[Federal Register Volume 66, Number 165 (Friday, August 24, 2001)]
[Proposed Rules]
[Pages 44672-44912]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-21213]



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Part II





Department of Health and Human Services





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Centers for Medicare & Medicaid Services



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42 CFR Part 413, et al.



Medicare Program; Changes to the Hospital Outpatient Prospective 
Payment System and Calendar Year 2002 Payment Rates; Proposed Rule

  Federal Register / Vol. 66, No. 165 / Friday, August 24, 2001 / 
Proposed Rules  

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 413, 419, and 489

[CMS-1159-P]
RIN 0938-AK54


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

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

ACTION: Proposed rule.

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

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

ADDRESSES: In commenting, please refer to file code CMS-1159-P. Because 
of staff and resource limitations, we cannot accept comments by 
facsimile (FAX) transmission. Mail written comments (one original and 
three copies) to the following address only: Centers for Medicare & 
Medicaid Services, Department of Health and Human Services, Attention: 
CMS-1159-P, P.O. Box 8017, Baltimore, MD 21244-8017.
    To ensure that mailed comments are received in time for us to 
consider them, please allow for possible delays in delivery.
    If you prefer, you may deliver (by hand or courier) your written 
comments (one original and three copies) to one of the following 
addresses:

Room 443-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., 
Washington, DC 20201, or
Room C5-16-03, 7500 Security Boulevard, Baltimore, MD 21244-1850.

    Comments mailed to the addresses indicated as appropriate for hand 
or courier delivery may be delayed and received too late for us to 
consider them.
    For information on viewing public comments, see the beginning of 
the SUPPLEMENTARY INFORMATION section.
    When ordering copies of the Federal Register containing this 
document, see the SUPPLEMENTARY INFORMATION section.

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

SUPPLEMENTARY INFORMATION:

Inspection of Public Comments

    Comments received timely will be available for public inspection as 
they are received, generally beginning approximately 3 weeks after 
publication of a document, at the headquarters of the Centers for 
Medicare & Medicaid Services, 7500 Security Blvd., Baltimore, MD 21244-
1850 on Monday through Friday of each week from 8:30 a.m. to 4 p.m. To 
schedule an appointment to view public comments, please call (410) 786-
7195 or (410) 786-4668.

Availability of Copies and Electronic Access

    Copies: To order copies of the Federal Register containing this 
document, send your request to: New Orders, Superintendent of 
Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. Specify the date 
of the issue requested and enclose a check or money order payable to 
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libraries throughout the country that receive the Federal Register.
    This Federal Register document is also available from the Federal 
Register online database through GPO Access, a service of the U.S. 
Government Printing Office. The Website address is: http://www.access.gpo.gov/nara/index.html. To assist readers in referencing 
sections contained in this document, we are providing the following 
table of contents.

Outline of Contents

I. Background
    A. Authority
    B. Summary of Rulemaking
    C. Summary of Relevant Provisions of the Benefits Improvement 
and Protection Act of 2000 (BIPA 2000)
    1. Accelerated Reduction of Beneficiary Copayment
    2. Revision of Payment Update
    3. Process and Standards for Determining Eligibility of Devices 
for Transitional Pass-Through Payments
    4. Application of Transitional Corridor Payments to Certain 
Hospitals That Did Not Submit A 1996 Cost Report
    5. Treatment of Children's Hospitals
    6. Transitional Pass-Through Payment for Temperature Monitored 
Cryoablation
    7. Contrast Enhanced Diagnostic Procedures
    8. Other Changes
II. Proposed Changes to the Ambulatory Payment Classification (APC) 
Groups and Relative Weights
    A. Recommendations of the Advisory Panel on APC Groups
    1. Establishment of the Advisory Panel
    2. Specific Recommendations of the Advisory Panel and Our 
Responses
    B. Additional APC Changes Resulting from BIPA Provisions
    1. Coverage of Glaucoma Screening
    2. APCs for Contrast Enhanced Diagnostic Procedures
    C. Other Changes Affecting the APCs
    1. Changes in Revenue Code Packaging
    2. Special Revenue Code Packaging for Specific Types of 
Procedures
    3. Limit on Variation of Costs of Services Classified Within a 
Group
    4. Observation Services
    5. List of Procedures That Will Be Paid Only As Inpatient 
Procedures
    6. Additional New Technology APC Groups
    D. Recalibration of APC Weights for CY 2002
III. Wage Index Changes
IV. Copayment Changes
    A. BIPA 2000 Coinsurance Limit
    B. Impact of BIPA 2000 Payment Rate Increase on Coinsurance
    C. Coinsurance and Copayment Changes Resulting from Change in an 
APC Group
V. Outlier Policy Changes
VI. Other Policy Decisions and Proposed Changes
    A. Change in Services Covered Within the Scope of the OPPS
    B. Categories of Hospitals Subject To and Excluded from the OPPS
    C. Conforming Changes: Additional Payments on a Reasonable Cost 
Basis
    D. Hospital Coding for Evaluation and Management Services
    E. Annual Drug Pricing Update
    F. Definition of Single-Use Devices
    G. Criteria for New Technology APCs
    1. Background
    2. Proposed Modifications to the Criteria and Process for 
Assigning Services to New Technology APCs a. Services Paid Under New 
Technology APCs b. Criteria for Assignment to New Technology APC c. 
Revision of Application for New Technology Status d. Length of Time 
in a New Technology APC
VII. Transitional Pass-Through Payment Issues

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    A. Background
    B. Discussion of Pro-Rata Reduction
    1. Data and Methodology
    2. Drugs and Biologicals
    3. Radiopharmaceutical Drugs and Biological Products
    4. Medical Devices
    5. Projecting to 2002
    C. Reducing Transitional Pass-Through Payments to Offset Costs 
Packaged into APC Groups
    1. Background
    2. Proposed Reduction for 2002
VIII. Conversion Factor Update for CY 2002
IX. Summary of and Responses to MedPAC Recommendations
X. Provider-Based Issues
    A. Background and April 7, 2000 Regulations
    B. Provider-Based Issues/Frequently Asked Questions
    C. Benefits Improvement and Protection Act of 2000
    1. Two-Year ``Grandfathering'
    2. Geographic Location Criteria
    3.Criteria for Temporary Treatment as Provider--Based
    D. Proposed Changes to Provider-Based Regulations
    1. Clarification of Requirements for Adequate Cost Data and Cost 
Finding
    2. Scope and Definitions
    3. BIPA Provisions on Grandfathering and Temporary Treatment as 
Provider-Based
    4. Reporting
    5. Geographic Location Criteria
    6. Notice to Beneficiaries of Coinsurance Liability
    7. Clarification of Protocols for Off-Campus Departments
    8. Other Changes
XI. Summary of Proposed Changes
    A. Changes Required by BIPA
    B. Additional Changes
    C. Technical Corrections
XII. Collection of Information Requirements
XIII. Response to Public Comments
XIV. Regulatory Impact Analysis
    Regulations Text

Addenda

Addendum A--List of Ambulatory Payment Classifications (APCs) with 
Status Indicators, Relative Weights, Payment Rates, and Copayment 
Amounts
Addendum B--Payment Status by HCPCS Code, and Related Information
Addendum C--Hospital Outpatient Payment for Procedures by APC: 
Displayed on Website Only
Addendum D--Payment Status Indicators for the Hospital Outpatient 
Prospective Payment System
Addendum E--CPT Codes Which Would Be Paid Only As Inpatient 
Procedures
Addendum G--Service Mix Indices by Hospital: Displayed on Website 
only
Addendum H--Wage Index for Urban Areas
Addendum I--Wage Index for Rural Areas
Addendum J--Wage Index for Hospitals That Are Reclassified

Alphabetical List of Acronyms Appearing in the Proposed Rule

APC  Ambulatory payment classification
APG  Ambulatory patient group
ASC  Ambulatory surgical center
AWP  Average wholesale price
BBA  1997 Balanced Budget Act of 1997
BIPA  2000 Medicare, Medicaid, and SCHIP Benefits Improvement and 
Protection Act of 2000
BBRA  1999 Balanced Budget Refinement Act of 1999
CAH  Critical access hospital
CAT  Computerized axial tomography
CCI  Correct Coding Initiative
CCR  Cost center specific cost-to-charge ratio
CMHC  Community mental health center
CMS  Centers for Medicare & Medicaid Services (Formerly known as the 
Health Care Financing Administration)
CORF  Comprehensive outpatient rehabilitation facility
CPI  Consumer Price Index
CPT  (Physician's) Current Procedural Terminology, Fourth Edition, 
2001, copyrighted by the American Medical Association
DME  Durable medical equipment
DMEPOS  DME, prosthetics (which include prosthetic devices and 
implants) orthotics, and supplies
DRG  Diagnosis-related group
EMTALA  Emergency Medical Treatment and Active Labor Act
FDA  Food and Drug Administration
FQHC  Federally qualified health center
HCPCS  Healthcare Common Procedure Coding System
HHA  Home health agency
ICD-9-CM  International Classification of Diseases, Ninth Edition, 
Clinical Modification
IME  Indirect medical education
JCAHO  Joint Commission on Accreditation of Healthcare Organizations
MRI  Magnetic resonance imaging
MSA  Metropolitan statistical area
NECMA  New England County Metropolitan Area
OPPS  Hospital outpatient prospective payment system
PPS  Prospective payment system
RFA  Regulatory Flexibility Act
RHC  Rural health clinic
RRC  Rural referral center
SCH  Sole community hospital
SNF  Skilled nursing facility

I. Background

A. Authority

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

B. Summary of Rulemaking

     On September 8, 1998, we published a proposed rule (63 FR 
47552) to establish in regulations a PPS for hospital outpatient 
services, to eliminate the formula-driven overpayment for certain 
hospital outpatient services, and to extend reductions in payment for 
costs of hospital outpatient services. On June 30, 1999, we published a 
correction notice (64 FR 35258) to correct a number of technical and 
typographic errors in the September 1998 proposed rule including the 
proposed amounts and factors used to determine the payment rates.
     On April 7, 2000, we published a final rule with comment 
period (65 FR 18438) that addressed the provisions of the PPS for 
hospital outpatient services scheduled to be effective for services 
furnished on or after July 1, 2000. Under this system, Medicare payment 
for hospital outpatient services included in the PPS is made at a 
predetermined, specific rate. These outpatient services are classified 
according to a list of ambulatory payment classifications (APCs). The 
April 7 final rule with comment period also established requirements 
for provider departments and provider-based entities and prohibited 
Medicare payment for non-physician services furnished to a hospital 
outpatient by a provider or supplier other than a hospital unless the 
services are furnished under arrangement. In addition, this rule 
extended reductions in payment for costs of hospital outpatient 
services as required by the BBA of 1997 and

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amended by the BBRA of 1999. Medicare regulations governing the 
hospital OPPS are set forth at 42 CFR 419.
     On June 30, 2000, we published a notice (65 FR 40535) 
announcing a delay in implementation of the OPPS from July 1, 2000 to 
August 1, 2000.
     On August 3, 2000, we published an interim final rule with 
comment period (65 FR 47670) that modified criteria that we use to 
determine which medical devices are eligible for transitional pass-
through payments. The August 3, 2000 rule also corrected and clarified 
certain provider-based provisions included in the April 7, 2000 rule.
     On November 13, 2000, we published an interim final rule 
with comment period (65 FR 67798). This rule provided for the annual 
update to the amounts and factors for OPPS payment rates effective for 
services furnished on or after January 1, 2001. We also responded to 
public comments on those portions of the April 7, 2000 final rule that 
implemented related provisions of the BBRA and public comments on the 
August 3, 2000 rule.

C. Summary of Relevant Provisions of the BIPA

    The BIPA, which was enacted on December 21, 2000, made the 
following changes to the Act relating to OPPS.
1. Accelerated Reduction of Beneficiary Copayment
    Section 111 amended section 1833(t)(8)(C) of the Act to limit the 
national copayment rate for OPPS services to 57 percent of the OPPS 
payment rate for services furnished in 2001 on or after April 1, 2001; 
55 percent for services in 2002 and 2003; 50 percent for services 
furnished in 2004; 45 percent for services furnished in 2005; and 40 
percent for services furnished in 2006 and thereafter.
    Section 111 also specifies that nothing in BIPA 2000 or the Act, 
shall be viewed as preventing a hospital from waiving the amount of any 
beneficiary coinsurance for outpatient hospital services that may have 
been increased as a result of implementation of the OPPS.
2. Revision of Payment Update
    Section 401 amended section 1833(t)(3)(C) of the Act to provide in 
2001 an update equal to the full rate of increase in the market basket 
index. The 2002 update factor remains as it was under the law before 
the enactment of BIPA, that is, the market basket index percentage 
increase minus 1 percentage point.
3. Process and Standards for Determining Eligibility of Devices for 
Transitional Pass-Through Payments
    Section 402 amended section 1833(t)(6) of the Act to require that 
the determination of eligibility for transitional pass-through payments 
be based on categories of devices (previously, eligibility was 
determined on a device-specific basis). The establishment of an initial 
set of categories was required effective for services furnished on or 
after April 1, 2001. This provision was implemented on March 22, 2001 
in Program Memorandum (PM) No. A-01-41, which set forth a list of 96 
initial categories.
    Section 402 of the BIPA also provides that the Secretary must 
establish criteria to use in creating additional device categories. 
These criteria will be set forth in an interim final rule with comment 
period that will be published in the Federal Register at a later date.
    Related to this issue is the issue of pro rata reductions of 
transitional pass through payments for new technology. A discussion of 
this can be found later in this document in Section VII. B.
4. Application of Transitional Corridor Payments to Certain Hospitals 
That Did Not Submit a 1996 Cost Report
    Section 403 amended section 1833(t)(7)(F)(ii)(I) of the Act to 
allow transitional corridor payments to hospitals subject to the OPPS 
that did not have a 1996 cost report by authorizing the use of the 
first available cost reporting period ending after 1996 and before 
2001.
5. Treatment of Children's Hospitals
    Section 405 amended section 1833(t) of the Act to give children's 
hospitals the same permanent hold harmless protection as cancer 
hospitals under the OPPS.
6. Transitional Pass-Through Payment for Temperature Monitored 
Cryoablation
    Section 406 amended section 1833(t)(6)(A)(ii) of the Act to include 
devices of temperature monitored cryoablation as eligible for 
transitional pass-through payments. This provision will be included in 
the interim final rule concerning changes in eligibility of devices for 
transitional pass-through payments mentioned above.
7. Contrast Enhanced Diagnostic Procedures
    Section 430 amended section 1833(t)(2) of the Act to require that 
procedures that use contrast agents be classified in groups that are 
separate from those to which procedures not using contrast agents are 
assigned. We implemented this provision in PM No. A-01-73, issued on 
June 1, 2001. In addition, section 430 amended section 1861(t)(1) of 
the Act to expand the definition of drugs to include contrast agents 
effective for contrast agents furnished on or after July 1, 2001.
8. Other Changes
    In addition to the provisions directly related to OPPS, BIPA 
included the following provisions that will require revision in the 
services assigned to APCs in the OPPS:
     Section 102 amended section 1861(s)(2) of the Act to allow 
coverage of glaucoma screening for certain high risk individuals 
effective for services furnished on or after January 1, 2002.
     Section 104(d)(2) directed the Secretary to determine if 
HCPCS codes are appropriate to describe mammography that uses new 
technology. The Secretary has created these codes for 2002.
    Throughout this proposed rule, we discuss these various provisions 
and the changes we are proposing to make in the OPPS for them.

II. Proposed Changes to the APC Groups and Relative Weights

    Under the OPPS, we pay for hospital outpatient services on a rate 
per service basis that varies according to the APC group to which the 
service is assigned. Each APC weight represents the median hospital 
cost of the services included in that APC relative to the median 
hospital cost of the services included in APC 0601, Mid-Level Clinic 
Visits. As described in the April 7, 2000 final rule (65 FR 18484), the 
APC weights are scaled to APC 0601 because a mid-level clinic visit is 
one of the most frequently performed services in the outpatient 
setting.
    Section 1833(t)(9)(A) of the Act requires the Secretary to review 
the components of the OPPS not less often than annually and to revise 
the groups and related payment adjustment factors to take into account 
changes in medical practice, changes in technology, and the addition of 
the new services, new cost data, and other relevant information. 
Section 1833(t)(9)(A) of the Act requires the Secretary, beginning in 
2001, to consult with an outside panel of experts when annually 
reviewing and updating the APC groups and the relative weights.
    Finally, section 1833(t)(2) of the Act provides that, subject to 
certain exceptions, the items and services within an APC group cannot 
be considered comparable with respect to

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the use of resources if the highest median or mean cost item or service 
in the group is more than 2 times greater than the lowest median or 
mean cost item or service within the same group (referred to as the ``2 
times rule''). We use the median cost of the item or service in 
implementing this provision. The statute authorizes the Secretary to 
make exceptions to the 2 times rule ``in unusual cases, such as low 
volume items and services.''
    The APC groups that we are proposing in this rule as the basis for 
payment in 2002 under the OPPS have been analyzed within this statutory 
framework.

A. Recommendations of the Advisory Panel on APC Groups

1. Establishment of the Advisory Panel
    Section 1833(t)(9)(A) of the Act, which requires that we consult 
with an outside panel of experts when annually reviewing and updating 
the APC groups and the relative weights, specifies that the panel will 
act in an advisory capacity. The expert panel, which is to be composed 
of representatives of providers, is to review and advise us about the 
clinical integrity of the APC groups and their weights. The panel is 
not restricted to using our data and may use data collected or 
developed by organizations outside the Department in conducting its 
review.
    On November 21, 2000, the Secretary signed the charter establishing 
an ``Advisory Panel on APC Groups'' (the Panel). The Panel is technical 
in nature and is governed by the provisions of the Federal Advisory 
Committee Act (FACA) as amended (Public Law 92-463). To establish the 
Panel, we solicited members in a notice published in the Federal 
Register on December 5, 2000 (65 FR 75943). We received applications 
from more than 115 individuals nominating either themselves or a 
colleague. After carefully reviewing the applications, CMS chose 15 
highly qualified individuals to serve on the panel. The Panel was 
convened for the first time on February 27, February 28, and March 1, 
2001. We published a notice in the Federal Register on February 12, 
2001 (66 FR 9857) to announce the location and time of the Panel 
meeting, a list of agenda items, and that the meeting was open to the 
public. We also provided additional information through a press release 
and our website.
2. Specific Recommendations of the Advisory Panel and Our Responses
    In this section of the proposed rule, we summarize the issues 
considered by the Panel, the Panel's APC recommendations, and our 
subsequent action with regard to the Panel's recommendations. The data 
used by the Panel in making its recommendation are the 1996 claims that 
were used to set the APC weights and payment rates for CY 2000 and 
2001.
    As discussed below, the Panel sometimes declined to recommend a 
change in an APC even though the APC violated the 2 times rule. In 
section II.C.3 of this preamble, we discuss our proposals regarding the 
2 times rule based on the data we are using to recalibrate the 2002 APC 
relative weights (that is, claims for services furnished on or after 
July 1, 1999 and before July 1, 2000). That section also details the 
criteria we use in deciding to make an exception to the 2 times rule. 
We asked the Panel to review many of the exceptions we implemented in 
2000 and 2001. The exceptions are referred to as ``violations of the 2 
times'' rule in the following discussion.

APC 0016: Level V Debridement & Destruction

APC 0017: Level VI Debridement & Destruction

    We asked the Panel to review the current placement of CPT code 
56501, Destruction of lesion(s), vulva; simple, any method, in APC 0016 
because the APC violates the 2 times rule. Because the procedure is a 
simple destruction of skin and superficial subcutaneous tissues, we 
would not expect it to have a median cost of $500. Thus, we believe 
that the higher costs associated with this code were the result of 
incorrect coding. To ensure that procedures in APC 0016 comply with the 
2 times rule, we asked the Panel to consider one of the following 
clinical options:
     Move CPT code 56501 to APC 0017.
     Retain CPT code 56501 in APC 0016 but split APC 0016 into 
three APCs to distinguish simple destruction lesions from extensive 
destruction lesions.
    The Panel rejected the option to split APC 0016 into three 
different APCs. The members stated that there was no validity in taking 
that approach because simple versus extensive destruction of lesions 
had greater significance in relation to physician work than in 
measuring facility resource use. They believed that many of the 
procedures assigned to APC 0016 are performed in a procedure room 
rather than in the operating room. The Panel considered factors such as 
the use of anesthesia and the method used to destroy the lesions as 
indicators of differences in facility resource consumption between 
simple and extensive destruction of lesions. The Panel agreed that the 
simple destruction of lesions should be assigned to the same APC as the 
extensive destruction of lesions if a laser is used to remove simple 
lesions. In this case, the Panel stated that the similarity in resource 
use is based on the method or technique used to perform the procedure.
    The Panel also noted that CPT code 11042, Debridement; skin, 
subcutaneous tissue, and muscle, is the most frequently performed 
procedure in APC 0016, accounting for approximately 85 percent of this 
APC's total volume. The Panel noted that this code had probably been 
billed incorrectly because of widespread misunderstanding about its 
definition.
    The Panel also reviewed procedures assigned to APCs 0014 (Level III 
Debridement & Destruction) and 0015 (Level IV Debridement & 
Destruction) and compared similarities and differences among those 
procedures and the ones assigned to APCs 0016 and 0017. During this 
comparative review, the Panel compared CPT code 56501 to the following 
two CPT codes: 46917, Destruction of lesion(s), anus, simple; laser 
surgery, which is assigned to APC 0014, and 54055, Destruction of 
lesion(s), penis, simple; electrodesiccation, which is assigned to APC 
0016. In reviewing these three procedures, the Panel questioned whether 
the resources involved supported their current APC assignments. After 
considerable discussion, the Panel recommended the following:
     Move CPT code 56501 from APC 0016 to APC 0017.
     Move CPT code 46917 from APC 0014 to APC 0017.
    The Panel recommended these changes to achieve clinical coherence 
and resource similarity among the procedures assigned to these APCs. 
Because CPT code 46917 is performed using laser equipment and requires 
anesthesia, the Panel believed it appropriate to move this procedure to 
APC 0017. Although the Panel considered the reassignment of CPT code 
54055 to APC 0017, it did not recommend this change. The Panel's 
recommended changes would group in APC 0017 simple destruction of 
lesion procedures that use laser or surgical techniques with extensive 
destruction of lesion procedures.
    We propose to accept the Panel's recommendation regarding CPT code 
56501 and to revise the APC accordingly. However, as shown below in 
Table 3, we are proposing to make

[[Page 44676]]

additional changes to these APCs because of the 2 times rule.

APC 0024: Level I Skin Repair

APC 0025: Level II Skin Repair

APC 0026: Level III Skin Repair

APC 0027: Level IV Skin Repair

    The composition of procedures in APCs 0025 and 0027 results in 
these APCs violating the 2 times rule. Therefore, we requested the 
Panel's advice in exploring other clinical options for reconfiguring 
the four skin repair APCs to achieve clinical and resource homogeneity 
among the procedures assigned to APCs 0025 and 0027 while retaining 
clinical and resource homogeneity for APCs 0024 and 0026. We asked the 
Panel to consider the following clinical options to achieve this 
result:
     Rearrange the procedures assigned to APCs 0024 through 
0027 based on the size or the length of the skin incision.
     Rearrange the procedures assigned to APCs 0024 through 
0027 based on the complexity of the repair, such as distinguishing 
repairs that involve layers of skin, flaps, or grafts from those that 
do not.
    The Panel reviewed the various options presented, which were 
modeled based on the 1996 claims data used in constructing the current 
APC groups and payment rates. Using these data, the Panel discussed 
size and complexity of the various repairs, considered the clinical 
differences in performing the repairs on different anatomical sites, 
and the clinical differences involved in making skin repairs using 
flaps and grafts versus layers of skin. As a result of its review, the 
Panel stated that they found no compelling clinical advantages in the 
options presented. The Panel also agreed that more current data would 
be needed to make appropriate recommendations about the actual merits 
and benefits of the various options. For these reasons, the Panel 
recommended the following:
     Make no changes to APCs 0024 and 0027.
     Reevaluate these APCs with new data when the Panel meets 
in 2002.
     The Panel, in preparation for the 2002 meeting, will 
discuss with and gather clinical and utilization information from their 
respective hospitals regarding these procedures.
    We propose to accept the Panel's recommendations. However, as shown 
in Table 3, we are proposing to make changes to these APCs based on the 
use of new data and application of the 2 times rule.

APC 0058: Level I Strapping and Casting Application

APC 0059: Level II Strapping and Casting Application

    APC 0058 (which consists of the simpler casting, splinting, and 
strapping procedures) violates the 2 times rule. The median costs for 
high volume procedures in APC 0058 vary widely, ranging from $27 to 
$83. The median costs associated with presumably more resource-
intensive procedures in APC 0059 are fairly uniform, ranging from $69 
to $119. To limit the cost variation in APC 0058, we asked the Panel to 
consider the following options:
     Move the following four codes from APC 0058 to APC 0059: 
CPT code 29515, Application of short splint (calf to foot); CPT code 
29520, Strapping; hip; CPT code 29530, Strapping; knee; and CPT code 
29590, Denis-Brown splint strapping.
     Create a new APC to include a third level of strapping and 
casting application procedures by regrouping all procedures assigned to 
both APCs 0058 and 0059 based on the following clinical distinctions: 
Removal/revision, strapping/splinting, and casting.
     Package certain CPT codes assigned to APC 0058 with 
relevant procedures.
    The Panel discussion revealed that codes grouped in APC 0058 are 
not always appropriately billed by hospitals. The Panel pointed out 
that code descriptors such as ``strapping of the hip'' are not commonly 
understood by hospital staff. The Panel noted that before 
implementation of OPPS, hospitals billed the items described by these 
codes as supplies (without a CPT code) when they were billed as 
anything other than an emergency room visit. They also stated that the 
use of these codes has been confused with the use of some codes 
associated with durable medical equipment. For these reasons, the Panel 
believed that the procedure costs reflected in our data are skewed. As 
a result, the Panel recommended that we do the following:
     Make no changes to APC 0058.
     Provide appropriate education and guidance to hospitals 
regarding appropriate use and billing of codes in APC 0058.
     Resubmit APC 0058 to the Panel for reevaluation when later 
data are available.
    We propose to accept the Panel's recommendations except that we 
propose to move CPT code 29515 to APC 0059 due to the 2 times rule and 
the newer data we are using for this proposed rule.

APC 0079: Ventilation Initiation and Management

    The codes in APC 0079 represent respiratory treatment and support 
provided in the outpatient setting. The cost variation among the 
assigned procedures in this APC raises concern about hospital coding 
practices. The median costs for these procedures range from $40 to 
$315. We asked the Panel to clarify whether these procedures are 
performed on outpatients or if they are performed on patients who come 
to the emergency room and are later admitted to the hospital as 
inpatients.
    The Panel acknowledged that there are major problems associated 
with appropriately assigning codes to these procedures which results in 
incorrect billing. The Panel concluded that additional information is 
necessary to better understand the issues raised. The Panel also 
advised that CPT code 94660, Continuous positive airway pressure 
ventilation (CPAP), initiation and management, is a sleep apnea 
procedure used in the treatment of obesity and is clinically different 
from all other procedures in APC 0079. For these reasons, the Panel 
recommended the following:
     Remove CPT code 94660 from APC 0079 and create a new APC 
for this one procedure.
    We propose to accept the Panel's recommendation by creating a new 
APC 0065, CPAP Initiation.

APC 0094: Resuscitation and Cardioversion

    We requested the Panel's assistance in determining whether it is 
clinically appropriate to remove the cardioversion procedures from APC 
0094 because the rest of the procedures assigned to APC 0094 are 
emergency procedures rather than elective. We proposed that the Panel 
consider the creation of a new APC for the cardioversion procedures or 
reassignment of the procedures to another APC that would be more 
appropriate in terms of clinical coherence and resource similarity. 
Splitting APC 0094 into two distinct groups, one for resuscitation 
procedures and the other for internal and external electrical 
cardioversion procedures, would not result in a significant difference 
in the APC payment rate for either of the new APCs.
    The Panel considered whether it was clinically appropriate to 
combine internal and external cardioversion procedures (CPT codes 92960 
and 92961, respectively) in the same APC. The Panel also questioned the 
conditions under which internal cardioversion procedures would be 
performed on an outpatient basis.

