050471..........................................................    3.14
050476..........................................................    2.73
050477..........................................................    4.61
050478..........................................................    1.57
050481..........................................................    2.80
050482..........................................................    1.06
050483..........................................................    3.44
050485..........................................................    3.44
050486..........................................................    2.39
050488..........................................................    2.21
050491..........................................................    2.52
050492..........................................................    2.39
050494..........................................................    3.25
050496..........................................................    2.55
050497..........................................................    1.04
050498..........................................................    2.58
050502..........................................................    3.66
050503..........................................................    3.44
050506..........................................................    2.44
050516..........................................................    3.39
050517..........................................................    2.78
050522..........................................................    2.46
050523..........................................................    2.22
050526..........................................................    2.04
050528..........................................................    2.12
050531..........................................................    3.41
050534..........................................................    2.45
050535..........................................................    2.86
050537..........................................................    2.76
050539..........................................................    2.31
050542..........................................................    2.06
050543..........................................................    3.65
050545..........................................................    0.99
050546..........................................................    0.94
050547..........................................................    1.12
050548..........................................................    0.81
050549..........................................................    2.87
050550..........................................................    2.38
050551..........................................................    2.61
050552..........................................................    1.32
050557..........................................................    2.30
050559..........................................................    2.89
050560..........................................................    2.10
050564..........................................................    2.61
050565..........................................................    2.02
050566..........................................................    1.55
050567..........................................................    2.31
050568..........................................................    2.82
050569..........................................................    2.55
050570..........................................................    3.36
050571..........................................................    3.32
050573..........................................................    2.43
050577..........................................................    4.54
050579..........................................................    2.39
050580..........................................................    2.36
050581..........................................................    2.45
050583..........................................................    3.40
050584..........................................................    2.20
050585..........................................................    2.85
050586..........................................................    3.12
050588..........................................................    2.72
050589..........................................................    3.13
050590..........................................................    3.28
050591..........................................................    2.53
050592..........................................................    3.06
050593..........................................................    1.95
050594..........................................................    3.76
050597..........................................................    2.92
050599..........................................................    1.65
050601..........................................................    2.91
050607..........................................................    1.80
050608..........................................................    1.91
050613..........................................................    0.75
050615..........................................................    2.77
050616..........................................................    2.60
050618..........................................................    1.32
050624..........................................................    2.96
050625..........................................................    2.60
050630..........................................................    2.33
050633..........................................................    2.71
050636..........................................................    3.18
050638..........................................................    1.47
050641..........................................................    2.70
050644..........................................................    2.58

[[Page 18791]]

 
050660..........................................................    1.47
050661..........................................................    1.54
050662..........................................................    1.05
050663..........................................................    2.23
050667..........................................................    1.07
050668..........................................................    1.18
050676..........................................................    0.91
050678..........................................................    3.03
050680..........................................................    1.56
050682..........................................................    1.29
050684..........................................................    2.07
050685..........................................................    2.62
050688..........................................................    1.75
050689..........................................................    2.53
050693..........................................................    2.19
050694..........................................................    2.25
050695..........................................................    1.71
050696..........................................................    3.37
050697..........................................................    4.88
050699..........................................................    2.68
050700..........................................................    2.52
050701..........................................................    2.18
050702..........................................................    0.93
050704..........................................................    2.10
050709..........................................................    2.93
050713..........................................................    3.24
052031..........................................................    1.13
053026..........................................................    1.62
053027..........................................................    1.03
053028..........................................................    1.25
053029..........................................................    1.40
053030..........................................................    0.97
053031..........................................................    1.25
053032..........................................................    0.83
053033..........................................................    1.14
053034..........................................................    1.85
053035..........................................................    1.41
053036..........................................................    1.39
053037..........................................................    1.42
053300..........................................................    1.47
053301..........................................................    2.09
053302..........................................................    1.70
053305..........................................................    1.00
054001..........................................................    1.55
054003..........................................................    2.23
054009..........................................................    1.56
054012..........................................................    1.60
054032..........................................................    1.55
054050..........................................................    1.85
054053..........................................................    1.66
054055..........................................................    1.32
054060..........................................................    1.55
054064..........................................................    1.32
054065..........................................................    1.53
054069..........................................................    1.55
054074..........................................................    1.55
054078..........................................................    2.06
054085..........................................................    1.55
054087..........................................................    1.55
054091..........................................................    1.82
054093..........................................................    2.49
054094..........................................................    1.59
054095..........................................................    1.55
054096..........................................................    1.58
054097..........................................................    1.57
054098..........................................................    1.32
054099..........................................................    1.69
054104..........................................................    2.67
054105..........................................................    1.55
054106..........................................................    1.56
054108..........................................................    1.45
054110..........................................................    1.55
054111..........................................................    1.55
054113..........................................................    1.55
054115..........................................................    1.55
054116..........................................................    1.57
054119..........................................................    1.55
054122..........................................................    1.05
054123..........................................................    1.58
054125..........................................................    1.83
054126..........................................................    1.55
054130..........................................................    1.61
054131..........................................................    1.85
054133..........................................................    0.72
060001..........................................................    3.12
060003..........................................................    3.01
060004..........................................................    1.51
060006..........................................................    2.24
060007..........................................................    1.59
060008..........................................................    2.16
060009..........................................................    2.35
060010..........................................................    2.53
060011..........................................................    1.32
060012..........................................................    1.94
060013..........................................................    1.91
060014..........................................................    2.56
060015..........................................................    1.84
060016..........................................................    2.15
060018..........................................................    2.30
060020..........................................................    2.29
060022..........................................................    1.85
060023..........................................................    2.62
060024..........................................................    1.62
060027..........................................................    2.23
060028..........................................................    2.77
060029..........................................................    1.10
060030..........................................................    2.93
060031..........................................................    2.37
060032..........................................................    2.92
060033..........................................................    1.69
060034..........................................................    2.06
060036..........................................................    1.88
060037..........................................................    1.48
060038..........................................................    1.46
060041..........................................................    0.99
060042..........................................................    1.65
060043..........................................................    1.29
060044..........................................................    2.43
060046..........................................................    3.04
060047..........................................................    0.95
060049..........................................................    2.79
060050..........................................................    2.00
060052..........................................................    1.79
060053..........................................................    1.78
060054..........................................................    2.64
060056..........................................................    1.10
060057..........................................................    2.11
060058..........................................................    1.34
060060..........................................................    1.27
060062..........................................................    1.52
060063..........................................................    0.78
060064..........................................................    3.29
060065..........................................................    2.34
060068..........................................................    1.25
060070..........................................................    1.32
060071..........................................................    2.19
060073..........................................................    1.33
060075..........................................................    2.68
060076..........................................................    1.96
060085..........................................................    1.17
060087..........................................................    2.10
060088..........................................................    1.53
060090..........................................................    1.60
060096..........................................................    2.09
060100..........................................................    2.06
060103..........................................................    4.46
060104..........................................................    2.40
060107..........................................................    1.34
062009..........................................................    0.80
062011..........................................................    2.22
063026..........................................................    1.58
063027..........................................................    1.58
063030..........................................................    2.31
063301..........................................................    1.51
063302..........................................................    1.41
064007..........................................................    1.55
064009..........................................................    1.39
064010..........................................................    1.61
064012..........................................................    1.52
064016..........................................................    2.18
064020..........................................................    1.55
070001..........................................................    2.88
070002..........................................................    2.63
070003..........................................................    2.19
070004..........................................................    2.36
070005..........................................................    2.09
070006..........................................................    2.48
070007..........................................................    2.92
070008..........................................................    2.12
070009..........................................................    2.79
070010..........................................................    2.68
070011..........................................................    2.12
070012..........................................................    2.27
070015..........................................................    2.25
070016..........................................................    2.15
070017..........................................................    2.56
070018..........................................................    2.28
070019..........................................................    2.96
070020..........................................................    2.24
070021..........................................................    2.61
070022..........................................................    2.69
070024..........................................................    2.52
070025..........................................................    3.27
070026..........................................................    2.20
070027..........................................................    2.35
070028..........................................................    2.28
070029..........................................................    2.48
070030..........................................................    2.60
070031..........................................................    2.23
070033..........................................................    2.12
070035..........................................................    2.48
070036..........................................................    2.07
070039..........................................................    1.17
072003..........................................................    1.05
072004..........................................................    0.87
072008..........................................................    1.85
073025..........................................................    1.16
074000..........................................................    1.50
074007..........................................................    1.55
074008..........................................................    1.78
080001..........................................................    3.31
080002..........................................................    2.32
080003..........................................................    2.90
080004..........................................................    2.55
080005..........................................................    2.95
080006..........................................................    2.52
080007..........................................................    2.26
083300..........................................................    3.78
084002..........................................................    1.67
090001..........................................................    3.61
090002..........................................................    1.92
090003..........................................................    1.81
090004..........................................................    2.59

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090006..........................................................    2.60
090007..........................................................    1.28
090008..........................................................    2.52
090010..........................................................    2.06
090011..........................................................    2.49
090015..........................................................    0.75
092002..........................................................    0.80
093025..........................................................    1.08
093300..........................................................    2.05
094004..........................................................    1.33
100001..........................................................    1.62
100002..........................................................    2.75
100004..........................................................    1.94
100006..........................................................    2.43
100007..........................................................    3.08
100008..........................................................    3.40
100009..........................................................    2.57
100010..........................................................    2.79
100012..........................................................    3.06
100014..........................................................    2.68
100015..........................................................    2.69
100017..........................................................    2.75
100018..........................................................    2.01
100019..........................................................    3.36
100020..........................................................    3.14
100022..........................................................    1.43
100023..........................................................    2.70
100024..........................................................    3.07
100025..........................................................    2.33
100026..........................................................    2.86
100027..........................................................    1.58
100028..........................................................    2.94
100029..........................................................    2.61
100030..........................................................    3.15
100032..........................................................    2.22
100034..........................................................    2.49
100035..........................................................    2.62
100038..........................................................    2.39
100039..........................................................    2.94
100040..........................................................    3.26
100043..........................................................    2.46
100044..........................................................    2.58
100045..........................................................    2.36
100046..........................................................    2.41
100047..........................................................    2.06
100048..........................................................    1.71
100049..........................................................    2.76
100050..........................................................    2.35
100051..........................................................    2.67
100052..........................................................    4.07
100053..........................................................    2.62
100054..........................................................    2.09
100055..........................................................    2.32
100056..........................................................    3.65
100057..........................................................    3.13
100060..........................................................    2.58
100061..........................................................    2.80
100062..........................................................    3.23
100063..........................................................    2.34
100067..........................................................    2.59
100068..........................................................    2.16
100069..........................................................    2.65
100070..........................................................    2.58
100071..........................................................    2.27
100072..........................................................    2.44
100073..........................................................    2.03
100075..........................................................    2.32
100076..........................................................    2.55
100077..........................................................    3.36
100078..........................................................    1.17
100079..........................................................    1.77
100080..........................................................    2.43
100081..........................................................    1.91
100082..........................................................    2.40
100084..........................................................    2.18
100085..........................................................    2.40
100086..........................................................    2.52
100087..........................................................    4.08
100088..........................................................    3.46
100090..........................................................    2.89
100093..........................................................    2.95
100098..........................................................    1.56
100099..........................................................    2.99
100102..........................................................    2.09
100103..........................................................    1.25
100105..........................................................    2.85
100106..........................................................    2.89
100107..........................................................    2.72
100108..........................................................    2.15
100109..........................................................    2.87
100110..........................................................    2.33
100112..........................................................    1.04
100113..........................................................    2.91
100114..........................................................    2.71
100117..........................................................    3.23
100118..........................................................    1.99
100121..........................................................    2.91
100122..........................................................    2.77
100124..........................................................    1.97
100125..........................................................    2.46
100126..........................................................    2.26
100127..........................................................    2.97
100128..........................................................    2.50
100129..........................................................    3.40
100130..........................................................    2.33
100131..........................................................    3.08
100132..........................................................    2.39
100134..........................................................    1.61
100135..........................................................    4.27
100137..........................................................    2.28
100138..........................................................    1.27
100139..........................................................    1.51
100140..........................................................    2.57
100142..........................................................    2.03
100144..........................................................    2.86
100145..........................................................    2.34
100146..........................................................    2.04
100147..........................................................    1.85
100150..........................................................    2.63
100151..........................................................    4.07
100154..........................................................    3.38
100156..........................................................    2.44
100157..........................................................    3.67
100159..........................................................    1.51
100160..........................................................    2.03
100161..........................................................    2.32
100162..........................................................    2.24
100165..........................................................    2.22
100167..........................................................    4.26
100168..........................................................    2.54
100169..........................................................    2.75
100170..........................................................    2.92
100172..........................................................    2.44
100173..........................................................    3.21
100174..........................................................    2.18
100175..........................................................    1.94
100176..........................................................    1.96
100177..........................................................    2.98
100179..........................................................    3.31
100180..........................................................    2.10
100181..........................................................    4.55
100183..........................................................    2.80
100187..........................................................    2.46
100189..........................................................    2.75
100191..........................................................    2.47
100199..........................................................    3.39
100200..........................................................    4.10
100203..........................................................    2.22
100204..........................................................    2.51
100206..........................................................    2.51
100208..........................................................    2.24
100209..........................................................    2.61
100210..........................................................    2.68
100211..........................................................    2.02
100212..........................................................    2.45
100213..........................................................    1.93
100217..........................................................    3.59
100220..........................................................    3.22
100221..........................................................    2.58
100222..........................................................    1.66
100223..........................................................    2.21
100224..........................................................    2.34
100225..........................................................    2.65
100226..........................................................    1.90
100228..........................................................    2.19
100229..........................................................    2.01
100230..........................................................    1.87
100231..........................................................    2.31
100232..........................................................    2.67
100234..........................................................    2.30
100235..........................................................    2.21
100236..........................................................    2.19
100237..........................................................    2.92
100238..........................................................    3.13
100240..........................................................    5.17
100241..........................................................    2.57
100242..........................................................    3.00
100243..........................................................    2.12
100244..........................................................    2.54
100246..........................................................    3.15
100248..........................................................    1.94
100249..........................................................    2.45
100252..........................................................    2.42
100253..........................................................    2.76
100254..........................................................    2.22
100255..........................................................    2.31
100256..........................................................    2.25
100258..........................................................    2.48
100259..........................................................    2.80
100260..........................................................    3.68
100262..........................................................    3.20
100263..........................................................    2.45
100264..........................................................    2.11
100265..........................................................    2.41
100266..........................................................    2.85
100267..........................................................    2.70
100268..........................................................    2.33
100269..........................................................    2.74
100270..........................................................    1.21
100271..........................................................    1.86
100275..........................................................    2.38
100276..........................................................    3.07
100277..........................................................    0.95
100279..........................................................    2.11
100280..........................................................    1.90
100281..........................................................    2.17
100282..........................................................    1.72
102009..........................................................    0.94
102013..........................................................    3.59
103026..........................................................    0.50
103027..........................................................    1.15
103028..........................................................    1.41
103030..........................................................    0.81

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103031..........................................................    1.52
103032..........................................................    1.73
103034..........................................................    1.36
103300..........................................................    7.02
103301..........................................................    2.56
104008..........................................................    1.72
104015..........................................................    1.55
104016..........................................................    1.53
104017..........................................................    1.55
104024..........................................................    1.75
104026..........................................................    1.55
104029..........................................................    1.55
104034..........................................................    1.56
104036..........................................................    1.58
104037..........................................................    1.55
104038..........................................................    1.68
104041..........................................................    1.81
104045..........................................................    1.69
104046..........................................................    1.55
104047..........................................................    1.55
104052..........................................................    1.56
104054..........................................................    1.57
104056..........................................................    1.54
104060..........................................................    1.43
110001..........................................................    2.73
110002..........................................................    1.75
110003..........................................................    2.69
110004..........................................................    2.62
110005..........................................................    2.65
110006..........................................................    3.33
110007..........................................................    2.64
110008..........................................................    2.44
110009..........................................................    1.15
110010..........................................................    3.09
110011..........................................................    2.39
110013..........................................................    1.55
110014..........................................................    1.70
110015..........................................................    1.76
110016..........................................................    3.17
110017..........................................................    1.28
110018..........................................................    2.22
110020..........................................................    3.19
110023..........................................................    2.44
110024..........................................................    3.80
110025..........................................................    2.85
110026..........................................................    1.76
110027..........................................................    1.62
110028..........................................................    2.89
110029..........................................................    2.10
110030..........................................................    3.04
110031..........................................................    2.55
110032..........................................................    2.72
110033..........................................................    2.97
110034..........................................................    1.43
110035..........................................................    2.93
110036..........................................................    2.93
110037..........................................................    1.63
110038..........................................................    2.20
110039..........................................................    2.96
110040..........................................................    2.05
110041..........................................................    2.04
110042..........................................................    3.56
110043..........................................................    3.18
110044..........................................................    2.66
110045..........................................................    2.47
110046..........................................................    2.26
110048..........................................................    1.63
110049..........................................................    1.30
110050..........................................................    1.78
110051..........................................................    1.91
110052..........................................................    1.04
110054..........................................................    2.16
110056..........................................................    1.26
110059..........................................................    2.38
110061..........................................................    1.25
110062..........................................................    0.97
110063..........................................................    1.50
110064..........................................................    2.05
110065..........................................................    1.13
110066..........................................................    2.56
110069..........................................................    2.55
110070..........................................................    1.84
110071..........................................................    1.29
110072..........................................................    1.55
110073..........................................................    2.16
110074..........................................................    2.78
110075..........................................................    2.39
110076..........................................................    2.79
110078..........................................................    2.95
110079..........................................................    1.23
110080..........................................................    1.97
110082..........................................................    3.62
110083..........................................................    3.30
110086..........................................................    1.97
110087..........................................................    2.75
110088..........................................................    0.94
110089..........................................................    2.39
110091..........................................................    3.09
110092..........................................................    1.71
110093..........................................................    1.48
110094..........................................................    1.01
110095..........................................................    2.97
110096..........................................................    1.48
110097..........................................................    1.32
110098..........................................................    1.77
110100..........................................................    1.27
110101..........................................................    1.56
110103..........................................................    1.28
110104..........................................................    2.20
110105..........................................................    2.49
110107..........................................................    2.05
110108..........................................................    0.81
110109..........................................................    1.61
110111..........................................................    1.68
110112..........................................................    1.52
110113..........................................................    1.41
110114..........................................................    1.60
110115..........................................................    2.62
110118..........................................................    0.76
110120..........................................................    1.15
110121..........................................................    4.84
110122..........................................................    2.79
110124..........................................................    2.19
110125..........................................................    3.21
110127..........................................................    1.59
110128..........................................................    2.41
110129..........................................................    2.94
110130..........................................................    1.82
110132..........................................................    2.04
110134..........................................................    1.23
110135..........................................................    4.68
110140..........................................................    2.41
110141..........................................................    1.22
110142..........................................................    1.50
110143..........................................................    3.07
110144..........................................................    1.92
110146..........................................................    1.72
110149..........................................................    1.57
110150..........................................................    2.56
110152..........................................................    1.77
110153..........................................................    2.02
110155..........................................................    1.35
110156..........................................................    1.52
110161..........................................................    3.52
110163..........................................................    3.22
110164..........................................................    2.47
110165..........................................................    2.62
110166..........................................................    2.82
110168..........................................................    2.47
110169..........................................................    7.21
110171..........................................................    2.37
110172..........................................................    3.25
110174..........................................................    1.87
110176..........................................................    2.69
110177..........................................................    2.47
110178..........................................................    8.34
110179..........................................................    2.22
110181..........................................................    1.14
110183..........................................................    2.32
110184..........................................................    2.16
110185..........................................................    1.45
110186..........................................................    3.32
110187..........................................................    2.45
110188..........................................................    2.91
110189..........................................................    1.99
110190..........................................................    1.73
110191..........................................................    3.54
110192..........................................................    2.42
110193..........................................................    3.14
110194..........................................................    1.47
110195..........................................................    1.20
110198..........................................................    2.98
110200..........................................................    4.48
110201..........................................................    2.34
110203..........................................................    1.35
110205..........................................................    1.77
110207..........................................................    1.28
110208..........................................................    1.59
110211..........................................................    1.00
110212..........................................................    1.99
112000..........................................................    1.04
112003..........................................................    1.69
112004..........................................................    0.79
113026..........................................................    1.40
113027..........................................................    0.40
113300..........................................................    2.36
114000..........................................................    1.55
114003..........................................................    1.55
114008..........................................................    1.55
114010..........................................................    1.67
114016..........................................................    1.54
114017..........................................................    1.61
114022..........................................................    1.55
114023..........................................................    1.59
114024..........................................................    1.57
114027..........................................................    1.55
114030..........................................................    1.67
114032..........................................................    1.55
114033..........................................................    1.54
114034..........................................................    1.55
120001..........................................................    2.95
120002..........................................................    2.93
120003..........................................................    2.15
120004..........................................................    2.18
120005..........................................................    3.21
120006..........................................................    2.09
120007..........................................................    3.17
120009..........................................................    1.26
120010..........................................................    2.69
120012..........................................................    1.32
120014..........................................................    2.83
120018..........................................................    0.71
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120022..........................................................    1.31
120024..........................................................    0.86
120025..........................................................    0.77
120026..........................................................    3.08
120027..........................................................    1.96
120028..........................................................    3.33
123025..........................................................    1.65
123300..........................................................    1.76
124001..........................................................    1.53
130001..........................................................    1.60
130002..........................................................    3.18
130003..........................................................    3.14
130005..........................................................    3.43
130006..........................................................    2.12
130007..........................................................    3.65
130008..........................................................    1.94
130009..........................................................    2.56
130010..........................................................    0.93
130011..........................................................    2.46
130012..........................................................    1.61
130013..........................................................    2.69
130014..........................................................    3.03
130015..........................................................    1.20
130016..........................................................    2.06
130017..........................................................    1.93
130018..........................................................    3.31
130019..........................................................    1.83
130021..........................................................    1.09
130022..........................................................    2.48
130024..........................................................    2.89
130025..........................................................    1.91
130026..........................................................    3.68
130027..........................................................    1.60
130028..........................................................    2.30
130029..........................................................    2.10
130030..........................................................    0.89
130031..........................................................    2.34
130034..........................................................    1.61
130035..........................................................    2.08
130036..........................................................    3.90
130037..........................................................    1.90
130043..........................................................    1.68
130044..........................................................    1.57
130045..........................................................    1.65
130048..........................................................    1.30
130049..........................................................    2.59
130054..........................................................    0.71
130056..........................................................    0.76
130060..........................................................    2.73
130061..........................................................    1.55
133025..........................................................    1.47
134002..........................................................    1.55
134009..........................................................    1.60
140001..........................................................    2.21
140002..........................................................    2.35
140003..........................................................    1.61
140005..........................................................    1.45
140007..........................................................    2.57
140008..........................................................    2.49
140010..........................................................    2.35
140011..........................................................    1.78
140012..........................................................    2.22
140013..........................................................    2.76
140014..........................................................    2.41
140015..........................................................    2.82
140016..........................................................    1.95
140018..........................................................    1.94
140019..........................................................    1.65
140024..........................................................    1.81
140025..........................................................    1.53
140026..........................................................    2.30
140027..........................................................    1.84
140029..........................................................    2.17
140030..........................................................    2.97
140031..........................................................    1.64
140032..........................................................    3.04
140033..........................................................    2.61
140034..........................................................    2.39
140035..........................................................    1.66
140036..........................................................    2.69
140037..........................................................    1.44
140038..........................................................    1.59
140040..........................................................    2.32
140041..........................................................    2.20
140042..........................................................    1.64
140043..........................................................    2.70
140045..........................................................    1.65
140046..........................................................    2.43
140047..........................................................    1.40
140048..........................................................    2.18
140049..........................................................    2.02
140051..........................................................    2.56
140052..........................................................    2.79
140053..........................................................    3.25
140054..........................................................    2.63
140055..........................................................    1.58
140058..........................................................    2.30
140059..........................................................    2.50
140061..........................................................    1.71
140062..........................................................    2.16
140063..........................................................    2.29
140064..........................................................    3.76
140065..........................................................    2.44
140066..........................................................    2.17
140067..........................................................    2.63
140068..........................................................    1.77
140069..........................................................    1.89
140070..........................................................    2.00
140074..........................................................    1.21
140075..........................................................    2.41
140077..........................................................    1.66
140079..........................................................    2.44
140080..........................................................    2.19
140081..........................................................    1.66
140082..........................................................    1.94
140083..........................................................    1.45
140084..........................................................    2.94
140086..........................................................    2.09
140087..........................................................    2.41
140088..........................................................    1.65
140089..........................................................    2.96
140090..........................................................    2.57
140091..........................................................    5.51
140093..........................................................    2.71
140094..........................................................    2.24
140095..........................................................    1.93
140097..........................................................    1.37
140100..........................................................    2.74
140101..........................................................    2.02
140102..........................................................    1.99
140103..........................................................    1.62
140105..........................................................    2.70
140107..........................................................    1.67
140108..........................................................    2.82
140109..........................................................    1.69
140110..........................................................    2.28
140112..........................................................    1.85
140113..........................................................    2.49
140114..........................................................    2.42
140115..........................................................    2.07
140116..........................................................    2.63
140117..........................................................    2.67
140118..........................................................    2.83
140119..........................................................    2.96
140120..........................................................    2.46
140121..........................................................    2.64
140122..........................................................    2.48
140125..........................................................    2.18
140127..........................................................    4.46
140128..........................................................    1.79
140129..........................................................    2.14
140130..........................................................    2.50
140132..........................................................    2.85
140133..........................................................    2.17
140135..........................................................    2.78
140137..........................................................    1.67
140138..........................................................    2.05
140139..........................................................    1.69
140140..........................................................    1.76
140141..........................................................    2.22
140143..........................................................    2.24
140144..........................................................    1.68
140145..........................................................    2.04
140146..........................................................    1.62
140147..........................................................    2.31
140148..........................................................    2.95
140150..........................................................    1.61
140151..........................................................    1.34
140155..........................................................    2.43
140158..........................................................    1.73
140160..........................................................    3.21
140161..........................................................    2.48
140162..........................................................    2.30
140164..........................................................    2.77
140165..........................................................    2.25
140166..........................................................    1.91
140167..........................................................    2.59
140168..........................................................    1.97
140170..........................................................    1.62
140171..........................................................    1.37
140172..........................................................    1.61
140173..........................................................    1.23
140174..........................................................    2.18
140176..........................................................    2.67
140177..........................................................    2.11
140179..........................................................    2.60
140180..........................................................    2.01
140181..........................................................    1.95
140182..........................................................    2.00
140184..........................................................    1.93
140185..........................................................    2.35
140186..........................................................    2.10
140187..........................................................    2.10
140188..........................................................    1.37
140189..........................................................    2.21
140190..........................................................    1.82
140191..........................................................    2.08
140193..........................................................    2.51
140197..........................................................    1.99
140199..........................................................    1.78
140200..........................................................    1.94
140202..........................................................    2.55
140203..........................................................    2.43
140205..........................................................    4.24
140206..........................................................    2.22
140207..........................................................    2.12
140208..........................................................    2.47
140209..........................................................    2.71
140210..........................................................    2.15
140211..........................................................    2.35
140212..........................................................    1.38
140213..........................................................    2.63
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140276..........................................................    2.47
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140281..........................................................    2.61
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140290..........................................................    3.26
140291..........................................................    2.60
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140294..........................................................    2.57
140297..........................................................    1.61
140300..........................................................    1.25
142006..........................................................    1.37
143025..........................................................    1.33
143026..........................................................    1.34
143027..........................................................    1.50
143300..........................................................    1.82
143301..........................................................    3.19
144005..........................................................    1.64
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144026..........................................................    1.55
144031..........................................................    2.28
144033..........................................................    1.55
144034..........................................................    1.54
144036..........................................................    1.57
150001..........................................................    2.13
150002..........................................................    2.14
150003..........................................................    2.39
150004..........................................................    2.20
150005..........................................................    2.41
150006..........................................................    2.80
150007..........................................................    2.44
150008..........................................................    2.61
150009..........................................................    2.79
150011..........................................................    1.92
150012..........................................................    2.78
150013..........................................................    2.18
150014..........................................................    2.23
150015..........................................................    2.76
150018..........................................................    3.00
150019..........................................................    2.19
150020..........................................................    2.70
150022..........................................................    2.63
150023..........................................................    2.63
150024..........................................................    1.31
150026..........................................................    2.75
150027..........................................................    1.74
150029..........................................................    3.77
150030..........................................................    2.56
150031..........................................................    1.68
150033..........................................................    2.41
150034..........................................................    2.79
150036..........................................................    1.92
150037..........................................................    2.58
150038..........................................................    1.73
150039..........................................................    2.16
150042..........................................................    2.75
150043..........................................................    1.93
150044..........................................................    2.38
150045..........................................................    1.67
150046..........................................................    2.72
150047..........................................................    1.89
150049..........................................................    1.94
150050..........................................................    1.76
150051..........................................................    2.17
150052..........................................................    2.37
150053..........................................................    1.99
150054..........................................................    1.72
150057..........................................................    2.23
150058..........................................................    3.07
150059..........................................................    1.88
150060..........................................................    1.65
150061..........................................................    2.02
150062..........................................................    2.18
150063..........................................................    1.49
150064..........................................................    2.03
150065..........................................................    2.37
150066..........................................................    1.54
150067..........................................................    2.12
150069..........................................................    2.68
150070..........................................................    1.93
150071..........................................................    1.58
150072..........................................................    1.97
150073..........................................................    1.99
150074..........................................................    2.46
150075..........................................................    2.12
150076..........................................................    2.07
150078..........................................................    1.80
150079..........................................................    1.71
150084..........................................................    3.60
150086..........................................................    2.32
150089..........................................................    2.57
150090..........................................................    1.89
150091..........................................................    1.90
150092..........................................................    1.54
150094..........................................................    2.25
150095..........................................................    2.28
150096..........................................................    2.12
150097..........................................................    2.03
150098..........................................................    1.75
150099..........................................................    2.46
150100..........................................................    2.70
150101..........................................................    2.03
150102..........................................................    1.68
150103..........................................................    1.32
150104..........................................................    2.03
150105..........................................................    1.94
150106..........................................................    1.93
150109..........................................................    3.35
150110..........................................................    1.52
150111..........................................................    1.74
150112..........................................................    2.58
150114..........................................................    1.61
150115..........................................................    2.82
150122..........................................................    2.07
150123..........................................................    1.29
150125..........................................................    2.42
150126..........................................................    2.68
150127..........................................................    1.22
150128..........................................................    2.62
150129..........................................................    2.02
150130..........................................................    1.39
150132..........................................................    2.65
150133..........................................................    2.30
150134..........................................................    1.80
150136..........................................................    2.61
152007..........................................................    0.59
152009..........................................................    0.55
153025..........................................................    2.03
153027..........................................................    2.31
153029..........................................................    1.35
153030..........................................................    1.78
154009..........................................................    1.69
154011..........................................................    1.85
154013..........................................................    1.51
154014..........................................................    1.44
154026..........................................................    1.65
154027..........................................................    1.73
154028..........................................................    1.37
154031..........................................................    1.62
154032..........................................................    1.79
154035..........................................................    1.59
154036..........................................................    1.53
154037..........................................................    1.66
154038..........................................................    1.71
154042..........................................................    1.66
160001..........................................................    3.30
160002..........................................................    2.13
160003..........................................................    1.84
160005..........................................................    2.00
160007..........................................................    1.19
160008..........................................................    2.28
160009..........................................................    2.03
160012..........................................................    1.62
160013..........................................................    3.05
160014..........................................................    1.71
160016..........................................................    3.06
160018..........................................................    1.55
160020..........................................................    1.65
160021..........................................................    2.56
160023..........................................................    1.68
160024..........................................................    2.78
160026..........................................................    1.91
160027..........................................................    1.96
160028..........................................................    2.46
160029..........................................................    3.39
160030..........................................................    3.47
160031..........................................................    1.59
160032..........................................................    2.35
160033..........................................................    3.02
160034..........................................................    2.31
160035..........................................................    0.98
160036..........................................................    2.10
160037..........................................................    2.01
160039..........................................................    1.65
160040..........................................................    3.64
160041..........................................................    1.49
160043..........................................................    1.68
160044..........................................................    2.29
160045..........................................................    2.87
160046..........................................................    2.22
160047..........................................................    2.33
160048..........................................................    1.72
160049..........................................................    1.08
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160056..........................................................    1.68
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160060..........................................................    1.89
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160062..........................................................    1.74
160063..........................................................    1.61
160064..........................................................    3.14
160065..........................................................    2.01
160066..........................................................    2.40
160067..........................................................    2.42
160068..........................................................    1.88
160069..........................................................    3.27
160070..........................................................    1.70
160072..........................................................    2.23
160073..........................................................    1.35
160074..........................................................    1.46
160075..........................................................    1.79
160076..........................................................    2.64
160077..........................................................    1.83
160079..........................................................    3.44
160080..........................................................    2.72
160081..........................................................    1.92
160082..........................................................    3.36
160083..........................................................    2.89
160085..........................................................    1.61
160086..........................................................    1.33
160088..........................................................    1.65
160089..........................................................    2.80
160090..........................................................    1.59
160091..........................................................    1.75
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160093..........................................................    1.40
160094..........................................................    2.93
160095..........................................................    1.16
160097..........................................................    2.12
160098..........................................................    1.38
160099..........................................................    1.74
160101..........................................................    1.22
160102..........................................................    2.85
160103..........................................................    1.30
160104..........................................................    2.24
160106..........................................................    3.18
160107..........................................................    1.49
160108..........................................................    2.35
160109..........................................................    1.62
160110..........................................................    2.28
160111..........................................................    1.64
160112..........................................................    2.48
160113..........................................................    1.34
160114..........................................................    2.75
160115..........................................................    2.45
160116..........................................................    1.98
160117..........................................................    2.86
160118..........................................................    1.80
160120..........................................................    0.95
160122..........................................................    2.30
160124..........................................................    2.14
160126..........................................................    1.82
160129..........................................................    2.98
160130..........................................................    1.42
160131..........................................................    1.61
160134..........................................................    1.13
160135..........................................................    1.78
160138..........................................................    1.34
160140..........................................................    1.69
160142..........................................................    1.41
160143..........................................................    1.92
160145..........................................................    1.64
160146..........................................................    2.96
160147..........................................................    1.66
160151..........................................................    1.39
160152..........................................................    1.41
160153..........................................................    2.76
164002..........................................................    4.09
170001..........................................................    3.29
170004..........................................................    1.61
170006..........................................................    2.01
170008..........................................................    2.18
170009..........................................................    2.47
170010..........................................................    2.83
170012..........................................................    3.18
170013..........................................................    3.53
170014..........................................................    1.86
170015..........................................................    2.47
170016..........................................................    2.73
170017..........................................................    2.59
170018..........................................................    1.74
170019..........................................................    3.41
170020..........................................................    3.81
170022..........................................................    2.57
170023..........................................................    5.62
170024..........................................................    2.36
170025..........................................................    2.06
170026..........................................................    3.15
170027..........................................................    3.18
170030..........................................................    1.56
170031..........................................................    2.04
170032..........................................................    1.63
170033..........................................................    2.67
170034..........................................................    1.90
170035..........................................................    1.52
170036..........................................................    1.04
170037..........................................................    3.34
170038..........................................................    1.02
170039..........................................................    1.64