[[Page 44677]]

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

APC 0102: Electronic Analysis of Pacemakers/Other Devices

    The neurologic procedures included in APC 0102 (CPT codes 95970 
through 95975), are significantly more complex than the routine cardiac 
pacemaker programming codes also assigned to this APC. Because we 
believe these codes are clinically different, we asked the Panel to 
consider the following:
     Create a new APC for the neurologic codes.
     Move the neurologic codes to APC 0215, Level I Nerve and 
Muscle Tests.
    One presenter appearing before the Panel stated that APC 0102 
involves clinical functions related to four different categories of 
devices; that is, pacemakers, defibrillators, infusion pumps, and 
neurostimulators. The presenter, who represented a device 
manufacturers' association, contended that these four categories of 
devices differ clinically. The presenter also stated that patients 
receiving these devices are clinically different and are even treated 
by different hospital departments. The presenter recommended the 
following:
     Split APC 0102 into two APCs: One APC for electronic 
analysis of pacemakers and other cardiac devices and a separate APC for 
electronic analysis of infusion pumps and neurostimulators.
     The APC created for electronic analysis of infusion pumps 
and neurostimulators would include the following CPT codes:

------------------------------------------------------------------------
               Code                              Descriptor
------------------------------------------------------------------------
62367............................  Analyze spine infusion pump.
62368............................  Analyze spine infusion pump.
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.
------------------------------------------------------------------------

     The APC created for electronic analysis of pacemakers and 
other cardiac devices would include the following CPT codes:

------------------------------------------------------------------------
               Code                              Descriptor
------------------------------------------------------------------------
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 single.
93743............................  Analyze ht pace device dual.
93744............................  Analyze ht pace device dual.
------------------------------------------------------------------------

    The presenter stated that reorganizing APC 0102 as recommended 
would establish groups that are more clinically and resource similar 
than the current grouping. The presenter believes that APC 0102 as 
currently configured violates the 2 times rule. The median costs for 
the 21 procedures currently included in APC 0102 vary from $19 to $145. 
Other presenters clarified clinical aspects of the procedures, 
identified which practitioners perform them, the time it takes to 
perform them, and how they are to be billed. Yet another presenter 
speaking on behalf of a specialty society noted that the society had 
previously commented on this APC and requested that we remove CPT codes 
93737 and 93738 from APC 0102.
    The Panel noted that because most of the codes are new, having been 
established since 1996 (the base year of data available to the Panel), 
these newer procedures could not have been included in the data file 
used to create the current APC payment rates. In the absence of 
frequency and median cost data for many of these procedures, the Panel 
was concerned about reorganizing the codes in this APC. Nonetheless, 
the Panel recommended the following reorganization of APC 0102 to 
better reflect clinical coherence:
     APC 0102 be split into four new APCs: One APC for analysis 
and programming of infusion pumps and CSF shunts; a second for analysis 
and programming of neurostimulators; a third for analysis and 
programming of pacemakers and internal loop recorders; and a fourth for 
analysis and programming of cardioverter-defibrillators.
    We propose to accept the Panel's recommendations and propose to 
create four new APCs as follows:

APC 0689: Electronic Analysis of Cardioverter-Defibrillator
APC 0690: Electronic Analysis of Pacemakers and Other Cardiac Devices
APC 0691: Electronic Analysis of Programmable Shunts/Pumps
APC 0692: Electronic Analysis of Neurostimulator Pulse Generators.

APC 0110: Transfusion

APC 0111: Blood Product Exchange

APC 0112: Extracorporeal Photopheresis

    The procedures included in APC 0110 are those related only to the 
services associated with performing the blood transfusion and 
monitoring the patient during the transfusion; the costs associated 
with the blood products themselves are not included in APC 0110. We 
advised the Panel that we were not certain that cost data for blood 
transfusions excluded the costs of the blood products because the APC 
0110 median cost of $289 seemed excessive. We expressed concern about 
hospital coding and billing practices for blood products, blood 
processing, storage, and transportation charges as represented in the 
1996 data. We asked the Panel to advise us on how to clarify hospital 
billing and coding practices for blood transfusions; we also asked if 
the Panel members believe that the median costs for transfusion 
procedures include the costs for blood products and, if so, how the 
procedures should be adjusted to eliminate these costs.
    A presenter representing a device manufacturers' association noted 
that these issues were examined extensively by several specialty 
societies that sent considerable data to us on the actual cost of the 
transfusion procedures before publication of the April 7, 2000 final 
rule (65 FR 18434). The presenter stated that the median costs for 
transfusion procedures that we used in calculating the final payment 
rate for APC 0110 was somewhat lower than the costs submitted by the 
specialty societies. The presenter believes that our experience under 
the APC system is too limited for us to make a judgment concerning the 
validity of the median costs. The presenter also believes that the 
payment rate for APC 0110 should have been adjusted to include costs 
for blood safety tests, such as the hepatitis and HIV look-back tests 
mandated by the FDA over the past several years, because these costs 
were not included in the 1996 data used to construct the APC rates. The 
presenter stated that these tests are expensive and that they increase 
the hospitals' costs to provide the blood. However, it was unclear 
whether these tests are separately billable under the lab fee schedule.
    In addition, the presenter explained that blood centers do not 
charge hospitals for blood because it is voluntarily donated, not 
manufactured. The presenter stated that blood centers charge hospitals 
what it costs them to provide the blood and that hospitals bill

[[Page 44678]]

acquisition and processing charges rather than charges for the blood 
itself. Based on the information provided, the presenter urged the 
Panel not to revise APC 0110 until more data become available.
    For APC 0111, another representative of a specialty society 
recommended that CPT code 36521, Therapeutic apheresis; with 
extracorporeal affinity column absorption and plasma reinfusion, be 
moved from APC 0111 to APC 0112. The presenter stated that CPT code 
36521 is more similar clinically and in resource use to 36522, 
Photopheresis, extracorporeal which is in APC 0112. The presenter 
stated that a major difference between the procedure represented by CPT 
codes 36521 and 36520, Therapeutic Apheresis; plasma and/or cell 
exchange, which is also assigned to APC 0111, and the other procedures 
codes assigned to APC 0111, is that hospitals can bill separately for 
blood products such as the plasma or albumin used in performing plasma 
exchange procedures. The presenter described CPT code 36521 as a 
``self-contained'' procedure not requiring the use of albumin or 
plasma, because the patient's own blood is processed through a machine 
and returned to the patient. The presenter stated that the materials 
and equipment used to perform this procedure make it much more costly 
than the other procedures assigned to APC 0111. The presenter, citing 
cost data from two medical centers where CPT code 36521 is frequently 
performed, stated that the total cost of the procedure, including the 
cost of the adsorption column, is approximately $2000. At this time, 
the commenter noted, only one of the adsorption columns (Prosorba) used 
for this procedure is eligible for transitional pass-through payments, 
which means that payments for this procedure, which are based upon the 
APC payment alone, are too low when one of the other columns is used 
and no additional pass-through payment is made. It was stated that the 
cost of many of the adsorption columns is over $1000 per column. The 
presenter concluded that moving CPT code 36521 from APC 0111 to APC 
0112 would comply with the statutory requirements for clinical 
coherence and resource similarity among procedures in the same APC.
    The Panel discussed various adsorption devices used in performing 
CPT code 36521, their eligibility for transitional pass-through 
payments, as well as the clinical and resource use difference between 
CPT codes 36520 and 36551. After considerable discussion, the Panel 
recommended the following:
     Take no action on APC 0110.
     Move CPT code 36521 from APC 0111 to APC 0112 to achieve 
clinical coherence and resource similarity with photopheresis 
procedures included in APC 0112. However, the Panel cautioned that the 
payment for APC 0112 captured the cost of the entire procedure 
including the cost of the adsorption column. For this reason, any 
additional payment for the adsorption column through the transitional 
pass-through payment mechanism would be a duplicate payment. Therefore, 
the panel asked that CMS address this problem when considering their 
recommendation.
    We propose to accept the Panel's recommendations. We note that 
effective April 1, 2001, the Prosorba column is no longer eligible for 
a transitional pass-through payment (see PMA-01-40 issued on March 27, 
2001).

APC 0116: Chemotherapy Administration by Other Technique Except 
Infusion

APC 0117: Chemotherapy Administration by Infusion Only

APC 0118: Chemotherapy Administration by Both Infusion and Other 
Technique

    We had received several comments requesting that oral delivery of 
chemotherapy and delivery of chemotherapy by infusion pumps and 
reservoirs be recognized for payment under the OPPS. We asked the Panel 
to examine this issue.
    With regard to oral administration of chemotherapy, the Panel heard 
several presenters discuss the need for extensive beneficiary education 
prior to administration of oral anticancer agents. The Panel agreed 
that the beneficiaries actually self-administer the drug and that 
beneficiary education was appropriately billed as a clinic visit. The 
Panel stated that this would be true whether the education involved 
cancer chemotherapy, diabetes management, or congestive heart failure 
management. Therefore, the Panel recommended that no new codes be 
created to specifically recognize oral administration of chemotherapy.
    With regard to recognizing chemotherapy administration through 
infusion pumps and ports, the Panel heard several presentations that 
this is becoming a common method of administering not only cancer 
chemotherapy but also for administering other types of pharmaceuticals. 
It was pointed out that because CPT codes 96520, Refilling and 
maintenance of portable pump, and 96530, Refilling and maintenance of 
implantable pump or reservoir, were excluded from the OPPS it was 
impossible for hospitals to be paid when performing these services. 
After lengthy discussion, the Panel recommended that refilling and 
maintenance of pumps and reservoirs be assigned to an APC.
    The Panel also discussed the current HCPCS Q codes for chemotherapy 
administration and concluded that these codes should continue to be 
recognized in the OPPS. In addition, the Panel discussed whether a new 
Q code should be developed for extended chemotherapy infusions.
    In summary, the Panel recommended the following:
     Hospitals be allowed to bill for patient education under 
the appropriate clinic codes.
     CPT codes 96520 and 96530 be assigned to a new APC.
     The current HCPCS Level II Q codes for chemotherapy 
administration should continue to be used.
     There is no need to develop a new HCPCS code for 
``extended chemotherapy infusions.''
     CMS should consider developing a new HCPCS code for 
flushing of ports and reservoirs.
    We propose to accept all the Panel recommendations except for the 
recommendation regarding flushing of ports and reservoirs. Flushing is 
performed in conjunction with either a chemotherapy administration 
service or an outpatient clinic visit. In the first case, flushing is 
part of the chemotherapy administration and its costs are adequately 
captured in the costs of the chemotherapy administration code. In the 
second case, we believe that the costs of flushing are adequately 
captured in the costs of the clinic visit and need not be paid 
separately. We are proposing to create a new APC 0125, Refilling of 
Infusion Pump.

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

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

[[Page 44679]]

being increasingly performed on an outpatient basis. One presenter 
representing a specialty society stated that 95 percent of these 
procedures are performed in the hospital outpatient setting. The 
presenter shared cost data from the bone marrow transplant unit of an 
academic medical center that showed the cost to harvest bone marrow to 
be about $1,800. The presenter observed that this cost is significantly 
higher than the APC payment rate of about $205 for APC 0123. Another 
presenter representing a group of hospitals stated that the supply 
costs alone for bone marrow harvesting are more than the current APC 
payment for the procedure. The presenter suggested that miscoding may 
have contributed to the low $15 median cost reflected in our database. 
After discussion, the Panel recommended the following:
     Make no changes in the procedures assigned to APC 0123 in 
the absence of sufficient data to support such modifications.
     The two presenters on this APC issue submit cost data for 
the Panel to use in reevaluating this issue at its 2002 meeting.
    We note that our analysis of the more recent claims data we are 
using to reclassify and recalibrate the APCs in this proposed rule 
reveals a significant increase in costs for this APC resulting in a 
proposed payment rate that is double the current rate. However, very 
few procedures (fewer than 20) were billed on an outpatient basis. We 
will have the Panel review this APC again at their next meeting.

APC 0142: Small Intestine Endoscopy

APC 0143: Lower GI Endoscopy

APC 0145: Therapeutic Anoscopy

APC 0147: Level II Sigmoidoscopy

APC 0148: Level I Anal/Rectal Procedures

APC 0149: Level II Anal/Rectal Procedures

APC 0150: Level III Anal/Rectal Procedures

    We presented these seven APCs to the Panel because of the 
inconsistencies in the median costs for some procedures included in 
APCs 0142, 0143, 0145, and 0147. We advised the Panel that our cost 
data do not show a progression of median costs proportional to 
increases in clinical complexity as we would expect. For example, the 
data indicate that a therapeutic anoscopy assigned to APC 0145 costs 
more than twice as much as a flexible or rigid sigmoidoscopy assigned 
to APC 0147. We stated our concern that cost disparity could provide 
incentives to use inappropriate procedures. Because of these concerns, 
we asked the Panel's advice in determining whether one of the following 
actions should be taken:
     Divide the codes in APC 0142 into separate APCs 
representing ileoscopy and small intestine procedures.
     Combine diagnostic anoscopy and Level I sigmoidoscopy.
     Merge APCs 0143, 0145, and 0147 into one APC.
    We also asked the Panel whether the costs associated with codes in 
APC 0145 appeared to be valid.
    During the Panel discussion, it was noted that the data distributed 
to the Panel for these APCs indicated that most of the procedures are 
billed as single procedures only 50 percent of the time. This raised 
questions as to whether the data include procedures such as flexible 
sigmoidoscopies that were miscoded as rigid sigmoidoscopies, 
colonoscopies, and anoscopies. In examining the data, the Panel 
considered what impact this miscoding would have on the cost data, and 
discussed the clinical approaches used to perform some of the 
procedures, what type of practitioners perform them, and other 
procedures and supplies that would be billed with them. As a result of 
this discussion, the Panel concluded that the data anomalies were 
probably attributable to miscoding because hospitals have not received 
sufficient guidance and information on appropriately coding procedures 
included in these APCs. The Panel also agreed that it would need more 
current data before it could consider reconfiguring these APCs. 
Therefore, the Panel recommended that we do the following:
     Make no changes to APCs 0142, 0143, 0145, and 0147.
     Provide information and guidance to better assist 
hospitals in understanding how to bill appropriately for services 
included in APCs 0142, 0143, 0145, and 0147.
     Resubmit these APCs to the Panel for review when newer 
data are available.
    We propose to accept the Panel's recommendations.

APC 0151: Endoscopic Retrograde Cholangio-Pancreatography (ERCP)

    We advised the Panel that we have received comments that indicate 
that it is inappropriate to assign both diagnostic and therapeutic ERCP 
procedures to the same APC. The commenters allege that virtually every 
hospital performs diagnostic ERCPs but only teaching hospitals perform 
therapeutic ERCPs. Based on our current data, if we created two APCs 
for ERCP procedures, the APC payment rate for therapeutic ERCPs would 
be lower than that for diagnostic ERCPs (approximately $526 and $535, 
respectively). Therefore, we requested the Panel's advice to help us 
determine whether to create separate APCs for diagnostic and 
therapeutic ERCP procedures.
    A presenter speaking on behalf of a specialty society made the 
following points:
     ERCP is the most complex endoscopy procedure to perform 
and is usually performed by gastroenterologists.
     ERCP is usually performed at large hospitals.
     The most complex ERCP procedures are usually performed in 
teaching hospitals.
     Current payments for ERCP are lower than the costs to 
perform the procedure (based on cost and frequency data gathered from 
several teaching hospitals).
     Single claims should not be used to calculate an APC 
payment rate for ERCP services because a single ERCP procedure usually 
consists of several components, each with its own CPT code (e.g., 
sphincterotomy and stent placement). Therefore, an ERCP billed as a 
single CPT code would represent aberrant billing and would not 
accurately reflect the costs of an ERCP.
    The OPPS data distributed to the Panel verified that the vast 
majority of the ERCP procedures are performed as multiple procedures. 
The Panel agreed that the use of single claims data could possibly skew 
the APC payment rate for ERCP services.
    The Panel recommended that we do the following:
     Do not reconfigure the ERCP procedures in APC 0151.
     Resubmit this issue to the Panel for review when more 
recent data are available.
     Explore the feasibility of using multiple claims rather 
than single claims to calculate appropriate APC payment rates for ERCP 
procedures.
    We propose to accept the Panel's recommendations. We are currently 
reviewing the potential for using multiple claims data for determining 
payment rates for ERCP procedures. As a first step in the process, in 
this proposed rule, we have determined a payment rate for ERCP 
procedures based on both single claims for ERCP procedures and, because 
ERCP procedures are typically done under radiologic guidance, on claims 
that included both an ERCP procedure and a radiologic supervision or 
guidance

[[Page 44680]]

procedure in this APC. Using these additional claims has resulted in 
significantly increasing the number of claims used to determine the 
payment rate for this APC and in a much higher proposed payment rate 
(about $825).

APC 0160: Level I Cystourethroscopy and other Genitourinary 
Procedures

APC 0161: Level II Cystourethroscopy and other Genitourinary 
Procedures

APC 0162: Level III Cystourethroscopy and other Genitourinary 
Procedures

APC 0163: Level IV Cystourethroscopy and other Genitourinary 
Procedures

APC 0169: Lithotripsy

    We advised the Panel that we had received a number of comments that 
advocated moving CPT code 52337, Cystoscopy, with ureteroscopy and/or 
pyeloscopy; with lithotripsy (ureteral catheterization is included), 
from APC 0162 to APC 0163. (We note that CPT code 52337 was deleted for 
2001 and replaced with an identical CPT code, 52353. We will use the 
new code in the following discussion.) Because of these comments, we 
sought the Panel's advice in examining the clinical and resource 
distinctions between CPT code 52353 and other procedures assigned to 
APC 0162. Other information shared with the Panel noted that most of 
the procedures included in APC 0162 are complicated cystourethroscopies 
while those assigned to APC 0163 are largely prostate procedures.
    One presenter representing a device manufacturer discussed the 
merits of reassigning CPT code 52353 to either APC 0163 or 0169 (APC 
0169 contains a single CPT code, 50590, Lithotripsy, extracorporeal 
shock wave (ESWL)). The presenter was concerned that our decision to 
assign the cystourethroscopic procedure to APC 0162 rather to APC 0163 
was not explained in our April 7, 2000 final rule.
    Furthermore, the presenter noted that this decision resulted in a 
40 percent decline in payment for the procedure which will make it 
difficult for hospitals to provide this service because the capital 
equipment, probes, and fibers required to perform the procedure are 
expensive. Moreover, the probes and fibers are ineligible for 
transitional pass-through payments because they are not single-use 
items. At the Panel's request, the presenter discussed the clinical 
differences between CPT codes 52353 and 50590. The presenter stated 
that code 50590 is a noninvasive procedure that involves breaking up 
kidney stones using shock waves produced outside the patient while code 
52353 is an invasive procedure that requires the urologist to insert 
different instruments through a cystoscope and a uretheroscope to 
access stones in the upper urinary tract (the ureter and kidney).
    The presenter also compared the cost of performing CPT code 52353 
with that for CPT code 52352, which involves the mechanical removal of 
stones. The presenter asked the Panel to consider the following two 
options to resolve this issue:
     Reassign CPT code 52353 to APC 0169, Lithotripsy. The 
presenter believes that this would be the most appropriate assignment 
clinically and from a cost perspective because both involve lithotripsy 
and require expensive capital equipment, fibers, and probes. Also, 
other payers using a similar procedure grouping system, ambulatory 
procedure groups (APGs), have grouped these procedures together.
     Restore CPT code 52353 to its original APC assignment, APC 
0163.
    In addition, the presenter expressed concern that the large number 
of procedures assigned to APC 0162 makes it difficult to achieve 
clinical homogeneity within the APC. The presenter asked that we work 
with appropriate groups to reconfigure APC 0162 because, as 
constituted, it appears to violate the 2 times rule.
    The Panel had a lengthy discussion regarding whether to move CPT 
code 52353 to APC 0163 or to APC 0169. The Panel considered the 
resources used for procedures in APCs 0163 and 0169 and noted that the 
lithotriptor used for code 50590 may be purchased or leased and that 
lease rates for lithotriptors have frequently been inflated. 
Furthermore, it noted that much of the equipment and resource use 
required for code 52353 is similar to the resource use of other 
procedures in APC 0163. In spite of these considerations, the Panel 
voted eight to seven to recommend moving CPT code 52353 from APC 0162 
to APC 0169 because both codes 52353 and 50590 are lithotripsy 
procedures.
    We reviewed the panel discussion very carefully and noted the close 
vote. After careful consideration, we propose to disagree with the 
Panel's recommendation and move code 52353 to APC 0163. The 1999-2000 
cost data, which contains over 400 single claims for code 52353 and 
over 6,000 single claims for code 50590, show that the median cost for 
code 52353 is much more similar to the median cost of other procedures 
in APC 0163 than it is to the median cost of APC 0169. Although both 
codes involve lithotripsy, the type of equipment used in the two 
procedures is very different. Clinically, the surgical approach used 
for code 52353 and the resources used (e.g., anesthesia and operating 
room costs) are much more similar to other procedures in APC 0163 than 
to those for code 50590. Additionally, the median cost for code 50590, 
which is $700 higher than that of code 52353, is dependent on the 
widely variable arrangements hospitals make for use of the 
extracorporeal lithotriptor. Therefore, we believe that placing code 
52353 in APC 0163 maintains its clinical coherence and similar use of 
resources.

APC 0191: Level I Female Reproductive Procedures

APC 0192: Level II Female Reproductive Procedures

APC 0193: Level III Female Reproductive Procedures

APC 0194: Level IV Female Reproductive Procedures

APC 0195: Level V Female Reproductive Procedures

    This group of APCs was presented to the Panel because APC 0195 
violates the 2 times rule. To facilitate the Panel's review of this 
issue, we distributed cost data on all the female reproductive 
procedures assigned to these five APCs. These data showed that the 
median costs for procedures assigned to APC 0195 ranged from a low of 
$365 to a high of $1,817. The CPT code 57288, Sling operation for 
stress incontinence (e.g., fascia or synthetic), which is assigned to 
APC 0195, has the highest median cost of the procedures in this group. 
We discussed with the Panel two clinical options for rearranging the 
procedures assigned to APC 0195 to comply with the 2 times rule. The 
first option would split APC 0195 into two separate APCs by separating 
vaginal procedures from abdominal procedures. The second option would 
split APC 0195 into three distinct APCs by retaining the separate APCs 
for abdominal and vaginal procedures and further distinguishing vaginal 
procedures based on whether they are simple or complex.
    The Panel discussed the rapid increase in the rate at which CPT 
code 57288 is performed on an outpatient basis. The Panel stated that 
this procedure is becoming more routine and replacing many of the 
older, more complex urinary dysfunctional procedures. Questions were 
raised about the frequency with which this procedure is performed alone 
as opposed to being performed as one of several procedures. The Panel 
was advised that the sling material and the relevant anchors used in 
performing

[[Page 44681]]

CPT code 57288 are eligible for transitional pass-through payments.
    One presenter, speaking on behalf of a device manufacturer, 
supported our proposal to divide APC 0195 into different clinical 
groupings. The presenter's testimony was limited to a discussion of CPT 
code 57288. The presenter concurred with the Panel's assessment of the 
current utilization trends for CPT code 57288, emphasized the high 
costs associated with performing this procedure, and highlighted the 
wide variation in techniques and devices used to perform it. Because of 
these factors, the presenter believes that the procedure is underpaid 
and that the 1996 cost data may not fully reflect the actual costs 
associated with performing CPT code 57288.
    The Panel also closely reviewed the other four APCs for female 
reproductive procedures to ensure each was clinically homogeneous. As a 
result of this review, the Panel recommended a number of changes for 
these APCs. These recommendations and those for APC 0195 are as 
follows:
     Move CPT codes 56350, Hysteroscopy, diagnostic, and 58555, 
Hysteroscopy, diagnostic/separate procedure, from APC 0191 to APC 0194 
(In 2001, CPT code 56350 was replaced with CPT code 58555.)
     Divide APC 0195 into two APCs to distinguish vaginal 
procedures from abdominal procedures.
     Retain the following vaginal procedures in APC 0195:

------------------------------------------------------------------------
         CPT code                            Descriptor
------------------------------------------------------------------------
57555....................  Excision of cervical stump, vaginal approach:
                            with anterior and/or posterior repair.
58800....................  Drainage of ovarian cyst(s), unilateral or
                            bilateral, (separate procedure); vaginal
                            approach.
58820....................  Drainage of ovarian abscess; vaginal
                            approach, open.
57310....................  Closure of urethrovaginal fistula.
57320....................  Closure of vesicovaginal fistula; vaginal
                            approach.
57530....................  Trachelectomy (cervicectomy), amputation of
                            cervix (separate procedure).
57291....................  Construction of artificial vagina; without
                            graft.
57220....................  Plastic operation on urethral sphincter,
                            vaginal approach (e.g., Kelly urethral
                            plication).
57550....................  Excision of cervical stump, vaginal approach.
57556....................  Excision of cervical stump, vaginal approach;
                            with repair of enterocele.
57289....................  Pereyra procedure, including anterior
                            colporrhaphy.
57300....................  Closure of rectovaginal fistula; vaginal or
                            transanal approach.
57284....................  Paravaginal defect repair (including repair
                            of cystocele, stress urinary incontinence,
                            and/or incomplete vaginal prolapse).
57265....................  Combined anteroposterior colporrhaphy; with
                            enterocele repair.
57268....................  Repair of enterocele vaginal approach
                            (separate procedure).
56625....................  Vulvectomy simple; complete.
58145....................  Myomectomy excision of fibroid tumor of
                            uterus, single or multiple (separate
                            procedure); vaginal approach.
57260....................  Combined anteroposterior colporrhaphy.
57240....................  Anterior colporrhaphy, repair of cystocele
                            with or without repair of urethrocele.
57250....................  Posterior colporrhaphy, repair of rectocele
                            with or without perineorrhaphy.
56620....................  Vulvectomy simple; partial.
57522....................  Conization of cervix, with or without
                            fulguration, with or without dilation and
                            curettage, with or without repair; loop
                            electrode excision.
------------------------------------------------------------------------

     Include the following abdominal procedures in a new APC 
titled ``Level VI Female Reproductive Procedures.''

------------------------------------------------------------------------
         CPT code                            Descriptor
------------------------------------------------------------------------
58920....................  Wedge resection or bisection of ovary,
                            unilateral or bilateral.
58900....................  Biopsy of ovary, unilateral or bilateral
                            (separate procedure).
58925....................  Ovarian cystectomy, unilateral or bilateral.
57288....................  Sling operation for stress incontinence
                            (e.g., fascia or synthetic).
57287....................  Removal or revision of sling for stress
                            incontinence (e.g., fascia or synthetic).
------------------------------------------------------------------------

     Move CPT code 57107 from APC 0194 to APC 0195, Level V 
Female Reproductive Procedures.
     Move CPT code 57109, Vaginectomy with removal of 
paravaginal tissue (radical vaginectomy) with bilateral total pelvic 
lympadenectomy and para-oortic lymph node sampling (biopsy), from APC 
0194 to the new APC, Level VI Female Reproductive Procedures.
    We propose to accept all of these Panel recommendations. These APCs 
would be reconfigured and renumbered as APCs 0188 to 0194. We are also 
proposing to add new APCs for Level VII and Level VIII Female 
Reproductive Procedures (APCs 0195 and 0202, respectively) based on the 
1999-2000 claims data and the 2 times rule.

APC 0210: Spinal Tap

APC 0211: Level I Nervous System Injections

APC 0212: Level II Nervous System Injections

    The Panel heard testimony from two presenters regarding the merits 
of modifying these three APCs. The first presenter, speaking on behalf 
of a manufacturer, discussed CPT code 64614, Chemodenervation of 
muscles; extremities and/or trunk muscles (e.g., for dystonia, cerebral 
palsy, multiple sclerosis). The presenter advised the Panel that 
although this is a new code for 2001, the procedure is well established 
and formerly coded using CPT code 64640, Destruction by neurolytic 
agent; other peripheral nerve or branch. The new code was created to 
distinguish chemodenervation of limb and trunk muscles from other 
chemodenervation procedures. The presenter claimed that this code is 
similar both clinically and in terms of resource use to the other 
chemodenervation procedures assigned to APC 0211, so it should be 
assigned to that APC instead of APC 0971, New Technology--Level II, 
where it is currently assigned.
    The second presenter, representing a specialty society, proposed 
regrouping the procedures assigned to APCs 0210, 0211, and 0212 based 
on similar levels of complexity and median costs. The presenter's 
proposal also included reassignment to these APCs of interventional 
pain procedures

[[Page 44682]]

currently assigned to APCs 040, Arthrocenteris and Ligament/Tendon 
Injection, 0105, Revision/Removal of Pacemakers, AICD, or Vascular 
Device, and 0971. The presenter contended that it was essential to 
reconfigure these APCs because of disparity in resource use among 
procedures currently assigned to the same APC. The presenter also 
claimed that many of these procedures are being underpaid in their 
current APC and, for that reason, a number of hospitals have chosen not 
to perform them in the outpatient setting. The presenter proposed 
establishing the following five levels of interventional pain 
procedures by regrouping the procedures into new APCs as stated below:
     Level I Nerve Injections (to include Trigger Point, Joint, 
Other Injections, and Lower Complexity Nerve Blocks):

------------------------------------------------------------------------
                                                            Reassigned
                        CPT code                             from APC
------------------------------------------------------------------------
20550...................................................             040
20600...................................................             040
20605...................................................             040
20610...................................................             040
64612...................................................            0211
64613...................................................            0211
64614...................................................            0971
64400-64418.............................................            0211
64425...................................................            0211
64430...................................................            0211
64435...................................................            0211
64445...................................................            0211
64450...................................................            0211
64505...................................................            0211
64508...................................................            0211
------------------------------------------------------------------------

     Level II Nerve Injections (to include Moderate Complexity 
Nerve Blocks and Epidurals):

------------------------------------------------------------------------
                                                            Reassigned
                        CPT code                             from APC
------------------------------------------------------------------------
27096...................................................            0210
62270...................................................            0210
62272...................................................            0210
62273...................................................            0212
62310-62319.............................................            0212
------------------------------------------------------------------------

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

------------------------------------------------------------------------
                 CPT code                       Reassigned from APC
------------------------------------------------------------------------
62280-62282..............................  0212
62290....................................  Currently Packaged.
62291....................................  Currently Packaged.
64420-64421..............................  0211
64470....................................  0211
64472....................................  0211
64475-64476..............................  0211
64479....................................  0211
64480....................................  0211
64483-64484..............................  0211
64510....................................  0211
64520....................................  0211
64530....................................  0211
64630....................................  0211
64640....................................  0211
------------------------------------------------------------------------

     Level IV Nerve Injections (to include High Complexity 
Lysis of Adhesions, Neurolytic Procedures, Removal of Implantable Pumps 
and Stimulators):

------------------------------------------------------------------------
                                                            Reassigned
                        CPT code                             from APC
------------------------------------------------------------------------
62263...................................................            0212
64600...................................................            0211
64605...................................................            0211
64610...................................................            0211
64620...................................................            0211
64622-64623.............................................            0211
64626-64627.............................................            0211
64680...................................................            0211
62355...................................................            0105
62365...................................................            0105
------------------------------------------------------------------------

     Level V Nerve Injections (to include Highest Complexity 
Disk and Spinal Endoscopies): CPT code 62287, Aspiration or 
decompression procedure, percutaneous, of nucleus pulposus of 
invertebral disk, any method, single or multiple levels, lumbar (e.g., 
manual or automated percutaneous diskectomy, percutaneous laser 
diskectomy), reassigned from APC 0220, Level I Nerve Procedures.
    The Panel recommended reassignment of CPT code 64614 from APC 0971 
to APC 0211.
    Concerning the suggested regrouping of interventional pain 
procedures, the Panel agreed that the recommended division of these 
procedures by clinical complexity would reflect resource use and was a 
reasonable approach to take. It was pointed out to the Panel that the 
costs for CPT codes 62290, Injection procedure for diskography, each 
level; lumbar, and 62291, Injection procedure for diskography, each 
level; cervical or thoracic, were packaged into the procedures with 
which they were billed. Therefore, the Panel concurred with the 
regrouping of procedures to establish Levels I, II, III, and IV with 
the following exceptions:
     The Panel recommended that CPT codes 62290 and 62291 not 
be included in Level III because they are packaged injections and 
should not be unpackaged and paid separately.
     The Panel opposed moving CPT codes 62355, Removal of 
previously implanted intrathecal or epidural catheter, and 62365, 
Removal of subcutaneous reservoir or pump, previously implanted for 
intrathecal or epidural infusion, from APC 0105 to Level IV Nerve 
Injections because they were neither clinically similar nor similar in 
resource use to the other codes assigned to this proposed APC.
     The Panel opposed the creation of Level V Nerve Tests as 
it included only one code and recommended that CPT code 62287 remain in 
APC 220.
    We propose to accept the Panel's recommendations for these 
services. We propose to create new APCs 0203, 0204, 0206, and 0207 to 
accommodate these proposed changes.