170041..........................................................    1.43
170043..........................................................    1.17
170044..........................................................    1.58
170045..........................................................    1.74
170049..........................................................    3.00
170051..........................................................    1.06
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170054..........................................................    1.71
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170056..........................................................    1.04
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170060..........................................................    2.49
170061..........................................................    2.07
170063..........................................................    1.28
170064..........................................................    1.61
170066..........................................................    1.17
170067..........................................................    2.08
170068..........................................................    3.51
170070..........................................................    2.26
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170075..........................................................    1.03
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170077..........................................................    1.94
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170082..........................................................    2.08
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170085..........................................................    1.62
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170100..........................................................    0.80
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170103..........................................................    4.48
170104..........................................................    3.66
170105..........................................................    2.02
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170110..........................................................    1.70
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170113..........................................................    2.29
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170115..........................................................    1.89
170116..........................................................    2.91
170117..........................................................    0.91
170119..........................................................    1.37
170120..........................................................    3.12
170122..........................................................    2.74
170123..........................................................    3.90
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170126..........................................................    1.20
170128..........................................................    1.96
170131..........................................................    1.93
170133..........................................................    3.64
170134..........................................................    1.84
170137..........................................................    2.80
170139..........................................................    0.72
170142..........................................................    3.08
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170146..........................................................    3.03
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170150..........................................................    3.35
170151..........................................................    1.95
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170160..........................................................    1.49
170164..........................................................    1.69
170166..........................................................    1.42
170171..........................................................    1.39
170175..........................................................    4.34
170176..........................................................    2.71
170182..........................................................    3.37
170183..........................................................    9.35
171304..........................................................    0.79
171305..........................................................    0.38
171310..........................................................    0.32
172004..........................................................    0.68
173025..........................................................    1.55
173027..........................................................    2.17
173028..........................................................    1.16
174003..........................................................    1.35
174006..........................................................    0.83
174012..........................................................    1.55
174014..........................................................    1.79
174016..........................................................    1.46
174018..........................................................    1.56
180001..........................................................    2.22
180004..........................................................    1.97
180005..........................................................    2.23
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180007..........................................................    2.91
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180012..........................................................    2.60
180013..........................................................    2.86
180014..........................................................    3.17
180015..........................................................    1.74
180016..........................................................    2.32
180017..........................................................    2.53
180018..........................................................    2.71
180019..........................................................    2.90
180021..........................................................    1.92
180023..........................................................    1.82
180024..........................................................    2.06
180025..........................................................    2.13
180026..........................................................    2.07
180027..........................................................    3.08
180030..........................................................    1.42
180031..........................................................    1.58
180032..........................................................    1.34
180033..........................................................    1.83
180034..........................................................    1.97
180035..........................................................    2.67
180036..........................................................    2.73
180037..........................................................    2.60
180038..........................................................    2.25
180040..........................................................    3.61
180041..........................................................    2.44
180042..........................................................    1.92
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180044..........................................................    2.50
180045..........................................................    2.60
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180047..........................................................    1.66
180048..........................................................    2.39
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180058..........................................................    1.42
180059..........................................................    1.54
180060..........................................................    0.81
180063..........................................................    1.48
180064..........................................................    2.22
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180066..........................................................    2.49
180067..........................................................    2.63
180070..........................................................    1.79
180072..........................................................    1.70
180075..........................................................    1.82
180078..........................................................    2.22
180079..........................................................    1.77
180080..........................................................    3.22
180087..........................................................    2.94
180088..........................................................    3.54
180092..........................................................    2.19
180093..........................................................    2.72
180094..........................................................    1.54
180095..........................................................    1.97
180099..........................................................    1.75
180101..........................................................    1.73
180102..........................................................    2.84
180103..........................................................    2.88
180104..........................................................    2.58
180105..........................................................    1.70
180106..........................................................    1.50
180108..........................................................    1.47
180115..........................................................    1.63
180116..........................................................    2.41
180117..........................................................    2.43
180118..........................................................    1.53
180120..........................................................    1.55
180121..........................................................    2.48
180122..........................................................    1.68
180123..........................................................    2.77
180124..........................................................    3.14
180126..........................................................    1.44
180127..........................................................    2.80
180128..........................................................    1.97
180129..........................................................    1.25
180130..........................................................    2.83
180132..........................................................    2.66
180133..........................................................    2.33
180134..........................................................    1.92
180136..........................................................    4.43
180137..........................................................    1.76
180138..........................................................    2.11
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180140..........................................................    1.19
180141..........................................................    2.02
182001..........................................................    2.05
183027..........................................................    1.32
183028..........................................................    1.51
184000..........................................................    1.97
184002..........................................................    0.78
184007..........................................................    1.55
184008..........................................................    1.66
184009..........................................................    1.64
184011..........................................................    1.81
184015..........................................................    0.87
190003..........................................................    2.15
190004..........................................................    2.45
190007..........................................................    1.87
190008..........................................................    2.74
190013..........................................................    1.83
190014..........................................................    2.81
190015..........................................................    2.42
190017..........................................................    2.18
190018..........................................................    2.35
190019..........................................................    1.89
190020..........................................................    2.64
190025..........................................................    2.15
190026..........................................................    2.24
190027..........................................................    2.06
190029..........................................................    2.05
190033..........................................................    1.17
190034..........................................................    2.07
190036..........................................................    2.73
190037..........................................................    1.00
190039..........................................................    2.12
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190041..........................................................    2.55
190043..........................................................    1.14
190044..........................................................    2.08
190045..........................................................    2.22
190046..........................................................    1.93
190048..........................................................    2.14
190049..........................................................    2.69
190050..........................................................    2.08
190053..........................................................    1.57
190054..........................................................    2.26
190059..........................................................    1.78
190060..........................................................    2.85
190064..........................................................    4.30
190065..........................................................    2.35
190071..........................................................    1.49
190077..........................................................    0.88
190078..........................................................    3.17
190079..........................................................    2.06
190081..........................................................    1.07
190083..........................................................    1.30
190086..........................................................    2.84
190088..........................................................    2.36
190089..........................................................    1.77
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190092..........................................................    1.88
190095..........................................................    2.00
190098..........................................................    1.55
190099..........................................................    1.42
190102..........................................................    3.14
190103..........................................................    0.98
190106..........................................................    1.71
190109..........................................................    2.29
190110..........................................................    1.51
190111..........................................................    3.47
190112..........................................................    2.78
190113..........................................................    3.09
190114..........................................................    1.72
190115..........................................................    4.85
190116..........................................................    2.27
190118..........................................................    1.80
190120..........................................................    1.57
190124..........................................................    2.30
190125..........................................................    2.21
190128..........................................................    2.36
190130..........................................................    1.76
190131..........................................................    1.51
190133..........................................................    1.54
190134..........................................................    1.16
190135..........................................................    2.45
190136..........................................................    1.05
190138..........................................................    7.09
190140..........................................................    1.77
190142..........................................................    1.06
190144..........................................................    2.68
190145..........................................................    1.54
190146..........................................................    1.99
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190148..........................................................    1.16
190149..........................................................    1.71
190151..........................................................    1.90
190152..........................................................    2.85
190155..........................................................    1.50
190156..........................................................    0.90
190158..........................................................    2.36
190160..........................................................    2.76
190162..........................................................    1.68
190164..........................................................    2.43
190167..........................................................    1.96
190170..........................................................    1.02
190173..........................................................    2.12
190175..........................................................    2.53
190176..........................................................    1.64
190177..........................................................    2.46
190178..........................................................    1.25
190182..........................................................    2.24
190184..........................................................    1.12
190185..........................................................    2.75
190186..........................................................    1.25
190189..........................................................    0.98
190190..........................................................    1.48
190191..........................................................    2.21
190196..........................................................    2.45
190197..........................................................    2.63
190200..........................................................    2.63
190201..........................................................    2.19
190202..........................................................    1.98
190203..........................................................    2.82
190204..........................................................    2.44
190205..........................................................    2.47
190206..........................................................    2.06
190207..........................................................    3.10
190208..........................................................    1.18
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190231..........................................................    4.55
190236..........................................................    3.56
192004..........................................................    1.30
192006..........................................................    1.78
192016..........................................................    3.50
192020..........................................................    0.79
193027..........................................................    1.77
193028..........................................................    1.84
193034..........................................................    1.22
193038..........................................................    1.62
193041..........................................................    0.89
193044..........................................................    2.62
193300..........................................................    1.52
194000..........................................................    3.15
194004..........................................................    1.32
194014..........................................................    1.53
194019..........................................................    1.57
194022..........................................................    1.32
194023..........................................................    1.52
194024..........................................................    1.40
194027..........................................................    1.56
194031..........................................................    1.63
194036..........................................................    1.47
194044..........................................................    1.54
194058..........................................................    1.55
200001..........................................................    2.71
200002..........................................................    2.25
200003..........................................................    1.96
200006..........................................................    1.43
200007..........................................................    1.64
200008..........................................................    2.14
200009..........................................................    2.23
200012..........................................................    1.69
200013..........................................................    2.05
200015..........................................................    2.19
200016..........................................................    1.92
200017..........................................................    2.72
200018..........................................................    2.23
200019..........................................................    2.23
200020..........................................................    2.32
200021..........................................................    2.52
200023..........................................................    1.08
200024..........................................................    2.50
200025..........................................................    2.47
200026..........................................................    1.83
200027..........................................................    1.77
200028..........................................................    1.83
200031..........................................................    1.84
200032..........................................................    1.99
200033..........................................................    2.24
200034..........................................................    2.74
200037..........................................................    1.95
200038..........................................................    2.48
200039..........................................................    2.55
200040..........................................................    2.89
200041..........................................................    2.42
200043..........................................................    1.29
200050..........................................................    2.80
200051..........................................................    2.73
200052..........................................................    1.79
200055..........................................................    1.47
200062..........................................................    1.46
200063..........................................................    2.52
200066..........................................................    2.16
204005..........................................................    1.68
204006..........................................................    1.54
220001..........................................................    2.29
220003..........................................................    2.21
220004..........................................................    2.30
220006..........................................................    2.26
220008..........................................................    2.19
220010..........................................................    2.68
220011..........................................................    1.67
220015..........................................................    2.19
220016..........................................................    2.31
220017..........................................................    2.13
220019..........................................................    2.43
220020..........................................................    1.82
220021..........................................................    2.13
220023..........................................................    2.01
220024..........................................................    2.35
220025..........................................................    1.85
220028..........................................................    2.02
220029..........................................................    2.15
220030..........................................................    1.57
220031..........................................................    1.87
220033..........................................................    2.15
220035..........................................................    2.37
220038..........................................................    2.07
220041..........................................................    2.29
220042..........................................................    2.16
220046..........................................................    2.57
220049..........................................................    2.46
220050..........................................................    2.20
220051..........................................................    2.52
220052..........................................................    2.08
220053..........................................................    2.05
220055..........................................................    2.53
220057..........................................................    2.30
220058..........................................................    2.07
220060..........................................................    2.36
220062..........................................................    1.78
220063..........................................................    2.16
220064..........................................................    2.33
220065..........................................................    1.92
220066..........................................................    2.62
220067..........................................................    2.39
220068..........................................................    1.42
220070..........................................................    2.08
220071..........................................................    1.88
220073..........................................................    2.06
220074..........................................................    2.06
220075..........................................................    2.83
220076..........................................................    1.93
220077..........................................................    2.11
220079..........................................................    1.89
220080..........................................................    2.09
220081..........................................................    1.92
220082..........................................................    2.28
220083..........................................................    1.87
220084..........................................................    2.57
220086..........................................................    1.93
220088..........................................................    2.06
220089..........................................................    2.12
220090..........................................................    2.05
220092..........................................................    2.22
220094..........................................................    2.04
220095..........................................................    1.92
220098..........................................................    2.29
220100..........................................................    1.96
220101..........................................................    2.23
220104..........................................................    1.44
220105..........................................................    2.21
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220107..........................................................    2.34
220108..........................................................    2.11
220111..........................................................    2.34
220116..........................................................    1.72
220119..........................................................    1.92
220123..........................................................    1.81
220126..........................................................    2.32
220128..........................................................    1.99
220135..........................................................    2.20
220162..........................................................    1.56
220163..........................................................    1.59
220171..........................................................    1.62
222000..........................................................    1.54
222002..........................................................    1.04
222006..........................................................    1.10
222008..........................................................    0.98
222024..........................................................    2.57
222026..........................................................    1.01
222027..........................................................    1.01
222029..........................................................    1.24
222035..........................................................    1.30
222041..........................................................    0.45
222043..........................................................    1.10
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223028..........................................................    1.62
223029..........................................................    1.05
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223032..........................................................    1.26
223302..........................................................    1.99
224007..........................................................    1.75
224018..........................................................    1.64
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224022..........................................................    2.67
224034..........................................................    1.57
224035..........................................................    1.31
230001..........................................................    1.98
230002..........................................................    3.04
230003..........................................................    1.99
230004..........................................................    2.85
230005..........................................................    2.32
230006..........................................................    2.20
230007..........................................................    2.85
230012..........................................................    1.22
230013..........................................................    2.28
230015..........................................................    2.20
230017..........................................................    2.90
230019..........................................................    3.09
230020..........................................................    3.32
230021..........................................................    3.02
230022..........................................................    2.25
230024..........................................................    2.94
230027..........................................................    1.97
230029..........................................................    2.37
230030..........................................................    2.80
230031..........................................................    2.57
230032..........................................................    3.42
230034..........................................................    2.13
230035..........................................................    2.21
230036..........................................................    2.62
230037..........................................................    2.46
230038..........................................................    2.97
230040..........................................................    2.66
230041..........................................................    2.56
230042..........................................................    2.04
230046..........................................................    2.04
230047..........................................................    3.03
230053..........................................................    1.46
230054..........................................................    2.58
230055..........................................................    2.07
230056..........................................................    1.77
230058..........................................................    2.77
230059..........................................................    3.12
230060..........................................................    2.39
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230070..........................................................    3.47
230071..........................................................   13.46
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230075..........................................................    2.74
230076..........................................................    4.83
230077..........................................................    3.51
230078..........................................................    2.17
230080..........................................................    3.55
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230085..........................................................    2.65
230086..........................................................    1.79
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230095..........................................................    2.79
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230100..........................................................    1.66
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230106..........................................................    1.97
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230110..........................................................    2.55
230111..........................................................    1.83
230113..........................................................    1.20
230114..........................................................    7.32
230115..........................................................    1.87
230116..........................................................    2.04
230117..........................................................    2.64
230118..........................................................    2.16
230119..........................................................    2.20
230120..........................................................    2.77
230121..........................................................    2.57
230122..........................................................    3.37
230124..........................................................    2.26
230125..........................................................    1.91
230128..........................................................    3.39
230130..........................................................    2.88
230132..........................................................    2.37
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230135..........................................................    2.66
230137..........................................................    2.40
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230142..........................................................    2.53
230143..........................................................    2.75
230144..........................................................    2.44
230145..........................................................    2.35
230146..........................................................    2.11
230147..........................................................    1.91
230149..........................................................    1.62
230151..........................................................    2.11
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230154..........................................................    1.52
230155..........................................................    1.61
230156..........................................................    2.46
230157..........................................................    2.73
230159..........................................................    2.74
230162..........................................................    1.04
230165..........................................................    3.20
230167..........................................................    2.97
230169..........................................................    2.72
230171..........................................................    1.61
230172..........................................................    1.86
230174..........................................................    2.13
230175..........................................................    1.55
230176..........................................................    2.96
230178..........................................................    1.91
230180..........................................................    2.02
230184..........................................................    5.45
230186..........................................................    1.92
230188..........................................................    2.38
230189..........................................................    1.41
230190..........................................................    1.28
230191..........................................................    2.01
230193..........................................................    2.22
230194..........................................................    1.22
230195..........................................................    2.84
230197..........................................................    3.63
230199..........................................................    2.25
230201..........................................................    2.58
230204..........................................................    2.72
230205..........................................................    2.62
230207..........................................................    2.22
230208..........................................................    2.41
230211..........................................................    0.91
230212..........................................................    2.15
230213..........................................................    1.35
230216..........................................................    2.08
230217..........................................................    2.66
230219..........................................................    2.46
230221..........................................................    2.13
230222..........................................................    2.66
230223..........................................................    2.86
230227..........................................................    2.69
230230..........................................................    2.88
230232..........................................................    1.16
230235..........................................................    2.24
230236..........................................................    2.79
230239..........................................................    2.40
230241..........................................................    2.58
230244..........................................................    2.53
230253..........................................................    2.64
230254..........................................................    2.61
230257..........................................................    5.56
230259..........................................................    2.83
230264..........................................................    3.02
230269..........................................................    2.85
230270..........................................................    3.10
230273..........................................................    1.95
230275..........................................................    1.90
230276..........................................................    1.34
230277..........................................................    2.81
230278..........................................................    1.84
230279..........................................................    1.59
230280..........................................................    2.00
233025..........................................................    1.26
233026..........................................................    1.09
233027..........................................................    1.24
233300..........................................................    3.39
234006..........................................................    1.63
234011..........................................................    1.71
234029..........................................................    1.46
234030..........................................................    1.64
240001..........................................................    3.26
240002..........................................................    2.84
240004..........................................................    1.30
240005..........................................................    1.12
240006..........................................................    2.89
240007..........................................................    2.92
240008..........................................................    2.88
240009..........................................................    1.53
240010..........................................................    3.69
240011..........................................................    2.58
240013..........................................................    2.49
240014..........................................................    2.65
240016..........................................................    3.00
240017..........................................................    3.88
240018..........................................................    3.20
240019..........................................................    2.95
240020..........................................................    2.08
240021..........................................................    1.94
240022..........................................................    2.29
240023..........................................................    2.46
240025..........................................................    2.01
240027..........................................................    2.68
240028..........................................................    2.16
240029..........................................................    2.97
240030..........................................................    3.11
240031..........................................................    2.26
240036..........................................................    2.44
240037..........................................................    1.93
240038..........................................................    3.13
240040..........................................................    2.51
240041..........................................................    2.49
240043..........................................................    3.30
240044..........................................................    2.56
240045..........................................................    2.04
240047..........................................................    3.16
240048..........................................................    3.81
240049..........................................................    1.87
240050..........................................................    3.12
240051..........................................................    1.95
240052..........................................................    2.17
240053..........................................................    3.27
240056..........................................................    3.03
240057..........................................................    2.35
240058..........................................................    1.44
240059..........................................................    3.44
240061..........................................................    4.55
240063..........................................................    2.66
240064..........................................................    3.06
240065..........................................................    1.73
240066..........................................................    4.22
240069..........................................................    3.56
240071..........................................................    2.37
240072..........................................................    2.79
240073..........................................................    1.65
240075..........................................................    2.45
240076..........................................................    2.75
240077..........................................................    2.34
240078..........................................................    3.66
240079..........................................................    1.91
240080..........................................................    2.09
240082..........................................................    1.86
240083..........................................................    2.36
240084..........................................................    2.83
240085..........................................................    1.53
240086..........................................................    2.09
240087..........................................................    2.23
240088..........................................................    1.90
240089..........................................................    1.37
240090..........................................................    3.29
240093..........................................................    2.68
240094..........................................................    1.66
240096..........................................................    1.46
240097..........................................................    6.54
240098..........................................................    2.05
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240100..........................................................    2.83
240101..........................................................    2.00
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240107..........................................................    1.69
240108..........................................................    2.55
240109..........................................................    1.82
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240111..........................................................    2.28
240112..........................................................    1.98
240114..........................................................    1.84
240115..........................................................    3.13
240116..........................................................    1.61
240117..........................................................    1.29
240119..........................................................    1.19
240121..........................................................    1.94
240122..........................................................    1.45
240123..........................................................    2.37
240124..........................................................    2.36
240125..........................................................    1.91
240127..........................................................    2.25
240128..........................................................    2.55
240129..........................................................    2.38
240130..........................................................    3.06
240132..........................................................    2.75
240133..........................................................    3.45
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240144..........................................................    2.78
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240155..........................................................    2.59