APC 0215: Level I Nerve and Muscle Tests

APC 0216: Level II Nerve and Muscle Tests

APC 0217: Level III Nerve and Muscle Tests

    We advised the Panel that we had received a comment contending that 
assignment of CPT code 95863, Needle electromyography, three 
extremities with or without related paraspinal areas, to APC 0216 
created an inappropriate incentive to perform tests on three 
extremities rather than two or four extremities. The payment of about 
$144 for APC 0216 is greater than the payment of about $58 for the same 
tests when performed on one, two, or four extremities. This is due to 
the fact that CPT codes 95860, 95861, and 95864, Needle 
electromyography, one, two, and four extremities with or without 
related paraspinal areas, respectively, are assigned to APC 0215. We 
distributed data to the Panel that showed a median cost of about $141 
for CPT code 95863, which is more than 3 times that of the median cost 
of $41 for CPT code 95864. We asked the Panel to consider the 
reassignment of CPT code 95863 from APC 0216 to APC 0215 and advised 
the Panel that, based on cost data available at the time of our 
meeting, this change could potentially reduce the payment for APC 0216. 
It was also noted that this change could result in a payment increase 
for APC 0215.
    The Panel reviewed the cost data for APCs 0215 and 0216 and noted 
that the median costs for both CPT codes 95863 and 95864 appeared 
aberrant. Based on the information presented, the Panel recommended 
that we move CPT code 95863 from APC 0216 to APC 0215.
    We propose to accept the Panel's recommendation with one exception. 
We are proposing to revise these APCs based on the 1999-2000 cost data 
and the 2 times rule, and CPT code 95863 would be assigned to a 
reconfigured APC for Level II Nerve and Muscle Tests (APC 0218).

[[Page 44683]]

APC 0237: Level III Posterior Segment Eye Procedures

    We advised the Panel that procedures assigned to APC 0237 are high 
volume procedures and rank among the top outpatient procedures billed 
under Medicare. We have received a number of comments disagreeing with 
the assignment of CPT code 67027, Implantation of intravitreal drug 
delivery system (e.g., ganciclovoir implant), which includes 
concomitant removal of vitreous, to APC 0237. This procedure was added 
to the CPT coding system after 1996 and, therefore, was not included in 
the 1996 data. We advised the Panel that ganciclovoir, the drug 
implanted during this procedure, is paid separately as a transitional 
pass-through item. Because the drug is paid separately, it should not 
be included in determining whether the resources associated with the 
surgical procedure are similar to the resources required to perform the 
other procedures assigned to APC 0237. We advised the Panel that, of 
the procedures assigned to APC 0237, we believe that CPT code 67027 is 
related to codes 65260, 65265, and 67005, all of which involve removal 
of foreign bodies and vitreous from the eye. To ensure that CPT code 
67027 is assigned to the appropriate APC, we asked the Panel to 
consider creation of a new APC, Level IV Posterior Segment Eye 
Procedures, for CPT codes 65260, 65265, 67005, and 67027. Based on the 
APC rates effective January 1, 2001, the suggested change could lower 
the APC rate for the four procedures by $400.
    The Panel reviewed the data and did not believe it was sufficient 
to support the creation of a new APC for these four procedures. 
Therefore, the Panel recommended that APC 0237 remain intact and that 
more recent claims data be analyzed to determine whether CPT code 67027 
is similar to the other procedures assigned to APC 0237.
    Based on the 1999-2000 claims data, we have determined that the 
resources used for code 67027 are similar to other procedures in APC 
0237. However, we will present APCs 0235, 0236, and 0237 to the Panel 
at their next meeting to determine whether any further changes should 
be made. We are proposing to make various other changes to these APCs 
based on the new data and the 2 times rule.

APC 0251: Level I ENT Procedures

    This APC violates the 2 times rule because it consists of a wide 
variety of minor ENT procedures, many of which are low volume services 
or codes for nonspecific procedures. In order to correct this problem, 
we proposed to the Panel that this APC be split by surgical site (e.g., 
nasal and oral). After reviewing cost data, the Panel agreed that the 
APC should be split but that current data were insufficient to 
determine how that split should be made. Therefore, the Panel asked 
that this APC, along with more recent cost data, be placed on the 
agenda at the next meeting.
    We agree that this APC should be reviewed by the Panel at its next 
meeting. However, our review of the more recent cost data indicates 
that significant violations of the 2 times rule still exist. In order 
to correct this problem, but keep the APC as intact as possible, we 
propose to move CPT codes 30300, Remove foreign body, intranasal; 
office type procedure, 40804, Removal of embedded foreign body, 
vestiblue of mouth; simple, and 42809, Removal of foreign body from 
pharynx, to APC 0340, Minor Ancillary Procedures. This APC consists of 
procedures such as removal of earwax that require similar resources.

APC 0264: Level II Miscellaneous Radiology Procedures

    We asked the panel to review this APC because it violated the 2 
times rule and consisted of a wide variety of unrelated procedures. 
Specifically, we believe that the costs associated with CPT codes 
74740, Hysterosalpingography, radiological supervision and 
interpretation, and 76102, Radiologic examination, complex motion 
(e.g., hypercycloidal) body section (e.g., mastoid polytomography), 
other than with urography; bilateral, were aberrant and that we would 
significantly underpay these procedures if we moved them into a lower 
paying APC. We also asked the Panel to determine whether this APC and 
APC 0263, Level I Miscellaneous Radiology Procedures, should be 
reconfigured by body system. After considerable discussion, the Panel 
agreed that the procedures in these APCs were not clinically 
homogeneous; however, it recommended that we leave these APCs intact 
because the data do not support any more coherent reorganization. The 
Panel requested that this APC be placed on the agenda for the 2002 
meeting.
    We agree with the Panel with the following revisions. First, BIPA 
requires us to assign procedures requiring contrast into different APCs 
from procedures not requiring contrast. This required changes to a 
number of radiologic APCs including APCs 0263 and 0264. In addition, in 
this proposed rule, we would move CPT code 75940, Percutaneous 
Placement of IVC filter, radiologic supervision and interpretation, to 
a new APC 0187, Placement/Reposition Miscellaneous Catheters, because 
its costs were significantly higher than the costs of the procedures 
remaining in APC 0264.

APC 0269: Echocardiogram except Transesophageal

APC 0270: Transesophageal Echocardiogram

    We asked the Panel to consider splitting these APCs based on 
whether or not 2D imaging is employed. After review of the data, the 
Panel recommended that we leave these APCs intact.
    We propose to leave APC 0270 intact except for the addition of two 
new codes for transesophageal echocardiography. We also propose to 
split APC 0269 into two APCs, APC 0269, Level I Echocardiogram Except 
Transesophageal and APC 0697, Level II Echocardiogram Except 
Transesophageal. One APC (0697) would include comprehensive 
echocardiograms and the other APC (0269) would include limited/follow-
up echocardiograms and doppler add-on procedures.

APC 0274: Myelography

    We advised the Panel that APC 0274 is clinically homogeneous but 
that it violates the 2 times rule. Procedures assigned to this APC 
include radiological supervision and interpretation of diagnostic 
studies of central nervous system structures (e.g., spinal cord and 
spinal nerves) performed after injection of contrast material. We 
shared data with the Panel that showed the median costs for the 
procedures assigned to this APC ranged from a low of about $109 to a 
high of about $295. We asked the Panel's recommendation for 
reconfiguring APC 0274 to comply with the 2 times rule.
    We informed the Panel members that we packaged the costs associated 
with radiologic injection codes into the radiological supervision and 
interpretation codes with which they were reported. The reason for 
doing this is that hospitals incur expenses for providing both services 
and they typically perform both an injection and a supervision and 
interpretation procedure on the same patient. Therefore, since neither 
an injection code nor a supervision and interpretation code should be 
billed alone, it would not be appropriate for us to use single claims 
data to determine the costs of performing these procedures. However, we 
are using single claims data in order to accurately

[[Page 44684]]

determine the costs of performing procedures. Therefore, in order to 
accurately determine the costs of a complete radiologic procedure, we 
had to package the costs of the injection component into the cost of 
the supervision and interpretation component with which it was billed. 
The Panel believed that, in 1996, hospitals generally did not bill the 
injection code when performing myelography. Furthermore, in 1996, some 
hospitals kept patients overnight after a myelogram. More recently, 
postmyelogram recovery time has decreased to about 6 hours. For these 
reasons, the Panel believed that the median costs of $109 and $174 
probably do not represent the actual resources used for CPT codes 
70010, Myelography, posterior fossa, radiological supervision and 
interpretation, and 70015, Cisternography, positive contrast, 
radiological supervision and interpretation. Therefore, the Panel 
recommended the following:
     Make no changes to APC 0274.
     Review new cost data to determine whether payment would 
increase for APC 0274.
    We propose to accept the Panel's recommendations.

APC 0279: Level I Diagnostic Angiography and Venography

APC 0280: Level II Diagnostic Angiography and Venography

    We presented these codes to the Panel for several reasons. APC 0279 
fails the 2 times rule, there are numerous codes in these APCs with no 
cost data, there are numerous ``add on'' codes in these APCs, and many 
of these procedures were performed infrequently in the outpatient 
setting in 1996.
    The Panel reviewed the clinical coherence of both APCs as well as 
the resources required to perform all these procedures. The Panel 
believed that it would be unusual for many of these procedures to be 
performed separately and that we would need to look at multiple claims 
to get accurate data. The Panel recommended the following:
     Create a new APC (APC 0287, Complex Venography) with the 
following CPT codes: 75831, 75840, 75842, 75860, 75870, 75872, and 
75880.
     Move CPT codes 75960, 75961, 75964, 75968, 75970, 75978, 
75992, and 75995 from APC 0279 to APC 0280.
    We propose to accept the Panel's recommendations. We note that, as 
proposed, APC 0279 violates the 2 times rule because of the low cost 
data for CPT code 75660, Angiography, external carotid, unilateral 
selective, radiological supervision and interpretation. We believe 
that, for these procedures, these cost data are aberrant. This code is 
clinically similar to the other codes in APC 0279 and moving code 75660 
to an APC with a lower weight could be an inappropriate APC assignment. 
Therefore, we believe that an exception to the 2 times rule is 
warranted.

APC 0300: Level I Radiation Therapy

APC 0302: Level III Radiation Therapy

    We presented this APC to the Panel because we received comments 
that the assignment of CPT code 61793, Stereotactic radiosurgery 
(particle beam, gamma ray, or linear accelerator), one or more 
sessions, to APC 0302 would result in inappropriate payment of this 
service. Many commenters wrote that stereotactic radiosurgery and 
intensity modulated radiation therapy (IMRT) required significantly 
more staff time, treatment time, and resources than other types of 
radiation therapy. Other commenters disagreed with our decision, 
effective January 1, 2001, to discontinue recognizing CPT code 61793, 
and to create two HCPCS level 2 codes, G0173, Stereotactic 
radiosurgery, complete course of therapy in one session, and G0174 
Intensity modulated radiation therapy (IMRT) plan, per session, to 
report both stereotactic radiosurgery and IMRT.
    We reported to the Panel that the APC assignment of these G codes 
and their payment rate was based on our understanding that stereotactic 
radiosurgery was generally performed on an inpatient basis and 
delivered a complete course of treatment in a single session, while 
IMRT was performed on an outpatient basis and required several sessions 
to deliver a complete course of treatment. We also explained to the 
Panel that it was our understanding that multiple CPT codes were billed 
for each session of stereotactic radiosurgery and IMRT. Therefore, we 
believed that the payment for APC 0302 was only a fraction of the total 
payment a hospital received for performing stereotactic radiosurgery or 
IMRT on an outpatient basis.
    Radiosurgery equipment manufacturers, physician groups, and patient 
advocacy groups have both submitted comments to us and provided 
testimony to the APC Panel on these issues. These comments have 
convinced us that we did not clearly understand either the relationship 
of IMRT to stereotactic radiosurgery or the various types of equipment 
used to perform these services.
    We are proposing to set forth a proposed new coding structure that 
more accurately reflects the clinical use of these services and the 
resources required to perform them. Our understanding of these 
services, based on review of the comments, the testimony before the 
Panel, the Panel discussion and recommendations, and meetings with 
knowledgeable stakeholders, is described below.
    Recent developments in the field of radiation oncology include the 
ability to deliver high doses of radiation to abnormal tissues (e.g., 
tumors) while minimizing delivery of radiation to adjacent normal 
tissues. Collectively, these procedures are called stereotactic 
radiosurgery and IMRT.
    Clinically, there are essentially two services required to deliver 
stereotactic radiosurgery and IMRT. First, there is ``treatment 
planning,'' which includes such activities as determining the location 
of all normal and abnormal tissues, determining the amount of radiation 
to be delivered to the abnormal tissue, determining the dose tolerances 
of normal tissues, and determining how to deliver the required dose to 
abnormal tissue while delivering a dose to adjacent normal tissues 
within their range of tolerance. These activities include the ability 
to manufacture various treatment devices for protection of normal 
tissue as well as the ability to ensure that the plan will deliver the 
intended doses to normal and abnormal tissue by simulating the 
treatment. Second, there is ``treatment delivery,'' which is the actual 
delivery of radiation to the patient in accordance with the treatment 
plan. Treatment delivery includes such activities as adjusting the 
collimator (a device that filters the radiation beams), doing setup and 
verification images, treating one or more areas, and performing quality 
control.
    Treatment planning requires specialized equipment including a 
duplicate of the actual equipment used to deliver the treatment, the 
ability to perform a CT scan, various disposable supplies, and 
involvement of various staff such as the physician, the physicist, the 
dosimetrist, and the radiation technologist. Treatment delivery 
requires specialized equipment to deliver the treatment and the 
involvement of the radiation technologist. The physician and physicist 
provide general oversight of this process.
    Although there are several types of equipment, produced by several 
manufacturers, used to accomplish this treatment, it is the consensus 
of the commenters and the Panel that the most useful way to categorize 
stereotactic radiosurgery and IMRT is by the source of radiation used 
for the treatment and

[[Page 44685]]

not by the type of equipment used. One reason for this is that the 
clinical indications for stereotactic radiosurgery and IMRT overlap. 
Therefore, a single disease process can be treated by either modality 
but the cost of treatment varies by source of radiation used for the 
treatment. Second, while both stereotactic radiosurgery and IMRT can 
deliver a complete course of treatment in either one or multiple 
sessions, the cost of treatment delivery per session is relatively 
fixed, and is closely related to the source of radiation used for the 
treatment. Therefore, we believe that appropriate APC assignment and 
payment can be made by creating a small number of HCPCS codes to 
describe these services. The proposed codes are as follows:
     GXXX1 Multi-source photon stereotactic radiosurgery 
(Cobalt 60 multi-source converging beams) plan, including dose volume 
histograms for target and critical structure tolerances, plan 
optimization performed for highly conformal distributions, plan 
positional accuracy and dose verification, all lesions treated, per 
course of treatment.
     GXXX2 Multi-source photon stereotactic radiosurgery, 
delivery including collimator changes and custom plugging, complete 
course of treatment, per lesion.
     G0174 Intensity modulated radiation therapy (IMRT) 
delivery to one or more treatment areas, multiple couch angles/fields/
arcs custom collimated pencil-beams with treatment setup and 
verification images, complete course of therapy requiring more than one 
session, per session.
     G0178 Intensity modulated radiation therapy (IMRT) plan, 
including dose volume histograms for target and critical structure 
partial tolerances, inverse plan optimization performed for highly 
conformal distributions, plan positional accuracy and dose 
verification, per course of treatment.
    We propose that HCPCS codes GXXX1, G0174, and G0178 have status 
indicators of S, while GXXX2 have a status indicator of T. We believe 
these are the correct status indicators because G0178 has a ``per 
session'' designation, while GXXX2 has a ``per lesion'' designation. 
Furthermore, it is our understanding that GXXX1 would not be billed on 
a ``per lesion'' basis as the planning process would take into account 
all lesions being treated and it would be extremely difficult to 
determine resource utilization for planning on a ``per lesion'' basis. 
Because the costs of performing GXXX1 will vary based on the number of 
lesions treated, payment would reflect a weighted average.
    It is our understanding that single-source photon stereotactic 
radiosurgery (or LINAC) planning and delivery are similar to IMRT 
planning and delivery in terms of clinical use and resource 
requirements. Therefore, we propose to require coding for single-source 
photon stereotactic radiosurgery under HCPCS codes G0174 and G0178.
    Further, we are aware that the AMA is establishing codes for IMRT 
planning and treatment delivery for 2002 and we propose to retire G0174 
and G0178 (with the usual 90-day phase out) and recognize the 
applicable CPT codes when they are established in January 2002.
    We believe that all activities required to perform stereotactic 
radiosurgery and IMRT are included in the codes described above. In 
order to avoid confusion and to optimize tracking of these services in 
terms of both utilization and cost, we propose to discontinue the use 
of any other radiation therapy codes for activities involved with 
planning and delivery of stereotactic radiosurgery and IMRT for 
purposes of hospital billing in OPPS. Thus, we would continue to not 
recognize CPT code 61793 for hospital billing purposes.
    We believe the coding requirements set forth above not only 
simplify the reporting process for hospitals, but appropriately 
recognize the clinical practice and resource requirements for 
stereotactic radiosurgery and IMRT.
    We seek comments on our proposal, including the code titles, 
descriptors, and coding requirements discussed above. We also request 
information regarding appropriate APC assignment and payment rates to 
inform our decision-making. In particular, we would like information 
regarding the costs of treatment delivery including any differences 
between the cost of a complete treatment in single versus multiple 
sessions.
    We also note that several commenters requested placement of the 
stereotactic delivery codes in surgical APCs and we request 
clarification and support for these comments within the context of our 
coding proposal. Specifically, we are concerned that appropriate 
payment be made for GXXX2, which has a ``per lesion'' descriptor.
    We believe that while the APC Panel did not make any specific 
recommendations regarding these codes, the concerns expressed by the 
Panel are addressed by our proposal.

APC 0311: Radiation Physics Services

APC 0312: Radio Element Application

APC 0313: Brachytherapy

    We presented APC 0311 to the Panel because we believed our cost 
data for CPT codes 77336, Continuing medical physics consultation, 
including assessment of treatment parameters, quality assurance of dose 
delivery, and review of patient treatment documentation in support of 
the radiation oncologist, reported per week of therapy; 77370, Special 
medical radiation physics consultation; and 77399, Unlisted procedure, 
medical radiation physics, dosimetry, and treatment devices, and 
special services, were inaccurate. We were concerned that these 
procedures, particularly code 77370, were not being paid appropriately 
in APC 0311.
    Presenters pointed out that, as with all radiation oncology 
services, the usual practice is to bill multiple CPT codes on the same 
date of service. Therefore, single claims were likely to be inaccurate 
bills and did not represent the true costs of the procedure. For this 
reason, presenters believe that using single claims to set payment 
rates for radiation oncology procedures was inappropriate and that we 
needed to develop a methodology that allowed the use of multiple claims 
data to set payment rates for these services.
    With regard to radiation physics consultation, presenters stated 
that the staff costs associated with CPT code 77370 were significantly 
greater than the costs of CPT codes 77336 and 77399. Therefore, they 
recommended that CPT codes 77336 and 77399 be moved from APC 0311 to 
APC 0304, Level I Therapeutic Radiation Treatment Preparation, and CPT 
code 77370 be moved from APC 0311 to APC 0305, Level II Therapeutic 
Radiation Treatment Preparation. The Panel agreed with this 
recommendation and we propose to accept the Panel's recommendation. We 
also agree that we should review the use of single claims to set 
payment rates for radiation oncology services. We plan to present this 
issue again at the 2002 Panel meeting.
    We presented APCs 0312 and 0313 to the Panel because commenters 
were concerned that the payment rates were too low for the procedures 
assigned to the APCs and that there were insufficient data to set 
payment rates for these APCs. The Panel agreed that the issue regarding 
the use of single claim data affected the payment rates for these 
services. However, there were insufficient data for the Panel to make

[[Page 44686]]

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

APC 0371: Allergy Injections

    We presented this APC to the Panel because it violates the 2 times 
rule. The median costs for CPT codes 95115, Professional Services for 
allergen immunotherapy not including provision of allergenic extracts; 
single injection, and 95117, Professional Services for allergen 
immunotherapy not including provision of allergenic extracts; two or 
more injections, were lower than the median costs for the other 
services in this APC.
    The Panel agreed that because codes 95115 and 95117 included 
administration of an injection only, the resource utilization for these 
services was lower than for the other services. The other services 
involve preparation of antigen and require more staff time and hospital 
resources to perform.
    In order to create clinical and resource homogeneity, the Panel 
recommended that we create a new APC for codes 95115 and 95117 and that 
we leave the other services in APC 0371. We propose to accept the Panel 
recommendation and create a new APC 0353, Level II Allergy Injections, 
and revise the title of APC 0371 to Level I Allergy Injections.

Observation Services

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

Inpatient Procedure List

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

B. Additional APC Changes Resulting from BIPA Provisions

1. Coverage of Glaucoma Screening
    Section 102 of the BIPA amended section 1861(s)(2) of the Act to 
provide payment for glaucoma screening for eligible Medicare 
beneficiaries, specifically, those with diabetes mellitus or a family 
history of glaucoma, and certain other individuals found to be at high 
risk for glaucoma as specified by our rulemaking. The implementation of 
this provision is discussed in detail in a separate proposed rule 
concerning the revisions in the physician payment policy for CY 2002.
    In order to implement section 102 of BIPA, we have established two 
new HCPCS codes for glaucoma screening:
    G0117--Glaucoma screening for high risk patients furnished by an 
ophthalmologist or optometrist.
    G0118--Glaucoma screening for high risk patients furnished under 
the direct supervision of an ophthalmologist or optometrist.
    We are proposing to assign the glaucoma screening codes to APC 
0230, Level I Eye Tests. We further propose to instruct our fiscal 
intermediaries to make payment for glaucoma screening only if it is the 
sole ophthalmologic service for which the hospital submits a bill for a 
visit. That is, the services included in glaucoma screening (a dilated 
eye examination with an intraocular pressure measurement and direct 
opthalmoscopy or slit-lamp biomicroscopy) would generally be performed 
during the delivery of another opthalmologic service that is furnished 
on the same day. If the beneficiary receives only a screening service, 
however, we would pay for it under APC 0230.
2. APCs for Contrast Enhanced Diagnostic Procedures
    Section 430 of the BIPA amended section 1833(t)(2) of the Act to 
require the Secretary to create additional APC groups to classify 
procedures that utilize contrast agents separately from those that do 
not, effective for items and services furnished on or after July 1, 
2001. On June 1, 2001, we issued a Program Memorandum, Transmittal A-
01-73, in which we made numerous coding and grouping changes to 
implement this provision. (This transmittal can be found at 
www.hcfa.gov/pubforms/transmit/AO173.pdf) We removed the radiological 
procedures whose descriptors included either ``without contrast 
material'' or ``without contrast material followed by contrast 
material'' from APC groups 0282, Level I, Computerized Axial 
Tomography; APC 0283, Level II, Computerized Axial Tomography; and APC 
0284, Magnetic Resonance Imaging. As a result, APCs 0283 and 0284 now 
include only imaging procedures that are performed with contrast 
materials. Additionally, reconfigured APC 0282 no longer includes 
radiological procedures that use contrast agents.
    Effective for items or services furnished on or after July 1, 2001, 
we created six new APC groups for the procedures removed from APCs 
0282, 0283, and 0284, as shown below. (Effective October 1, 2001, we 
will eliminate APC 0338. Refer to Transmittal A-01-73 for a detailed 
description of this change.) For services furnished on or after July 1, 
2001 and before January 1, 2002, the payment rates for the new imaging 
APCs are the same as those associated with the APCs from which the 
procedures were moved. In this proposed rule, the weights for the new 
APCs are recalibrated based on the data we are using to set the weights 
for 2002.

  Table 1.--APC Groups Reconfigured to Separate Imaging Procedures That
 Use Contrast Material From Procedures That Do Not Use Contrast Material
------------------------------------------------------------------------
            APC                    SI                  APC title
------------------------------------------------------------------------
0282......................  S                 Miscellaneous Computerized
                                               Axial Tomography.
0283......................  S                 Computerized Axial
                                               Tomography with Contrast.
0284......................  S                 Magnetic Resonance Imaging
                                               and Angiography with
                                               Contrast.
0332......................  S                 Computerized Axial
                                               Tomography w/o Contrast.
0333......................  S                 CT Angio and Computerized
                                               Axial Tomography w/o
                                               Contrast followed by with
                                               Contrast.
0335......................  S                 Magnetic Resonance
                                               Imaging,
                                               Temporomandibular Joint.
0336......................  S                 Magnetic Resonance
                                               Angiography and Imaging
                                               without Contrast.
0337......................  S                 Magnetic Resonance Imaging
                                               and Angiography w/o
                                               Contrast followed by with
                                               Contrast.
0338......................  S                 Magnetic Resonance
                                               Angiography, Chest and
                                               Abdomen with or w/o
                                               Contrast.
------------------------------------------------------------------------

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

[[Page 44687]]



------------------------------------------------------------------------
         APC                HCPCS           SI        Short descriptor
------------------------------------------------------------------------
0282.................           76370  S            CAT scan for therapy
                                                     guide.
                                76375  S            3d/holograph
                                                     reconstr add-on.
                                76380  S            CAT scan for follow-
                                                     up study.
                                G0131  S            Ct scan, bone
                                                     density study.
                                G0132  S            Ct scan, bone
                                                     density study.
0283.................           70460  S            Ct head/brain w/dye.
                                70481  S            Ct orbit/ear/fossa w/
                                                     dye.
                                70487  S            Ct maxillofacial w/
                                                     dye.
                                70491  S            Ct soft tissue neck
                                                     w/dye.
                                71260  S            Ct thorax w/dye.
                                72126  S            Ct neck spine w/dye.
                                72129  S            Ct chest spine w/
                                                     dye.
                                72132  S            Ct lumbar spine w/
                                                     dye.
                                72193  S            Ct pelvis w/dye.
                                73201  S            Ct upper extremity w/
                                                     dye.
                                73701  S            Ct lower extremity w/
                                                     dye.
                                74160  S            Ct abdomen w/dye.
                                76355  S            CAT scan for
                                                     localization.
                                76360  S            CAT scan for needle
                                                     biopsy.
0284.................           70542  S            MRI orbit/face/neck
                                                     w/dye.
                                70545  S            Mr angiography head
                                                     w/dye.
                                70548  S            Mr angiography neck
                                                     w/dye.
                                70552  S            MRI brain w/dye.
                                71551  S            MRI chest w/dye.
                                72142  S            MRI neck spine w/
                                                     dye.
                                72147  S            MRI chest spine w/
                                                     dye.
                                72149  S            MRI lumbar spine w/
                                                     dye.
                                72196  S            MRI pelvis w/dye.
                                73219  S            MRI upper extremity
                                                     w/dye.
                                73222  S            MRI joint upr extrem
                                                     w/dye.
                                73719  S            MRI lower extremity
                                                     w/dye.
                                73722  S            MRI joint of lwr
                                                     extr w/dye.
                                74182  S            MRI abdomen w/dye.
                                75553  S            Heart MRI for morph
                                                     w/dye.
                                C8900  S            MRA w/cont, abd.
                                C8903  S            MRI w/cont, breast,
                                                     uni.
                                C8906  S            MRI w/cont, breast,
                                                     bi.
                                C8909  S            MRA w/cont, chest.
                                C8912  S            MRA w/cont, lwr ext.
0332.................           70450  S            CAT scan of head or
                                                     brain.
                                70480  S            Ct orbit/ear/fossa w/
                                                     o dye.
                                70486  S            Ct maxillofacial w/o
                                                     dye.
                                70490  S            Ct soft tissue neck
                                                     w/o dye.
                                71250  S            Ct thorax w/o dye.
                                72125  S            Ct neck spine w/o
                                                     dye.
                                72128  S            Ct chest spine w/o
                                                     dye.
                                72131  S            Ct lumbar spine w/o
                                                     dye.
                                72192  S            Ct pelvis w/o dye.
                                73200  S            Ct upper extremity w/
                                                     o dye.
                                73700  S            Ct lower extremity w/
                                                     o dye.
                                74150  S            Ct abdomen w/o dye.
0333.................           70470  S            Ct head/brain w/o&w
                                                     dye.
                                70482  S            Ct orbit/ear/fossa w/
                                                     o&w dye.
                                70488  S            Ct maxillofacial w/
                                                     o&w dye.
                                70492  S            Ct sft tsue nck w/o
                                                     & w/dye.
                                70496  S            Ct angiography,
                                                     head.
                                70498  S            Ct angiography,
                                                     neck.
                                71270  S            Ct thorax w/o&w dye.
                                71275  S            Ct angiography,
                                                     chest.
                                72127  S            Ct neck spine w/o&w
                                                     dye.
                                72130  S            Ct chest spine w/o&w
                                                     dye.
                                72133  S            Ct lumbar spine w/
                                                     o&w dye.
                                72191  S            Ct angiograph pelv w/
                                                     o&w dye.
                                72194  S            Ct pelvis w/o&w dye.
                                73202  S            Ct uppr extremity w/
                                                     o&w dye.
                                73206  S            Ct angio upr extrm w/
                                                     o&w dye.
                                73702  S            Ct lwr extremity w/
                                                     o&w dye.
                                73706  S            Ct angio lwr extr w/
                                                     o&w dye.
                                74170  S            Ct abdomen w/o&w
                                                     dye.
                                74175  S            Ct angio abdom w/o&w
                                                     dye.
                                75635  S            Ct angio abdominal
                                                     arteries.
0335.................           70336  S            Magnetic image, jaw
                                                     joint.
                                75554  S            Cardiac mri/
                                                     function.
                                75555  S            Cardiac mri/limited
                                                     study.

[[Page 44688]]

 
                                76390  S            Mr spectroscopy.
                                76400  S            Magnetic image, bone
                                                     marrow.
0336.................           70540  S            MRI orbit/face/neck
                                                     w/o dye.
                                70544  S            Mr angiography head
                                                     w/o dye.
                                70547  S            Mr angiography neck
                                                     w/o dye.
                                70551  S            MRI brain w/o dye.
                                71550  S            MRI chest w/o dye.
                                72141  S            MRI neck spine w/o
                                                     dye.
                                72146  S            MRI chest spine w/o
                                                     dye.
                                72148  S            MRI lumbar spine w/o
                                                     dye.
                                72195  S            MRI pelvis w/o dye.
                                73218  S            MRI upper extremity
                                                     w/o dye.
                                73221  S            MRI joint upr extrem
                                                     w/o dye.
                                73718  S            MRI lower extremity
                                                     w/o dye.
                                73721  S            MRI joint of lwr
                                                     extre w/o dye.
                                74181  S            MRI abdomen w/o dye.
                                75552  S            Heart MRI for morph
                                                     w/o dye.
                                C8901  S            MRA w/o cont, abd.
                                C8904  S            MRI w/o cont,
                                                     breast, uni.
                                C8910  S            MRA w/o cont, chest.
                                C8913  S            MRA w/o cont, lwr
                                                     ext.
0337.................           70543  S            MRI orbt/fac/nck w/
                                                     o&w dye.
                                70546  S            Mr angiograph head w/
                                                     o&w dye.
                                70549  S            Mr angiograph neck w/
                                                     o&w dye.
                                70553  S            MRI brain w/o&w dye.
                                71552  S            MRI chest w/o&w dye.
                                72156  S            MRI neck spine w/o&w
                                                     dye.
                                72157  S            MRI chest spine w/
                                                     o&w dye.
                                72158  S            MRI lumbar spine w/
                                                     o&w dye.
                                72197  S            MRI pelvis w/o&w
                                                     dye.
                                73220  S            MRI uppr extremity w/
                                                     o&w dye.
                                73223  S            MRI joint upr extr w/
                                                     o&w dye.
                                73720  S            MRI lwr extremity w/
                                                     o&w dye.
                                73723  S            MRI joint lwr extr w/
                                                     o&w dye.
                                74183  S            MRI abdomen w/o&w
                                                     dye.
                                C8902  S            MRA w/o fol w/cont,
                                                     abd.
                                C8905  S            MRI w/o fol w/cont,
                                                     brst, uni.
                                C8908  S            MRI w/o fol w/cont,
                                                     breast, bi.
                                C8911  S            MRA w/o fol w/cont,
                                                     chest.
                                C8914  S            MRA w/o fol w/cont,
                                                     lwr ext.
------------------------------------------------------------------------

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

C. Other Changes Affecting the APCs

1. Changes in Revenue Code Packaging
    In the April 7, 2000 final rule, we described how, in calculating 
the per procedure and per visit costs to determine the median cost of 
an APC (and therefore its relative weight), we used the charges billed 
using the revenue codes that contained items that were integral to 
performing the procedure or visit (65 FR 18483). For example, in 
calculating the cost of a surgical procedure, we included charges for 
revenue codes such as operating room, treatment rooms, recovery, 
observation, medical and surgical supplies, pharmacy, anesthesia, casts 
and splints, and donor tissue, bone, and organ. For medical visit 
costs, we included charges for items such as medical and surgical 
supplies, drugs, and observation. The complete list of the revenue 
centers by type of APC group was printed in the April 7, 2000 rule (65 
FR 18484).
    In the November 13, 2000 interim final rule, we made some changes 
to the list of revenue codes to reflect the charges associated with 
implantable devices (65 FR 67806 and 67825). As we stated in that rule, 
charges included in revenue codes 274 (prosthetic/orthotic devices), 
275 (pacemaker), and 278 (other implants) were not included in the 
initial APC payment rates because, before enactment of BBRA, we were 
proposing to pay these devices outside of the OPPS, and, after the 
enactment of the BBRA, it was not feasible to revise our database to 
include these revenue codes in developing the April 7, 2000 final rule. 
As discussed in the November 13, 2000 interim final rule, we were later 
able to incorporate these revenue codes in our database, and effective 
January 1, 2001, we updated the APC payment rates to reflect inclusion 
of this information.
    We have continued to review and revise the list of revenue codes to 
be included in the database and we are proposing several changes to the 
list of revenue codes that are packaged with the costs used to 
calculate the proposed APC rates. Some of these changes reflect the 
addition of revenue codes and others are a further refinement of our 
methodology. The following are the specific changes we are proposing to 
make:
     Package additional revenue centers that may be used to 
bill for implantable devices (including durable medical equipment (DME) 
and brachytherapy seeds) with surgical procedures. These additional 
centers are revenue codes 280 (oncology), 289 (other oncology), 290 
(DME), and 624 (investigational devices).
     Package revenue codes 280, 289, and 624 with other 
diagnostic and radiology services.
     Package the revenue codes for medical social services, 560 
(medical social services) and 569 (other medical social services). 
These services are not

[[Page 44689]]

paid separately in the hospital outpatient setting but often constitute 
discharge-planning services if provided with an outpatient service.
     Package revenue code 637 (self-administered drug (insulin 
administered in an emergency diabetic coma)) with medical visits. 
Although this is a self-administrable drug, it is covered when 
administered as described.
     Remove revenue code 723 (circumcision) from the list of 
packaged revenue codes because circumcision is a payable procedure 
under OPPS and should not be packaged.
     Package revenue code 942 (education/training) with medical 
visits and the category of ``All Other APC Groups.'' Patient training 
and education are generally not paid as a separate service under 
Medicare, but may be included as part of an otherwise payable service 
such as a medical visit. We believe that training and education 
services generally occur as part of a medical visit or psychiatric 
service.
     Remove the revenue codes in the range of 890 through 899 
(donor bank), as these are no longer valid revenue codes.
2. Special Revenue Code Packaging for Specific Types of Procedures
    We are proposing that the same packaging used for surgical 
procedures be used for corneal tissue implant procedures in APC 0244, 
Corneal Transplant, except that organ acquisition revenue codes and the 
revenue codes used to bill implantable devices are not packaged with 
corneal implants.
    There are certain other diagnostic procedures with CPT codes that 
are similar to surgical procedures. The cost of these procedures (HCPCS 
codes 92980-92996, 93501-93505, and 93510-93536) reflects both the 
revenue code packaging for ambulatory surgical center (ASC) and other 
surgery, as well as the revenue code packaging for other diagnostic 
services.
    A complete listing of the revenue codes that we are proposing in 
this rule and that we used for purposes of calculating median costs of 
services are shown below in Table 2.

Table 2.--Packaged Services by Revenue Code

Surgery

250  PHARMACY
251  GENERIC
252  NONGENERIC
257  NONPRESCRIPTION DRUGS
258  IV SOLUTIONS
259  OTHER PHARMACY
260  IV THERAPY, GENERAL CLASS
262  IV THERAPY/PHARMACY SERVICES
263  IV THERAPY/DRUG SUPPLY/DELIVERY
264  IV THERAPY/SUPPLIES
269  OTHER IV THERAPY
270  M&S SUPPLIES
271  NONSTERILE SUPPLIES
272  STERILE SUPPLIES
274  PROSTHETIC/ORTHOTIC DEVICES
275  PACEMAKER DRUG
276  INTRAOCULAR LENS SOURCE DRUG
278  OTHER IMPLANTS
279  OTHER M&S SUPPLIES
280  ONCOLOGY
289  OTHER ONCOLOGY
290  DURABLE MEDICAL EQUIPMENT
370  ANESTHESIA
379  OTHER ANESTHESIA
390  BLOOD STORAGE AND PROCESSING
399  OTHER BLOOD STORAGE AND PROCESSING
560  MEDICAL SOCIAL SERVICES
569  OTHER MEDICAL SOCIAL SERVICES
624  INVESTIGATIONAL DEVICE (IDE)
630  DRUGS REQUIRING SPECIFIC IDENTIFICATION, GENERAL CLASS
631  SINGLE SOURCE
632  MULTIPLE
633  RESTRICTIVE PRESCRIPTION
700  CAST ROOM
709  OTHER CAST ROOM
710  RECOVERY ROOM
719  OTHER RECOVERY ROOM
720  LABOR ROOM
721  LABOR
762  OBSERVATION ROOM
810  ORGAN AQUISITION
819  OTHER ORGAN ACQUISITION

Medical Visit

250  PHARMACY
251  GENERIC
252  NONGENERIC
257  NONPRESCRIPTION DRUGS
258  IV SOLUTIONS
259  OTHER PHARMACY
270  M&S SUPPLIES
271  NONSTERILE SUPPLIES
272  STERILE SUPPLIES
279  OTHER M&S SUPPLIES
560  MEDICAL SOCIAL SERVICES
569  OTHER MEDICAL SOCIAL SERVICES
630  DRUGS REQUIRING SPECIFIC IDENTIFICATION, GENERAL CLASS
631  SINGLE SOURCE DRUG
632  MULTIPLE SOURCE DRUG
633  RESTRICTIVE PRESCRIPTION
637  SELF-ADMINISTERED DRUG (INSULIN ADMIN. IN EMERGENCY DIABETIC 
COMA)
700  CAST ROOM
709  OTHER CAST ROOM
762  OBSERVATION ROOM
942  EDUCATION/TRAINING

Other Diagnostic

254  PHARMACY INCIDENT TO OTHER DIAGNOSTIC
280  ONCOLOGY
289  OTHER ONCOLOGY
372  ANESTHESIA INCIDENT TO OTHER DIAGNOSTIC
560  MEDICAL SOCIAL SERVICES
569  OTHER MEDICAL SOCIAL SERVICES
622  SUPPLIES INCIDENT TO OTHER DIAGNOSTIC
624  INVESTIGATIONAL DEVICE (IDE)
710  RECOVERY ROOM
719  OTHER RECOVERY ROOM
762  OBSERVATION ROOM

Radiology

255  PHARMACY INCIDENT TO RADIOLOGY
280  ONCOLOGY
289  OTHER ONCOLOGY
371  ANESTHESIA INCIDENT TO RADIOLOGY
560  MEDICAL SOCIAL SERVICES
710  RECOVERY ROOM
719  OTHER RECOVERY ROOM
569  OTHER MEDICAL SOCIAL SERVICES
621  SUPPLIES INCIDENT TO RADIOLOGY
624  INVESTIGATIONAL DEVICE (IDE)
762  OBSERVATION ROOM

All Other APC Groups

250  PHARMACY
251  GENERIC
252  NONGENERIC
257  NONPRESCRIPTION DRUGS
258  IV SOLUTIONS
259  OTHER PHARMACY
260  IV THERAPY, GENERAL CLASS
262  IV THERAPY PHARMACY SERVICES
263  IV THERAPY/DRUG/SUPPLY/DELIVERY
264  IV THERAPY SUPPLIES
269  OTHER IV THERAPY
270  M&S SUPPLIES
271  NONSTERILE SUPPLIES
272  STERILE SUPPLIES
279  OTHER M&S SUPPLIES
560  MEDICAL SOCIAL SERVICES
569  OTHER MEDICAL SOCIAL SERVICES
630  DRUG REQUIRING SPECIFIC IDENTIFICATION, GENERAL CLASS
631  SINGLE SOURCE DRUG
632  MULTIPLE SOURCE DRUG
633  RESTRICTIVE PRESCRIPTION
762  OBSERVATION ROOM
942  EDUCATION/TRAINING
3. Limit on Variation of Costs of Services Classified Within a Group
    Section 1833(t)(2) of the Act provides that the items and services 
within an APC group cannot be considered comparable with respect to the 
use of resources if the highest cost item or service within a group is 
more than 2 times greater than the lowest cost item or service within 
the same group, but the Secretary may make exceptions to this limit on 
the variation of costs within each group in unusual cases such as low 
volume items and services. No exception may be made, however, in the 
case of a drug or biological that has been designated as an orphan drug 
under section 526 of the Federal Food, Drug, and Cosmetic Act.
    Based on the proposed APC changes discussed above in this section 
of this preamble and the use of more current data to calculate the 
median cost of procedures classified to APCs, we reviewed all the APCs 
to determine which of them would not meet the 2 times limit. We use the 
following

[[Page 44690]]

criteria when deciding whether to make exceptions to the 2 times rule 
for affected APCs:
     Resource homogeneity.
     Clinical homogeneity.
     Hospital concentration.
     Frequency of service (volume).
     Opportunity for upcoding and code fragmentation.
    For a detailed discussion of these criteria, refer to the April 7, 
2000 final rule (65 FR 18457).
    The following list contains APCs that we propose to except from the 
2 times rule based on the criteria cited above. In cases in which 
compliance with the 2 times rule appeared to conflict with a 
recommendation of the APC Advisory Panel, we generally accepted the 
Panel recommendation. This was because Panel recommendations were based 
on explicit consideration of resource use, clinical homogeneity, 
hospital specialization, and the quality of the data used to determine 
payment rates.

0001  Photochemotherapy
0041  Arthroscopy
0044  Closed Treatment Fracture/Dislocation Except Finger/Toe/Trunk
0047  Arthroplasty without Prosthesis
0058  Level I Strapping and Cast Application
0077  Level I Pulmonary Treatment
0093  Vascular Repair/Fistula Construction
0096  Noninvasive Vascular Studies
0097  Cardiac Monitoring for 30 days
0115  Cannula/Access Device Procedures
0121  Level I Tube Changes and Repositioning
0140  Esophageal Dilation without Endoscopy
0147  Level II Sigmoidoscopy
0164  Level I Urinary and Anal Procedures
0165  Level II Urinary and Anal Procedures
0182  Insertion of Penile Prosthesis
0198  Pregnancy and Neonatal Care Procedures
0203  Level V Nerve Injections
0204  Level VI Nerve Injections
0207  Level IV Nerve Injections
0213  Extended EEG Studies and Sleep Studies
0215  Level I Nerve and Muscle Tests
0231  Level II Eye Tests
0238  Level I Repair and Plastic Eye Procedures
0251  Level I ENT Procedures
0260  Level I Plain Film Except Teeth
0265  Level I Diagnostic Ultrasound Except Vascular
0279  Level I Angiography and Venography except Extremity
0285  Positron Emission Tomography (PET)
0305  Level II Therapeutic Radiation Preparation
0322  Brief Individual Psychotherapy
0345  Level I Transfusion Lab Procedures
0349  Miscellaneous Lab Procedures
0354  Administration of Influenza/Pneumonia Vaccine
0356  Level II Immunizations
0363  Otorhinolaryngologic Function Tests
0364  Level I Audiometry
0373  Neuropsychological Testing
0602  High Level Clinic Visits
0694  Level III Excision/Biopsy
0697  Level II Transesophageal Procedures

4. Observation Services
    Observation services have a long intertwined clinical and payment 
history. For many years, beneficiaries have been placed in 
``observation status'' in order to receive treatment or be monitored 
before making a decision concerning their next placement (that is, 
admit to the hospital or discharge to home). This occurs most 
frequently after surgery or a visit to the emergency department. 
Typically, beneficiaries placed in observation have failed to respond 
to initial emergency department treatment for their condition (for 
example, exacerbation of asthma), have symptoms placing them at 
significant risk for mortality (for example, chest pains with the 
possibility of myocardial infarction), or have received anesthesia for 
a surgical procedure and need to be monitored postoperatively. 
Clinically, most beneficiaries do not require more than 24 hours of 
observation before a decision concerning admission or discharge can be 
made. Therefore, it is rare that it is clinically justifiable to keep a 
patient in observation for more than 24 to 48 hours. The location where 
observation services are provided is facility-specific, and sometimes 
individual-specific. It is not uncommon for beneficiaries to be 
observed in the emergency department, in a designated unit near the 
emergency department, or in an intensive care or other unit in the 
facility.
    After implementation of the Medicare hospital inpatient PPS in 
1983, peer review organizations (PROs) began to review inpatient 
admissions to determine whether the admission and the length of stay 
were appropriate. Because ``observation care'' is considered to be an 
outpatient service, facilities began using ``observation'' as an 
administrative mechanism to care for beneficiaries who, if admitted as 
inpatients, might have their admission questioned by the PRO. Moreover, 
before the implementation of the OPPS, the payment for observation care 
was on a reasonable cost basis, which frequently gave hospitals a 
financial incentive to keep beneficiaries in ``observation status'' 
even though they were clinically being treated as inpatients. 
Occasionally, beneficiaries were kept in observation for days and weeks 
resulting in both excessive payments from the Medicare program and 
excessive copayments from the beneficiary. In response to this 
practice, Medicare revised its manuals in November 1996, limiting 
covered observation services to no more than 48 hours (section 456 of 
the Hospital Manual and section 3663 of the Intermediary Manual).
    The costs for all observation services provided in the outpatient 
setting, even those provided in excess of 48 hours, were included in 
the initial APC payment rates. Currently, observation services are not 
paid separately, that is, they are not assigned to a separate APC. 
Instead, costs for observation services are packaged into payments for 
services with which the observation was billed in 1996. Observation was 
most frequently billed with emergency department visits, clinic visits, 
and surgical procedures. The payments for all APCs include the costs of 
observation to the extent that it was billed in 1996. In the 1996 data, 
we identified and packaged a total of $392 million from revenue codes 
760, 761, 762, and 769, which represented observation services.
    In the April 7, 2000 final rule (65 FR 18448), we responded to 
numerous comments concerning observation services. Even though 
commenters acknowledged that being paid separately for observation 
services following a surgical procedure was unnecessary, many 
commenters requested that we pay separately for observation services 
following emergency department visits. Among those commenters 
requesting separate payment for observation, some requested separate 
payment for specific medical conditions, and others requested payment 
for all medical conditions. Some commenters provided articles and books 
containing clinical research on the value and cost effectiveness of 
observation for certain patients. Although we did not decide to create 
a separate APC for observation services, we did include this topic in 
the agenda for our APC Panel, which met from February 27 to March 1, 
2001. While individual Panel members agreed that use of observation 
services had been abused in the past by hospitals seeking to maximize 
payment, the Panel also agreed that observation services following 
clinic and emergency room visits should be paid separately. In 
addition, the Panel believed that observation following surgery should 
be packaged into the payment for the surgical procedure. The Panel did 
not dispute that the vast majority of patients are admitted to the 
hospital or discharged home from observation in less than 24 hours, and 
Panel members judged that a rule limiting separate payment to 24 hours 
of observation

[[Page 44691]]

would be reasonable. The Panel also noted that because Medicare 
currently allows hospitals to report observation services up to 48 
hours, hospital staff and coders would have to be educated were we to 
change the current standard.
    Since the Panel meeting, we have reviewed all comments we have 
received on this issue. In determining whether we should pay separately 
for observation services, our primary concern is to ensure that 
Medicare beneficiaries have access to medically necessary observation 
care. We also want to ensure that payment be made only for 
beneficiaries actually receiving observation care, and that payment be 
restricted to clinically appropriate observation care. We paid 
particular attention to the Qualcare criteria (severity of illness and 
intensity of service criteria used by some insurance plans to determine 
whether it is appropriate for a patient to receive observation care) 
for observation services and to those comments providing medical 
evidence on the value and cost effectiveness of observation care. We 
also carefully considered logistical and administrative issues related 
to delivering observation care such as whether payment for emergency 
services should be bundled into observation services, the potential for 
overuse of the services, and the need for treatment guidelines. We also 
considered how to most appropriately define the starting time, 
discharge time, and minimum length of stay for observation care.
    Finally, in considering whether to make a separate payment for 
observation care, we had to balance the issues of access, medical 
necessity, potential for abuse, and need to ensure appropriate payment. 
As a threshold requirement for candidate medical conditions, we sought 
published criteria regarding the following:
     Risk stratification of patients to determine which patient 
sub-populations benefit from observation care.
     Which patients should be admitted to observation.
     Which patients should be discharged home from observation.
     When patients should be admitted to the hospital from 
observation.
     Patient management.
    We found that these criteria were met for chest pain, asthma, and 
congestive heart failure.
    The fulfillment of these criteria ensured that, for these 
conditions, observation care avoided significant morbidity and 
mortality from inappropriate discharge to home while at the same time 
avoiding unnecessary inpatient admissions. For example, the use of 
observation for selected patients with asthma and congestive heart 
failure can reduce the rate of return emergency visits and subsequent 
admission. The literature clearly shows that for these patients, 
observation care requires prolonged physiologic monitoring and 
intensive treatment to result in the beneficial outcomes.
    After careful consideration, we are proposing--
     To continue to package observation services into surgical 
procedures; and
     To create a single APC, APC 0339, Observation, to make 
separate payment for observation services for three medical conditions, 
chest pain, asthma, and congestive heart failure, when certain criteria 
(as described below) are met.
    We are further proposing to instruct hospitals that payment under 
APC 0339 for observation services would be subject to the following 
billing requirements and conditions:
     An emergency department visit (APC 0610, 0611, or 0612) or 
a clinic visit (APC 0600, 0601, or 0602) is billed in conjunction with 
each bill for observation services.
     Observation care is billed hourly for a minimum of 8 hours 
up to a maximum of 48 hours. We would not pay separately for any hours 
a beneficiary spends in observation over 24 hours, but all costs beyond 
24 hours would be packaged into the APC payment for observation 
services.
     Observation time begins at the clock time appearing on the 
nurse's observation admission note. (We note that this coincides with 
the initiation of observation care or with the time of the patient's 
arrival in the observation unit.)
     Observation time ends at the clock time documented in the 
physician's discharge orders, or, in the absence of such a documented 
time, the clock time when the nurse or other appropriate person signs 
off on the physician's discharge order. (This time coincides with the 
end of the patient's period of monitoring or treatment in observation.)
     The beneficiary is under the care of a physician during 
the period of observation, as documented in the medical record by 
admission, discharge, and other appropriate progress notes, timed, 
written, and signed by the physician.
     The medical record includes documentation that the 
physician used risk stratification criteria to determine that the 
beneficiary would benefit from observation care. (These criteria may be 
either published generally accepted medical standards or established 
hospital-specific standards.)
     The hospital furnishes certain other diagnostic services 
along with observation services to ensure that separate payment is made 
only for those beneficiaries truly requiring observation care. We 
believe that these tests are typically performed on beneficiaries 
requiring observation care for the three specified conditions and they 
are medically necessary to determine whether a beneficiary will benefit 
from being admitted to observation care and the appropriate disposition 
of a patient in observation care. The diagnostic tests are as follows:
     For chest pain, at least two sets of cardiac enzymes and 
two sequential electrocardiograms.
     For asthma, a peak expiratory flow rate (PEFR) (CPT code 
94010) and nebulizer treatments.
     For congestive heart failure, a chest x-ray, an 
electrocardiogram, and pulse oximetry.
    We are proposing to make payment for APC 0339 only if the tests 
described above are billed on the same claim as the observation 
service.
    (We are not proposing to require telemetry and other ongoing 
monitoring services as criteria to make separate payment for 
observation services. Although these services are often medically 
necessary to ensure prompt diagnosis of cardiac arrhythmias and other 
disorders, we do not believe they are necessary to support separate 
payment for observation services.)
    We propose to require that, in order to receive payment for APC 
0339, the hospital must include one of the ICD-9-CM diagnosis codes 
listed below in the diagnosis field of the bill. We propose the 
following diagnosis codes to indicate a symptom or condition that would 
require observation:

For Chest Pain

411.1  Intermediate coronary syndrome
411.81  Coronary occlusion without myocardial infarction
411.0  Postmyocardial infarction syndrome
411.89  Other acute ischemic heart disease
413.0  Angina decubitus
413.1  Prinzmetal angina
413.9  Other and unspecified angina pectoris
786.05  Shortness of breath
786.50  Chest pain, unspecified
786.51  Precordial pain
786.52  Painful respiration
786.59  Other chest pain

For Asthma

493.01  Extrinsic asthma with status asthmaticus
493.02  Extrinsic asthma with acute exacerbation

[[Page 44692]]

493.11  Intrinsic asthma with status asthmaticus
493.12  Intrinsic asthma with acute exacerbation
493.21  Chronic obstructive asthma with status asthmaticus
493.22  Chronic obstructive asthma with acute exacerbation
493.91  Asthma, unspecified with status asthmaticus
493.92  Asthma, unspecified with acute exacerbation

For Congestive Heart Failure

428.0  Congestive heart failure
428.1  Left heart failure
428.9  Heart failure, unspecified

    We used the following process to identify the appropriate median 
cost for APC 0339. First, we identified in the 1999-2000 claims data 
all hospital outpatient claims for observation using revenue codes 760, 
761, 762, and 769. We then selected the subset of these claims that 
were billed for patients with chest pain, asthma, and congestive heart 
failure. Because no standard method for coding these claims was in 
place in 1996, we identified all diagnosis codes that could reasonably 
have been used to classify beneficiaries as having chest pain, asthma, 
and congestive heart failure. We then verified that these beneficiaries 
received appropriate observation care for chest pain, asthma, or 
congestive heart failure by identifying the claims in which one or more 
of the tests identified above were performed. The median costs of these 
claims were used to establish the median costs of APC 0339.
    We appreciate that there are other medical conditions for which 
selected beneficiaries may benefit from observation care and we are 
interested in comments on whether we should make separate payment for 
observation care for other conditions. We will consider medical 
research submitted to support the benefits of observation services for 
these conditions. This information will assist us in determining 
whether these other conditions meet the criteria we used to select the 
three conditions we have proposed to include in APC 0339.
5. List of Procedures That Will Be Paid Only as Inpatient Procedures
    Before implementation of the OPPS, Medicare paid reasonable costs 
for services provided in the outpatient department. The claims 
submitted were subject to medical review by the fiscal intermediaries 
to determine the appropriateness of providing certain services in the 
outpatient setting. We did not specify in regulations those services 
that were appropriate to provide only in the inpatient setting and 
that, therefore, should be payable only when provided in that setting.
    Section 1833(t)(1)(B)(i) of the Social Security Act gave the 
Secretary broad authority to determine the services to be covered and 
paid for under the OPPS. In the September 8, 1998 OPPS proposed rule, 
we defined a set of services that are typically provided only in an 
inpatient setting and, hence, would not be paid by Medicare under the 
OPPS. This set of services is referred to as the ``inpatient list.''
    We received numerous comments on the inpatient list. In the April 
7, 2000 final rule, we revised the proposed list by removing a number 
of services and we discussed in greater detail the criteria we will use 
to define which services will be included on the inpatient list (65 FR 
18455). These are services that require inpatient care because of the 
invasive nature of the procedure, the need for at least 24 hours of 
postoperative recovery time or monitoring before the patient can be 
safely discharged, or the underlying physical condition of the patient.
    After publication of the April 7 final rule, we received 
information from a number of groups demonstrating that certain services 
are routinely provided safely in the outpatient setting. As a result, 
in the November 13, 2000 interim final rule, we removed 44 procedures 
from the list (65 FR 67826). In that rule, we also stated that we would 
update the list at least quarterly to reflect advances in medical 
practice that permit procedures to be routinely performed in the 
outpatient setting. And, on June 1, 2001, we issued Program Memorandum 
A-01-73 in which we moved an additional 23 procedures from the 
inpatient list.
    At its February 2001 meeting, the APC Advisory Panel discussed the 
existence of the inpatient list. The Advisory Panel generally favored 
its elimination. In this instance, we disagree with the position taken 
by the Panel. Rather, we propose to continue the current policy of 
reviewing the HCPCS codes on the inpatient list and eliminating 
procedures from the list if they can be appropriately performed on the 
Medicare population in the outpatient setting. Our medical and policy 
staff, supplemented as appropriate by the APC Advisory Panel, would 
review comments submitted by the public and consider advances in 
medical practice in making decisions to remove codes from the list. We 
would continue to use the following criteria, which we discussed in the 
April 7, 2000 final rule, when deciding to remove codes from the list:
     Most outpatient departments are equipped to provide the 
services to the Medicare population.
     The simplest procedure described by the code may be 
performed in most outpatient departments.
     The procedure is related to codes we have already moved 
off the inpatient list (for example, the radiologic part of an 
interventional cardiology procedure).
    We would continue to update the list in response to comments as 
often as quarterly through program memoranda to reflect current 
advances in medical practice. We believe that the current list 
addresses the concerns of previous commenters and reflects a general 
consensus about those services that hospitals and physicians agree are 
not routinely performed in the outpatient setting. Therefore, at this 
time, we are proposing no further changes to the inpatient list, which 
is set forth in Addendum E to this proposed rule.
6. Additional New Technology APC Groups
    In the April 7, 2000 final rule, we created 15 new technology APC 
groups to pay for new technologies that do not meet the statutory 
requirements for transitional pass-through payments and for which we 
have little or no data upon which to base assignment to an appropriate 
APC. APC groups 0970 through 0984 are the current new technology APCs. 
We currently assign services to a new technology APC for 2 to 3 years 
based solely on costs, without regard to clinical factors. This method 
of paying for new technologies allows us to gather data on their use 
for subsequent assignment to a clinically-based APC. Payment rates for 
the new technology APCs are based on the midpoint of ranges of possible 
costs.
    After evaluating the costs of services in the new technology APCs, 
we are proposing that APC 0982, which covers a range of costs from 
$2500 to $3500, be split into two APCs, as follows: APC 0982, which 
would encompass services whose costs fall between $2500 and $3000, and 
APC 0983, which would encompass those services whose costs fall between 
$3000 and $3500. APC 0984 would then encompass services whose costs 
fall between $3500 and $5000 and we would create a new APC, 0985, for 
services whose costs fall between $5000 and $6000. We believe that 
subdividing the current range of costs within APC 0982 would allow us 
to pay more accurately for the services in that cost range.
    In section VI.G of this preamble, we describe several modifications 
and refinements to the criteria and process

[[Page 44693]]

for assigning services to new technology APCs that we are proposing in 
this rule.
    Table 3 below, lists all of the APC groups that we are proposing to 
change for 2002.