240157..........................................................    2.46
240160..........................................................    2.58
240161..........................................................    1.77
240162..........................................................    2.16
240163..........................................................    1.89
240166..........................................................    3.66
240169..........................................................    2.39
240170..........................................................    1.83
240171..........................................................    2.87
240172..........................................................    2.01
240173..........................................................    2.63
240179..........................................................    1.84
240184..........................................................    1.71
240187..........................................................    3.42
240193..........................................................    2.12
240200..........................................................    0.91
240207..........................................................    2.75
240210..........................................................    2.78
240211..........................................................    1.04
242004..........................................................    1.59
243300..........................................................    1.41
243301..........................................................    1.45
243302..........................................................    6.10
244009..........................................................    3.31
250001..........................................................    2.17
250002..........................................................    1.57
250003..........................................................    1.07
250004..........................................................    2.27
250005..........................................................    0.94
250006..........................................................    2.22
250007..........................................................    1.98
250008..........................................................    1.07
250009..........................................................    2.99
250010..........................................................    1.62
250012..........................................................    1.46
250015..........................................................    2.25
250017..........................................................    1.36
250018..........................................................    0.66
250019..........................................................    2.28
250020..........................................................    1.40
250021..........................................................    0.75
250023..........................................................    0.70
250024..........................................................    0.90
250025..........................................................    2.05
250027..........................................................    1.72
250029..........................................................    1.62
250030..........................................................    1.06
250031..........................................................    2.52
250032..........................................................    1.96
250033..........................................................    1.70
250034..........................................................    3.67
250035..........................................................    1.84
250036..........................................................    1.88
250037..........................................................    1.50
250038..........................................................    1.35
250039..........................................................    1.02
250040..........................................................    2.53
250042..........................................................    2.37
250043..........................................................    1.84
250044..........................................................    1.99
250045..........................................................    1.77
250048..........................................................    3.17
250049..........................................................    1.44
250050..........................................................    2.13
250051..........................................................    1.22
250057..........................................................    2.41
250058..........................................................    2.59
250059..........................................................    1.87
250060..........................................................    1.04
250061..........................................................    1.51
250063..........................................................    1.43
250065..........................................................    1.46
250066..........................................................    1.13
250067..........................................................    1.45
250068..........................................................    1.54
250069..........................................................    3.53
250071..........................................................    1.19
250072..........................................................    2.38
250076..........................................................    0.67
250077..........................................................    1.38
250078..........................................................    2.73
250079..........................................................    1.17
250081..........................................................    3.27
250082..........................................................    2.32
250083..........................................................    1.27
250084..........................................................    2.89
250085..........................................................    1.35
250088..........................................................    1.99
250089..........................................................    1.70
250093..........................................................    1.88
250094..........................................................    3.86
250095..........................................................    2.03
250096..........................................................    1.97
250097..........................................................    2.14
250098..........................................................    1.33
250099..........................................................    3.06
250100..........................................................    2.80
250101..........................................................    1.10
250102..........................................................    2.82
250104..........................................................    3.29
250105..........................................................    1.35
250107..........................................................    1.21
250109..........................................................    1.25
250112..........................................................    1.25
250117..........................................................    1.42
250119..........................................................    1.66
250120..........................................................    2.27
250122..........................................................    2.74
250123..........................................................    3.13
250124..........................................................    1.39
250125..........................................................    2.27
250126..........................................................    1.23
250128..........................................................    1.77
250131..........................................................    1.65
250136..........................................................    2.92
250138..........................................................    3.33
250141..........................................................    2.99
250145..........................................................    1.32
250146..........................................................    1.31
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250149..........................................................    1.26
252003..........................................................    0.50
253025..........................................................    1.93
254001..........................................................    1.55
254002..........................................................    1.50
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260002..........................................................    2.38
260003..........................................................    1.52
260004..........................................................    1.40
260005..........................................................    2.56
260006..........................................................    2.13
260008..........................................................    1.17
260009..........................................................    2.66
260011..........................................................    2.37
260012..........................................................    1.48
260013..........................................................    2.16
260014..........................................................    2.52
260015..........................................................    2.36
260017..........................................................    2.87
260018..........................................................    1.11
260019..........................................................    1.77
260020..........................................................    2.41
260021..........................................................    2.14
260022..........................................................    2.47
260023..........................................................    2.33
260024..........................................................    1.73
260025..........................................................    3.53
260027..........................................................    2.51
260029..........................................................    2.18
260030..........................................................    1.38
260031..........................................................    2.62
260032..........................................................    2.44
260034..........................................................    1.35
260035..........................................................    1.51
260036..........................................................    1.87
260039..........................................................    1.61
260040..........................................................    2.57
260044..........................................................    1.97
260047..........................................................    2.11
260048..........................................................    1.99
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270033..........................................................    0.91
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271232..........................................................    0.94
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271234..........................................................    1.56
280001..........................................................    2.04
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280010..........................................................    1.15
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280013..........................................................    2.00
280014..........................................................    1.81
280015..........................................................    2.04
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280020..........................................................    2.38
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280022..........................................................    1.21
280023..........................................................    2.78
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280025..........................................................    1.09
280026..........................................................    1.69
280028..........................................................    2.26
280029..........................................................    1.49
280030..........................................................    2.19
280031..........................................................    1.42
280032..........................................................    3.03
280033..........................................................    1.60
280034..........................................................    2.54
280035..........................................................    1.59
280037..........................................................    1.21
280038..........................................................    2.20
280039..........................................................    2.21
280040..........................................................    3.15
280041..........................................................    1.34
280042..........................................................    1.26
280043..........................................................    1.87
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280049..........................................................    1.41
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280060..........................................................    2.26
280061..........................................................    3.72
280062..........................................................    1.90
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280065..........................................................    2.36
280066..........................................................    1.67
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280075..........................................................    2.76
280076..........................................................    1.80
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280080..........................................................    1.52
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280082..........................................................    1.53
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280084..........................................................    1.69
280085..........................................................    2.61
280088..........................................................    3.10
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280108..........................................................    3.91
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280114..........................................................    1.49
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280125..........................................................    2.66
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284007..........................................................    3.05
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290015..........................................................    1.38
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290019..........................................................    2.42
290020..........................................................    0.94
290021..........................................................    2.36
290022..........................................................    2.77
290027..........................................................    1.27
290032..........................................................    2.34
290038..........................................................    1.70
290039..........................................................    2.60
292002..........................................................    1.01
293027..........................................................    2.09
294003..........................................................    1.57
294004..........................................................    1.56
294005..........................................................    2.31
300001..........................................................    2.65
300003..........................................................    1.80
300005..........................................................    2.43
300006..........................................................    1.57
300007..........................................................    2.44
300008..........................................................    2.59
300009..........................................................    2.10
300010..........................................................    1.75
300011..........................................................    2.21
300013..........................................................    1.65
300014..........................................................    2.30
300015..........................................................    2.49
300016..........................................................    2.08
300017..........................................................    1.97
300018..........................................................    2.48
300019..........................................................    2.25
300021..........................................................    1.87
300022..........................................................    2.33
300023..........................................................    1.99
300024..........................................................    2.11
300028..........................................................    1.65
300029..........................................................    2.86
300033..........................................................    1.52
303026..........................................................    1.85
303027..........................................................    0.47
304001..........................................................   11.15
304003..........................................................    1.55
310001..........................................................    1.98
310002..........................................................    2.01
310005..........................................................    2.33
310006..........................................................    2.74
310008..........................................................    2.88
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310011..........................................................    2.95
310013..........................................................    2.30
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310017..........................................................    2.70
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310020..........................................................    2.39
310021..........................................................    2.29
310022..........................................................    2.52
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310025..........................................................    2.33
310026..........................................................    2.09
310027..........................................................    2.40
310028..........................................................    2.05
310029..........................................................    3.53
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310032..........................................................    2.20
310034..........................................................    2.75
310036..........................................................    1.93
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310039..........................................................    2.77
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310043..........................................................    2.81
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310045..........................................................    2.63
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310050..........................................................    1.91
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310052..........................................................    2.08
310054..........................................................    2.34
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310120..........................................................    1.73
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320006..........................................................    2.87
320009..........................................................    2.44
320011..........................................................    1.76
320012..........................................................    2.54
320013..........................................................    2.15
320014..........................................................    1.79
320016..........................................................    2.94
320017..........................................................    2.03
320018..........................................................    2.95
320019..........................................................    1.21
320021..........................................................    1.80
320022..........................................................    3.20
320023..........................................................    1.33
320030..........................................................    2.00
320031..........................................................    1.27
320032..........................................................    1.44
320033..........................................................    2.26
320035..........................................................    1.18
320037..........................................................    2.32
320038..........................................................    2.61
320046..........................................................    2.17
320048..........................................................    1.53
320063..........................................................    2.36
320065..........................................................    2.27
320067..........................................................    1.21
320068..........................................................    2.33
320069..........................................................    1.96
320074..........................................................    2.12
320079..........................................................    2.29
322002..........................................................    3.05
322003..........................................................    0.68
323027..........................................................    0.58
323028..........................................................    1.76
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324003..........................................................    1.56
324004..........................................................    1.59
324007..........................................................    1.68
324010..........................................................    1.85
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330010..........................................................    2.17
330011..........................................................    1.70
330012..........................................................    2.20
330013..........................................................    2.59
330014..........................................................    1.92
330016..........................................................    1.90
330023..........................................................    2.50
330024..........................................................    2.41
330025..........................................................    1.87
330027..........................................................    0.92
330028..........................................................    2.00
330029..........................................................    1.55
330030..........................................................    2.54
330033..........................................................    1.59
330034..........................................................    1.09
330036..........................................................    2.29
330037..........................................................    2.61
330038..........................................................    1.88
330039..........................................................    1.19
330041..........................................................    3.15
330043..........................................................    1.95
330044..........................................................    2.25
330045..........................................................    2.79
330046..........................................................    2.01
330047..........................................................    2.35
330048..........................................................    2.82
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330053..........................................................    1.93
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330058..........................................................    1.81
330059..........................................................    2.21
330061..........................................................    2.74
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330064..........................................................    2.38
330065..........................................................    2.46
330066..........................................................    2.06
330067..........................................................    2.40
330072..........................................................    1.95
330073..........................................................    1.90
330074..........................................................    2.96
330075..........................................................    2.05
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330079..........................................................    2.09
330084..........................................................    2.26
330085..........................................................    1.75
330086..........................................................    1.96
330088..........................................................    1.68
330090..........................................................    2.37
330091..........................................................    2.31
330092..........................................................    1.22
330094..........................................................    2.09
330095..........................................................    2.49
330096..........................................................    2.30
330097..........................................................    1.80
330100..........................................................    5.13
330101..........................................................    2.50
330102..........................................................    2.92
330103..........................................................    2.74
330104..........................................................    2.04
330106..........................................................    2.65
330107..........................................................    2.39
330108..........................................................    2.31
330111..........................................................    1.94
330114..........................................................    0.90
330115..........................................................    2.41
330116..........................................................    2.02
330118..........................................................    2.57
330119..........................................................    2.61
330121..........................................................    1.33
330122..........................................................    2.87
330125..........................................................    1.89
330126..........................................................    2.28
330132..........................................................    1.47
330133..........................................................    2.88
330135..........................................................    2.39
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330140..........................................................    2.32
330141..........................................................    2.43
330144..........................................................    2.39
330148..........................................................    1.69
330151..........................................................    2.05
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330157..........................................................    1.99
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330162..........................................................    3.96
330163..........................................................    2.58
330164..........................................................    1.88
330166..........................................................    2.04
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330169..........................................................    2.19
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330175..........................................................    2.10
330177..........................................................    1.91
330179..........................................................    1.23
330180..........................................................    1.95
330181..........................................................    2.22
330182..........................................................    3.70
330183..........................................................    2.02
330184..........................................................    2.37
330185..........................................................    1.70
330186..........................................................    0.62
330188..........................................................    2.57
330189..........................................................    7.27
330191..........................................................    2.18
330193..........................................................    2.64
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330213..........................................................    1.69
330214..........................................................    2.42
330215..........................................................    2.59
330218..........................................................    1.87
330219..........................................................    1.90
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330225..........................................................    2.34
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330229..........................................................    2.03
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330246..........................................................    2.60
330249..........................................................    2.04
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330273..........................................................    2.53
330275..........................................................    1.99
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330306..........................................................    1.92
330307..........................................................    2.53
330308..........................................................    2.77
330314..........................................................    2.63
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330327..........................................................    1.71
330331..........................................................    2.29
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330333..........................................................    3.09
330336..........................................................    2.09
330338..........................................................    2.72
330339..........................................................    2.11
330340..........................................................    2.53
330350..........................................................    2.13
330353..........................................................    2.88
330354..........................................................    1.74
330357..........................................................    2.06
330359..........................................................    0.95
330372..........................................................    2.87
330381..........................................................    2.05
330386..........................................................    1.99
330389..........................................................    1.74
330390..........................................................    1.39
330393..........................................................    2.43
330394..........................................................    2.50
330395..........................................................    2.27
330397..........................................................    1.48
330398..........................................................    2.93
330399..........................................................    1.38
331300..........................................................    0.79
332012..........................................................    1.34
332022..........................................................    1.08
333025..........................................................    1.23
333027..........................................................    1.19
333028..........................................................    0.89
333300..........................................................    1.87
334002..........................................................    1.55
334048..........................................................    2.24
334055..........................................................    1.59
340001..........................................................    1.76
340002..........................................................    3.52
340003..........................................................    2.17
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340005..........................................................    2.27
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340014..........................................................    1.55
340015..........................................................    2.89
340016..........................................................    3.02
340017..........................................................    2.73
340018..........................................................    2.38
340019..........................................................    1.73
340020..........................................................    2.03
340021..........................................................    2.55
340022..........................................................    2.01
340023..........................................................    1.95
340024..........................................................    2.16
340025..........................................................    2.66
340027..........................................................    2.93
340028..........................................................    2.42
340030..........................................................    2.25
340031..........................................................    2.08
340032..........................................................    2.37
340035..........................................................    2.22
340036..........................................................    1.70
340037..........................................................    1.77
340038..........................................................    3.18
340039..........................................................    2.57
340040..........................................................    2.88
340041..........................................................    1.93
340042..........................................................    2.35
340044..........................................................    1.73
340045..........................................................    1.26
340047..........................................................    2.39
340049..........................................................    7.04
340050..........................................................    2.41
340051..........................................................    2.60
340052..........................................................    1.84
340053..........................................................    3.14
340054..........................................................    2.59
340055..........................................................    1.98
340060..........................................................    2.27
340061..........................................................    1.97
340063..........................................................    1.40
340064..........................................................    2.13
340065..........................................................    2.01
340067..........................................................    2.52
340068..........................................................    2.46
340069..........................................................    2.33
340070..........................................................    2.66
340071..........................................................    2.02
340072..........................................................    2.29
340073..........................................................    3.16
340075..........................................................    2.12
340080..........................................................    1.71
340084..........................................................    1.83
340085..........................................................    2.18
340087..........................................................    2.01
340088..........................................................    3.10
340089..........................................................    1.58
340090..........................................................    2.03
340091..........................................................    2.88
340093..........................................................    1.99
340094..........................................................    3.53
340096..........................................................    2.50
340097..........................................................    2.52
340098..........................................................    2.42
340099..........................................................    2.05
340101..........................................................    2.58
340104..........................................................    1.67
340105..........................................................    3.75
340106..........................................................    1.71
340107..........................................................    2.92
340109..........................................................    3.44
340111..........................................................    2.10
340112..........................................................    1.77
340113..........................................................    2.38
340114..........................................................    2.00
340115..........................................................    2.50
340116..........................................................    2.78
340119..........................................................    2.31
340120..........................................................    1.91
340121..........................................................    2.15
340123..........................................................    2.13
340125..........................................................    3.76
340126..........................................................    2.61
340127..........................................................    1.99
340129..........................................................    2.51
340130..........................................................    2.48
340131..........................................................    2.69
340132..........................................................    2.04
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340141..........................................................    2.73
340142..........................................................    2.13
340143..........................................................    2.77
340144..........................................................    2.72
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340146..........................................................    1.90
340147..........................................................    3.03
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340151..........................................................    2.44
340153..........................................................    3.95
340155..........................................................    2.38
340158..........................................................    2.82
340159..........................................................    1.51
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340166..........................................................    2.10
340171..........................................................    2.70
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342003..........................................................    1.39
342012..........................................................    0.79
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344005..........................................................    1.55
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344014..........................................................    0.79
344015..........................................................    1.55
344019..........................................................    1.55
344020..........................................................    1.55
350001..........................................................    1.09
350002..........................................................    3.66
350003..........................................................    2.36
350004..........................................................    3.95
350005..........................................................    2.06
350006..........................................................    1.99
350007..........................................................    2.75
350008..........................................................    1.73
350009..........................................................    3.26
350010..........................................................    3.09
350011..........................................................    3.23
350012..........................................................    2.13
350013..........................................................    1.93
350014..........................................................    2.06
350015..........................................................    3.37
350016..........................................................    1.18
350017..........................................................    2.65
350018..........................................................    2.58
350019..........................................................    3.33
350020..........................................................    1.45
350021..........................................................    2.55
350023..........................................................    2.01
350024..........................................................    2.03
350025..........................................................    1.13
350027..........................................................    1.30
350029..........................................................    1.36
350030..........................................................    2.77
350033..........................................................    2.00
350034..........................................................    1.89
350035..........................................................    0.85
350038..........................................................    2.02
350039..........................................................    2.08
350041..........................................................    1.51
350042..........................................................    3.25
350043..........................................................    3.06
350044..........................................................    1.70
350047..........................................................    1.95
350049..........................................................    2.14
350050..........................................................    1.55
350051..........................................................    1.58
350053..........................................................    1.33
350055..........................................................    1.22
350056..........................................................    1.96
350058..........................................................    1.71
350060..........................................................    0.79
350061..........................................................    2.56
360001..........................................................    2.87
360002..........................................................    2.52
360003..........................................................    1.95
360006..........................................................    3.15
360007..........................................................    1.98
360008..........................................................    2.28
360009..........................................................    2.47
360010..........................................................    2.48
360011..........................................................    2.00
360012..........................................................    2.85
360013..........................................................    2.27
360014..........................................................    2.61
360016..........................................................    1.93
360017..........................................................    3.43
360018..........................................................    2.52
360019..........................................................    2.10
360020..........................................................    2.20
360021..........................................................    5.55
360024..........................................................    2.41
360025..........................................................    2.09
360026..........................................................    1.80
360027..........................................................    2.46
360028..........................................................    4.56
360029..........................................................    2.63
360030..........................................................    2.31
360031..........................................................    2.13
360032..........................................................    2.59
360034..........................................................    1.96
360035..........................................................    2.10
360036..........................................................    2.35
360037..........................................................    2.27
360039..........................................................    2.26
360040..........................................................    2.08
360041..........................................................    2.24
360042..........................................................    2.23
360044..........................................................    2.19
360045..........................................................    1.93
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360048..........................................................    2.31
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360070..........................................................    2.00
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360114..........................................................    2.18
360115..........................................................    2.16
360116..........................................................    1.88
360118..........................................................    2.26
360121..........................................................    2.88
360123..........................................................    2.22
360125..........................................................    1.75
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360128..........................................................    1.65
360129..........................................................    1.77
360130..........................................................    2.00
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360132..........................................................    2.43
360133..........................................................    2.66
360134..........................................................    2.53
360136..........................................................    1.62
360137..........................................................    2.29
360140..........................................................    1.73
360141..........................................................    2.77
360142..........................................................    1.99
360143..........................................................    2.23
360144..........................................................    2.68
360145..........................................................    2.60
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360148..........................................................    2.21
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360150..........................................................    3.15
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360152..........................................................    2.65
360153..........................................................    1.88
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360161..........................................................    2.35
360162..........................................................    1.75
360163..........................................................    2.90
360164..........................................................    1.72
360165..........................................................    1.84
360166..........................................................    1.67
360170..........................................................    2.09
360172..........................................................    2.93
360174..........................................................    2.57
360175..........................................................    2.58
360176..........................................................    1.80
360177..........................................................    1.52
360178..........................................................    2.58
360179..........................................................    2.31
360180..........................................................    2.68
360184..........................................................    1.65
360185..........................................................    1.85
360186..........................................................    1.54
360187..........................................................    2.58
360188..........................................................    1.82
360189..........................................................    2.44
360192..........................................................    2.28
360193..........................................................    2.49
360194..........................................................    2.25
360195..........................................................    2.67
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360210..........................................................    2.67
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360231..........................................................    1.46
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360236..........................................................    2.41
360239..........................................................    2.61
360241..........................................................    1.27
360242..........................................................    1.72
360243..........................................................    1.55
360244..........................................................    1.55
360245..........................................................    1.58
362004..........................................................    1.97
362007..........................................................    0.47
362009..........................................................    1.59
362014..........................................................    7.33
362015..........................................................    1.48
363300..........................................................    1.97
363303..........................................................    2.62
363305..........................................................    1.94
363306..........................................................    1.34
364003..........................................................    1.64
364017..........................................................    1.97
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364038..........................................................    1.85
370001..........................................................    3.25
370002..........................................................    2.74
370004..........................................................    2.77
370005..........................................................    1.46
370006..........................................................    2.59
370007..........................................................    1.79
370008..........................................................    2.75
370011..........................................................    1.95
370012..........................................................    1.29
370013..........................................................    2.96
370014..........................................................    2.86
370015..........................................................    1.85
370016..........................................................    2.53
370017..........................................................    1.88
370018..........................................................    3.22
370019..........................................................    2.37
370020..........................................................    2.21
370021..........................................................    1.40
370022..........................................................    2.97
370023..........................................................    2.42
370025..........................................................    2.44
370026..........................................................    3.08
370028..........................................................    3.11
370029..........................................................    2.34
370030..........................................................    1.95
370032..........................................................    3.62
370033..........................................................    2.56
370034..........................................................    2.57
370035..........................................................    1.78
370036..........................................................    0.76
370037..........................................................    3.69
370038..........................................................    1.47
370039..........................................................    1.91
370040..........................................................    3.03
370041..........................................................    1.70
370042..........................................................    1.40
370043..........................................................    1.12
370045..........................................................    1.56
370046..........................................................    2.02
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370048..........................................................    1.96
370049..........................................................    2.95
370051..........................................................    1.31
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370057..........................................................    1.98
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370063..........................................................    1.38
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370065..........................................................    2.50
370071..........................................................    1.48
370072..........................................................    1.33
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370077..........................................................    1.96
370078..........................................................    3.60
370079..........................................................    1.78
370080..........................................................    1.83
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370083..........................................................    2.31
370084..........................................................    1.53
370085..........................................................    1.79
370086..........................................................    2.26
370089..........................................................    2.25
370091..........................................................    3.07
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370122..........................................................    0.92
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370125..........................................................    1.86
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370190..........................................................    2.49
370192..........................................................    2.87
372004..........................................................    0.74
373025..........................................................    0.87
373026..........................................................    1.03
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374012..........................................................    1.50
374013..........................................................    1.36
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380001..........................................................    2.80
380002..........................................................    3.93
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380005..........................................................    5.17
380006..........................................................    2.75
380007..........................................................    3.08
380008..........................................................    1.66
380009..........................................................    2.18
380010..........................................................    1.76
380011..........................................................    2.28
380013..........................................................    1.59
380014..........................................................    2.69
380017..........................................................    3.80
380018..........................................................    2.58
380019..........................................................    1.83
380020..........................................................    3.61
380021..........................................................    2.54
380022..........................................................    2.71
380023..........................................................    2.43
380025..........................................................    2.73
380026..........................................................    2.33
380027..........................................................    1.96
380029..........................................................    2.14
380031..........................................................    1.63
380033..........................................................    3.16
380035..........................................................    2.96
380036..........................................................    2.44
380037..........................................................    2.28
380038..........................................................    2.93
380039..........................................................    1.89
380040..........................................................    2.17
380042..........................................................    1.87
380047..........................................................    3.63
380048..........................................................    2.14
380050..........................................................    2.51
380051..........................................................    3.02
380052..........................................................    2.57
380056..........................................................    1.51
380060..........................................................    2.44
380061..........................................................    2.63
380062..........................................................    0.92
380063..........................................................    1.81
380064..........................................................    1.96
380065..........................................................    1.84
380066..........................................................    2.92
380068..........................................................    1.49
380069..........................................................    1.80
380070..........................................................    1.93
380071..........................................................    3.34
380072..........................................................    1.77
380075..........................................................    3.14
380078..........................................................    1.85
380081..........................................................    0.99
380082..........................................................    2.58
380083..........................................................    2.44
380084..........................................................    2.05
380087..........................................................    2.42
380088..........................................................    2.32
380089..........................................................    2.73
380090..........................................................    3.04
384006..........................................................    1.63
390001..........................................................    2.47
390002..........................................................    2.56
390003..........................................................    1.74
390004..........................................................    2.56
390005..........................................................    2.28
390006..........................................................    1.65
390007..........................................................    3.19
390008..........................................................    1.94
390009..........................................................    2.49
390010..........................................................    2.64
390011..........................................................    2.41
390012..........................................................    2.54
390013..........................................................    2.84
390015..........................................................    1.97
390016..........................................................    2.16
390017..........................................................    2.14
390018..........................................................    2.79
390019..........................................................    2.23
390022..........................................................    2.76
390023..........................................................    1.75
390024..........................................................    3.14
390025..........................................................    1.03
390026..........................................................    1.96
390028..........................................................    3.01
390029..........................................................    2.74
390030..........................................................    2.19
390031..........................................................    2.12
390032..........................................................    2.28
390035..........................................................    2.56
390036..........................................................    2.57
390037..........................................................    2.74
390039..........................................................    2.41
390040..........................................................    1.90
390041..........................................................    2.86
390042..........................................................    2.29
390043..........................................................    3.02
390044..........................................................    2.65
390045..........................................................    2.41
390046..........................................................    1.97
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390050..........................................................    3.05
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390062..........................................................    2.85
390063..........................................................    3.48
390065..........................................................    2.31
390066..........................................................    2.15
390067..........................................................    2.55
390068..........................................................    1.83
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390073..........................................................    2.60
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390078..........................................................    2.98
390079..........................................................    3.00
390080..........................................................    2.35
390083..........................................................    1.81
390084..........................................................    1.68
390086..........................................................    2.21
390088..........................................................    2.14
390090..........................................................    2.91
390091..........................................................    2.29
390093..........................................................    1.95
390095..........................................................    2.40
390096..........................................................    1.84
390097..........................................................    2.39
390100..........................................................    2.55
390101..........................................................    1.69
390102..........................................................    2.83
390103..........................................................    2.11
390104..........................................................    1.97
390106..........................................................    2.06
390107..........................................................    2.54
390108..........................................................    2.53
390109..........................................................    1.55
390110..........................................................    2.16
390111..........................................................    1.93
390112..........................................................    2.21
390113..........................................................    2.49
390114..........................................................    2.33
390115..........................................................    2.35
390116..........................................................    2.31
390118..........................................................    2.79
390119..........................................................    2.51
390121..........................................................    2.47
390122..........................................................    2.04
390123..........................................................    2.99
390125..........................................................    2.33
390127..........................................................    2.58
390128..........................................................    2.85
390130..........................................................    2.18
390131..........................................................    2.60
390132..........................................................    2.08
390133..........................................................    2.68
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390195..........................................................    2.89
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390198..........................................................    1.87
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390231..........................................................    2.19
390233..........................................................    2.03
390235..........................................................    1.87
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390238..........................................................    2.43
390242..........................................................    2.48
390244..........................................................    1.01
390245..........................................................    2.18
390246..........................................................    2.44
390247..........................................................    1.13
390249..........................................................    1.13
390256..........................................................    1.87
390258..........................................................    2.45
390260..........................................................    3.75
390262..........................................................    2.73
390263..........................................................    3.02
390265..........................................................    1.57
390266..........................................................    3.04
390267..........................................................    2.67
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390270..........................................................    2.58
390277..........................................................    1.31
390279..........................................................    2.40
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393040..........................................................    3.59
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393042..........................................................    1.77
393043..........................................................    0.98
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400001..........................................................    1.65
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400003..........................................................    1.58
400004..........................................................    2.04
400005..........................................................    1.76
400006..........................................................    2.56
400007..........................................................    1.11
400009..........................................................    1.87
400011..........................................................    2.39
400012..........................................................    1.22
400013..........................................................    1.42
400014..........................................................    4.78
400016..........................................................    1.87
400017..........................................................    2.13
400018..........................................................    1.39
400019..........................................................    3.28
400021..........................................................    1.94
400022..........................................................    1.95
400027..........................................................    0.88
400028..........................................................    1.61
400029..........................................................    1.12
400032..........................................................    1.18
400094..........................................................    1.13
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400102..........................................................    2.07
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400113..........................................................    1.87
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400122..........................................................    0.96
400123..........................................................    3.95
400124..........................................................    7.82
404002..........................................................    2.72
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410004..........................................................    2.02
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410006..........................................................    2.27
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410009..........................................................    3.00
410010..........................................................    1.89
410011..........................................................    2.36
410012..........................................................    2.67
410013..........................................................    2.56
413025..........................................................    1.27
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420006..........................................................    1.29
420007..........................................................    2.64
420009..........................................................    2.81
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420016..........................................................    1.79
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430013..........................................................    3.09
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430027..........................................................    3.97
430028..........................................................    2.58
430029..........................................................    1.96
430031..........................................................    1.74
430033..........................................................    1.72
430034..........................................................    1.42
430036..........................................................    2.00
430037..........................................................    1.34
430038..........................................................    2.55
430040..........................................................    2.03
430041..........................................................    1.71
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430060..........................................................    1.05
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430065..........................................................    1.41
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430077..........................................................    3.25
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434004..........................................................    1.77
440001..........................................................    1.78
440002..........................................................    3.88
440003..........................................................    2.91
440006..........................................................    3.43
440007..........................................................    1.27
440008..........................................................    2.51
440009..........................................................    3.09
440010..........................................................    1.83
440011..........................................................    2.47
440012..........................................................    1.94
440014..........................................................    1.65
440015..........................................................    3.03
440016..........................................................    2.08
440017..........................................................    2.53
440018..........................................................    1.62
440019..........................................................    2.59
440020..........................................................    2.08
440023..........................................................    1.65
440024..........................................................    3.03
440025..........................................................    2.28
440026..........................................................    0.96
440029..........................................................    3.02
440030..........................................................    3.03
440031..........................................................    2.41
440032..........................................................    1.55
440033..........................................................    1.95
440034..........................................................    2.66
440035..........................................................    2.55
440039..........................................................    2.24
440040..........................................................    1.63
440041..........................................................    1.78
440046..........................................................    2.60
440047..........................................................    1.87
440048..........................................................    3.27
440049..........................................................    2.65
440050..........................................................    2.49
440051..........................................................    1.73
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440053..........................................................    3.01
440054..........................................................    2.09
440056..........................................................    1.86
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440058..........................................................    3.01
440059..........................................................    2.48
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440070..........................................................    1.77
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440090..........................................................    1.66
440091..........................................................    3.29
440100..........................................................    1.89
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440104..........................................................    2.70
440105..........................................................    6.65
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440114..........................................................    1.96
440115..........................................................    1.91
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440125..........................................................    2.79
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440144..........................................................    3.94
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440187..........................................................    1.94
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440211..........................................................    1.50
442007..........................................................    0.93
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443029..........................................................    3.28
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444006..........................................................    1.50
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444011..........................................................    1.70
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450002..........................................................    2.42
450004..........................................................    1.82
450005..........................................................    2.10
450007..........................................................    2.96
450008..........................................................    1.81
450010..........................................................    2.54
450011..........................................................    2.92
450014..........................................................    1.79
450015..........................................................    1.30
450016..........................................................    3.15
450018..........................................................    1.54
450020..........................................................    2.19
450021..........................................................    1.91
450023..........................................................    2.67
450024..........................................................    1.59
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450034..........................................................    2.20
450037..........................................................    2.45
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450042..........................................................    2.28
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450123..........................................................    1.81
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450128..........................................................    1.96
450130..........................................................    3.66
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450132..........................................................    2.27
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450135..........................................................    2.53
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450140..........................................................    1.45
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450146..........................................................    0.96
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450166..........................................................    0.89
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450264..........................................................    0.95
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450276..........................................................    1.49
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450306..........................................................    3.74
450307..........................................................    0.96
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450327..........................................................    0.99
450330..........................................................    1.72
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450340..........................................................    2.59
450341..........................................................    1.92
450346..........................................................    2.03
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450353..........................................................    1.76
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450370..........................................................    4.89
450371..........................................................    2.14
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450389..........................................................    1.82
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450417..........................................................    1.87
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450429..........................................................    0.92
450431..........................................................    3.06
450438..........................................................    2.81
450446..........................................................    1.56
450447..........................................................    3.17
450451..........................................................    2.28
450457..........................................................    3.06
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450462..........................................................    2.18
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450465..........................................................    3.29
450467..........................................................    1.51
450469..........................................................    2.86
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450475..........................................................    2.34
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450488..........................................................    1.99
450489..........................................................    1.16
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450544..........................................................    2.04
450545..........................................................    3.67
450547..........................................................    1.58
450550..........................................................    2.14
450551..........................................................    2.35
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450574..........................................................    0.86
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450586..........................................................    1.68
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450591..........................................................    2.79
450596..........................................................    2.40
450597..........................................................    1.62
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450656..........................................................    2.67
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450659..........................................................    2.45
450661..........................................................    3.17
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450665..........................................................    1.72
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450669..........................................................    2.34
450670..........................................................    2.50
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450673..........................................................    1.27
450675..........................................................    2.26
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450678..........................................................    2.78
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450688..........................................................    2.14
450690..........................................................    1.61
450694..........................................................    2.52
450696..........................................................   10.88
450697..........................................................    2.05
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450700..........................................................    1.29
450702..........................................................    2.40
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450706..........................................................    2.28
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450711..........................................................    2.54
450712..........................................................    1.58
450713..........................................................    2.33
450715..........................................................    1.66
450716..........................................................    2.68
450717..........................................................    2.11
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450723..........................................................    1.91
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450766..........................................................    5.91
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450777..........................................................    1.59
450779..........................................................    2.04
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450795..........................................................    0.95
450797..........................................................    9.66
450798..........................................................    0.52
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450802..........................................................    3.03
450803..........................................................    1.09
450804..........................................................    6.10
450809..........................................................    2.33
450811..........................................................    4.24
450813..........................................................    0.96
452013..........................................................    0.96
452019..........................................................    2.02
452022..........................................................    0.50
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452039..........................................................    2.99
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490015..........................................................    3.19
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490019..........................................................    2.31
490020..........................................................    2.71
490021..........................................................    4.47
490022..........................................................    2.51
490023..........................................................    2.38
490024..........................................................    2.41
490027..........................................................    1.99
490030..........................................................    2.72
490031..........................................................    1.99
490032..........................................................    1.79
490033..........................................................    1.86
490035..........................................................    2.24
490037..........................................................    2.53
490038..........................................................    2.45
490040..........................................................    3.17
490041..........................................................    3.49
490042..........................................................    2.44
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490045..........................................................    2.18
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490118..........................................................    2.66
490119..........................................................    2.87
490120..........................................................    2.67
490122..........................................................    2.96
490123..........................................................    2.48
490124..........................................................    2.04
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490127..........................................................    1.71
490130..........................................................    2.18
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492001..........................................................    0.79
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493026..........................................................    0.95
493027..........................................................    2.22
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494016..........................................................    1.61
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500001..........................................................    2.76
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500005..........................................................    2.36
500007..........................................................    3.32
500008..........................................................    1.76
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500023..........................................................    2.26
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500025..........................................................    3.38
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500036..........................................................    2.81
500037..........................................................    1.78
500039..........................................................    3.11
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500055..........................................................    1.92
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500071..........................................................    3.26
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510023..........................................................    2.47
510024..........................................................    3.34
510026..........................................................    1.65
510027..........................................................    1.74
510028..........................................................    1.53
510029..........................................................    2.69
510030..........................................................    2.36
510031..........................................................    3.42
510033..........................................................    2.25
510038..........................................................    1.72
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510043..........................................................    1.04
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510047..........................................................    2.69
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510050..........................................................    2.35
510053..........................................................    1.65
510055..........................................................    2.34
510058..........................................................    2.55
510059..........................................................    8.87
510060..........................................................    1.67
510063..........................................................    1.27
510065..........................................................    1.25
510066..........................................................    2.08
510067..........................................................    2.57
510068..........................................................    2.41
510070..........................................................    3.32
510071..........................................................    2.27
510072..........................................................    1.53
510077..........................................................    2.18
510081..........................................................    1.38
510082..........................................................    1.71
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510085..........................................................    1.82
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513028..........................................................    1.85
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514007..........................................................    6.63
514008..........................................................    2.21
520002..........................................................    2.77
520003..........................................................    2.36
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520006..........................................................    2.33
520007..........................................................    1.68
520008..........................................................    2.45
520009..........................................................    2.18
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520011..........................................................    3.20
520013..........................................................    2.03
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520017..........................................................    2.13
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520021..........................................................    2.83
520024..........................................................    1.93
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520030..........................................................    3.48
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530012..........................................................    2.33
530014..........................................................    2.79
530015..........................................................    2.27
530016..........................................................    2.03
530017..........................................................    2.10
530018..........................................................    1.65
530019..........................................................    1.56
530022..........................................................    2.09
530023..........................................................    1.65
530025..........................................................    2.01
530026..........................................................    1.52
530027..........................................................    1.58
530029..........................................................    1.01
530031..........................................................    1.02
530032..........................................................    2.22
534003..........................................................    1.56
650001..........................................................    2.01
------------------------------------------------------------------------