                               Table 3.--APC Groups Proposed To Be Changed in 2002
----------------------------------------------------------------------------------------------------------------
       APC                 Title                  SI             APC panel          2 times           Other
----------------------------------------------------------------------------------------------------------------
0002............  Fine needle Biopsy/      T                 ................  X                 ...............
                   Aspiration.
0004............  Level I Needle Biopsy/   T                 ................  X                 ...............
                   Aspiration Except Bone
                   Marrow.
0006............  Level I Incision &       T                 ................  X                 ...............
                   Drainage.
0007............  Level II Incision &      T                 ................  X                 ...............
                   Drainage.
0008............  Level III Incision &     T                 ................  X                 ...............
                   Drainage.
0012............  Level I Debridement &    T                 ................  X                 ...............
                   Destruction.
0013............  Level II Debridement &   T                 ................  X                 ...............
                   Destruction.
0014............  Level III Debridement    T                 ................  X                 ...............
                   and Destruction.
0015............  Level IV Debridement &   T                 ................  X                 ...............
                   Destruction.
0016............  Level V Debridement &    T                 X                 X                 ...............
                   Destruction.
0017............  Level VI Debridement &   T                 X                 X                 ...............
                   Destruction.
0018............  Biopsy of Skin/Puncture  T                 ................  X                 ...............
                   of Lesion.
0019............  Level I Excision/Biopsy  T                 ................  X                 ...............
0020............  Level II Excision/       T                 ................  X                 ...............
                   Biopsy.
0021............  Level IV Excision/       T                 ................  X                 ...............
                   Biopsy.
0022............  Level V Excision/Biopsy  T                 ................  X                 ...............
0026............  Level III Skin Repair..  T                 ................  X                 ...............
0027............  Level IV Skin Repair...  T                 ................  X                 ...............
0029............  Level II Incision/       T                 ................  X                 ...............
                   Excision Breast.
0030............  Level I Breast           T                 ................  X                 ...............
                   Reconstruction.
0032............  Insertion of Central     T                 ................  X                 ...............
                   Venous/Arterial
                   Catheter.
0035............  Placement of Arterial/   T                 ................  X                 ...............
                   Central Venous
                   Catheter.
0043............  Closed Treatment         T                 ................  X                 ...............
                   Fracture Finger/Toe/
                   Trunk.
0044............  Closed Treatment         T                 ................  X                 ...............
                   Fracture/Dislocation
                   except Finger/Toe/
                   Trunk.
0045............  Bone/Joint Manipulation  T                 ................  X                 ...............
                   Under Anesthesia.
0049............  Level I Musculoskeletal  T                 ................  X                 ...............
                   Procedures Except Hand
                   and Foot.
0050............  Level II                 T                 ................  X                 ...............
                   Musculoskeletal
                   Procedures Except Hand
                   and Foot.
0058............  Level I Strapping and    S                 ................  X                 ...............
                   Cast Application.
0059............  Level II Strapping and   S                 ................  X                 ...............
                   Cast Application.
0068............  CPAP Initiation........  S                 X                 ................  ...............
0069............  Thoracoscopy...........  T                 ................  X                 ...............
0074............  Level IV Endoscopy       T                 ................  X                 ...............
                   Upper Airway.
0075............  Level V Endoscopy Upper  T                 ................  X                 ...............
                   Airway.
0076............  Endoscopy Lower Airway.  T                 ................  X                 ...............
0079............  Ventilation Initiation   S                 X                 ................  ...............
                   and Management.
0082............  Coronary Atherectomy...  T                 ................  X                 ...............
0083............  Coronary Angioplasty...  T                 ................  X                 ...............
0087............  Cardiac                  S                 X                 ................  ...............
                   Electrophysiologic
                   Recording/Mapping.
0088............  Thrombectomy...........  T                 ................  X                 ...............
0093............  Vascular Repair/Fistula  T                 ................  X                 ...............
                   Construction.
0094............  Resuscitation and        S                 X                 ................  ...............
                   Cardioversion.
0097............  Cardiac Monitoring for   T                 ................  X                 ...............
                   30 days.
0102............  Electronic Analysis of   S                 X                 ................  ...............
                   Pacemakers/other
                   Devices.
0105............  Revision/Removal of      T                 X                 ................  ...............
                   Pacemakers, AICD, or
                   Vascular Device.
0111............  Blood Product Exchange.  S                 X                 ................  ...............
0112............  Apheresis,               S                 X                 ................  ...............
                   Photopheresis, and
                   Plasmapheresis.
0115............  Cannula/Access Device    T                 ................  X                 ...............
                   Procedures.
0125............  Refilling of Infusion    T                 X                 ................  ...............
                   Pump.
0130............  Level I Laparoscopy....  T                 ................  X                 ...............
0131............  Level II Laparoscopy...  T                 ................  X                 ...............
0148............  Level I Anal/Rectal      T                 ................  X                 ...............
                   Procedure.
0149............  Level III Anal/Rectal    T                 ................  X                 ...............
                   Procedure.
0150............  Level IV Anal/Rectal     T                 ................  X                 ...............
                   Procedure.
0155............  Level II Anal/Rectal     T                 ................  X                 ...............
                   Procedure.
0156............  Level II Urinary and     T                 ................  X                 ...............
                   Anal Procedures.
0160............  Level I                  T                 ................  X                 ...............
                   Cystourethroscopy and
                   other Genitourinary
                   Procedures.
0161............  Level II                 T                 ................  X                 ...............
                   Cystourethroscopy and
                   other Genitourinary
                   Procedures.
0162............  Level III                T                 ................  X                 ...............
                   Cystourethroscopy and
                   other Genitourinary
                   Procedures.
0163............  Level IV                 T                 ................  X                 ...............
                   Cystourethroscopy and
                   other Genitourinary
                   Procedures.
0164............  Level I Urinary and      T                 ................  X                 ...............
                   Anal Procedures.
0165............  Level III Urinary and    T                 ................  X                 ...............
                   Anal Procedures.
0188............  Level II Female          T                 X                 X                 ...............
                   Reproductive Proc.
0189............  Level III Female         T                 X                 X                 ...............
                   Reproductive Proc.
0191............  Level I Female           T                 X                 X                 ...............
                   Reproductive Proc.
0192............  Level IV Female          T                 X                 X                 ...............
                   Reproductive Proc.
0193............  Level V Female           T                 X                 X                 ...............
                   Reproductive Proc.
0194............  Level VI Female          T                 X                 X                 ...............
                   Reproductive Proc.
0195............  Level VII Female         T                 X                 X                 ...............
                   Reproductive Proc.

[[Page 44694]]

 
0196............  Dilation and Curettage.  T                 ................  X                 ...............
0203............  Level V Nerve            T                 X                 ................  ...............
                   Injections.
0204............  Level VI Nerve           T                 X                 ................  ...............
                   Injections.
0206............  Level III Nerve          T                 X                 ................  ...............
                   Injections.
0207............  Level IV Nerve           T                 X                 ................  ...............
                   Injections.
0208............  Laminotomies and         T                 X                 ................  ...............
                   Laminectomies.
0209............  Level II Extended EEG    S                 ................  X                 ...............
                   Studies and Sleep
                   Studies.
0212............  Level II Nervous System  T                 X                 ................  ...............
                   Injections.
0213............  Level I Extended EEG     S                 ................  X                 ...............
                   Studies and Sleep
                   Studies.
0215............  Level I Nerve and        S                 X                 X                 ...............
                   Muscle Tests.
0216............  Level III Nerve and      S                 X                 X                 ...............
                   Muscle Tests.
0217............  Level III Nerve and      S                 ................  X                 ...............
                   Muscle Tests.
0218............  Level II Nerve and       S                 ................  X                 ...............
                   Muscle Tests.
0230............  Level I Eye Tests &      S                 ................  X                 X
                   Treatments.
0231............  Level III Eye Tests &    S                 ................  X                 ...............
                   Treatments.
0232............  Level I Anterior         S                 ................  X                 ...............
                   Segment Eye.
0233............  Level II Anterior        T                 ................  X                 ...............
                   Segment Eye.
0234............  Level III Anterior       T                 ................  X                 ...............
                   Segment Eye Procedures.
0235............  Level I Posterior        T                 ................  X                 ...............
                   Segment Eye Procedures.
0236............  Level II Posterior       T                 ................  X                 ...............
                   Segment Eye Procedures.
0237............  Level III Posterior      T                 ................  X                 ...............
                   Segment Eye Procedures.
0238............  Level I Repair and       T                 ................  X                 ...............
                   Plastic Eye Procedures.
0239............  Level II Repair and      T                 ................  X                 ...............
                   Plastic Eye Procedures.
0245............  Level I Cataract         T                 ................  X                 ...............
                   Procedures without IOL
                   Insert.
0249............  Level II Cataract        T                 ................  X                 ...............
                   Procedures without IOL
                   Insert.
0251............  Level I ENT Procedures.  T                 ................  X                 ...............
0252............  Level II ENT Procedures  T                 ................  X                 ...............
0253............  Level III ENT            T                 ................  X                 ...............
                   Procedures.
0254............  Level IV ENT Procedures  T                 ................  X                 ...............
0256............  Level V ENT Procedures.  T                 ................  X                 ...............
0259............  Level VI ENT Procedures  T                 ................  X                 ...............
0260............  Level I Plain Film       X                 ................  X                 ...............
                   Except Teeth.
0261............  Level II Plain Film      X                 ................  X                 ...............
                   Except Teeth Including
                   Bone Density
                   Measurement.
0263............  Level I Miscellaneous    X                 ................  X                 ...............
                   Radiology Procedures.
0264............  Level II Miscellaneous   X                 ................  X                 ...............
                   Radiology Procedures.
0265............  Level I Diagnostic       X                 ................  X
                   Ultrasound Except
                   Vascular.
0266............  Level II Diagnostic      S                 ................  X                 ...............
                   Ultrasound Except
                   Vascular.
0269............  Level I Echocardiogram   S                 ................  X                 ...............
                   Except Transesophageal.
0271............  Mammography............  S                 ................  ................  X
0272............  Level I Fluoroscopy....  X                 ................  X                 ...............
0279............  Level I Angiography and  S                 X                 ................  ...............
                   Venography except
                   Extremity.
0280............  Level II Angiography     S                 X                 ................  ...............
                   and Venography.
0282............  Miscellaneous            S                 ................  X                 X
                   Computerized Axial
                   Tomography.
0283............  Computerized Axial       S                 ................  ................  X
                   Tomography with
                   Contrast.
0284............  Magnetic Resonance       S                 ................  ................  X
                   Imaging and
                   Angiography with
                   Contrast.
0287............  Complex Venography.....  S                 X                 ................  ...............
0288............  CT, Bone Density.......  S                 ................  X                 ...............
0289............  Needle Localization for  X                 X                 ................  ...............
                   Breast Biopsy.
0291............  Level I Diagnostic       S                 ................  X                 ...............
                   Nuclear Medicine
                   Excluding Myocardial
                   Scans.
0292............  Level II Diagnostic      S                 ................  X                 ...............
                   Nuclear Medicine
                   Excluding Myocardial
                   Scans.
0300............  Level I Radiation        S                 ................  X                 ...............
                   Therapy.
0301............  Level II Radiation       S                 ................  X                 ...............
                   Therapy.
0302............  Level III Radiation      S                 ................  X                 ...............
                   Therapy.
0304............  Level I Therapeutic      X                 X                 ................  ...............
                   Radiation Treatment
                   Preparation.
0305............  Level II Therapeutic     X                 X                 ................  ...............
                   Radiation Treatment
                   Preparation.
0312............  Radioelement             S                 X                 ................  ...............
                   Applications.
0332............  Computerized Axial       S                 ................  X                 X
                   Tomography w/o
                   Contrast.
0333............  CT Angio and             S                 ................  X                 X
                   Computerized Axial
                   Tomography w/o
                   Contrast followed by
                   with Contrast.
0335............  Magnetic Resonance       S                 ................  ................  X
                   Imaging,
                   Temporomandular Joint.
0336............  Magnetic Resonance       S                 ................  X                 X
                   Angiography and
                   Imaging without
                   Contrast.
0337............  Magnetic Resonance       S                 ................  ................  X
                   Imaging and
                   Angiography w/o
                   Contrast followed by
                   with Contrast.
0338............  Magnetic Resonance       S                 ................  ................  X
                   Angiography, Chest and
                   Abdomen with or w/o
                   Contrast.
0339............  Observation............  X                 X                 ................  ...............
0340............  Minor Ancillary          X                 ................  X                 ...............
                   Procedures.
0345............  Level I Transfusion      X                 ................  X                 ...............
                   Laboratory Procedures.
0346............  Level II Transfusion     X                 ................  X                 ...............
                   Laboratory Procedures.
0347............  Level III Transfusion    X                 ................  X                 ...............
                   Laboratory Procedures.
0352............  Level II Injections....  X                 ................  X                 ...............
0353............  Level II Allergy         X                 X                 ................  ...............
                   Injections.
0355............  Level I Immunizations..  K                 ................  X                 ...............

[[Page 44695]]

 
0356............  Level II Immunizations.  K                 ................  X                 ...............
0359............  Level I Injections.....  K                 ................  X                 ...............
0360............  Level I Alimentary       X                 ................  X                 ...............
                   Tests.
0361............  Level II Alimentary      X                 ................  X                 ...............
                   Tests.
0364............  Level I Audiometry.....  X                 ................  X                 ...............
0365............  Level II Audiometry....  X                 ................  X                 ...............
0367............  Level I Pulmonary Test.  X                 ................  X                 ...............
0368............  Level II Pulmonary       X                 ................  X                 ...............
                   Tests.
0369............  Level III Pulmonary      X                 ................  X                 ...............
                   Tests.
0371............  Level I Allergy          X                 X                 ................  ...............
                   Injections.
0689............  Electronic Analysis of   S                 X                 ................  ...............
                   Cardioverter-
                   Defibrillators.
0690............  Electronic Analysis of   S                 X                 ................  ...............
                   Pacemakers and other
                   Cardiac Devices.
0691............  Electronic Analysis of   S                 X                 ................  ...............
                   Programmable Shunts/
                   Pumps.
0692............  Electronic Analysis of   S                 X                 ................  ...............
                   Neurostimulator Pulse
                   Generators.
0693............  Level II Breast          T                 ................  X                 ...............
                   Reconstruction.
0694............  Level III Excision/      T                 ................  X                 ...............
                   Biopsy.
0695............  Level VII Debridement &  T                 ................  X                 ...............
                   Destruction.
0696............  Repair/Replacement of    T                 X                 ................  ...............
                   Cardioverter-
                   Defibrillators.
0697............  Level II Echocardiogram  S                 ................  X                 ...............
                   Except Transesophageal.
0698............  Level II Eye Tests &     S                 ................  X                 ...............
                   Treatments.
0699............  Level IV Eye Tests &     T                 ................  X                 ...............
                   Treatment.
0982............  New Technology--Level    T                 ................  ................  X
                   XII ($2500-3000).
0983............  New Technology--Level    T                 ................  ................  X
                   XIV ($3000-3500).
0984............  New Technology--Level    T                 ................  ................  X
                   XV ($3500-5000).
0985............  New Technology--Level    T                 ................  ................  X
                   XVI ($5000-6000).
----------------------------------------------------------------------------------------------------------------

D. Recalibration of APC Weights for CY 2002

    Section 1833(t)(9)(A) of the Act requires that the Secretary review 
and revise the relative payment weights for APCs at least annually 
beginning in 2001 for application in 2002. In the April 7, 2000 final 
rule (65 FR 18482), we explained in detail how we calculated the 
relative payment weights that were implemented on August 1, 2000 for 
each APC group. Except for some reweighting due to APC changes, these 
relative weights continued to be in effect for 2001. (See the November 
13, 2000 interim final rule (65 FR 67824-67827).)
    To recalibrate the relative APC weights for services furnished on 
or after January 1, 2002 and before January 1, 2003, we are proposing 
to use the same basic methodology that we described in the April 7, 
2000 final rule to recalibrate the relative weights for 2002. That is, 
we would recalibrate the weights based on claims and cost report data 
for outpatient services. We propose to use the most recent available 
data to construct the database for calculating APC group weights. For 
the purpose of recalibrating APC relative weights for 2002, the most 
recent available claims data are the approximately 98 million final 
action claims for hospital outpatient department services furnished on 
or after July 1, 1999 and before July 1, 2000. We matched these claims 
to the most recent cost report filed by the individual hospitals 
represented in our claims data. The APC relative weights would continue 
to be based on the median hospital costs for services in the APC 
groups.
    The methodology we followed to calculate the APC relative weights 
proposed for CY 2002 is as follows:
     We excluded from the data approximately 15.4 million 
claims for those bill and claim types that would not be paid under the 
OPPS (for example, bill type 72X for dialysis services for patients 
with ESRD).
     Using the most recent available cost report from each 
hospital, we converted billed charges to costs and aggregated them to 
the procedure or visit level first by identifying the cost-to-charge 
ratio specific to each hospital's cost centers (``cost center specific 
cost-to-charge ratios'' or CCRs) and then by matching the CCRs to 
revenue centers used on the hospital's 1999-2000 outpatient bills. The 
CCRs included operating and capital costs but excluded costs paid on a 
reasonable cost basis that are described elsewhere of this preamble.
     We eliminated from the hospital CCR data 283 hospitals 
that we identified as having reported charges on their cost reports 
that were not actual charges (for example, they make uniform charges 
for all services).
     We calculated the geometric mean of the total operating 
CCRs of hospitals remaining in the CCR data. We removed from the CCR 
data 67 hospitals whose total operating CCR exceeded the geometric mean 
by more than 3 standard deviations.
     We excluded from our data approximately 1.8 million claims 
from the hospitals that we removed or trimmed from the hospital CCR 
data.
     We matched revenue centers from the remaining universe of 
approximately 80.8 million claims to CCRs of 5,653 hospitals.
     We separated the 80.8 million claims that we had matched 
with a cost report into two distinct groups: single-procedure claims 
and multiple-procedure claims. Single-procedure claims were those that 
included only one HCPCS code (other than laboratory and incidentals 
such as packaged drugs and venipuncture) that could be grouped to an 
APC. Multiple-procedure claims included more than one HCPCS code that 
could be mapped to an APC. There were approximately 36.4 million 
single-procedure claims and 44.4 million multiple-procedure claims.
     To calculate median costs for services within an APC, we 
used only single-procedure bills. We did not use multiple-procedure 
claims because we are not able to specifically allocate charges or 
costs for packaged items and services such as anesthesia, recovery 
room, drugs, or supplies to a particular procedure when more than one 
significant procedure or medical visit is billed on a claim. Use of the 
single-procedure bills minimizes the risk of improperly assigning costs 
to the wrong procedure or visit.
     For each single-procedure claim, we calculated a cost for 
every billed line item charge by multiplying each

[[Page 44696]]

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 the OPPS (for example, laboratory, ambulance, and therapy 
services).
     To calculate the per-service costs, we used the charges 
shown in the revenue centers that contained items integral to 
performing the service. These included those items that we previously 
discussed as being subject to our proposed packaging provision. For 
instance, in calculating the surgical procedure cost, we included 
charges for the operating room, treatment rooms, recovery, observation, 
medical and surgical supplies, pharmacy, anesthesia, casts and splints, 
and donor tissue, bone, and organ. For medical visit cost estimates, we 
included charges for items such as medical and surgical supplies, 
drugs, and observation in those instances where it is still packaged. 
See sections II.C.1 and II.C.2 of this preamble for a discussion and 
complete listing of the revenue centers that we are proposing to use to 
calculate per-service costs.
     We standardized costs for geographic wage variation by 
dividing the labor-related portion of the operating and capital costs 
for each billed item by the current FY 2001 hospital inpatient 
prospective payment system wage index published in the Federal Register 
on August 1, 2000 (65 FR 47054). We used 60 percent to represent our 
estimate of that portion of costs attributable, on average, to labor. A 
more detailed discussion of wage index adjustments is found in section 
III of this preamble.
     We summed the standardized labor-related cost and the 
nonlabor-related cost component for each billed item to derive the 
total standardized cost for each procedure or medical visit.
     We removed extremely unusual costs that appeared to be 
errors in the data using a trimming methodology analogous to what we 
use in calculating the DRG weights for the hospital inpatient PPS. That 
is, we eliminated any bills with costs outside of 3 standard deviations 
from the geometric mean.
     After trimming the procedure and visit level costs, we 
mapped each procedure or visit cost to its assigned APC, including, to 
the extent possible, the proposed APC changes described elsewhere in 
this preamble.
     We calculated the median cost, weighted by procedure 
volume, for each APC.
     Using the weighted median APC costs, we calculated the 
relative payment weights for each APC. We scaled all the relative 
payment weights to APC 0601, Mid-level clinic visit, because it is one 
of the most frequently performed services in the hospital outpatient 
setting. This approach is consistent with that used in developing 
relative value units for the Medicare physician fee schedule. We 
assigned APC 0601 a relative payment weight of 1.00 and divided the 
median cost for each APC by the median cost for APC 0601, to derive the 
relative payment weight for each APC. The median cost for APC 0601 is 
$54.00.
    Section 1833(t)(9)(B) of the Act requires that APC reclassification 
and recalibration changes and wage index changes be made in a manner 
that assures that aggregate payments under the OPPS for 2002 are 
neither greater than nor less than the aggregate payments that would 
have been made without the changes. To comply with this requirement 
concerning the APC changes, we compared aggregate payments using the CY 
2001 relative weights to aggregate payments using the CY 2002 proposed 
weights. Based on this comparison, we are proposing to make an 
adjustment of 1.022 to the weights. The weights that we are proposing 
for 2002, which incorporate the recalibration adjustments explained in 
this section, are listed in Addendum A and Addendum B.

III. Wage Index Changes

    Under section 1833(t)(2)(D) of the Act, we are required to 
determine a wage adjustment factor to adjust for geographic wage 
differences, in a budget neutral manner, that portion of the OPPS 
payment rate and copayment amount that is attributable to labor and 
labor-related costs.
    We used the proposed Federal fiscal year (FY) 2002 hospital 
inpatient PPS wage index to make wage adjustments in determining the 
proposed payment rates set forth in this proposed rule. The proposed FY 
2002 hospital inpatient wage index published in the May 4, 2001 Federal 
Register (66 FR 22821) is reprinted in this proposed rule as Addendum 
H, Wage Index for Urban Areas; Addendum I, Wage Index for Rural Areas; 
and Addendum J, Wage Index for Hospitals That Are Reclassified. We 
propose to use the final FY 2002 hospital inpatient wage index to 
calculate the payment rates and coinsurance amounts that we will 
publish in the final rule implementing the OPPS for calendar year (CY) 
2002.

IV. Copayment Changes

    We note that in section 1833(t) of the Act, the terms ``copayment'' 
and ``coinsurance'' appear to be used interchangeably. To be consistent 
with CMS usage, we make a distinction between the two terms throughout 
this preamble. We propose to make conforming changes to part 419 of the 
regulations to reflect the following usage:
     ``Coinsurance'' means the percent of the Medicare-approved 
amount that beneficiaries pay for a service furnished in the hospital 
outpatient department (after they meet the Part B deductible).
     ``Copayment'' means the set dollar amount that 
beneficiaries pay under the OPPS. For example, if the payment rate for 
an APC is $200 and the beneficiary is responsible for paying $50, the 
copayment is $50 and the coinsurance is 25 percent.

A. BIPA 2000 Coinsurance Limit

    As discussed in section I.C of this preamble, certain provisions of 
BIPA 2000 affect beneficiary copayment amounts under the OPPS. Section 
111 of the BIPA added section 1833(t)(8)(C)(ii) of the Act, to 
accelerate the reduction of beneficiary copayment amounts, providing 
that, for services furnished on or after April 1, 2001 and before 
January 1, 2002, the national unadjusted coinsurance for an APC cannot 
exceed 57 percent of the APC payment rate. The statute provides for 
further reductions in future years so that the national unadjusted 
coinsurance for an APC cannot exceed 55 percent in 2002 and 2003, 50 
percent in 2004, 45 percent in 2005, and 40 percent in 2006 and 
thereafter.
    We implemented the reduction in beneficiary copayments for 2001 
effective April 1, 2001 through changes to the OPPS PRICER software 
used to calculate OPPS payments to hospitals from the Medicare Program 
and beneficiary copayments.
    We would revise Sec. 419.41 to conform the regulations text to this 
provision.

B. Impact of BIPA 2000 Payment Rate Increase on Coinsurance

    Under the statute as enacted by BBA 1997, APC payment rates for 
2001 were to be based on the payment rates for 2000 increased by the 
inpatient hospital market basket percentage increase minus 1 percentage 
point; however, section 401 of the BIPA 2000 increased APC payment 
rates for 2001 to reflect an update based on the full market basket

[[Page 44697]]

percentage increase. The Congress intended for the increased payment to 
be in effect for the entire calendar year 2001; however, to provide us 
sufficient time to make the change, the Congress adopted a special 
payment rule for 2001. Under section 401(c) of the BIPA, the payment 
rates in effect for services furnished on or after January 1, 2001 and 
before April 1, 2001 are the rates as determined under the statute 
prior to the enactment of BIPA. For services furnished on or after 
April 1, 2001 and before January 1, 2002 the payment rates reflect the 
full market basket update and are further increased by 0.32 percent to 
account for the timing delay in implementing the full market basket 
update for 2001. The 0.32 percent increase is a temporary increase that 
applies only to the period April 1 through December 31, 2001 and is not 
considered in updating the OPPS conversion factor for 2002. The 
increase in APC payment rates for 2001 was implemented effective April 
1, 2001 through changes to the OPPS PRICER software. We would revise 
Sec. 419.32 to conform to the statute.
    The section 401 increase to the APC payment rates affected 
beneficiary copayments in several ways. In cases for which the 
beneficiary coinsurance was already based on 20 percent of the APC 
payment rate, the increase in the APC payment rate caused a 
corresponding increase in the copayment for the APC. For all other 
APCs, the copayment amount remained at the same level. In addition, 
because the minimum copayment amount for an APC, which is the lowest 
amount a provider may elect to charge, if it chooses to reduce 
copayments for an APC, is based on 20 percent of the APC amount, the 
increase to an APC payment rate under section 401 of BIPA, resulted in 
an increase to the minimum copayment amount for each APC.

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

    National unadjusted copayment amounts for the original APCs that 
went into effect on August 1, 2000 were, by statute, based on 20 
percent of the national median charge billed for services in the APC 
group during calendar year 1996, trended forward to 1999, but could be 
no lower than 20 percent of the APC payment rate. Although the BBA 1997 
specified how copayments were to be determined initially, the statute 
does not specify how copayments are to be determined in the future as 
the APC groups are recalibrated or as individual services are 
reclassified from one APC group to another. In this section, we are 
proposing the method we intend to apply in determining copayments for 
new APCs (that is, those created after 2001) and for APCs that are 
revised because of recalibration and reclassification.
    In developing a proposed approach to be used in determining 
copayments for new or revised APCs, we took into account the following:
     One of the Congress's goals in authorizing an OPPS is to 
reduce beneficiary copayment liability until the copayment for every 
hospital outpatient service equals 20 percent of the prospectively 
determined payment rate for that service. Therefore, when given two 
possible copayment amounts or coinsurance percentages for a service as 
the result of an APC change, we should opt for the lower value.
     In general, we should use the coinsurance percentage (that 
is, the percentage of the total payment rate represented by the 
copayment amount) as the factor for comparison of the old versus the 
new copayment amount rather than a copayment dollar amount.
     Notwithstanding any changes, the coinsurance for an APC 
cannot be lower than 20 percent of the payment rate for an APC group.
     Notwithstanding any changes, the coinsurance for an APC 
cannot exceed 55 percent of the payment rate for an APC in 2002 or the 
applicable copayment limits under section 1833(t)(8)(C)(ii) of the Act 
in subsequent years.
    The following describes how we propose to determine copayment 
amounts for new and revised APCs for 2002 and subsequent years:
    1. If a newly created APC group consists of services that were not 
included in the 1996 data base or whose charges were not separately 
calculated in that data base (that is, the services were excluded or 
packaged) the unadjusted copayment amount would be 20 percent of the 
APC payment rate.
    2. If recalibrating the relative payment weights results in an APC 
having a decrease in its payment rate for a subsequent year, the 
unadjusted copayment amount will be calculated so that the coinsurance 
percentage for the APC remains the same that it was before the payment 
rate decrease. For example, assume the APC had a payment rate of $100 
and an unadjusted copayment amount of $50, resulting in a coinsurance 
percentage of 50 percent. If the new payment rate for the APC is 
lowered to $80, the copayment amount is calculated using the prior 
coinsurance percentage of 50 percent; therefore, the new copayment 
amount would be 50 percent of $80 or $40.
    3. If recalibrating the relative payment weights results in an APC 
having an increase in its payment rate for a subsequent year, the 
unadjusted copayment amount would be calculated so that the copayment 
dollar amount for the APC remains the same as it was before the payment 
rate increase. That is, the unadjusted copayment amount would not 
change. For example, assume the APC had a payment rate of $100 and an 
unadjusted copayment amount of $60 (a coinsurance percentage of 60 
percent). If the new payment rate for the APC is increased to $150, the 
unadjusted copayment amount would remain at $60 (a coinsurance 
percentage of 40 percent).
    4. If a newly created APC group consists of services from two or 
more existing APCs, the unadjusted copayment amount would be calculated 
based on the lowest coinsurance percentage of the contributing APCs. 
For example, a new APC is created by moving some or all of the services 
from two existing APCs into the new APC. Assume that one contributing 
APC had a payment rate of $100 and an unadjusted copayment amount of 
$40, coinsurance percentage of 40 percent. Assume the other 
contributing APC had a payment rate of $150 and an unadjusted copayment 
amount of $75, a coinsurance percentage of 50 percent. If the new APC 
had a payment rate of $130, the unadjusted copayment amount for the new 
APC would be based on a coinsurance percentage of 40. The unadjusted 
copayment amount for the new APC would be 40 percent of $130, or $52.
    5. If an APC payment rate is increased due to a conversion factor 
update, the unadjusted copayment amount for the APC would not change.

V. Outlier Policy Changes

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

[[Page 44698]]

OPPS services furnished on or after January 1, 2002.
    One difficulty we face with calculating outliers based on 
individual services is how to treat the charges for packaged services 
(for example, drugs, supplies, anesthesia, and equipment) when more 
than one OPPS service appears on a bill. These packaged services do not 
in themselves generate an APC payment but their charges must be taken 
into account to determine the cost of a service such as a surgical or 
diagnostic procedure or medical visit that does generate an APC 
payment. When more than one HCPCS code that will result in an APC 
payment appears on a bill, it is currently impossible to determine 
which packaged service is associated with an individual OPPS payable 
service. For example, when multiple surgical procedures are performed 
on the same day, we cannot determine how much of the operating room, 
drug, supply, anesthesia, or recovery room charge is attributable to 
each procedure. Similarly, if a medical visit and a surgical procedure 
occur on the same day, we cannot accurately determine how much of the 
charge for any drug, supply, or other packaged service that appears on 
the bill is attributable to each individual OPPS service.
    One solution would be to require hospitals to submit separate bills 
for each OPPS service so that we can be certain that the correct 
packaged services attributable to the individual OPPS service will be 
taken into account in determining an outlier payment for that service. 
We believe, however, such a requirement would be excessively burdensome 
to hospitals and would greatly increase fiscal intermediary workloads. 
In addition, billing of individual services for the same day on 
separate bills would prohibit us from applying the correct coding 
edits. Finally, we believe that the limit on outlier payments (up to 
2.5 percent of the total OPPS payments in each year before 2004 and up 
to 3 percent for subsequent years) does not justify the burden that 
would result from requiring separate bills for each OPPS service.
    Another approach we considered is to allocate the charges for any 
packaged service among the individual OPPS services that appear on the 
bill. We considered two possible ways to do this. First, we could 
divide the packaged charges equally among the OPPS services so that if 
there were three services that generated APC payments, one third of the 
charges for the packaged services would be assigned to each OPPS 
service. We also considered dividing the total packaged charges among 
the OPPS services based on the ratio of the APC payment rate for an 
individual OPPS service to the total APC payment rates for all services 
on the bill. Thus, if a service resulted in an APC rate of $200 and the 
total APC payment rates for all services on the bill were $2,000, that 
individual APC would be allocated 10 percent of the packaged charges 
appearing on the bill.
    We prefer using one of the approaches that would allocate packaged 
charges among the APCs on a bill to avoid disruptive billing changes. 
Of the two ways to allocate charges for packaged services, we are 
proposing that charges be allocated to each OPPS service based on the 
percent the APC payment rate for that service bears to the total APC 
rates for all OPPS services on the bill. We believe that this 
allocation method is somewhat more precise than simply dividing evenly 
the total packaged charges by the number of APCs on the bill.
    We also propose to convert charges to costs for calculating outlier 
payments by continuing to apply a single overall hospital-specific 
cost-to-charge ratio instead of applying hospital-specific departmental 
cost-to-charge ratios. There is no universal crosswalk of revenue codes 
to cost report cost centers that is used by all hospitals. Although 
departmental cost-to-charge ratios are more precise for purposes of 
determining costs of specific services, hospitals have considerable 
discretion in assigning charges billed under specific revenue codes to 
specific departments on their cost reports. Therefore, we do not have a 
way of defining, in a uniform manner that is accurate for all 
hospitals, which department cost-to-charge ratio to apply to a revenue 
code billed by a hospital. We considered establishing a basic crosswalk 
that we would apply uniformly to every hospital, but this could result 
in a distorted or inaccurate model of how some hospitals actually 
assign charges. Given the appropriate resources, we could gather data 
from hospitals upon which to base a crosswalk specific to every 
hospital paid under the OPPS. But collecting these data would impose 
significant burden and administrative costs on hospitals and on our 
contractors. Given that outliers represent only 2 to 3 percent of total 
OPPS expenditures, we believe that the increased accuracy in 
calculating outlier payments that we could gain would not be sufficient 
to justify the significant additional administrative burden and cost 
that would be required. For this reason, we are proposing to continue 
to apply a single hospital-specific outpatient cost-to-charge ratio to 
convert billed charges to costs for calculating outlier payments.
    As explained in the April 7, 2000 final rule (65 FR 18498), we set 
a target for outlier payments at 2.0 percent of total payments. We also 
explained, for purposes of simulating payments to calculate outlier 
thresholds, that we set the parameters for determining outlier payments 
as if the target were 2.5 percent. We believed that it would be likely 
that using simulation 1996 claims data would overstate the percentage 
of payments that would be made. Based on the simulations, we set a 
threshold for outlier payments at 2.5 times the claim cost and a 
payment percent of 75 percent of the cost above the threshold for both 
2000 and 2001.
    In setting the 2002 outlier threshold and payment percentage, we 
account for the charge to service level rather than claim level outlier 
calculation. In this proposed rule, we would again set the target for 
outlier payment at 2.0 percent. However, because we believe that the 
claims data we are using to set the 2002 proposed payment rates reflect 
much better coding of services than did the 1996 data, we would set 
these parameters to reach a target of 2.0 percent (rather than 2.5 
percent). Based on our simulations, the proposed threshold for 2002 is 
3 times the service costs and the proposed payment percentage for costs 
above that threshold is set at 50 percent.

VI. Other Policy Decisions and Proposed Changes

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

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

[[Page 44699]]

    In the April 7, 2000 final rule, we included inpatient ``Part B-
only'' services within the definition of services payable under the 
OPPS (68 FR 18543). We have subsequently been approached by 
representatives of some hospitals that do not have outpatient 
departments and that, therefore, do no billing for Part B services 
except for a relatively few ``Part B-only'' services that they furnish 
to their inpatients. That is, the only bills these hospitals would ever 
submit for Part B payment are for the ancillary services designated as 
``Part B-only'' services. These hospitals are concerned about the 
administrative burden and prohibitive costs they would incur if they 
were to change their billing systems to accommodate OPPS requirements 
solely to receive payment for ``Part B-only'' services.
    We recognize that there are certain hospitals that do not have 
outpatient departments and that do not provide outpatient department 
services but that do provide inpatient services to Medicare 
beneficiaries. The only services these hospitals bill under OPPS are 
services furnished to inpatients. That is, these are special billings 
under the Part B-only benefit for limited ancillary services provided 
to beneficiaries who are admitted to the hospital as inpatients and who 
are not receiving services on an outpatient basis. We further 
acknowledge that the expense of converting their billing systems to 
accommodate the OPPS is disproportionate to the Part B revenues that 
these hospitals receive. Therefore, we are proposing to revise 
Sec. 419.22 by adding subparagraph (r) to exclude from payment under 
the OPPS Part B-only services that are furnished to inpatients of 
hospitals that do no other billing for hospital outpatient services 
under Part B.
    Under this proposed revision of the regulations, hospitals with 
outpatient departments would continue to bill under the OPPS for Part 
B-only services that they furnish to their inpatients. However, a 
hospital that does not have an outpatient department would be unable to 
bill under the OPPS for any Part B-only service the hospital furnished 
to its inpatients because those services would not fall within the 
scope of covered OPD services. If a hospital with no outpatient 
department is currently billing under the OPPS, the hospital would have 
to revert to its previous payment methodology for services furnished on 
or after January 1, 2002. That methodology would be an all-inclusive 
rate for hospitals paid that way prior to the implementation of OPPS 
and reasonable cost for other hospitals.
    We do not know at this time, and are not sure it would be possible 
to ascertain, the potential number of hospitals that would be affected 
by this regulatory change. However, we expect the financial impact on 
the program to be small, because this revised rule would apply only to 
the relatively few hospitals that are billing for the very limited 
range of Part B-only services for a small number of beneficiaries.

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

    In Sec. 419.20(b) of the regulations, certain hospitals in Maryland 
that qualify under section 1814(b)(3) of the Act for payment under the 
State's payment system are excluded from the OPPS. Critical access 
hospitals (CAHs) that are paid under a reasonable cost-based system as 
required under section 1834(g) of the Act are also excluded. In 
addition, we stated in the April 7, 2000 final rule that the outpatient 
services provided by the hospitals of the Indian Health Services (IHS) 
will continue to be paid under separately established rates. We also 
noted that we intended to consult with the IHS and develop a plan to 
transition these hospitals into OPPS. With these exceptions, the OPPS 
applies to all other hospitals that participate in the Medicare 
program.
    It has been brought to our attention that under the statute, 
hospitals located in Guam, Saipan, American Samoa, and the Virgin 
Islands are excluded from the hospital inpatient PPS. These hospitals 
currently lack a charge structure for billing and, in some cases, are 
not equipped to prepare a cost report. They furnish very few services 
that would be subject to the OPPS. In addition, we believe that because 
of their distant locations, they incur costs that might not be 
adequately recognized by a PPS. Prior to implementation of the OPPS, 
each of the hospitals in Guam, American Samoa, Saipan, and the Virgin 
Islands had its own unique Medicare payment methodology for the 
outpatient services they furnish. In light of these factors, we are 
proposing to revise Sec. 419.20 of the regulations by adding paragraph 
(b)(3) to exclude these hospitals from OPPS consistent with their 
treatment under inpatient PPS. In addition, we would revise that 
section to include the hospitals of the IHS so that it is clear that 
they are excluded until we develop a plan to include them. We would 
note that it may also be possible to include the hospitals in the 
territories in the OPPS in the future.

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

    Hospitals subject to the OPPS are paid for certain items and 
services that are outside the scope of the OPPS on a reasonable cost or 
other basis. Payments for the following services are made on a 
reasonable cost basis or otherwise applicable methodology:
    a. The direct costs of medical education as described in 
Sec. 413.86.
    b. The costs of nursing and allied health programs as described in 
Sec. 413.85.
    c. The costs associated with interns and residents not in approved 
teaching programs as described in Sec. 415.202.
    d. The costs of teaching physicians attributable to Part B services 
for hospitals that elect cost-based payment for teaching physicians 
under Sec. 415.160.
    e. The costs of anesthesia services furnished to hospital 
outpatients by qualified nonphysician anesthetists (certified 
registered nurse anesthetists and anesthesiologists' assistants) 
employed by the hospital or obtained under arrangements, for hospitals 
that meet the requirements under Sec. 412.113(c).
    f. Bad debts for uncollectible deductible and coinsurance amounts 
as described in Sec. 413.80(b).
    g. Organ acquisition costs paid under Part B. Interim payments for 
these services are made on a biweekly basis and final payments are 
determined at cost report settlement.
    We would revise Sec. 419.2(c) to make conforming changes that 
reflect the exclusion of these costs from the OPPS rates.

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

    In the April 7, 2000 final rule, we emphasized the importance of 
each facility accurately assessing the intensity, resource use, and 
charges for evaluation and management (E/M) services, in order to 
ensure proper reporting of the service provided. We stated that ``the 
billing information that the hospitals report during the first years of 
implementation of the hospital outpatient PPS will be vitally important 
to our revision of weights and other adjustments that affect payment in 
future years.'' (65 FR 18451)
    We went on to state, ``We realize that while these HCPCS codes 
appropriately represent different levels of physician effort, they do 
not adequately describe nonphysician resources. However, * * * the same 
concept can be applied to each code in terms of the differences in 
resource utilization. Therefore, each facility should develop a system 
for

[[Page 44700]]

mapping the provided services or combination of services furnished to 
the different levels of effort represented by the codes * * *. We will 
hold each facility accountable for following its own system for 
assigning the different levels of HCPCS codes. As long as the services 
furnished are documented and medically necessary and the facility is 
following its own system, which reasonably relates the intensity of 
hospital resources to the different levels of HCPCS codes, we will 
assume that it is in compliance with these reporting requirements as 
they relate to the clinic/emergency department visit code reported on 
the bill. Therefore, we would not expect to see a high degree of 
correlation between the code reported by the physician and that 
reported by the facility * * *. We will work with the American Hospital 
Association and the American Medical Association to propose the 
establishment of appropriate facility-based patient visit codes * * 
*.''
    We understand that facilities have developed several different 
systems for determining resource consumption to assign proper E/M 
codes. Some of these systems are based on clinical (``condition'') 
criteria, and others are based on weighted scoring criteria. We 
continue to believe that proper facility coding of E/M services is 
critical for assuring appropriate payments. In order to achieve this, 
we are interested in developing and implementing a standardized coding 
process for facility reporting of E/M services. This process could 
include the use of current HCPCS codes or the establishment of new 
HCPCS codes in conjunction with guidelines for facility coding.
    At this time, we are soliciting comments from hospitals and other 
interested parties on this issue. We will submit these comments to the 
APC Advisory Panel and ask for the Panel's recommendations regarding 
the development and implementation of a facility coding process for E/M 
services. In order to ensure consideration by the Panel, comments must 
be received by November 1, 2001. Send comments regarding facility 
coding of E/M services to: OPPS-E/M coding, Centers for Medicare & 
Medicaid Services, Mailstop C4-05-17, 7500 Security Boulevard, 
Baltimore, Maryland 21244-1850. CMS will review both the public 
comments and the recommendations from the Panel and propose a coding 
process in the proposed rule for 2003.

E. Annual Drug Pricing Update

    Under the OPPS, we pay for drugs and biologicals in one of three 
ways.
1. Packaged Payment
    As we explain in the April 7, 2000 final rule, we generally package 
the cost of drugs, biologicals, and pharmaceuticals into the APC 
payment rate for the primary procedure or treatment with which the 
drugs are usually furnished (65 FR 18450). No separate payment is made 
under the OPPS for drugs, biologicals, and pharmaceuticals whose costs 
are packaged into the APCs with which they are associated.
2. Transitional Pass-Through Payments for Eligible Drugs and 
Biologicals
    As we explain in the April 7, 2000 final rule and in section VII of 
this preamble, the BBRA 1999 provided for special transitional pass-
through payments for a period of 2 to 3 years for the following drugs 
and biologicals:
     Current orphan drugs, as designated under section 526 of 
the Federal Food, Drug, and Cosmetic Act;
     Current drugs and biologic agents used for treatment of 
cancer;
     Current radiopharmaceutical drugs and biological products; 
and
     New drugs and biologic agents in instances where the item 
was not being paid for as a hospital outpatient service as of December 
31, 1996, and where the cost of the item is ``not insignificant'' in 
relation to the hospital outpatient PPS payment amount.
    In this context, ``current'' refers to those items for which 
hospital outpatient payment was being made on August 1, 2000, the date 
on which the OPPS was implemented. A ``new'' drug or biological is a 
product that was not paid as a hospital outpatient service prior to 
January 1, 1997 and for which the cost is not insignificant in relation 
to the payment for the APC to which it is assigned.
    Section 1833(t)(6)(D)(i) of the Act sets the payment rate for pass-
through eligible drugs as the amount determined under section 1842(o) 
of the Act, that is, 95 percent of the applicable average wholesale 
price (AWP). Section 1833(t)(6)(D)(i) of the Act also sets the amount 
of additional payment for pass-through-eligible drugs and biologicals 
(the pass-through payment amount). The pass-through payment amount is 
the difference between 95 percent of the applicable AWP and the portion 
of the otherwise applicable fee schedule amount (that is, the APC 
payment rate) that the Secretary determines is associated with the drug 
or biological. Therefore, as we explain in the April 7 final rule (65 
FR 18481), in order to determine the correct pass-through payment 
amount, we first had to determine the cost that was packaged for the 
drug or biological within its related APC. In order to determine this 
amount, we used the following methodology, which we also explain in the 
April 7 final rule.
    When we implemented the OPPS on August 1, 2000, costs for drugs and 
biologicals eligible for transitional pass-through payment were, to the 
extent possible, not included in the payment rates for the APC groups 
into which they had been packaged prior to enactment of the BBRA 1999. 
That is, to the extent feasible, we removed from the APC groups into 
which they were packaged, the costs of as many of the pass-through 
eligible drugs and biologicals as we could identify in the 1996 claims 
data. Then, we assigned each drug and biological eligible for a pass-
through payment to its own, separate APC group, the total payment rate 
for which was set at 95 percent of the applicable AWP.
    Next, in order to establish the applicable beneficiary copayment 
amount and pass-through payment amount, we had to determine the cost of 
the pass-through eligible drug or biological that would have been 
included in the payment rate for its associated APC had the drug or 
biological been packaged. We used hospital acquisition costs as a proxy 
for the amount that would have been packaged, based on data taken from 
an external survey of hospital drug costs. (See the April 7, 2000 final 
rule (65 FR 18481)).
    We imputed the acquisition cost for the various drugs and 
biologicals in pass-through APCs by multiplying their applicable AWP by 
one of the following ratios. The following ratios are based on the 
survey data, and they represent, on average, hospital drug acquisition 
cost relative to AWP:
     For drugs with one manufacturer (sole-source), the ratio 
of acquisition cost to AWP equals 0.68.
     For drugs with more than one manufacturer (multi-source), 
the ratio of acquisition cost to AWP equals 0.61.
     For drugs with more than one manufacturer and with generic 
competitors, the ratio of acquisition cost to AWP equals 0.43.
    In accordance with section 1833(t)(7) of the Act, we base 
beneficiary copayment amounts for pass-through drugs only on that 
portion of the drug's cost that would have been included in the payment 
amount for an associated APC had the drug been packaged. Therefore, 
having determined the hospital acquisition cost of the drug based on 
the ratios described above, we multiply the acquisition cost by 20

[[Page 44701]]

percent to calculate the beneficiary copayment for the pass-through 
drug or biological APCs. Finally, to calculate the actual pass-through 
payment amount, we subtract from the applicable 95 percent of AWP the 
hospital acquisition cost less the beneficiary copayment amount.
    To illustrate this payment methodology, consider a current sole 
source drug with an average wholesale price (AWP) of $100 per dose. 
Under section 1842(o) of the Act, the total allowed payment for the 
drug is $95, that is, 95 percent of AWP. We impute the cost of the drug 
based on survey data, which indicate hospital acquisition costs for 
this type of drug on average to be 68 percent of its AWP (or $68). In 
the absence of the pass-through provisions, this cost would be packaged 
into the APC payment for the procedure or service with which the drug 
or biological is furnished. Therefore, we define the beneficiary 
coinsurance as 20 percent of the imputed cost of $68, resulting in a 
copayment amount $13.60. The pass-through payment amount is $27 (the 
difference between 95 percent of AWP ($95) and the portion of the APC 
payment that is based on the cost of the drug ($68)). The total 
Medicare program payment in this example equals $81.40 (cost of the 
drug in the APC ($68) less beneficiary copay ($13.60) plus pass-through 
payment ($27)).
    In this proposed rule, we are clarifying that, for purposes of 
calculating transitional pass-through payment amounts, we make no 
distinction between new and current drugs and biologicals. Rather, we 
assume that drugs and biologicals defined as ``new'' under section 
1833(t)(6)(A)(iv)(I) of the Act, that is, for which payment was not 
being made as of December 31, 1996, nonetheless replace or are 
alternatives to drugs, biologicals, or therapies whose costs would have 
been reflected in our 1996 claims data and, thus, have been packaged 
into an associated APC. Therefore, we assume that our imputed 
acquisition cost, based on the external survey data, represents that 
portion of the APC payment attributable to new as well as current drugs 
and biologicals. For that reason, we are discontinuing use of the 
payment status indicator ``J'' that we introduced in the November 13, 
2000 final rule to designate a ``new'' drug/biological pass-through. 
Instead, we would assign payment status indicator ``G'' to both current 
and new drugs that are eligible for pass-through payment under the 
OPPS. (Addendum D lists the definition of the OPPS payment status 
indicators.)
3. Separate APCs for Drugs Not Eligible for Transitional Pass-Through 
Payment
    There are some drugs and biologicals for which we did not have 
adequate cost data yet that are not eligible for transitional pass-
through payments. Beginning with the April 7, 2000 final rule, we 
created separate APCs for these drugs and biologicals. For example, we 
did not package into the emergency room visit APCs the various drugs 
classified as tissue plasminogen activators (tPAs) and other 
thrombolytic agents, which are used to treat patients with myocardial 
infarctions. Rather, we created individual APC groups for these drugs 
to allow separate payment so as not to discourage their use where 
appropriate.
    We based the payment rate for these APCs on median hospital 
acquisition costs. To determine the hospital acquisition cost for the 
drugs, we imputed a cost using the same ratios of drug acquisition cost 
to AWP that we discuss in section VI.E.2. in connection with 
calculating acquisition costs for transitional pass-through drug 
payments. That is, we multiplied the AWP for the drug by the applicable 
ratio (sole or multi-source drug) based on data collected in an 
external survey of hospital drug acquisition costs.
    We set beneficiary co-payment amounts for these drug APCs at 20 
percent of the imputed acquisition cost. We use status indicator ``K'' 
to denote the APCs for drugs, biologicals, and pharmaceuticals that are 
paid separately from and in addition to the procedure or treatment with 
which they are associated yet are not eligible for transitional pass-
through payment. Refer to Addendum A to identify these APCs.
4. Annual Drug Pricing Update
    a. Drugs Eligible for Pass-Through Payments. We used the AWPs 
reported in the Drug Topics Red Book to determine the payment rates for 
the pass-through drugs and biologicals. In the November 13, 2000 
interim final rule (65 FR 67809), in response to a comment that we 
update the AWPs for pass-through drugs on a quarterly basis, we stated 
that, due to the complexity of the new payment system, we would be able 
to update the rates only on an annual basis. We also noted that the new 
rates would be effective for the quarter following the publication of 
the updated AWP values in the Red Book. It was our understanding that, 
although there are quarterly updates to the AWPs in the Red Book, the 
annual update is published in April of each year. It was our intention 
to update the AWPs for drugs each July 1, the quarter following the 
annual publication, and we did use the April 2001 version of the Red 
Book to update the APC rates for drugs eligible for pass-through 
payments. The pass-through payment rates for drugs and biologicals 
updated for 2001 went into effect July 1, 2001 (Program Memorandum A-
01-73, issued on June 1, 2001).
    We found that doing an update for all the pass-through drugs and 
biologicals at mid-year was disruptive to both our computer systems and 
pricing software. Because it is now our understanding that even though 
the April publication is the annual printed version of the Red Book, 
there are quarterly updates available that we can use to update the 
AWPs. In fact, we have found that since the implementation of the pass-
through payments in OPPS, many manufacturers have availed themselves of 
the Red Book quarterly update system to make frequent and large 
increases to their AWPs. Therefore, we do not believe it is necessary 
to wait until publication of the annual Red Book to do an update to the 
pass-through rates for drugs and biologicals to reflect the most recent 
AWPs.
    Thus, we are proposing to update the APC rates for drugs that are 
eligible for pass-through payments in 2002 using the July 2001 or 
October 2001 version of Red Book (depending upon which is available 
when we develop the final rule). The updated rates effective January 1, 
2002 would remain in effect until we implement the next annual update 
in 2003, when we would again update the AWPs based on the latest 
quarterly version of the Red Book. This would place the update of pass-
through drug prices on the same calendar year schedule as the other 
annual OPPS updates.
    b. Drugs in Separate APCs Not Eligible for Pass-Through Payments. 
We used the conversion factor published in the November 13, 2000 final 
rule (65 FR 67827) to update, effective January 1, 2001, the APC rates 
for the drugs that are not eligible for pass-through payments that are 
in separate APCs. We also made payment adjustments to these APC groups 
effective April 1, 2001, as required by section 401(c) of the BIPA, 
which sets forth a special payment rule that had the effect of 
providing a full market basket update in 2001.
    For 2002, we propose to recalibrate the weights for the APCs for 
drugs that are not pass-through items and make the other adjustments 
applicable to the APC groups that we discuss in sections III, IV, and 
VIII of this proposed rule.

[[Page 44702]]

F. Definition of Single-Use Devices

    Our definition of a device eligible for pass-through payment 
includes a criterion whereby eligible devices are used for one patient 
only and are single use (65 FR 47674, August 3, 2000). In the November 
13, 2000 interim final rule, we stated, in response to a comment, that 
additional pass-through payments would not be made for devices that are 
reprocessed or reused because they are not single-use items. We further 
indicated that hospitals submitting pass-through claims for these 
devices might be considered to be engaging in fraudulent billing 
practices (65 FR 67822).
    Since publishing our November 13, 2000 rule, much has come to our 
attention regarding reprocessed single-use devices. Reprocessors and 
professional associations using reprocessed devices commented that, 
under certain circumstances, the FDA considers reprocessed devices to 
be single-use devices. The FDA corroborated that it considers 
previously used single-use devices that have been appropriately 
reprocessed to be considered to be a single-use device. The 
reprocessing industry also indicated that reprocessed single use 
devices are of much lower cost to hospitals than original equipment 
manufactured single-use devices.
    We have learned that the FDA published guidance for the 
reprocessing of single-use devices (FDA's ``Enforcement Priorities for 
Single-Use Devices Reprocessed by Third Parties and Hospitals,'' issued 
August 14, 2000). This document presents a phased-in regulatory scheme 
for reprocessed devices. As such, we are proposing to follow FDA's 
guidance on reprocessed single-use device. We would consider 
reprocessed single-use devices that are otherwise eligible for pass-
through payment as part of a category of devices to be eligible for 
that payment if they meet FDA's most recent regulatory criteria on 
single-use devices. Also, reprocessed devices must meet any FDA 
guidance or other regulatory requirements in the future regarding 
single use. Reprocessed devices adhering to these guidelines would be 
considered as having met our criterion of approval or clearance by the 
FDA. We have met with and will continue to meet and coordinate with the 
FDA concerning that Federal agency's definition and regulation of 
single-use devices.
    Parties advise us that reprocessed devices reduce the costs to 
hospitals substantially. Therefore, we would expect that the hospital 
charges on claims submitted for pass-through payments for reprocessed 
single-use devices would reflect the lower cost of these devices.