--------------------
\1\ Large Urban Area

\2\ Hospitals geographically located in the area are assigned the 
statewide rural wage index for FY 2000.

 

 

 

 

                 Addendum H.--Wage Index for Urban Areas
------------------------------------------------------------------------
                                                                   Wage
         Urban Code          Urban Area  (Constituent Counties)   Index
------------------------------------------------------------------------
0040.......................  Abilene, TX Taylor, TX............   0.8179
0060.......................  2 Aguadilla, PR Aguada, PR           0.4249
                              Aguadilla, PR Moca, PR.
0080.......................  Akron, OH Portage, OH Summit, OH..   1.0163
0120.......................  Albany, GA Dougherty, GA Lee, GA..   1.0372
0160.......................  Albany-Schenectady-Troy, NY          0.8754
                              Albany, NY Montgomery, NY
                              Rensselaer, NY Saratoga, NY
                              Schenectady, NY Schoharie, NY.
0200.......................  Albuquerque, NM Bernalillo, NM       0.8499
                              Sandoval, NM Valencia, NM.
0220.......................  Alexandria, LA Rapides, LA........   0.7910
0240.......................  Allentown-Bethlehem-Easton, PA       0.9550
                              Carbon, PA Lehigh, PA
                              Northampton, PA.
0280.......................  Altoona, PA Blair, PA.............   0.9342
0320.......................  Amarillo, TX Potter, TX Randall,     0.8435
                              TX.
0380.......................  Anchorage, AK Anchorage, AK.......   1.3009
0440.......................  Ann Arbor, MI Lenawee, MI            1.1483
                              Livingston, MI Washtenaw, MI.
0450.......................  Anniston, AL Calhoun, AL..........   0.8462
0460.......................  Appleton-Oshkosh-Neenah, WI          0.8913
                              Calumet, WI Outagamie, WI
                              Winnebago, WI.
0470.......................  Arecibo, PR Arecibo, PR Camuy, PR    0.4815
                              Hatillo, PR.
0480.......................  Asheville, NC Buncombe, NC           0.8884
                              Madison, NC.
0500.......................  Athens, GA Clarke, GA Madison, GA    0.9800
                              Oconee, GA.
0520.......................  1 Atlanta, GA Barrow, GA Bartow,     1.0050
                              GA Carroll, GA Cherokee, GA
                              Clayton, GA Cobb, GA Coweta, GA
                              DeKalb, GA Douglas, GA Fayette,
                              GA Forsyth, GA Fulton, GA
                              Gwinnett, GA Henry, GA Newton, GA
                              Paulding, GA Pickens, GA
                              Rockdale, GA Spalding, GA Walton.
0560.......................  Atlantic-Cape May, NJ Atlantic, NJ   1.1050
                              Cape May, NJ.
0580.......................  Auburn-Opelika, AL Lee, AL........   0.7748
0600.......................  Augusta-Aiken, GA-SC Columbia, GA    0.9013
                              McDuffie, GA Richmond, GA Aiken,
                              SC Edgefield, SC.
0640.......................  1 Austin-San Marcos, TX Bastrop,     0.9081
                              TX Caldwell, TX Hays, TX Travis,
                              TX Williamson, TX.
0680.......................  2 Bakersfield, CA Kern, CA........   0.9951
0720.......................  1 Baltimore, MD Anne Arundel, MD     0.9891
                              Baltimore, MD Baltimore City, MD
                              Carroll, MD Harford, MD Howard,
                              MD Queen Anne's, MD.
0733.......................  Bangor, ME Penobscot, ME..........   0.9609
0743.......................  Barnstable-Yarmouth, MA              1.3302
                              Barnstable, MA.
0760.......................  Baton Rouge, LA Ascension, LA East   0.8707
                              Baton Rouge, LA Livingston, LA
                              West Baton Rouge, LA.
0840.......................  Beaumont-Port Arthur, TX Hardin,     0.8624
                              TX Jefferson, TX Orange, TX.
0860.......................  Bellingham, WA Whatcom, WA........   1.1394
0870.......................  2 Benton Harbor, MI Berrien, MI...   0.8831
0875.......................  1 Bergen-Passaic, NJ Bergen, NJ      1.1833
                              Passaic, NJ.
0880.......................  Billings, MT Yellowstone, MT......   1.0038
0920.......................  Biloxi-Gulfport-Pascagoula, MS       0.7949
                              Hancock, MS Harrison, MS Jackson,
                              MS.
0960.......................  Binghamton, NY Broome, NY Tioga,     0.8750
                              NY.
1000.......................  Birmingham, AL Blount, AL            0.8994
                              Jefferson, AL St. Clair, AL
                              Shelby, AL.
1010.......................  Bismarck, ND Burleigh, ND Morton,    0.7893
                              ND.
1020.......................  Bloomington, IN Monroe, IN........   0.8593
1040.......................  Bloomington-Normal, IL McLean, IL.   0.8993
1080.......................  Boise City, ID Ada, ID Canyon, ID.   0.9086
1123.......................  1 2 Boston-Worcester-Lawrence-       1.1369
                              Lowell-Brockton, MA-NH (MA
                              Hospitals) Bristol, MA Essex, MA
                              Middlesex, MA Norfolk, MA
                              Plymouth, MA Suffolk, MA
                              Worcester, MA Hillsborough, NH
                              Merrimack, NH Rockingham, NH
                              Strafford, NH.
1123.......................  1 Boston-Worcester-Lawrence-Lowell-  1.1358
                              Brockton, MA-NH (NH Hospitals)
                              Bristol, MA Essex, MA Middlesex,
                              MA Norfolk, MA Plymouth, MA
                              Suffolk, MA Worcester, MA
                              Hillsborough, NH Merrimack, NH
                              Rockingham, NH Strafford, NH.

[[Page 18814]]

 
1125.......................  Boulder-Longmont, CO Boulder, CO..   0.9944
1145.......................  Brazoria, TX Brazoria, TX.........   0.8516
1150.......................  Bremerton, WA Kitsap, WA..........   1.1011
1240.......................  Brownsville-Harlingen-San Benito,    0.9212
                              TX Cameron, TX.
1260.......................  Bryan-College Station, TX Brazos,    0.8501
                              TX.
1280.......................  1 Buffalo-Niagara Falls, NY Erie,    0.9604
                              NY Niagara, NY.
1303.......................  Burlington, VT Chittenden, VT        1.0558
                              Franklin, VT Grand Isle, VT.
1310.......................  Caguas, PR Caguas, PR Cayey, PR      0.4561
                              Cidra, PR Gurabo, PR San Lorenzo,
                              PR.
1320.......................  2 Canton-Massillon, OH Carroll, OH   0.8649
                              Stark, OH.
1350.......................  Casper, WY Natrona, WY............   0.9199
1360.......................  Cedar Rapids, IA Linn, IA.........   0.9018
1400.......................  Champaign-Urbana, IL Champaign, IL   0.9163
1440.......................  Charleston-North Charleston, SC      0.8988
                              Berkeley, SC Charleston, SC
                              Dorchester, SC.
1480.......................  Charleston, WV Kanawha, WV Putnam,   0.9095
                              WV.
1520.......................  1 Charlotte-Gastonia-Rock Hill, NC-  0.9433
                              SC Cabarrus, NC Gaston, NC
                              Lincoln, NC Mecklenburg, NC
                              Rowan, NC Stanly, NC Union, NC
                              York, SC.
1540.......................  Charlottesville, VA Albemarle, VA    1.0573
                              Charlottesville City, VA
                              Fluvanna, VA Greene, VA.
1560.......................  Chattanooga, TN-GA Catoosa, GA       0.9731
                              Dade, GA Walker, GA Hamilton, TN
                              Marion, TN.
1580.......................  2 Cheyenne, WY Laramie, WY........   0.8859
1600.......................  1 Chicago, IL Cook, IL DeKalb, IL    1.0872
                              DuPage, IL Grundy, IL Kane, IL
                              Kendall, IL Lake, IL McHenry, IL
                              Will, IL.
1620.......................  Chico-Paradise, CA Butte, CA......   1.0390
1640.......................  1 Cincinnati, OH-KY-IN Dearborn,     0.9434
                              IN Ohio, IN Boone, KY Campbell,
                              KY Gallatin, KY Grant, KY Kenton,
                              KY Pendleton, KY Brown, OH
                              Clermont, OH Hamilton, OH Warren,
                              OH.
1660.......................  Clarksville-Hopkinsville, TN-KY      0.8283
                              Christian, KY Montgomery, TN.
1680.......................  1 Cleveland-Lorain-Elyria, OH        0.9688
                              Ashtabula, OH Cuyahoga, OH
                              Geauga, OH Lake, OH Lorain, OH
                              Medina, OH.
1720.......................  Colorado Springs, CO El Paso, CO..   0.9218
1740.......................  Columbia, MO Boone, MO............   0.8904
1760.......................  Columbia, SC Lexington, SC           0.9357
                              Richland, SC.
1800.......................  Columbus, GA-AL Russell, AL          0.8510
                              Chattahoochee, GA Harris, GA
                              Muscogee, GA.
1840.......................  1 Columbus, OH Delaware, OH          0.9907
                              Fairfield, OH Franklin, OH
                              Licking, OH Madison, OH Pickaway,
                              OH.
1880.......................  Corpus Christi, TX Nueces, TX San    0.8702
                              Patricio, TX.
1890.......................  Corvallis, OR Benton, OR..........   1.1087
1900.......................  Cumberland, MD-WV (Maryland          0.8801
                              Hospitals) Allegany, MD Mineral,
                              WV.
1920.......................  1 Dallas, TX Collin, TX Dallas, TX   0.9589
                              Denton, TX Ellis, TX Henderson,
                              TX Hunt, TX Kaufman, TX Rockwall,
                              TX.
1950.......................  Danville, VA Danville City, VA       0.9061
                              Pittsylvania, VA.
1960.......................  Davenport-Moline-Rock Island, IA-    0.8706
                              IL Scott, IA Henry, IL Rock
                              Island, IL.
2000.......................  Dayton-Springfield, OH Clark, OH     0.9336
                              Greene, OH Miami, OH Montgomery,
                              OH.
2020.......................  2 Daytona Beach, FL Flagler, FL      0.8986
                              Volusia, FL.
2030.......................  Decatur, AL Lawrence, AL Morgan,     0.8679
                              AL.
2040.......................  Decatur, IL Macon, IL.............   0.8321
2080.......................  1 Denver, CO Adams, CO Arapahoe,     1.0197
                              CO Denver, CO Douglas, CO
                              Jefferson, CO.
2120.......................  Des Moines, IA Dallas, IA Polk, IA   0.8754
                              Warren, IA.
2160.......................  1 Detroit, MI Lapeer, MI Macomb,     1.0421
                              MI Monroe, MI Oakland, MI St.
                              Clair, MI Wayne, MI.
2180.......................  Dothan, AL Dale, AL Houston, AL...   0.7836
2190.......................  Dover, DE Kent, DE................   0.9335
2200.......................  Dubuque, IA Dubuque, IA...........   0.8520
2240.......................  Duluth-Superior, MN-WI St. Louis,    1.0165
                              MN Douglas, WI.
2281.......................  Dutchess County, NY Dutchess, NY..   0.9872
2290.......................  Eau Claire, WI Chippewa, WI Eau      0.8957
                              Claire, WI.
2320.......................  El Paso, TX El Paso, TX...........   0.8947
2330.......................  Elkhart-Goshen, IN Elkhart, IN....   0.9379
2335.......................  2 Elmira, NY Chemung, NY..........   0.8636
2340.......................  Enid, OK Garfield, OK.............   0.7953
2360.......................  Erie, PA Erie, PA.................   0.9023
2400.......................  Eugene-Springfield, OR Lane, OR...   1.0765
2440.......................  2 Evansville-Henderson, IN-KY (IN    0.8396
                              Hospitals) Posey, IN Vanderburgh,
                              IN Warrick, IN Henderson, KY.
2440.......................  Evansville-Henderson, IN-KY (KY      0.8303
                              Hospitals) Posey, IN Vanderburgh,
                              IN Warrick, IN Henderson, KY.
2520.......................  Fargo-Moorhead, ND-MN Clay, MN       0.8620
                              Cass, ND.
2560.......................  Fayetteville, NC Cumberland, NC...   0.8494
2580.......................  Fayetteville-Springdale-Rogers, AR   0.7773
                              Benton, AR Washington, AR.
2620.......................  Flagstaff, AZ-UT Coconino, AZ        1.0348
                              Kane, UT.
2640.......................  Flint, MI Genesee, MI.............   1.1020
2650.......................  Florence, AL Colbert, AL             0.7927
                              Lauderdale, AL.
2655.......................  Florence, SC Florence, SC.........   0.8618
2670.......................  Fort Collins-Loveland, CO Larimer,   1.0302
                              CO.
2680.......................  1 Ft. Lauderdale, FL Broward, FL..   1.0172
2700.......................  2 Fort Myers-Cape Coral, FL Lee,     0.8986
                              FL.

[[Page 18815]]

 
2710.......................  Fort Pierce-Port St. Lucie, FL       1.0109
                              Martin, FL St. Lucie, FL.
2720.......................  Fort Smith, AR-OK Crawford, AR       0.7844
                              Sebastian, AR Sequoyah, OK.
2750.......................  2 Fort Walton Beach, FL Okaloosa,    0.8986
                              FL.
2760.......................  Fort Wayne, IN Adams, IN Allen, IN   0.9096
                              De Kalb, IN Huntington, IN Wells,
                              IN Whitley, IN.
2800.......................  1 Forth Worth-Arlington, TX Hood,    0.9835
                              TX Johnson, TX Parker, TX
                              Tarrant, TX.
2840.......................  Fresno, CA Fresno, CA Madera, CA..   1.0262
2880.......................  Gadsden, AL Etowah, AL............   0.8754
2900.......................  Gainesville, FL Alachua, FL.......   1.0102
2920.......................  Galveston-Texas City, TX             0.9732
                              Galveston, TX.
2960.......................  Gary, IN Lake, IN Porter, IN......   0.9369
2975.......................  2 Glens Falls, NY Warren, NY         0.8636
                              Washington, NY.
2980.......................  Goldsboro, NC Wayne, NC...........   0.8333
2985.......................  Grand Forks, ND-MN Polk, MN Grand    0.9097
                              Forks, ND.
2995.......................  Grand Junction, CO Mesa, CO.......   0.9188
3000.......................  1 Grand Rapids-Muskegon-Holland,     1.0135
                              MI Allegan, MI Kent, MI Muskegon,
                              MI Ottawa, MI.
3040.......................  Great Falls, MT Cascade, MT.......   1.0459
3060.......................  Greeley, CO Weld, CO..............   0.9722
3080.......................  Green Bay, WI Brown, WI...........   0.9215
3120.......................  1 Greensboro-Winston-Salem-High      0.9037
                              Point, NC Alamance, NC Davidson,
                              NC Davie, NC Forsyth, NC
                              Guilford, NC Randolph, NC Stokes,
                              NC Yadkin, NC.
3150.......................  Greenville, NC Pitt, NC...........   0.9500
3160.......................  Greenville-Spartanburg-Anderson,     0.9188
                              SC Anderson, SC Cherokee, SC
                              Greenville, SC Pickens, SC
                              Spartanburg, SC.
3180.......................  Hagerstown, MD Washington, MD.....   0.8853
3200.......................  Hamilton-Middletown, OH Butler, OH   0.8989
3240.......................  Harrisburg-Lebanon-Carlisle, PA      0.9917
                              Cumberland, PA Dauphin, PA
                              Lebanon, PA Perry, PA.
3283.......................  1 2 Hartford, CT Hartford, CT        1.2413
                              Litchfield, CT Middlesex, CT
                              Tolland, CT.
3285.......................  2 Hattiesburg, MS Forrest, MS        0.7306
                              Lamar, MS.
3290.......................  Hickory-Morganton-Lenoir, NC         0.9148
                              Alexander, NC Burke, NC Caldwell,
                              NC Catawba, NC.
3320.......................  Honolulu, HI Honolulu, HI.........   1.1479
3350.......................  Houma, LA Lafourche, LA              0.7837
                              Terrebonne, LA.
3360.......................  1 Houston, TX Chambers, TX Fort      0.9387
                              Bend, TX Harris, TX Liberty, TX
                              Montgomery, TX Waller, TX.
3400.......................  Huntington-Ashland, WV-KY-OH Boyd,   0.9757
                              KY Carter, KY Greenup, KY
                              Lawrence, OH Cabell, WV Wayne, WV.
3440.......................  Huntsville, AL Limestone, AL         0.8822
                              Madison, AL.
3480.......................  1 Indianapolis, IN Boone, IN         0.9792
                              Hamilton, IN Hancock, IN
                              Hendricks, IN Johnson, IN
                              Madison, IN Marion, IN Morgan, IN
                              Shelby, IN.
3500.......................  Iowa City, IA Johnson, IA.........   0.9607
3520.......................  Jackson, MI Jackson, MI...........   0.8840
3560.......................  Jackson, MS Hinds, MS Madison, MS    0.8387
                              Rankin, MS.
3580.......................  Jackson, TN Madison, TN Chester,     0.8600
                              TN.
3600.......................  1 2 Jacksonville, FL Clay, FL        0.8986
                              Duval, FL Nassau, FL St. Johns,
                              FL.
3605.......................  2 Jacksonville, NC Onslow, NC.....   0.8290
3610.......................  2 Jamestown, NY Chautauqua, NY....   0.8636
3620.......................  Janesville-Beloit, WI Rock, WI....   0.9656
3640.......................  Jersey City, NJ Hudson, NJ........   1.1674
3660.......................  Johnson City-Kingsport-Bristol, TN-  0.8894
                              VA Carter, TN Hawkins, TN
                              Sullivan, TN Unicoi, TN
                              Washington, TN Bristol City, VA
                              Scott, VA Washington, VA.
3680.......................  2 Johnstown, PA Cambria, PA          0.8524
                              Somerset, PA.
3700.......................  Jonesboro, AR Craighead, AR.......   0.7251
3710.......................  2 Joplin, MO Jasper, MO Newton, MO   0.7723
3720.......................  Kalamazoo-Battlecreek, MI Calhoun,   0.9981
                              MI Kalamazoo, MI Van Buren, MI.
3740.......................  Kankakee, IL Kankakee, IL.........   0.8598
3760.......................  1 Kansas City, KS-MO Johnson, KS     0.9322
                              Leavenworth, KS Miami, KS
                              Wyandotte, KS Cass, MO Clay, MO
                              Clinton, MO Jackson, MO
                              Lafayette, MO Platte, MO Ray, MO.
3800.......................  Kenosha, WI Kenosha, WI...........   0.9033
3810.......................  Killeen-Temple, TX Bell, TX          0.9932
                              Coryell, TX.
3840.......................  Knoxville, TN Anderson, TN Blount,   0.9199
                              TN Knox, TN Loudon, TN Sevier, TN
                              Union, TN.
3850.......................  Kokomo, IN Howard, IN Tipton, IN..   0.8984
3870.......................  La Crosse, WI-MN Houston, MN La      0.8933
                              Crosse, WI.
3880.......................  Lafayette, LA Acadia, LA             0.8397
                              Lafayette, LA St. Landry, LA St.
                              Martin, LA.
3920.......................  Lafayette, IN Clinton, IN            0.8809
                              Tippecanoe, IN.
3960.......................  Lake Charles, LA Calcasieu, LA....   0.7966
3980.......................  2 Lakeland-Winter Haven, FL Polk,    0.8986
                              FL.
4000.......................  Lancaster, PA Lancaster, PA.......   0.9255
4040.......................  Lansing-East Lansing, MI Clinton,    0.9977
                              MI Eaton, MI Ingham, MI.
4080.......................  Laredo, TX Webb, TX...............   0.8323
4100.......................  Las Cruces, NM Dona Ana, NM.......   0.8590
4120.......................  1 Las Vegas, NV-AZ Mohave, AZ        1.1258
                              Clark, NV Nye, NV.

[[Page 18816]]

 
4150.......................  Lawrence, KS Douglas, KS..........   0.8222
4200.......................  Lawton, OK Comanche, OK...........   0.9532
4243.......................  Lewiston-Auburn, ME Androscoggin,    0.8899
                              ME.
4280.......................  Lexington, KY Bourbon, KY Clark,     0.8552
                              KY Fayette, KY Jessamine, KY
                              Madison, KY Scott, KY Woodford,
                              KY.
4320.......................  Lima, OH Allen, OH Auglaize, OH...   0.9108
4360.......................  Lincoln, NE Lancaster, NE.........   0.9670
4400.......................  Little Rock-North Little Rock, AR    0.8614
                              Faulkner, AR Lonoke, AR Pulaski,
                              AR Saline, AR.
4420.......................  Longview-Marshall, TX Gregg, TX      0.8738
                              Harrison, TX Upshur, TX.
4480.......................  1 Los Angeles-Long Beach, CA Los     1.2085
                              Angeles, CA.
4520.......................  Louisville, KY-IN Clark, IN Floyd,   0.9381
                              IN Harrison, IN Scott, IN
                              Bullitt, KY Jefferson, KY Oldham,
                              KY.
4600.......................  Lubbock, TX Lubbock, TX...........   0.8411
4640.......................  Lynchburg, VA Amherst, VA Bedford,   0.8814
                              VA Bedford City, VA Campbell, VA
                              Lynchburg City, VA.
4680.......................  Macon, GA Bibb, GA Houston, GA       0.8530
                              Jones, GA Peach, GA Twiggs, GA.
4720.......................  Madison, WI Dane, WI..............   0.9729
4800.......................  2 Mansfield, OH Crawford, OH         0.8649
                              Richland, OH.
4840.......................  Mayaguez, PR Anasco, PR Cabo Rojo,   0.4674
                              PR Hormigueros, PR Mayaguez, PR
                              Sabana Grande, PR San German, PR.
4880.......................  McAllen-Edinburg-Mission, TX         0.8120
                              Hidalgo, TX.
4890.......................  Medford-Ashland, OR Jackson, OR...   1.0492
4900.......................  Melbourne-Titusville-Palm Bay, FL    0.9296
                              Brevard, Fl.
4920.......................  1 Memphis, TN-AR-MS Crittenden, AR   0.8244
                              DeSoto, MS Fayette, TN Shelby, TN
                              Tipton, TN.
4940.......................  Merced, CA Merced, CA.............   1.0509
5000.......................  1 Miami, FL Dade, FL..............   1.0233
5015.......................  1 Middlesex-Somerset-Hunterdon, NJ   1.0876
                              Hunterdon, NJ Middlesex, NJ
                              Somerset, NJ.
5080.......................  1 Milwaukee-Waukesha, WI             0.9845
                              Milwaukee, WI Ozaukee, WI
                              Washington, WI Waukesha, WI.
5120.......................  1 Minneapolis-St. Paul, MN-WI        1.0929
                              Anoka, MN Carver, MN Chisago, MN
                              Dakota, MN Hennepin, MN Isanti,
                              MN Ramsey, MN Scott, MN
                              Sherburne, MN Washington, MN
                              Wright, MN Pierce, WI St. Croix,
                              WI.
5140.......................  Missoula, MT Missoula, MT.........   0.9085
5160.......................  Mobile, AL Baldwin, AL Mobile, AL.   0.8267
5170.......................  Modesto, CA Stanislaus, CA........   1.0111
5190.......................  1 Monmouth-Ocean, NJ Monmouth, NJ    1.1258
                              Ocean, NJ.
5200.......................  Monroe, LA Ouachita, LA...........   0.8221
5240.......................  Montgomery, AL Autauga, AL Elmore,   0.7724
                              AL Montgomery, AL.
5280.......................  Muncie, IN Delaware, IN...........   1.0834
5330.......................  Myrtle Beach, SC Horry, SC........   0.8529
5345.......................  Naples, FL Collier, FL............   0.9839
5360.......................  1 Nashville, TN Cheatham, TN         0.9449
                              Davidson, TN Dickson, TN
                              Robertson, TN Rutherford TN
                              Sumner, TN Williamson, TN Wilson,
                              TN.
5380.......................  1 Nassau-Suffolk, NY Nassau, NY      1.4074
                              Suffolk, NY.
5483.......................  1 New Haven-Bridgeport-Stamford-     1.2417
                              Waterbury-Danbury, CT Fairfield,
                              CT New Haven, CT.
5523.......................  New London-Norwich, CT New London,   1.2428
                              CT.
5560.......................  1 New Orleans, LA Jefferson, LA      0.9089
                              Orleans, LA Plaquemines, LA St.
                              Bernard, LA St. Charles, LA St.
                              James, LA St. John The Baptist,
                              LA St. Tammany, LA.
5600.......................  1 New York, NY Bronx, NY Kings, NY   1.4517
                              New York, NY Putnam, NY Queens,
                              NY Richmond, NY Rockland, NY
                              Westchester, NY.
5640.......................  1 Newark, NJ Essex, NJ Morris, NJ    1.0772
                              Sussex, NJ Union, NJ Warren, NJ.
5660.......................  Newburgh, NY-PA Orange, NY Pike,     1.0908
                              PA.
5720.......................  1 Norfolk-Virginia Beach-Newport     0.8442
                              News, VA-NC Currituck, NC
                              Chesapeake City, VA Gloucester,
                              VA Hampton City, VA Isle of
                              Wight, VA James City, VA Mathews,
                              VA Newport News City, VA Norfolk
                              City, VA Poquoson City, VA
                              Portsmouth City, VA Suffolk C.
5775.......................  1 Oakland, CA Alameda, CA Contra     1.5095
                              Costa, CA.
5790.......................  Ocala, FL Marion, FL..............   0.9615
5800.......................  Odessa-Midland, TX Ector, TX         0.8873
                              Midland, TX.
5880.......................  1 Oklahoma City, OK Canadian, OK     0.8589
                              Cleveland, OK Logan, OK McClain,
                              OK Oklahoma, OK Pottawatomie, OK.
5910.......................  Olympia, WA Thurston, WA..........   1.0932
5920.......................  Omaha, NE-IA Pottawattamie, IA       1.0455
                              Cass, NE Douglas, NE Sarpy, NE
                              Washington, NE.
5945.......................  1 Orange County, CA Orange, CA....   1.1592
5960.......................  1 Orlando, FL Lake, FL Orange, FL    0.9806
                              Osceola, FL Seminole, FL.
5990.......................  Owensboro, KY Daviess, KY.........   0.8104
6015.......................  Panama City, FL Bay, FL...........   0.9169
6020.......................  Parkersburg-Marietta, WV-OH (WV      0.8414
                              Hospitals) Washington, OH Wood,
                              WV.
6020.......................  2 Parkersburg-Marietta, WV-OH (OH    0.8649
                              Hospitals) Washington, OH Wood,
                              WV.
6080.......................  2 Pensacola, FL Escambia, FL Santa   0.8986
                              Rosa, FL.
6120.......................  Peoria-Pekin, IL Peoria, IL          0.8399
                              Tazewell, IL Woodford, IL.
6160.......................  1 Philadelphia, PA-NJ Burlington,    1.1186
                              NJ Camden, NJ Gloucester, NJ
                              Salem, NJ Bucks, PA Chester, PA
                              Delaware, PA Montgomery, PA
                              Philadelphia, PA.
6200.......................  1 Phoenix-Mesa, AZ Maricopa, AZ      0.9464
                              Pinal, AZ.
6240.......................  Pine Bluff, AR Jefferson, AR......   0.7697

[[Page 18817]]

 
6280.......................  1 Pittsburgh, PA Allegheny, PA       0.9634
                              Beaver, PA Butler, PA Fayette, PA
                              Washington, PA Westmoreland, PA.
6323.......................  2 Pittsfield, MA Berkshire, MA....   1.1369
6340.......................  Pocatello, ID Bannock, ID.........   0.8973
6360.......................  Ponce, PR Guayanilla, PR Juana       0.4971
                              Diaz, PR Penuelas, PR Ponce, PR
                              Villalba, PR Yauco, PR.
6403.......................  Portland, ME Cumberland, ME          0.9487
                              Sagadahoc, ME York, ME.
6440.......................  1 Portland-Vancouver, OR-WA          1.0996
                              Clackamas, OR Columbia, OR
                              Multnomah, OR Washington, OR
                              Yamhill, OR Clark, WA.
6483.......................  1 Providence-Warwick-Pawtucket, RI   1.0690
                              Bristol, RI Kent, RI Newport, RI
                              Providence, RI Washington, RI.
6520.......................  Provo-Orem, UT Utah, UT...........   0.9818
6560.......................  Pueblo, CO Pueblo, CO.............   0.8853
6580.......................  Punta Gorda, FL Charlotte, FL.....   0.9508
6600.......................  Racine, WI Racine, WI.............   0.9216
6640.......................  1 Raleigh-Durham-Chapel Hill, NC     0.9544
                              Chatham, NC Durham, NC Franklin,
                              NC Johnston, NC Orange, NC Wake,
                              NC.
6660.......................  Rapid City, SD Pennington, SD.....   0.8363
6680.......................  Reading, PA Berks, PA.............   0.9436
6690.......................  Redding, CA Shasta, CA............   1.1263
6720.......................  Reno, NV Washoe, NV...............   1.0655
6740.......................  Richland-Kennewick-Pasco, WA         1.1224
                              Benton, WA Franklin, WA.
6760.......................  Richmond-Petersburg, VA Charles      0.9545
                              City County, VA Chesterfield, VA
                              Colonial Heights City, VA
                              Dinwiddie, VA Goochland, VA
                              Hanover, VA Henrico, VA Hopewell
                              City, VA New Kent, VA Petersburg
                              City, VA Powhatan, VA Prince
                              George, VA Richmond City, V.
6780.......................  1 Riverside-San Bernardino, CA       1.1061
                              Riverside, CA San Bernardino, CA.
6800.......................  Roanoke, VA Botetourt, VA Roanoke,   0.8142
                              VA Roanoke City, VA Salem City,
                              VA.
6820.......................  Rochester, MN Olmsted, MN.........   1.1429
6840.......................  1 Rochester, NY Genesee, NY          0.9184
                              Livingston, NY Monroe, NY
                              Ontario, NY Orleans, NY Wayne, NY.
6880.......................  Rockford, IL Boone, IL Ogle, IL      0.8783
                              Winnebago, IL.
6895.......................  Rocky Mount, NC Edgecombe, NC        0.8735
                              Nash, NC.
6920.......................  1 Sacramento, CA El Dorado, CA       1.2284
                              Placer, CA Sacramento, CA.
6960.......................  Saginaw-Bay City-Midland, MI Bay,    0.9294
                              MI Midland, MI Saginaw, MI.
6980.......................  St. Cloud, MN Benton, MN Stearns,    0.9608
                              MN.
7000.......................  St. Joseph, MO Andrew, MO            0.8943
                              Buchanan, MO.
7040.......................  1 St. Louis, MO-IL Clinton, IL       0.9052
                              Jersey, IL Madison, IL Monroe, IL
                              St. Clair, IL Franklin, MO
                              Jefferson, MO Lincoln, MO St.
                              Charles, MO St. Louis, MO St.
                              Louis City, MO Warren, MO.
7080.......................  Salem, OR Marion, OR Polk, OR.....   0.9949
7120.......................  Salinas, CA Monterey, CA..........   1.4710
7160.......................  1 Salt Lake City-Ogden, UT Davis,    0.9854
                              UT Salt Lake, UT Weber, UT.
7200.......................  San Angelo, TX Tom Green, TX......   0.7845
7240.......................  1 San Antonio, TX Bexar, TX Comal,   0.8318
                              TX Guadalupe, TX Wilson, TX.
7320.......................  1 San Diego, CA San Diego, CA.....   1.1955
7360.......................  1 San Francisco, CA Marin, CA San    1.3784
                              Francisco, CA San Mateo, CA.
7400.......................  1 San Jose, CA Santa Clara, CA....   1.3492
7440.......................  1 San Juan-Bayamon, PR Aguas         0.4657
                              Buenas, PR Barceloneta, PR
                              Bayamon, PR Canovanas, PR
                              Carolina, PR Catano, PR Ceiba, PR
                              Comerio, PR Corozal, PR Dorado,
                              PR Fajardo, PR Florida, PR
                              Guaynabo, PR Humacao, PR Juncos,
                              PR Los Piedras, PR Loiza, PR Lug.
7460.......................  San Luis Obispo-Atascadero-Paso      1.0470
                              Robles, CA San Luis Obispo, CA.
7480.......................  Santa Barbara-Santa Maria-Lompoc,    1.0819
                              CA Santa Barbara, CA.
7485.......................  Santa Cruz-Watsonville, CA Santa     1.3927
                              Cruz, CA.
7490.......................  Santa Fe, NM Los Alamos, NM Santa    1.0437
                              Fe, NM.
7500.......................  Santa Rosa, CA Sonoma, CA.........   1.3000
7510.......................  Sarasota-Bradenton, FL Manatee, FL   0.9905
                              Sarasota, FL.
7520.......................  Savannah, GA Bryan, GA Chatham, GA   0.9953
                              Effingham, GA.
7560.......................  2 Scranton--Wilkes-Barre--           0.8524
                              Hazleton, PA Columbia, PA
                              Lackawanna, PA Luzerne, PA
                              Wyoming, PA.
7600.......................  1 Seattle-Bellevue-Everett, WA       1.1289
                              Island, WA King, WA Snohomish, WA.
7610.......................  2 Sharon, PA Mercer, PA...........   0.8524
7620.......................  2 Sheboygan, WI Sheboygan, WI.....   0.8759
7640.......................  Sherman-Denison, TX Grayson, TX...   0.9329
7680.......................  Shreveport-Bossier City, LA          0.9049
                              Bossier, LA Caddo, LA Webster, LA.
7720.......................  Sioux City, IA-NE Woodbury, IA       0.8549
                              Dakota, NE.
7760.......................  Sioux Falls, SD Lincoln, SD          0.8776
                              Minnehaha, SD.
7800.......................  South Bend, IN St. Joseph, IN.....   0.9793
7840.......................  Spokane, WA Spokane, WA...........   1.0799
7880.......................  Springfield, IL Menard, IL           0.8684
                              Sangamon, IL.
7920.......................  Springfield, MO Christian, MO        0.7991
                              Greene, MO Webster, MO.
8003.......................  2 Springfield, MA Hampden, MA        1.1369
                              Hampshire, MA.
8050.......................  State College, PA Centre, PA......   0.9138
8080.......................  2 Steubenville-Weirton, OH-WV (OH    0.8649
                              Hospitals) Jefferson, OH Brooke,
                              WV Hancock, WV.
8080.......................  Steubenville-Weirton, OH-WV (WV      0.8614
                              Hospitals) Jefferson, OH Brooke,
                              WV Hancock, WV.
8120.......................  Stockton-Lodi, CA San Joaquin, CA.   1.0518

[[Page 18818]]

 
8140.......................  2 Sumter, SC Sumter, SC...........   0.8264
8160.......................  Syracuse, NY Cayuga, NY Madison,     0.9441
                              NY Onondaga, NY Oswego, NY.
8200.......................  Tacoma, WA Pierce, WA.............   1.1631
8240.......................  2 Tallahassee, FL Gadsden, FL        0.8986
                              Leon, FL.
8280.......................  1 Tampa-St. Petersburg-Clearwater,   0.9119
                              FL Hernando, FL Hillsborough, FL
                              Pasco, FL Pinellas, FL.
8320.......................  Terre Haute, IN Clay, IN             0.8570
                              Vermillion, IN Vigo, IN.
8360.......................  Texarkana, AR-Texarkana, TX          0.8174
                              Miller, AR Bowie, TX.
8400.......................  Toledo, OH Fulton, OH Lucas, OH      0.9593
                              Wood, OH.
8440.......................  Topeka, KS Shawnee, KS............   0.9326
8480.......................  Trenton, NJ Mercer, NJ............   0.9955
8520.......................  Tucson, AZ Pima, AZ...............   0.8742
8560.......................  Tulsa, OK Creek, OK Osage, OK        0.8086
                              Rogers, OK Tulsa, OK Wagoner, OK.
8600.......................  Tuscaloosa, AL Tuscaloosa, AL.....   0.8064
8640.......................  Tyler, TX Smith, TX...............   0.9369
8680.......................  2 Utica-Rome, NY Herkimer, NY        0.8636
                              Oneida, NY.
8720.......................  Vallejo-Fairfield-Napa, CA Napa,     1.2655
                              CA Solano, CA.
8735.......................  Ventura, CA Ventura, CA...........   1.0952
8750.......................  Victoria, TX Victoria, TX.........   0.8378
8760.......................  Vineland-Millville-Bridgeton, NJ     1.0517
                              Cumberland, NJ.
8780.......................  Visalia-Tulare-Porterville, CA       1.0411
                              Tulare, CA.
8800.......................  Waco, TX McLennan, TX.............   0.8075
8840.......................  1 Washington, DC-MD-VA-WV District
                              of Columbia, DC Calvert, MD
                              Charles, MD Frederick, MD
                              Montgomery, MD Prince Georges, MD
                              Alexandria City, VA Arlington, VA
                              Clarke, VA Culpeper, VA Fairfax,
                              VA Fairfax City, VA Falls Church
                              City, VA Fauquier,.
8920.......................  Waterloo-Cedar Falls, IA Black       0.8841
                              Hawk, IA.
8940.......................  Wausau, WI Marathon, WI...........   0.9445
8960.......................  1 West Palm Beach-Boca Raton, FL     0.9909
                              Palm Beach, FL.
9000.......................  2 Wheeling, WV-OH (WV Hospitals)     0.8068
                              Belmont, OH Marshall, WV Ohio, WV.
9000.......................  2 Wheeling, WV-OH (OH Hospitals)     0.8649
                              Belmont, OH Marshall, WV Ohio, WV.
9040.......................  Wichita, KS Butler, KS Harvey, KS    0.9421
                              Sedgwick, KS.
9080.......................  Wichita Falls, TX Archer, TX         0.7652
                              Wichita, TX.
9140.......................  2 Williamsport, PA Lycoming, PA...   0.8524
9160.......................  Wilmington-Newark, DE-MD New         1.1274
                              Castle, DE Cecil, MD.
9200.......................  Wilmington, NC New Hanover, NC       0.9707
                              Brunswick, NC.
9260.......................  2 Yakima, WA Yakima, WA...........   1.0446
9270.......................  Yolo, CA Yolo, CA.................   1.0485
9280.......................  York, PA York, PA.................   0.9309
9320.......................  Youngstown-Warren, OH Columbiana,    0.9996
                              OH Mahoning, OH Trumbull, OH.
9340.......................  Yuba City, CA Sutter, CA Yuba, CA.   1.0662
9360.......................  Yuma, AZ Yuma, AZ.................   0.9924
------------------------------------------------------------------------

--------------------
\1\ All counties within state are classified as urban.