G. Criteria for New Technology APCs

1. Background
    In the April 7, 2000 final rule (68 FR 18477), we created a set of 
new technology APCs to pay for certain new technology services under 
the OPPS. These APCs are intended to pay for new technology services 
that were not addressed by the transitional pass-through provisions of 
the BBRA 1999. We indicated that the new technology APCs would be 
defined on the basis of costs and not the clinical characteristics of a 
service.
    We initially established groups 0970 through 0984 as the new 
technology APCs with costs ranging from less than $50 to $6,000. The 
payment rate for each of these APCs is based on the midpoint of a range 
of costs. For example, the payment for new technology APC 0974, which 
includes services that cost from $300 to $500, is set at $400.
    The new technology APCs that were implemented on August 1, 2000 
were populated with 11 new technology services. We state in the April 
7, 2000 rule that we will pay for an item or service under a new 
technology APC for at least 2 years but no more than 3 years, 
consistent with the term of transitional pass-through payments. After 
that period of time, during the annual APC update cycle, we stated that 
we will move the item or service into the existing APC structure based 
on its clinical attributes and, based on claims data, its resource 
costs. For a new technology APC, the beneficiary coinsurance is 20 
percent of the APC payment rate.
    In the April 7, 2000 rule, we specified an application process and 
the information that must be supplied for us to consider a request for 
payment under the new technology APCs (65 FR 18478). We also described 
the five criteria we would use to determine whether a service is 
eligible for assignment to a new technology APC group. These criteria, 
which we are currently using, are as follows:
     The item or service is one that could not have been billed 
to the Medicare program in 1996 or, if it was available in 1996, the 
costs of the service could not have been adequately represented in 1996 
data.
     The item or service does not qualify for an additional 
payment under the transitional pass-through payments provided for by 
section 1833(t)(6) of the Act as a current orphan drug, as a current 
cancer therapy drug or biological or brachytherapy, as a current 
radiopharmaceutical drug or biological product, or as a new medical 
device, drug, or biological.
     The item or service has a HCPCS code.
     The item or service falls within the scope of Medicare 
benefits under section 1832(a) of the Act.
     The item or service is determined to be reasonable and 
necessary in accordance with section 1862(a)(1)(A) of the Act.
2. Proposed Modifications to the Criteria and Process for Assigning 
Services to New Technology APCs
    Based on the experience we have gained and data we have collected 
since publication of the April 7, 2000 final rule, we are proposing to 
revise--(a) the definition of what is appropriately paid for under the 
new technology APCs; (b) the criteria for determining whether a service 
may be paid under the new technology APCs; (c) the information that we 
will require to determine eligibility for assignment to a new 
technology APC; and (d) the length of time we will pay for a service in 
a new technology APC.
    a. Services Paid Under New Technology APCs. We propose to limit 
eligibility for placement in new technology APCs to complete services 
or procedures. That is, the following are not eligible for placement in 
a new technology APC: items, materials, supplies, apparatuses, 
instruments, implements, or equipment that are used to accomplish a 
more comprehensive service or procedure.
    We would continue to exclude devices or any drug, biologic, 
radiopharmaceutical, product, or commodity for which payment could be 
made under the transitional pass-through provisions. We believe that 
the new technology APCs should be reserved for only those comprehensive 
services or procedures that are truly new. Individual components of a 
service or procedure that do not meet the transitional pass-through 
payment criteria should be incorporated into a current APC and as 
hospitals begin to use the new items, supplies, or equipment the costs 
will become incorporated into the weight of the APC. To the extent 
possible, we believe that hospitals should be making the decision on 
what items, supplies, and equipment on the basis of efficiency and 
appropriate treatment of the patient. However, we believe it is 
appropriate to incorporate truly new services and procedures that 
replace much less

[[Page 44703]]

expensive services or procedures into a new technology APC to afford 
access to our beneficiaries.
    Furthermore, we wish to clarify that we do not consider that merely 
being a different approach to an existing treatment or procedure 
qualifies a service for assignment to a new technology APC. As new 
approaches to existing procedures and services are adopted and 
performed, we expect the costs associated with these variations and 
improvements to be reflected in the claims data that we use to annually 
update the APC relative weights.
    b. Criteria for Assignment to New Technology APC. In light of the 
experience we have gained over the past year in reviewing requests for 
new technology and transitional pass-through status, developing 
criteria to define new medical services and technologies under the 
inpatient PPS, and determining categories of new devices under the 
transitional pass-through provisions, we are proposing that the 
following criteria be used to determine whether a service be assigned 
to a new technology APC. These modifications are based on changes in 
data (we are no longer using 1996 data to set payment rates) and our 
continuing experience with the system of assigning new technology APCs.
     The service is one that could not have been adequately 
represented in the claims data being used for the most current annual 
payment update. (Current criterion based on 1996 data.)
     The service does not qualify for an additional payment 
under the transitional pass-through provisions. (This criterion is 
unchanged.)
     The service cannot reasonably be placed in an existing APC 
group that is appropriate in terms of clinical characteristics and 
resource costs. We believe it is unnecessary to assign a new service to 
a new technology APC if it may be appropriately placed in a current 
APC.
     The service falls within the scope of Medicare benefits 
under section 1832(a) of the Act. (This criterion is unchanged.)
     The service is determined to be reasonable and necessary 
in accordance with section 1862(a)(1)(A) of the Act. (This criterion is 
unchanged.)
    We would delete the criterion that the service must have a HCPCS 
code. In the absence of an appropriate HCPCS code, we would consider 
creating a HCPCS code that describes the procedure or service. These 
HCPCS codes would be solely for hospitals to use when billing under the 
OPPS.
    c. Revision of Application for New Technology Status. We also 
propose to change the information that interested parties must submit 
to have a service or procedure considered for assignment to a new 
technology APC. Based on our experience over the past year in reviewing 
new technology APC applications, we believe that the criteria would 
better assist us in determining eligibility for these APCs than do the 
current criteria. Specifically, to be considered, we propose to require 
that requests include the following information:
     The name by which the service is most commonly known. We 
currently require only the trade/brand name.
     A clinical vignette, including patient diagnoses that the 
service is intended to treat, the typical patient, and a description of 
what resources are used to furnish the service by both the facility and 
the physician. For example, for a surgical procedure this would include 
staff, operating room, and recovery room services as well as equipment, 
supplies, and devices, etc. This criterion would replace the criterion 
that requires a detailed description of the clinical application of the 
service. We believe we need a fuller description to help us understand 
how the service is furnished in hospitals.
     A list of any drugs or devices used as part of the service 
that require approval from the Food and Drug Administration (FDA) and 
information to document receipt of FDA approval/clearances and the date 
obtained. This would be a refinement of the current requirement for 
demonstrating FDA approval.
     A description of where the service is currently being 
performed (by location) and the approximate number of patients 
receiving the service in each location. This criterion and the one that 
follows would help inform our analysis by providing us with medical 
contacts.
     An estimate of the number of physicians who are furnishing 
the service nationally and the specialties they represent.
     Information about the clinical use and efficacy of the 
service such as peer-reviewed articles. Again, this criterion would 
assist us in our clinical review of the procedure.
     The CPT or HCPCS Level II code(s) that are currently being 
used to report the service and an explanation of why use of these HCPCS 
codes is inadequate to report the service under the OPPS. This 
criterion and the three that follow are refinements of the current 
HCPCS requirement.
     A list of the CPT or HCPCS Level II codes for all items 
and procedures that are an integral part of the service. This list 
should include codes for all procedures and services that, if coded in 
addition to the code for the service under consideration for new 
technology status, would represent unbundling.
     A list of all CPT and HCPCS Level II codes that would 
typically be reported in addition to the service.
     A proposal for a new HCPCS code, including a descriptor 
and rationale for why the descriptor is appropriate. The proposal 
should include the reason why the service does not have a CPT or HCPCS 
Level II code, and why the CPT or HCPCS Level II code or codes 
currently used to describe the service are inadequate.
     An itemized list of the costs incurred by a hospital to 
furnish the new technology service, including labor, equipment, 
supplies, overhead, etc. (This criterion is unchanged.)
     The name, address, and telephone number of the party 
making the request. (This criterion is unchanged.)
     Other information as CMS may require to evaluate specific 
requests. (This criterion is unchanged.)
    d. Length of Time in a New Technology APC. We are also proposing to 
change the period of time during which a service may be paid under a 
new technology APC. Although section 1833(t)(6)(B) of the Act, as 
amended by section 201 of BBRA 1999, sets a 2 to 3 year period of 
payment for transitional pass-through payments, this requirement does 
not extend to new technology APCs. In the April 7, 2000 final rule we 
stated our intention to adopt the same period of payment for new 
technology APCs for consistency. However, the experience we have gained 
during the first year of the OPPS has led us to the conclusion that a 
more flexible payment period would be preferable. Therefore, we are 
proposing to modify the time frame that we established for new 
technology APCs in the April 7, 2000 final rule and to retain a service 
within a new technology APC group until we have acquired adequate data 
that allow us to assign the service to a clinically appropriate APC. 
This would allow us to move a service from a new technology APC in less 
than 2 years if the data were available and would also allow us to 
retain a service in a new technology APC for more than 3 years if these 
data were not available.
    We invite comment on the changes to the definition, criteria, 
application process, and timeframe that we are proposing for services 
and procedures that may qualify for assignment to a new technology APC 
under the OPPS.

[[Page 44704]]

VII. Transitional Pass-Through Payment Issues

A. Background

    Section 1833(t)(6) of the Act provides for temporary additional 
payments or ``transitional pass-through payments'' for certain 
innovative medical devices, drugs, and biologicals. As originally 
enacted by the BBRA, this provision required the Secretary to make 
additional payments to hospitals for current orphan drugs, as 
designated under section 526 of the Federal Food, Drug, and Cosmetic 
Act; current drugs, biologic agents, and brachytherapy devices used for 
the treatment of cancer; and current radiopharmaceutical drugs and 
biological products. Transitional pass-through payments are also 
required for new medical devices, drugs, and biologic agents that were 
not being paid for as a hospital outpatient service as of December 31, 
1996 and whose cost is ``not insignificant'' in relation to the OPPS 
payment for the procedures or services associated with the new device, 
drug, or biological. Under the statute, transitional pass-through 
payments are to be made for at least 2 years but not more than 3 years.
    Section 402 of BIPA, which was enacted on December 21, 2000, made 
several changes to section 1833(t)(6) of the Act. First, section 
1833(t)(6)(B)(i) of the Act, as amended, requires us to establish by 
April 1, 2001, initial categories to be used for purposes of 
determining which medical devices are eligible for transitional pass-
through payments. We fulfilled this requirement through the issuance on 
March 22, 2001 of two Program Memoranda, Transmittals A-01-40 and A-01-
41. These Program Memoranda can be found on the CMS homepage at 
www.hcfa.gov/pubforms/transmit/A0140.pdf and www.hcfa.gov/pubforms/transmit/A0141.pdf, respectively. We note that section 
1833(t)(6)(B)(i)(II) of the Act explicitly authorizes the Secretary to 
establish initial categories by program memorandum.
    Transmittal A-01-41 includes a list of the initial device 
categories and a crosswalk of all the item-specific C-codes for 
individual devices that were approved for transitional pass-through 
payments as of January 20, 2001 to the initial category code by which 
the device is to be billed beginning April 1, 2001.
    Section 1833(t)(6)(B)(ii) of the Act also requires us to establish, 
through rulemaking, criteria that will be used to create additional 
categories, other than those established initially. The criteria for 
new categories are the subject of a separate interim final rule with 
comment period, which will be published at a later date.
    Transitional pass-through categories are for devices only; they do 
not apply to drugs or biologicals. The regulations governing 
transitional pass-through payments for eligible drugs and biologicals 
remain unchanged. The process to apply for transitional pass-through 
payment for eligible drugs and biological agents, including 
radiopharmaceuticals, can be found in the April 7, 2000 Federal 
Register (65 FR 18481) and on the CMS web site at http://www.hcfa.gov/medlearn/appdead.htm. If we revise the application instructions in any 
way, we will post the revisions on our web site and submit the changes 
for the Office of Management and Budget (OMB) review under the 
Paperwork Reduction Act.

B. Discussion of Pro Rata Reduction

    Section 1833(t)(6)(E) of the Act limits the total projected amount 
of transitional pass-through payments for a given year to an 
``applicable percentage'' of projected total payments under the 
hospital OPPS. For a year before 2004, the applicable percentage is 2.5 
percent; for 2004 and subsequent years, the applicable percentage is 
specified by the Secretary up to 2.0 percent. If the Secretary 
estimates before the beginning of the calendar year that the total 
amount of pass-through payments in that year would exceed the 
applicable percentage, section 1833(t)(6)(E)(iii) of the Act requires a 
(prospective) uniform reduction in the amount of each of the 
transitional pass-through payments made in that year to ensure that the 
limit is not exceeded.
    In order to prepare for making an estimate, we have constructed an 
extensive database that includes outpatient claims data submitted by 
hospitals for services furnished on or after July 1, 1999 and before 
July 1, 2000. We are also collecting device cost and utilization data 
that were provided by manufacturers. We are extracting device cost and 
utilization data from applications for pass-through status submitted by 
manufacturers, hospitals, specialty societies, and other entities. In 
their applications for pass-through status, manufacturers have supplied 
information on the expected cost to hospitals of devices and the 
procedures with which the devices are commonly used.
    The information that we have collected thus far suggests that a 
significant pro rata reduction could be required for 2002 in order to 
meet the statutory limit on the amount of the pass-through payments. 
Given the potential magnitude of the reductions, we are reviewing our 
data and methodology to identify any flaws or weaknesses in them and to 
determine whether a significant reduction would actually be required 
under the statute. We are also considering the appropriateness of a 
number of possible alternative approaches to different technical 
aspects of estimating payments that would have the effect of minimizing 
the amount of any potential reduction in these payments. Below is a 
discussion of the methodology that we contemplate employing in 
developing our estimate.
    We are considering a number of possible approaches to different 
technical aspects of estimating payments. As is always the case in 
making these types of estimates, it is necessary to make a number of 
assumptions in interpreting the data. We are tentatively contemplating 
using the following assumptions and techniques in developing our 
methodology:
1. Data and Methodology
    We plan to base the estimate of 2002 pass-through expenditures on 
the claims we would use to set payment rates for 2002, 2001 pass-
through amounts for drugs and radiopharmaceuticals, and device cost and 
use data from pass-through applications submitted by manufacturers, 
hospitals, specialty societies, and other entities. Projections to CY 
2002 would employ price, volume, and service-mix inflators consistent 
with our baseline for OPPS spending. Estimates for drugs, 
radiopharmaceuticals, and devices would be made separately and combined 
for the final projection of pass-through spending.
2. Drugs and Biologicals
    We would identify those drugs eligible for pass-through status that 
have been separately billed to the Medicare program on the claims that 
we intend to employ for the estimate. We would multiply the frequency 
of use for each of these drugs (that is, the number of line items 
multiplied by the number of units billed as shown in the claims data) 
by its 2001 pass-through payment amount. If any drugs are not reflected 
in the claims data, we would make an appropriate adjustment. Such an 
adjustment might take into account the extent to which the non-coded 
items are classified as orphan drugs and therefore would likely be used 
infrequently.
3. Radiopharmaceutical Drugs and Biological Products
    Similar to the drug estimate, we would identify those

[[Page 44705]]

radiopharmaceuticals eligible for pass-through status that were 
separately billed to Medicare in the claims data file. We would 
estimate expenditures for these radiopharmaceuticals directly as 
described above. For radiopharmaceutical drugs, we would multiply the 
frequency of use for each item by the 2001 pass-through amount. We 
would estimate expenditures for the remaining items by using the 
frequency counts for all nuclear medicine procedures not billed with 
one of these radiopharmaceuticals.
4. Medical Devices
    We would estimate the transitional pass-through payments 
attributable to devices by linking the frequencies for all device-
related procedures in the claims data file with the cost and use data 
supplied by the manufacturers or other entities as part of their 
applications for pass-through status. We would match each device 
eligible as of January 2001 with the procedures with which it would be 
used. We would then calculate an average cost for each device or device 
package associated with a procedure.
    The statute requires that we calculate transitional pass-through 
payments for devices by adjusting the hospital's charge for the device 
to cost and then subtracting an amount that reflects the device costs 
already included in the payment for the associated APC. As we explained 
in the April 7, 2000 final rule (65 FR 18481) we were not able to 
implement these subtractions at the time of implementation of the 
system. For 2001, as we explain in section III.C. of this preamble, we 
made these deductions for pacemakers and neurostimulators but not other 
devices because it was not feasible to make the deductions for the 
other devices at that time. As also explained in section III.C., we are 
proposing to make these subtractions for most other devices beginning 
in 2002. For the purpose of doing this estimation, we would deduct 
these amounts from each device package before multiplying that cost by 
the procedure frequencies. In total, we project the deductions to be 
$450 million. (See section III.C. for a discussion of how we calculated 
the deductions.)
5. Projecting to 2002
    After making the three estimates as determined above, we plan to 
project prices and quantities in the estimates to 2002 using actuarial 
projections of price, volume, and service increase consistent with the 
OPPS baseline. We would add the three separate results for drugs, 
radiopharmaceuticals, and devices to determine an estimate of total 
pass-through spending.

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

1. Background
    As discussed above in section II.C.1. of this preamble, in the 
November 13, 2000 interim final rule (65 FR 67806 and 67825), we 
explained that we originally excluded costs in revenue codes 274 
(Prosthetic/orthotic devices), 275 (Pacemaker), and 278 (Other 
implants) from the calculation of APC payment rates because, before 
enactment of the BBRA 1999, we had proposed to pay for implantable 
devices outside of the OPPS and after the enactment of the BBRA, it was 
not feasible to revise our database to include these revenue codes in 
developing the April 7, 2000 final rule. We were able to make the 
necessary revisions and adjustments in time for implementation on 
January 1, 2001. When we packaged costs from these revenue codes to 
recalculate APC rates for 2001, to comply with the BBRA 1999 
requirement, the median costs for a handful of procedures related to 
pacemakers and neurostimulators significantly increased. Therefore, we 
restructured the affected APCs to account for these changes in 
procedure level median costs.
    Under section 1833(t)(6)(D)(ii) of the Act, as added by the BBRA 
1999 and redesignated by BIPA, the amount of additional payment for an 
eligible device is the amount by which the hospital's cost exceeds the 
portion of the otherwise applicable APC payment amount that the 
Secretary determines is associated with the device. Thus, beginning 
January 1, 2001, for eligible devices, we deducted from transitional 
pass-through payments the dollar increase in the rates for the new APCs 
for procedures associated with the devices. Effective April 1, 2001, we 
revised our policy to subtract the dollar amount from the otherwise 
applicable pass-through payment for each category of device. The dollar 
amount subtracted in 2001 from transitional pass-through payments for 
affected categories of devices is as follows:

  Table 4.--CY 2001 Reductions to Pass-Through Payments to Offset Device-
             Related Costs Packaged in Associated APC Groups
------------------------------------------------------------------------
                                                      Subtract from the
                                                         pass-through
      For item billed under HCPCS code. * * *            payment the
                                                      following amount:
------------------------------------------------------------------------
C1767 Generator, neurostimulator (implantable).....              $643.73
C1778 Lead, neurostimulator (implantable)..........               501.27
C1785 Pacemaker, dual chamber, rate-responsive                  2,843.00
 (implantable).....................................
C1786 Pacemaker, single chamber, rate-responsive                2,843.00
 (implantable).....................................
C1816 Receiver and/or transmitter, neurostimulator                537.83
 (implantable).....................................
C2619 Pacemaker, dual chamber, non rate-responsive              2,843.00
 (implantable).....................................
C2620 Pacemaker, single chamber, non rate-                      2,843.00
 responsive (implantable)..........................
------------------------------------------------------------------------

    The increase in certain APC rates for device costs on January 1, 
2001 was offset by the simultaneous reduction of the associated pass-
through payments. Payments for the procedures in the affected APCs that 
did not include a pass-through device increased for 2001 and for 
procedures that did include devices, total payment for the procedure 
plus the device or devices did not change.
    For 2002, in this proposed rule we are estimating the portion of 
each APC rate that could reasonably be attributed to the cost of 
associated devices that are eligible for pass-through payments. This 
amount will be deducted from the pass-through payments for those 
devices as required by the statute. Since the deductions to the pass-
through payments for costs included in APCs for 2002 are included in 
the recalibration of the weights and the fixed pool of dollars for 
outpatient services, the total payment for the procedure plus device or 
devices will be reduced rather than remain constant as they did in 
2001.

[[Page 44706]]

2. Proposed Reductions for 2002
    First, we reviewed the APCs to determine which of them contained 
services that are associated with a category of devices eligible for a 
transitional pass-through payment. We then estimated the portion of the 
costs in those APCs that could reasonably be attributed to the cost of 
pass-through devices as follows:
     For each procedure associated with a pass-through device 
or devices, we examined all single-service bills (that is, bills that 
include services payable only under one APC) to determine utilization 
patterns for specific revenue centers that would reasonably be used for 
device-related charges in revenue codes 272 (sterile supplies), 275 
(pacemakers), and 278 (other implants).
     We removed the costs in those revenue codes to calculate a 
cost for the bill net of device-related costs (reduced cost). For 
example, the average bill cost (in 1999-2000 dollars) for insertion of 
a cardiac pacemaker (CPT 33208) was $5,733. The average cost associated 
with revenue code 275 was $4,163, so the reduced cost for the procedure 
was $1,570. We calculated the ratio of the reduced cost ($1,570) to the 
full bill costs ($5,733), and we applied that ratio to the costs on any 
bills for CPT 33208 that did not use revenue code 275 to establish 
reduced cost at the procedure code level across all claims.
     To determine the reduced cost at the APC level and that 
portion of the APC payment rate associated with device costs, we 
calculated the median cost of the reduced cost bills for each relevant 
APC. For this calculation of the median, we allowed the full costs of 
bills for services in the APC that were not associated with pass-
through devices.
     We calculated, for the APC, the percentage difference 
between the APC median of full cost or unreduced bills and the APC 
median where some or all of the bills had reduced costs. We applied 
this percent difference to the proposed APC payment rate in order to 
calculate the share of that rate attributable to the device or devices 
associated with procedures in the APC. In Table 5, we show the amount 
that we propose to subtract from the pass-through payment for an 
eligible device that is billed with the related APCs.

 Table 5.--Proposed Reduction to Pass-Through Payment to Offset Device-
             Related Costs Packaged in Associated APC Groups
------------------------------------------------------------------------
                                                         Device-related
                                                           cost to be
                                            Percent      subtracted from
         APC             Description      differences     pass-through
                                                           payment for
                                                         eligible device
------------------------------------------------------------------------
00032................  Insertion of              20.11               $73
                        Central Venous/
                        Arterial
                        Catheter.
00080................  Diagnostic                 9.99               164
                        Cardiac
                        Catheterizatio
                        n.
00081................  Non-Coronary              27.06               303
                        Angioplasty or
                        Atherectomy.
00082................  Coronary                   6.95               462
                        Atherectomy.
00083................  Coronary                  19.85               506
                        Angioplasty.
00088................  Thrombectomy...           10.86               161
00089................  Insertion/                72.69             3,052
                        Replacement of
                        Permanent
                        Pacemaker and
                        Electrodes.
00090................  Insertion/                77.13             2,877
                        Replacement of
                        Pacemaker
                        Pulse
                        Generator.
00104................  Transcatheter             11.64               422
                        Placement of
                        Intracoronary
                        Stents.
00106................  Insertion/                79.55               640
                        Replacement/
                        Repair of
                        Pacemaker and/
                        or Electrodes.
00107................  Insertion of              81.69             6,449
                        Cardioverter-
                        Defibrillator.
0108.................  Insertion/                71.16             5,768
                        Replacement/
                        Repair of
                        Cardioverter-
                        Defibrillator
                        Leads.
0122.................  Level II Tube             24.92                72
                        Changes and
                        Repositioning.
0151.................  Endoscopic                 7.35                61
                        Retrograde
                        Cholangio-
                        Pancreatograph
                        y (ERCP).
0152.................  Percutaneous              12.05               107
                        Biliary
                        Endoscopic
                        Procedures.
0154.................  Hernia/                    8.80               108
                        Hydrocele
                        Procedures.
0182.................  Insertion of              57.22             2,500
                        Penile
                        Prosthesis.
0185.................  Removal or                56.82             1,652
                        Repair of
                        Penile
                        Prosthesis.
0202.................  Level VIII                25.02               503
                        Female
                        Reproductive
                        Procedures.
0222.................  Implantation of           75.70             4,330
                        Neurological
                        Device.
0223.................  Implantation of           79.51               359
                        Pain
                        Management
                        Device.
0225.................  Implantation of           67.25             1,154
                        Neurotransmitt
                        er Electrodes.
0227.................  Implantation of           80.23             3,871
                        Drug Infusion
                        Device.
0229.................  Transcatheter             35.46             1,083
                        Placement of
                        Intravascular
                        Shunts.
0246.................  Cataract                  12.87               146
                        Procedures
                        with IOL
                        Insert.
------------------------------------------------------------------------

VIII. Conversion Factor Update for CY 2002

    Section 1833(t)(3)(C)(ii) of the Act requires us to update the 
conversion factor used to determine payment rates under the OPPS on an 
annual basis. Section 1833(t)(3)(C)(iv) of the Act, as redesignated by 
section 401 of the BIPA, provides that for 2002, the update is equal to 
the hospital inpatient market basket percentage increase applicable to 
hospital discharges under section 1886(b)(3)(B)(iii) of the Act, 
reduced by one percentage point. Further, section 401 of the BIPA 
increased the conversion factor for 2001 to reflect an update equal to 
the full market basket percentage increase amount.
    The most recent forecast of the hospital market basket increase for 
FY 2002 is 3.3 percent. To set the proposed OPPS conversion factor for 
2002, we increased the 2001 conversion factor of $50.080, which 
reflects the BIPA provision of the full market basket update, by 2.3 
percent, that is, the 3.3 percentage increase minus 1 percentage point.
    In accordance with section 1833(t)(9)(B) of the Act, we further 
adjusted the proposed conversion factor for 2002 to ensure that the 
revisions we are proposing to update the wage index are made on a 
budget-neutral basis. A budget neutrality factor of 0.9924 was 
calculated for wage index changes by comparing total payments from our 
simulation model using the proposed FY 2002 hospital inpatient PPS wage

[[Page 44707]]

index values to those payments using the current (FY 2001) wage index 
values.
    The increase factor of 2.3 percent for 2002 and the required wage 
index budget neutrality adjustment of 0.9924 result in a proposed 
conversion factor for 2002 of $50.842.

IX. Summary of and Responses to MedPac Recommendations

    The Medicare Payment Advisory Commission (MedPAC) offered several 
recommendations dealing with the OPPS in its March 2001 Report to 
Congress. Below we summarize each recommendation and respond to it.
    MedPAC Recommendation: MedPAC has offered two recommendations 
regarding the update to the conversion factor in the OPPS. The first 
recommendation is that the Secretary should not use an expenditure 
target to update the conversion factor. The second recommendation is 
that Congress should require an annual update of the conversion factor 
in the OPPS that is based on the relevant factors influencing the costs 
of efficiently providing hospital outpatient care, and not just the 
change in input prices.
    Response: Section 1833(t)(3)(C)(ii) of the Act requires the 
Secretary to update the conversion factor annually. Under section 
1833(t)(3)(C)(iv) of the Act the update is equal to the hospital market 
basket percentage increase applicable under the hospital inpatient PPS, 
minus one percentage point for the years 2000 and 2002. The Secretary 
has the authority under section 1833(t)(3)(C)(iv) of the Act to 
substitute a market basket that is specific to hospital outpatient 
services. Finally, section 1833(t)(2)(F) of the Act requires the 
Secretary to develop a method for controlling unnecessary increases in 
the volume of covered hospital outpatient services, and section 
1833(t)(9)(C) of the Act authorizes the Secretary to adjust the update 
to the conversion factor if the volume of services increased beyond the 
amount established under section 1833(t)(2)(F) of the Act.
    In the September 8, 1998 proposed rule on the OPPS, we indicated 
that we were considering the option of developing an outpatient-
specific market basket and invited comments on possible sources of data 
suitable for constructing one (63 FR 47579). We received no comments in 
response to this invitation, and we therefore announced in the April 7, 
2000 final rule that we would update the conversion factor by the 
hospital inpatient market basket increase, minus one percentage point, 
for the years 2000, 2001, and 2002 (65 FR 18502). As required by 
section 401(c) of the BIPA, we made payment adjustments effective April 
1, 2001 under a special payment rule that has had the effect of 
providing a full market basket update in 2001. We are, however, working 
with a contractor to study the option of developing an outpatient-
specific market basket and would welcome comments and recommendations 
regarding appropriate data sources. We will also study the feasibility 
of developing appropriate adjustments for factors that influence the 
costs of efficiently providing hospital outpatient care, such as 
productivity increases and the introduction of new technologies, and 
the availability of appropriate sources of data for calculating the 
factors.
    In the September 8, 1998 proposed rule on the OPPS, we proposed 
employing a modified version of the physicians' sustainable growth rate 
system (SGR) as an adjustment in the update framework to control for 
excess increases in the volume of covered outpatient services (63 FR 
47586-47587). In response to comments on this proposal, we announced in 
the April 7, 2000 final rule that we had decided to delay 
implementation of a volume control mechanism, and to continue to study 
the options with a contractor (65 FR 18503). We will take MedPAC's 
recommendation into consideration in making a decision, and before 
implementing volume control mechanism we will publish a proposed rule 
with an opportunity for public comment.
    MedPAC Recommendation: MedPAC recommends that the Secretary should 
develop formalized procedures in the OPPS for expeditiously assigning 
codes, updating relative weights, and investigating the need for 
service classification changes to recognize the costs of new and 
substantially improved technologies.
    Response: Beginning with the April 7, 2000 final rule implementing 
the OPPS, we have outlined a comprehensive process to recognize the 
costs of new technology in the new system. One component of this 
process is the provision for pass-through payments for devices, drugs, 
and biologicals (see the discussion in conjunction with the next MedPAC 
recommendation). The other component is the creation of new APC groups 
to accommodate payment for new technology services that are not 
eligible for transitional pass-through payments. We assign new 
technology services that cannot be appropriately placed within existing 
APC groups to new technology APC groups, using costs alone (rather than 
costs plus clinical coherence) as the basis for the assignment. We 
describe revised criteria for assignment to a new technology group in 
section VI.G. of this preamble. When it is necessary, creation of new 
technology APC groups involves establishment of new codes. New codes 
are established through a well-ordered process that operates on an 
annual cycle. The cycle starts with submission of information by 
interested parties no later than April 1 of each year and ends with the 
announcement of new codes in October. As we stated previously, in the 
absence of an appropriate HCPCS code, we would consider creating a 
HCPCS code that describes the procedure or service. These codes would 
be solely for hospitals to use when billing under the OPPS.
    We have also provided a mechanism for moving these services from 
the new technology APCs to clinically related APCs as part of the 
annual update of the APC groups. As described in section VI of this 
preamble, a service is retained within a new technology APC group until 
we have acquired adequate data that allow us to assign the service to 
an appropriate APC. We use the annual APC update cycle to assign the 
service to an existing APC that is similar both clinically and in terms 
of resource costs. If no such APC exists, we create a new APC for the 
service.
    MedPAC Recommendation: MedPAC recommends that pass-through payments 
for specific technologies should be made in the OPPS only when a 
technology is new or substantially improved and adds substantially to 
the cost of care in an APC. MedPAC believes that the definition of 
``new'' should not include items whose costs were included in the 1996 
data used to set the OPPS payment rates.
    Response: The statute requires that, under the OPPS, transitional 
pass-through payments are made for certain drugs, devices, and 
biologicals. The items designated by the statute to receive these pass-
through payments include the following:
     Current orphan drugs, as designated under section 526 of 
the Federal Food, Drug, and Cosmetic Act.
     Current drugs and biologicals used for the treatment of 
cancer, and brachytherapy and temperature monitored cryoablation 
devices used for the treatment of cancer.
     Current radiopharmaceutical drugs and biologicals.
     New drugs and biologicals in instances in which the item 
was not being paid as a hospital outpatient service as of December 31, 
1996, and when the cost of the item is ``not insignificant'' in 
relation to the OPPS payment amount.
     Effective April 1, 2001, categories of Medical devices 
when the cost of the