 

 

 

 

 

                 Addendum I.--Wage Index for Rural Areas
------------------------------------------------------------------------
                                                                   Wage
                         Nonurban Area                            Index
------------------------------------------------------------------------
Alabama........................................................   0.7390
Alaska.........................................................   1.2057
Arizona........................................................   0.8544
Arkansas.......................................................   0.7236
California.....................................................   0.9951
Colorado.......................................................   0.8813
Connecticut....................................................   1.2413
Delaware.......................................................   0.9166
Florida........................................................   0.8986
Georgia........................................................   0.8094
Hawaii.........................................................   1.0726
Idaho..........................................................   0.8651
Illinois.......................................................   0.8047
Indiana........................................................   0.8396
Iowa...........................................................   0.7926
Kansas.........................................................   0.7460
Kentucky.......................................................   0.8043
Louisiana......................................................   0.7486
Maine..........................................................   0.8639
Maryland.......................................................   0.8631
Massachusetts..................................................   1.1369
Michigan.......................................................   0.8831
Minnesota......................................................   0.8669
Mississippi....................................................   0.7306
Missouri.......................................................   0.7723
Montana........................................................   0.8398
Nebraska.......................................................   0.8007
Nevada.........................................................   0.9097
New Hampshire..................................................   0.9905
1 New Jersey...................................................  .......
New Mexico.....................................................   0.8378
New York.......................................................   0.8636
North Carolina.................................................   0.8290
North Dakota...................................................   0.7647
Ohio...........................................................   0.8649
Oklahoma.......................................................   0.7255
Oregon.........................................................   0.9873
Pennsylvania...................................................   0.8524
Puerto Rico....................................................   0.4249
1 Rhode Island.................................................  .......
South Carolina.................................................   0.8264
South Dakota...................................................   0.7576
Tennessee......................................................   0.7650
Texas..........................................................   0.7471
Utah...........................................................   0.8906
Vermont........................................................   0.9427
Virginia.......................................................   0.7916
Washington.....................................................   1.0446
West Virginia..................................................   0.8068
Wisconsin......................................................   0.8759
Wyoming........................................................   0.8859
------------------------------------------------------------------------


[[Page 18819]]


  Federal Register / Vol. 65, No. 68 / Friday, April 7, 2000 / Rules 
and Regulations  

       Addendum J.--Wage Index for Hospitals That Are Reclassified
------------------------------------------------------------------------
                                                                   Wage
                              Area                                Index
------------------------------------------------------------------------
Abilene, TX....................................................   0.8179
Akron, OH......................................................   0.9981
Albany, GA.....................................................   0.9544
Alexandria, LA.................................................   0.7910
Amarillo, TX...................................................   0.8435
Anchorage, AK..................................................   1.3009
Ann Arbor, MI..................................................   1.1343
Atlanta, GA....................................................   1.0050
Austin-San Marcos, TX..........................................   0.9081
Baltimore, MD..................................................   0.9891
Baton Rouge, LA................................................   0.8707
Beaumont-Port Arthur, TX.......................................   0.8624
Benton Harbor, MI..............................................   0.8831
Bergen-Passaic, NJ.............................................   1.1833
Billings, MT...................................................   1.0038
Biloxi-Gulfport-Pascagoula, MS.................................   0.7949
Binghamton, NY.................................................   0.8750
Birmingham, AL.................................................   0.8994
Bismarck, ND...................................................   0.7893
Boise City, ID.................................................   0.9086
Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH...............   1.1358
Burlington, VT.................................................   1.0122
Caguas, PR.....................................................   0.4561
Champaign-Urbana, IL...........................................   0.9163
Charleston-North Charleston, SC................................   0.8988
Charleston, WV.................................................   0.8861
Charlotte-Gastonia-Rock Hill, NC-SC............................   0.9433
Chattanooga, TN-GA.............................................   0.9453
Chicago, IL....................................................   1.0872
Cincinnati, OH-KY-IN...........................................   0.9434
Clarksville-Hopkinsville, TN-KY................................   0.8283
Cleveland-Lorain-Elyria, OH....................................   0.9688
Columbia, MO...................................................   0.8736
Columbia, SC...................................................   0.9215
Columbus, GA-AL................................................   0.8318
Columbus, OH...................................................   0.9728
Corpus Christi, TX.............................................   0.8599
Dallas, TX.....................................................   0.9589
Danville, VA...................................................   0.8706
Davenport-Moline-Rock Island, IA-IL............................   0.8606
Dayton-Springfield, OH.........................................   0.9231
Denver, CO.....................................................   1.0197
Des Moines, IA.................................................   0.8754
Dothan, AL.....................................................   0.7836
Dover, DE......................................................   1.0511
Duluth-Superior, MN-WI.........................................   1.0165
Elkhart-Goshen, IN.............................................   0.9379
Eugene-Springfield, OR.........................................   1.0765
Evansville-Henderson, IN-KY....................................   0.8396
Fargo-Moorhead, ND-MN (ND and SD Hospitals)....................   0.8620
Fargo-Moorhead, ND-MN (MN Hospital)............................   0.8669
Fayetteville, NC...............................................   0.8494
Flagstaff, AZ-UT...............................................   0.9860
Flint, MI......................................................   1.0918
Fort Collins-Loveland, CO......................................   1.0197
Fort Pierce-Port St. Lucie, FL.................................   1.0109
Fort Smith, AR-OK..............................................   0.7696
Fort Walton Beach, FL..........................................   0.8713
Forth Worth-Arlington, TX......................................   0.9835
Fresno, CA.....................................................   1.0262
Gadsden, AL....................................................   0.8754
Gainesville, FL................................................   0.9963
Goldsboro, NC..................................................   0.8333
Grand Forks, ND-MN.............................................   0.9097
Grand Rapids-Muskegon-Holland, MI..............................   1.0017
Great Falls, MT................................................   1.0459
Greeley, CO....................................................   0.9449
Green Bay, WI..................................................   0.9215
Greensboro-Winston-Salem-High Point, NC........................   0.9037
Greenville, NC.................................................   0.9237
Greenville-Spartanburg-Anderson, SC............................   0.9188
Hagerstown, MD.................................................   0.8853
Harrisburg-Lebanon-Carlisle, PA................................   0.9793
Hartford, CT...................................................   1.1715
Hickory-Morganton-Lenoir, NC...................................   0.9148
Honolulu, HI...................................................   1.1479
Houston, TX....................................................   0.9387
Huntington-Ashland, WV-KY-OH...................................   0.9436
Huntsville, AL.................................................   0.8608
Indianapolis, IN...............................................   0.9792
Iowa City, IA..................................................   0.9460
Jackson, MS....................................................   0.8268
Jackson, TN....................................................   0.8447
Jacksonville, FL...............................................   0.8957
Johnson City-Kingsport-Bristol, TN-VA..........................   0.8894
Jonesboro, AR..................................................   0.7251
Joplin, MO.....................................................   0.7678
Kalamazoo-Battlecreek, MI......................................   0.9981
Kansas City, KS-MO.............................................   0.9322
Knoxville, TN..................................................   0.9199
Kokomo, IN.....................................................   0.8984
Lafayette, LA..................................................   0.8397
Lansing-East Lansing, MI.......................................   0.9834
Las Vegas, NV-AZ...............................................   1.1258
Lexington, KY..................................................   0.8552
Lima, OH.......................................................   0.9108
Lincoln, NE....................................................   0.9451
Little Rock-North Little Rock, AR..............................   0.8432
Longview-Marshall, TX..........................................   0.8541
Los Angeles-Long Beach, CA.....................................   1.2085
Louisville, KY-IN..............................................   0.9381
Macon, GA......................................................   0.8530
Madison, WI....................................................   0.9729
Mansfield, OH..................................................   0.8649
Memphis, TN-AR-MS..............................................   0.8244
Merced, CA.....................................................   1.0509
Milwaukee-Waukesha, WI.........................................   0.9845
Minneapolis-St. Paul, MN-WI....................................   1.0929
Missoula, MT...................................................   0.9085
Monmouth-Ocean, NJ.............................................   1.1258
Monroe, LA.....................................................   0.8062
Montgomery, AL.................................................   0.7724
Myrtle Beach, SC...............................................   0.8357
Nashville, TN..................................................   0.9254
New Haven-Bridgeport-Stamford-Waterbury-Danbury, CT............   1.2417
New London-Norwich, CT.........................................   1.2328
New Orleans, LA................................................   0.9089
New York, NY...................................................   1.4399
Newark, NJ.....................................................   1.0772
Newburgh, NY-PA................................................   1.0837
Norfolk-Virginia Beach-Newport News, VA-NC.....................   0.8442
Oakland, CA....................................................   1.5095
Oklahoma City, OK..............................................   0.8589
Omaha, NE-IA...................................................   1.0455
Orange County, CA..............................................   1.1592
Orlando, FL....................................................   0.9806
Peoria-Pekin, IL...............................................   0.8399
Philadelphia, PA-NJ............................................   1.1186
Phoenix-Mesa, AZ...............................................   0.9464
Pittsburgh, PA.................................................   0.9496
Pocatello, ID..................................................   0.8651
Portland, ME...................................................   0.9487
Portland-Vancouver, OR-WA......................................   1.0996
Provo-Orem, UT.................................................   0.9818
Raleigh-Durham-Chapel Hill, NC.................................   0.9544
Roanoke, VA....................................................   0.8142
Rockford, IL...................................................   0.8783
Sacramento, CA.................................................   1.2284
Saginaw-Bay City-Midland, MI...................................   0.9294
St. Cloud, MN..................................................   0.9608
St. Louis, MO-IL...............................................   0.9052
Salt Lake City-Ogden, UT.......................................   0.9854
San Diego, CA..................................................   1.1955
Santa Fe, NM...................................................   0.9911
Santa Rosa, CA.................................................   1.3000
Seattle-Bellevue-Everett, WA...................................   1.1289
Sharon, PA.....................................................   0.8524
Sherman-Denison, TX............................................   0.8833
Sioux City, IA-NE..............................................   0.8549
South Bend, IN.................................................   0.9692
Springfield, IL................................................   0.8684
Springfield, MO................................................   0.7991
Syracuse, NY...................................................   0.9441
Tallahassee, FL................................................   0.8274
Tampa-St. Petersburg-Clearwater, FL............................   0.9119
Texarkana, AR-Texarkana, TX....................................   0.8174
Toledo, OH.....................................................   0.9593
Topeka, KS.....................................................   0.9326
Tulsa, OK......................................................   0.7931
Tuscaloosa, AL.................................................   0.8064
Tyler, TX......................................................   0.9199
Vallejo-Fairfield-Napa, CA.....................................   1.2167
Victoria, TX...................................................   0.8378
Waco, TX.......................................................   0.8075
Washington, DC-MD-VA-WV........................................   1.1053
Waterloo-Cedar Falls, IA.......................................   0.8841
Wausau, WI.....................................................   0.9445
Wichita, KS....................................................   0.9082
Rural Colorado.................................................   0.8813
Rural Florida..................................................   0.8986
Rural Illinois.................................................   0.8047
Rural Louisiana................................................   0.7486
Rural Michigan.................................................   0.8831
Rural Minnesota................................................   0.8669
Rural Missouri.................................................   0.7723
Rural Montana..................................................   0.8398
Rural Oregon...................................................   0.9873
Rural Tennessee................................................   0.7650
Rural Texas....................................................   0.7471
Rural Virginia (KY Hospital)...................................   0.8043
Rural Washington...............................................   1.0333
Rural Wyoming..................................................   0.8859
------------------------------------------------------------------------

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

Copyright American Dental Association. All rights reserved.

 

 

 

 

[[Page 18820]]



          Addendum K.--Codes Eligible for Pass-Through Payment
------------------------------------------------------------------------
  CPT/
 HCPCS                             Description
------------------------------------------------------------------------
  A4642  Satumomab pendetide per dose
  A9502  Technetium TC99M tetrofosmin
  A9600  Strontium-89 chloride
  A9605  Samarium sm153 lexidronamm
  J0205  Alglucerase injection
  J0207  Amifostine
  J0256  Alpha 1 proteinase inhibitor
  J0286  Amphotericin B lipid complex
  J0476  Baclofen intrathecal trial
  J0585  Botulinum toxin a per unit
  J0640  Leucovorin calcium injection
  J0735  Clonidine hydrochloride
  J0850  Cytomegalovirus imm IV/vial
  J1190  Dexrazoxane HCl injection
  J1260  Dolasetron mesylate
  J1325  Epoprostenol injection
  J1436  Etidronate disodium inj
  J1440  Filgrastim 300 mcg injeciton
  J1561  Immune globulin 500 mg
  J1562  Immune globulin 5 gms
  J1565  RSV-ivig
  J1620  Gonadorelin hydroch/100 mcg
  J1626  Granisetron HCl injection
  J1745  Infliximab injection
  J1785  Injection imiglucerase/unit
  J1825  Interferon beta-1a
  J1830  Interferon beta-1b/.25 MG
  J1950  Leuprolide acetate/3.75 MG
  J2275  Morphine sulfate injection
  J2352  Octreotide acetate injection
  J2355  Oprelvekin injection
  J2405  Ondansetron hcl injection
  J2430  Pamidronate disodium/30 MG
  J2545  Pentamidine isethionte/300mg
  J2765  Metoclopramide hcl injection
  J2790  Rho d immune globulin inj
  J2820  Sargramostim injection
  J3010  Fentanyl citrate injeciton
  J3280  Thiethylperazine maleate inj
  J3305  Inj trimetrexate glucoronate
  J7190  Factor viii
  J7191  Factor VIII (porcine)
  J7192  Factor viii recombinant
  J7194  Factor ix complex
  J7197  Antithrombin iii injection
  J7198  Anti-inhibitor
  J7310  Ganciclovir long act implant
  J7505  Monoclonal antibodies
  J7913  Daclizumab, Parenteral, 25 m
  J8510  Oral busulfan
  J8520  Capecitabine, oral, 150 mg
  J8530  Cyclophosphamide oral 25 MG
  J8560  Etoposide oral 50 MG
  J8600  Melphalan oral 2 MG
  J8610  Methotrexate oral 2.5 MG
  J9000  Doxorubic hcl 10 MG vl chemo
  J9001  Doxorubicin hcl liposome inj
  J9015  Aldesleukin/single use vial
  J9020  Asparaginase injection
  J9031  Bcg live intravesical vac
  J9040  Bleomycin sulfate injection
  J9045  Carboplatin injection
  J9050  Carmus bischl nitro inj
  J9060  Cisplatin 10 MG injeciton
  J9065  Inj cladribine per 1 MG
  J9070  Cyclophosphamide 100 MG inj
  J9093  Cyclophosphamide lyophilized
  J9100  Cytarabine hcl 100 MG inj
  J9120  Dactinomycin actinomycin d
  J9130  Dacarbazine 10 MG inj
  J9150  Daunorubicin
  J9151  Daunorubicin citrate liposom
  J9165  Diethylstilbestrol injection
  J9170  Docetaxel
  J9181  Etoposide 10 MG inj
  J9185  Fludarabine phosphate inj
  J9190  Fluorouracil injection
  J9200  Floxuridine injection
  J9201  Gemcitabine HCl
  J9202  Goserelin acetate implant
  J9206  Irinotecan injection
  J9208  Ifosfomide injection
  J9209  Mesna injection
  J9211  Idarubicin hcl injeciton
  J9212  Interferon alfacon-1
  J9213  Interferon alfa-2a inj
  J9214  Interferon alfa-2b inj
  J9215  Interferon alfa-n3 inj
  J9216  Interferon gamma 1-b inj
  J9218  Leuprolide acetate injeciton
  J9230  Mechlorethamine hcl inj
  J9245  Inj melphalan hydrochl 50 MG
  J9250  Methotrexate sodium inj
  J9265  Paclitaxel injection
  J9266  Pegaspargase/singl dose vial
  J9268  Pentostatin injection
  J9270  Plicamycin (mithramycin) inj
  J9280  Mitomycin 5 MG inj
  J9293  Mitoxantrone hydrochl/5 MG
  J9310  Rituximab cancer treatment
  J9320  Streptozocin injection
  J9340  Thiotepa injection
  J9350  Topotecan
  J9360  Vinblastine sulfate inj
  J9370  Vincristine sulfate 1 MG inj
  J9390  Vinorelbine tartrate/10 mg
  J9600  Porfimer sodium
  Q0136  Non esrd epoetin alpha inj
  Q0160  Factor IX non-recombinant
  Q0161  Factor IX recombinant
  Q0163  Diphenhydramine HCl 50mg
  Q0164  Prochlorperazine maleate 5mg
  Q0166  Granisetron HCl 1 mg oral
  Q0167  Dronabinol 2.5mg oral
  Q0169  Promethazine HCl 12.5mg oral
  Q0171  Chlorpromazine HCl 10mg oral
  Q0173  Trimethobenzamide HCl 250mg
  Q0174  Thiethylperazine maleate10mg
  Q0175  Perphenazine 4mg oral
  Q0177  Hydroxyzine pamoate 25mg
  Q0179  Ondansetron HCl 8mg oral
  Q0180  Dolasetron mesylate oral
  Q0187  Factor viia recombinant
  Q2002  Elliot's B solution
  Q2003  Aprotinin, 10,000 kiu
  Q2004  Treatment for bladder calcul
  Q2005  Corticorelin ovine triflutat
  Q2006  Digoxin immune FAB (Ovine),
  Q2007  Ethanolamine oleate, 1000 ml
  Q2008  Fomepizole, 1.5 G
  Q2009  Fosphenytoin, 50 mg
  Q2010  Glatiramer acetate, 25 mgeny
  Q2011  Hemin, 1 mg
  Q2012  Pegademase bovine inj 25 I.U
  Q2013  Pentastarch 10% inj, 100 ml
  Q2014  Sermorelin acetate, 0.5 mg
  Q2015  Somatrem, 5 mg
  Q2016  Somatropin, 1 mg
  Q2017  Teniposide, 50 mg
  Q2018  Urofollitropin, 75 I.U.
  Q3001  Brachytherapy Seeds
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[FR Doc. 00-8215 Filed 3-31-00 11:00 am]
BILLING CODE 4120-01-P