[[Page 44708]]

category is not insignificant'' in relation to the OPPS payment amount.
    We are publishing a separate interim final rule in which we lay out 
the criteria for establishing categories of devices eligible for pass-
through payments.
    Section 1833(t)(6) of the Act provides that once a category is 
established, a specific device may receive a pass-through payment for 2 
to 3 years if the device is described by an existing category, 
regardless of whether it was being paid as a hospital outpatient 
service as of December 31, 1996 or its cost meets the ``not 
insignificant'' criterion. Thus, the statute allows for certain devices 
that do not meet MedPAC's recommended limitation on a ``new'' device to 
receive transitional pass-through payments. However, no categories are 
created on the basis of devices that were paid for on or before 
December 31, 1996. That is, while devices paid for on or before 
December 31, 1996 can be included in a category, we would establish a 
category only on the basis of devices that were not being paid as 
hospital outpatient services as of December 31, 1996.
    MedPAC Recommendation: MedPAC recommends that pass-through payments 
for specific technologies in the OPPS should be made on a budget-
neutral basis and that the costs of new or substantially improved 
technologies should be factored into the update of the outpatient 
conversion factor.
    Response: The statute requires that the transitional pass-through 
payments for drugs, devices, and biologicals be made on a budget 
neutral basis. Estimated pass-through payments are limited under the 
statute to 2.5 percent (and up to 2.0 percent for 2004 and thereafter) 
of estimated total program payments for covered hospital outpatient 
services. We adjust the conversion factor to account for the proportion 
of total program payments for covered hospital outpatient services, up 
to the statutory limit, that we estimate will be made in pass-through 
payments. As we have discussed in response to MedPAC's recommendation 
concerning an update framework for the OPPS conversion factor, we will 
study the feasibility of including appropriate adjustments for factors, 
including introduction of new technologies, that influence the costs of 
efficiently providing hospital outpatient care within such a framework.
    MedPAC Recommendation: MedPAC recommends that the Congress should 
continue the reduction in outpatient coinsurance to achieve a 20 
percent coinsurance rate by 2010.
    Response: For most services that Medicare covers, the program is 
responsible for 80 percent of the total payment amount, and 
beneficiaries pay 20 percent. However, under the cost-based payment 
system in place for outpatient services before the OPPS, beneficiaries 
paid 20 percent of the hospital's charges for these services. As a 
result, coinsurance was often more than 20 percent of the total payment 
amount for the services.
    The BBA established a formula under the OPPS that was designed to 
reduce coinsurance gradually to 20 percent of the total payment amount. 
Under this formula, a national copayment amount was set for each 
service category, and that amount is to remain frozen as payment rates 
increase until the coinsurance percentage falls to 20 percent for all 
services. On average, beneficiaries have paid about 16 percent less in 
copayments for hospital outpatient services during 2000 under the OPPS 
than they would have paid under the previous system. However, it is 
true that the coinsurance remains higher than 20 percent of the 
Medicare payment amount for many services.
    Subsequent legislation has placed caps on the coinsurance 
percentages to speed up this process. Specifically, section 111 of BIPA 
amended section 1833(t)(8)(C)(ii) of the Act to reduce beneficiary 
coinsurance liability by phasing in a cap on the coinsurance percentage 
for each service. Starting on April 1, 2001, coinsurance for a single 
service furnished in 2001 cannot exceed 57 percent of the total payment 
amount for the service. The cap will be 55 percent in 2002 and 2003, 
and will be reduced by 5 percentage points each year from 2004 to 2006 
until coinsurance is limited to 40 percent of the total payment for 
each service. The underlying process for decreasing coinsurance will 
also continue during this period (see discussion in section IV.A. of 
this preamble). However, MedPAC projects that under current law, it 
would take until 2029 to reach the goal of 20 percent coinsurance for 
all services.
    We agree with MedPAC's goal of continuing the reduction in 
outpatient coinsurance, and we would welcome enactment of a practical 
measure to do so.

X. Provider-Based Issues

A. Background and April 7, 2000 Regulations

    On April 7, 2000, we published a final rule specifying the criteria 
that must be met for a determination regarding provider-based status 
(65 FR 18504). Since the beginning of the Medicare program, some 
providers, which we refer to as ``main providers,'' have functioned as 
a single entity while owning and operating multiple departments, 
locations, and facilities. Having clear criteria for provider-based 
status is important because this designation can result in additional 
Medicare payments for services furnished at the provider-based 
facility, and may also increase the coinsurance liability of Medicare 
for those services.
    The regulations at Sec. 413.65 define provider-based status as 
``the relationship between a main provider and a provider-based entity 
or a department of a provider, remote location of a hospital, or 
satellite facility, that complies with the provisions of this 
section.'' Section 413.65(b)(2) states that before a main provider may 
bill for services of a facility as if the facility is provider-based, 
or before it includes costs of those services on its cost report, the 
facility must meet the criteria listed in the regulations at 
Sec. 413.65(d). Among these criteria are the requirements that the main 
provider and the facility must have common licensure (when 
appropriate), the facility must operate under the ownership and control 
of the main provider, and the facility must be located in the immediate 
vicinity of the main provider.
    The effective date of these regulations was originally set at 
October 10, 2000, but was subsequently delayed and is now in effect for 
cost reporting periods beginning on or after January 10, 2001. Program 
instructions on provider-based status issued prior to that date, found 
in Section 2446 of the Provider Reimbursement Manual--Part 1 (PRM-1), 
Section 2004 of the Medicare State Operations Manual (SOM), and CMS 
Program Memorandum (PM) A-99-24, will apply to any facility for periods 
before the new regulations become applicable to it. (Some of these 
instructions will not be applied because they have been superseded by 
specific legislation on provider-based status, as described in item C 
below).

B. Provider-Based Issues/Frequently Asked Questions

    Following publication of the April 7, 2000 final rule, we received 
many requests for clarification of policies on specific issues related 
to provider-based status. In response, we published a list of 
``Frequently Asked Questions'' and the answers to them on the CMS web 
site at www.hcfa.gov/medlearn/provqa.htm. (This document can also be 
obtained by contacting the CMS (Formerly, HCFA) Regional Office.)

[[Page 44709]]

These Qs and As did not revise the regulatory criteria, but do provide 
subregulatory guidance for their implementation.

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

    On December 21 2000, the Benefits Improvement and Protection Act 
(BIPA) of 2000 (Pub. L. 106-554) was enacted. Section 404 of BIPA 
contains provisions that significantly affect the provider-based 
regulations at Sec. 413.65. Section 404 includes a grandfathering 
provision for facilities treated as provider-based on October 1, 2000; 
alternative criteria for meeting the geographic location requirement; 
and criteria for temporary treatment as provider-based.
1. Two-Year ``Grandfathering''
    Under section 404(a) of BIPA, any facilities or organizations that 
were ``treated'' as provider-based in relation to any hospital or CAH 
on October 1, 2000 will continue to be treated as such until October 1, 
2002. For the purpose of this provision, we interpret ``treated as 
provider-based'' to include those facilities with formal CMS 
determinations, as well as those facilities without formal CMS 
determinations that were being paid as provider-based as of October 1, 
2000. As a result, existing provider-based facilities and organizations 
may retain that status without meeting the criteria in the regulations 
under Secs. 413.65(d), (e), (f), and (h) until October 1, 2002. These 
provisions concern provider-based status requirements, joint ventures, 
management contracts, and services under arrangement. Thus, the 
provider-based facilities and organizations affected under section 
404(a) are not required to submit an application for or obtain a 
provider-based status determination in order to continue receiving 
reimbursement as provider-based during this period.
    These provider-based facilities and organizations will not be 
exempt from the Emergency Medical Treatment and Active Labor Act 
(EMTALA) requirements for provider-based facilities and organizations 
(revised Sec. 489.24(b) and new Sec. 489.24(i)) or from the obligations 
of hospital outpatient departments and hospital-based entities in 
Sec. 413.65(g), such as the requirement that off-campus facilities 
provide written notices to Medicare beneficiaries of coinsurance 
liability. These requirements become effective for hospitals on the 
first day of the hospital's cost reporting period beginning on or after 
January 10, 2001.
    We are aware that many hospitals and physicians continue to have 
significant concerns with our policy on the applicability of EMTALA to 
provider-based facilities and organizations. We intend to re-examine 
these regulations and, in particular, reconsider the appropriateness of 
applying EMTALA to off-campus locations. At the same time, we want to 
assure that those departments that Medicare pays as hospital-based 
departments are appropriately integrated with the hospital as a whole. 
We intend to publish a proposed rule to address these issues more 
fully.
2. Geographic Location Criteria
    Section 404(b) of BIPA provides that those facilities or 
organizations that are not included in the grandfathering provision at 
section 404(a) are deemed to comply with the ``immediate vicinity'' 
requirements of the new regulations under Sec. 413.65(d)(7) if they are 
located not more than 35 miles from the main campus of the hospital or 
critical access hospital. Therefore, those facilities located within 35 
miles of the main provider satisfy the immediate vicinity requirement 
as an alternative to meeting the ``75/75 test'' under 
Sec. 413.65(d)(7).
    In addition, BIPA provides that certain facilities or organizations 
are deemed to comply with the requirements for geographic proximity 
(either the ``75/75 test'' or the ``35-mile test'') if they are owned 
and operated by a main provider that is a hospital with a 
disproportionate share adjustment percentage greater than 11.75 percent 
and is (1) owned or operated by a unit of State or local government, 
(2) a public or private nonprofit corporation that is formally granted 
governmental powers by a unit of State or local government, or (3) a 
private hospital that has a contract with a state or local government 
that includes the operation of clinics of the hospital to assure access 
in a well-defined service area to health care services for low-income 
individuals who are not entitled to benefits under Medicare or 
Medicaid.
    These geographic location criteria are permanent. While those 
facilities or organizations treated as provider-based on October 1, 
2000 are covered by the two-year grandfathering provision noted above, 
the geographic location criteria at section 404(b) of BIPA and the 
regulations at Sec. 413.65(d)(7) will apply to facilities or 
organizations not treated as provider-based as of that date, effective 
with the hospital's cost reporting period beginning on or after January 
10, 2001. Beginning October 1, 2002, these criteria will also apply to 
the grandfathered facilities.
3. Criteria for Temporary Treatment as Provider-Based
    Finally, section 404(c) of BIPA also provides that a facility or 
organization that seeks a determination of provider-based status on or 
after October 1, 2000 and before October 1, 2002 may not be treated as 
not having provider-based status for any period before a determination 
is made. Thus, recovery for overpayments will not be made retroactively 
for noncompliance with the provider-based criteria once a request for a 
determination during that time period has been made. For hospitals that 
do not qualify for grandfathering under section 404(a), until a uniform 
application is available, a request for provider-based status should be 
submitted to the appropriate CMS Regional Office (RO). At a minimum, 
the request should include the identity of the main provider and the 
facility or organization for which provider-based status is being 
sought and supporting documentation to demonstrate compliance with the 
provider-based status criteria in effect at the time the application is 
submitted. Once such a request has been submitted on or after October 
1, 2000, and before October 1, 2002, CMS will treat the facility or 
organization as being provider-based from the date it began operating 
as provider-based (as long as that date is on or after October 1, 2000) 
until the effective date of a CMS determination that the facility or 
organization is not provider-based.
    Facilities requesting a provider-based status determination on or 
after October 1, 2002 will not be covered by the provision concerning 
temporary treatment as provider-based in section 404(c) of BIPA. Thus, 
as stated in Sec. 413.65(n), CMS ROs will make provider-based status 
applicable as of the earliest date on which a request for determination 
has been made and all requirements for provider-based status in effect 
as of the date of the request are shown to have been met, not on the 
date of the formal CMS determination. If a facility or organization 
does not qualify for provider-based status and CMS learns that the 
provider has treated the facility or organization as provider-based 
without having obtained a provider-based determination under applicable 
regulations, CMS will review all payments and may seek recovery for 
overpayments in accordance with the regulations at Sec. 413.65(j), 
including overpayments made for the period of time between submission 
of the request or application for provider-based status and the 
issuance of a formal CMS determination.

[[Page 44710]]

D. Proposed Changes to Provider-Based Regulations

    To fully implement the provisions of section 404 of BIPA and to 
codify the clarifications currently stated only in the Q&As on 
provider-based status, as described above, we are proposing to revise 
the regulations as follows.
1. Clarification of Requirements for Adequate Cost Data and Cost 
Finding (Sec. 413.24(d))
    As part of the April 7, 2000, final rule implementing the 
prospective payment system for hospital outpatient services to Medicare 
beneficiaries, under Sec. 413.24, Adequate Cost Data and Cost Finding, 
we added a new paragraph (d)(6), entitled ``Management Contracts.'' 
Since publication of the final rule, we have received several questions 
concerning the new paragraph.
    In response to these questions, we are proposing changes in wording 
to clarify the meaning of that paragraph. In addition, for further 
clarity, we are revising the coding and title of that material. Under 
our proposal, Sec. 413.24(d)(6)(i) would become Sec. 413.24(d)(6) and 
Sec. 413.24(d)(6)(ii) would become Sec. 413.24(d)(7). As revised, 
paragraph (d)(6) would address the situation when the main provider in 
a provider-based complex purchases services for a provider-based entity 
or for a department of the provider through a contract for services 
(for example, a management contract), directly assigning the costs to 
the provider-based entity or department and reporting the costs 
directly in the cost center for that entity or department. In any 
situation in which costs are directly assigned to a cost center, there 
is a risk of excess cost in that cost center resulting from the 
directly assigned costs plus a share of overhead improperly allocated 
to the cost center which duplicates the directly assigned costs. This 
duplication could result in improper Medicare payment to the provider. 
Therefore, where a provider has purchased services for a provider-based 
entity or for a provider department, like general service costs of the 
provider (for example, like costs in the administrative and general 
cost center) must be separately identified to ensure that they are not 
improperly allocated to the entity or the department. If the like costs 
of the provider cannot be separately identified, the costs of the 
services purchased through a contract for the provider-based entity or 
provider department must be reclassified to the main provider and 
allocated among the main provider's benefiting cost centers.
    For costs of services furnished to free-standing entities, we would 
also clarify in revised Sec. 413.24(d)(7), that the costs that a 
provider incurs to furnish services to free-standing entities with 
which it is associated are not allowable costs of that provider. Any 
costs of services furnished to a free-standing entity must be 
identified and eliminated from the allowable costs of the servicing 
provider, to prevent Medicare payment to that provider for those costs. 
This may be done by including the free-standing entity on the cost 
report as a nonreimbursable cost center for the purpose of allocating 
overhead costs to that entity. If this method would not result in an 
accurate allocation of costs to the entity, the provider must develop 
detailed work papers showing how the cost of services furnished by the 
provider to the entity were determined. These costs are removed from 
the applicable cost centers of the servicing provider.
    This revision is not a change in the policy, but instead is a 
clarification to the policy set forth in the April 7, 2000 final rule.
2. Scope and Definitions (Sec. 413.65(a))
    In Q/A 9 published on the CMS (Formerly, HCFA) web site at 
www.hcfa.gov/medlearn/provqa.htm, we identified specific types of 
facilities for which provider-based determinations would not be made, 
since their status would not affect either Medicare payment levels or 
beneficiary liability. (This document may also be obtained by 
contacting the CMS (Formerly, HCFA) Regional Office.) The facilities 
identified in Q/A 9 are ambulatory Surgical Centers (ASCs), 
comprehensive outpatient rehabilitation facilities (CORFs); home health 
agencies (HHAs); skilled nursing facilities (SNFs); hospices; inpatient 
rehabilitation units that are excluded from the inpatient PPS for acute 
hospital services; independent diagnostic testing facilities and any 
other facilities that furnish only clinical diagnostic laboratory 
tests; facilities furnishing only physical, occupational or speech 
therapy to ambulatory patients, for as long as the $1500 annual cap on 
coverage of physical, occupational, and speech therapy, as described in 
section 1833(g)(2) of the Act, remains suspended by the action of 
subsequent legislation; and end-stage renal disease (ESRD) facilities. 
Determinations for ESRD facilities are made under Sec. 413.174.
    We propose to revise the regulations at Sec. 413.65(a) to clarify 
that these facilities are not subject to the provider-based 
requirements and that provider-based determinations will not be made 
for them.
3. BIPA Provisions on Grandfathering and Temporary Treatment as 
Provider-Based (Secs. 413.65(b)(2) and (b)(5))
    Current regulations at Sec. 413.65(b)(2) state that a main provider 
or a facility must contact CMS (Formerly, HCFA) and the facility must 
be determined by CMS (Formerly, HCFA) to be provider-based before the 
main provider bills for services of the facility as if the facility 
were provider-based, or before it includes costs of those services on 
its cost report. However, as explained earlier, sections 404(a) and (c) 
of BIPA require that certain facilities be grandfathered for a 2-year 
period, and that facilities applying between October 1, 2000 and 
October 1, 2002 for provider-based status with respect to a hospital be 
given provider-based status on a temporary basis, pending a decision on 
their applications. To implement these provisions, we propose to revise 
the regulations in Sec. 413.65(b)(2) to state that if a facility was 
treated as provider-based in relation to a hospital or CAH on October 
1, 2000, it will continue to be considered provider-based in relation 
to that hospital or CAH until October 1, 2002, and the requirements, 
limitations, and exclusions specified in paragraphs (d), (e), (f), and 
(h) of Sec. 413.65 will not apply to that hospital or CAH with respect 
to that facility until October 1, 2002. We would further state that for 
purposes of paragraph (b)(2), a facility will be considered to have 
been treated as provider-based on October 1, 2000, if on that date it 
either had a written determination from CMS (Formerly, HCFA) that it 
was provider-based as of that date, or was billing and being paid as a 
provider-based department or entity of the hospital.
    We would also propose to add a new Sec. 413.65(b)(2) to state that 
a facility for which a determination of provider-based status in 
relation to a hospital or CAH is requested on or after October 1, 2000 
and before October 1, 2002 will be treated as provider-based in 
relation to the hospital or CAH from the first date on or after October 
1, 2000 on which the facility was licensed (to the extent required by 
the State), staffed and equipped to treat patients until the date on 
which CMS (Formerly, HCFA) determines that the facility does not 
qualify for provider-based status.
4. Reporting (Sec. 413.65(c)(1))
    Current regulations at Sec. 413.65(c) state that a main provider 
that creates or acquires a facility or organization for which it wishes 
to claim provider-based

[[Page 44711]]

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 CMS (Formerly, HCFA) if 
the facility or organization is located off the campus of the provider, 
or inclusion of the costs of the facility or organization in the 
provider's cost report would increase the total costs on the provider's 
cost report by at least 5 percent, and must furnish all information 
needed for a determination as to whether the facility or organization 
meets the requirements in paragraph (d) of this section for provider-
based status. Concern has been expressed that such reporting would 
duplicate the requirement for obtaining approval of a facility as 
provider-based before billing its services that way or including its 
costs on the cost report of the main provider (current 
Sec. 413.65(b)(2)). To prevent any unnecessary duplicate reporting, we 
propose to delete the current requirement from Sec. 413.65(c)(1). We 
would, however, retain the requirement that a main provider that has 
had one or more facilities considered provider-based also report to CMS 
(Formerly, HCFA) any material change in the relationship between it and 
any provider-based facility, such as a change in ownership of the 
facility or entry into a new or different management contract that 
could affect the provider-based status of the facility.
5. Geographic Location Criteria (Sec. 413.65(d)(7))
    As explained earlier in C.2 of this section, section 404(b) of BIPA 
mandates that facilities seeking provider-based status be considered to 
meet any geographic location criteria if they are located not more than 
35 miles from the main campus of the hospital or CAH to which they wish 
to be based, or meet other specific criteria relating to their 
ownership and operation. To implement this provision, we propose to 
revise Sec. 413.65(d)(7) to state that facility will meet provider-
based location criteria if it and the main provider are located on the 
same campus, or if one of the following three criteria are met:
     The facility or organization is located within a 35-mile 
radius of the main campus of the hospital or CAH that is the potential 
main provider;
     The facility or organization is owned and operated by a 
hospital or CAH that--
    (A) Is owned or operated by a unit of State or local government;
    (B) Is a public or nonprofit corporation that is formally granted 
governmental powers by a unit of State or local government; or,
    (C) Is a private hospital that has a contract with a State or local 
government that includes the operation of clinics located off the main 
campus of the hospital to assure access in a well-defined service area 
to health care services to low-income individuals who are not entitled 
to benefits under Medicare (or medical assistance under a Medicaid 
State plan); and
    (D) Has a disproportionate share adjustment (as determined under 
Sec. 412.106 of this chapter) greater than 11.75 percent or is 
described in Sec. 412.106(c)(2) of this chapter implementing section 
1886(d)(5)(F)(i)(II) of the Act.
     The facility meets the criteria currently set forth in 
Sec. 413.65(d)(7)(i) for service to the same patient population as the 
main provider.
6. Notice to Beneficiaries of Coinsurance Liability (Sec. 413.65(g)(7))
    Current regulations at Sec. 413.65(g)(7) state that when a Medicare 
beneficiary is treated in a hospital outpatient department or hospital-
based entity (other than an RHC) that is not located on the main 
provider's campus, the hospital has a duty to provide written notice to 
the beneficiary, prior to the delivery of services, of the amount of 
the beneficiary's potential financial liability (that is, of the fact 
that the beneficiary will incur a coinsurance liability for an 
outpatient visit to the hospital as well as for the physician service, 
and of the amount of that liability). The notice must be one that the 
beneficiary can read and understand.
    Some concern had been expressed that providing notice of a 
beneficiary's exact liability might be difficult in cases where the 
treating physician was in the process of diagnosing the patient's 
condition and was unsure of exactly what services might be required. In 
response to this concern we clarified in the preamble to an interim 
final rule with comment period published on August 3, 2000 (65 FR 
47670) that if the exact type and extent of care needed is not known, 
the hospital may furnish a written notice to the patient that explains 
the fact that the beneficiary will incur a coinsurance liability to the 
hospital that they would not incur if the facility were not provider-
based. The interim final rule preamble Sec. 413.65(g)(7)) further 
explained that the hospital may furnish an estimate based on typical or 
average charges for visits to the facility, while stating that the 
patient's actual liability will depend upon the actual services 
furnished by the hospital. If the beneficiary is unconscious, under 
great duress, or for any other reason unable to read a written notice 
and understand and act on his or her own rights, the notice must be 
provided, prior to the delivery of services, to the beneficiary's 
authorized representative.
    We are proposing to amend Sec. 413.65(g)(7) to include this 
clarifying language.
7. Clarification of Protocols for Off-Campus Departments 
(Sec. 489.24(i)(2)(ii))
    Current regulations at Sec. 489.24(i) specify the antipatient 
dumping obligations that hospitals have with respect to individuals who 
come to off-campus hospital departments for the examination or 
treatment of a potential emergency medical conditions. These 
obligations are sometimes known as EMTALA obligations, after the 
Emergency Medical Treatment and Active Labor Act, which is the 
legislation that first imposed the obligations. Currently, hospitals 
are responsible for ensuring that personnel at their off-campus 
departments are trained and given appropriate protocols for the 
handling of emergency cases.
    In the case of off-campus departments not routinely staffed with 
physicians, RNs, or LPNs, the department's personnel must be given 
protocols that direct them to contact emergency personnel at the main 
hospital campus before arranging an appropriate transfer to a medical 
facility other than the main hospital.
    Some concern had been expressed that taking the time needed to make 
such contacts might inappropriately delay the appropriate transfer of 
emergency patients in cases where the patient's condition was 
deteriorating rapidly. In response to this concern we clarified in the 
preamble to the interim final rule with comment period published on 
August 3, 2000 cited above (65 FR 47670) that in any case of the kind 
described in Sec. 489.24(i)(2)(ii) the contact with emergency personnel 
at the main hospital campus should be made either concurrently with or 
after the actions needed to arrange an appropriate transfer, if doing 
otherwise would significantly jeopardize the individual's life or 
health. This does not relieve the off-campus department of the 
responsibility for making the contact, but only clarifies that the 
contact may be delayed in specific cases where doing otherwise would 
endanger a patient subject to EMTALA protection.
    We are proposing to amend Sec. 489.24(i)(2)(ii) to include this 
clarifying language.

[[Page 44712]]

8. Other Changes
    In addition to the changes cited above, we are proposing to make 
the following conforming and clarifying changes:
     We are correcting date references in Secs. 413.65(i)(1)(i) 
and (i)(2), in order to take into account the effective date of the 
current regulations.
     We are substituting ``CMS'' for ``HCFA'' throughout the 
revised sections of part 413, to reflect the renaming of the Health 
Care Financing Administration (HCFA) as the Centers for Medicare & 
Medicaid Services (CMS).

XI. Summary of Proposed Changes for 2002

A. Changes Required by BIPA 2000

    We are proposing the following changes to the OPPS, to implement 
the provisions of BIPA 2000:
     Limit coinsurance to a specified percentage of APC payment 
amounts.
     Provide hold-harmless transitional corridor payments to 
children's hospitals.
     Provide separate APCs for services that use contrast 
agents and those that do not.
     Pay for glaucoma screening as a covered service.
     Pay for certain new technology used in screening and 
diagnostic mammograms.

B. Additional Changes

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

C. Technical Corrections

    We are proposing to make conforming changes to the regulations in 
42 CFR parts 413, 419 and 489.
    In part 413 we would--
     Revise Sec. 413.24(d)(6) and (d) (7) to clarify 
requirements for adequate cost data and cost findings and clarify the 
meaning of the paragraph.
     Revise Sec. 413.65(a)(1) to clarify the specified types of 
facilities identified in this section that are not subject to the 
provider-based requirements and that provider-based determinations will 
not be made for them.
     Revise the definition of ``Provider-based entity'' in 
Sec. 413.65(a)(2).
     Revise Sec. 413.65(b) to implement the BIPA provisions on 
grandfathering and temporary treatment of a facility as provider-based.
     Delete the existing requirement in Sec. 413.65(c)(1) in 
order to prevent unnecessary duplicate reporting.
     Specify in Sec. 413.65(d)(7) that a facility will meet 
provider-based geographic location criteria if it and the main provider 
are located on the same campus, or if a facility meets one of the three 
criteria specified in this paragraph.
     Clarify in Sec. 413.65(g)(7) that the hospital may furnish 
an estimate based on typical or average charges for visits to the 
facility, while stating that the patient's actual liability will depend 
upon the actual services furnished by the hospital.
     Correct date references in Secs. 413.65(i)(1)(ii) and 
(i)(2), in order to take into account the effective date of the current 
regulations.
    In part 419, we would--
     Revise Sec. 419.2 to clarify the costs that are excluded 
from the OPPS rates.
     Revise the reference to the effective date of the OPPS to 
August 1, 2000 in Sec. 419.20(a).
     Add new Secs. 419.20(b)(3) and (b)(4) to specify that a 
hospital located outside one of the 50 States, the District of 
Columbia, or Puerto Rico, or a hospital of the Indian Health Service is 
excluded from the hospital outpatient prospective payment system.
     Add a new Sec. 419.22(r) to specify that services defined 
in Sec. 419.21(b) that are furnished to inpatients of hospitals that do 
not submit claims for outpatients services under Medicare Part B are 
not paid for under the hospital OPPS.
     Revise Sec. 419.32 to reflect the revised update to the 
payment rates, as required by section 401 of BIPA.
     Replace the word ``coinsurance'' each time it appears in 
Secs. 419.40, 419.41, 419.42 and 419.43 with the word ``copayment.''
     Redesignate existing Sec. 419.41(c)(4)(ii) as paragraph 
(c)(4)(iv), and add paragraphs (c)(4)(ii) and (c)(4)(iii) to include 
the provisions of section 1833(t)(8)(C)(ii) of the Act. This section 
would specify that, effective for services furnished from April 1, 2001 
through December 31, 2001, the national unadjusted coinsurance rate for 
an APC cannot exceed 57 percent of the prospective rate for that APC 
and the national unadjusted coinsurance rate for an APC cannot exceed 
55 percent in calendar year 2004, 45 percent in calendar year 2005, and 
40 percent in calendar year 2006 and thereafter.
     Revise Sec. 419.70(d) to give children's hospitals the 
same permanent hold harmless protection as cancer hospitals under the 
OPPS, as required by section 405 of BIPA.

[[Page 44713]]

     Revise Sec. 489.24(i)(2)(ii) to clarify that, for the 
purposes of arranging an appropriate transfer of a patient from an off-
campus department, staff at the off-campus department may delay 
contacting the emergency personnel at the main hospital campus in the 
specific cases where doing otherwise would endanger a patient.

XII. Collection of Information Requirements

    Under the Paperwork Reduction Act of 1995, we are required to 
provide 60-day notice in the Federal Register and solicit public 
comment before a collection of information requirement is submitted to 
the Office of Management and Budget (OMB) for review and approval. In 
order to fairly evaluate whether an information collection should be 
approved by OMB, section 3506(c)(2)(A) of the Paperwork Reduction Act 
of 1995 requires that we solicit comment on the following issues:
     The need for the information collection and its usefulness 
in carrying out the proper functions of our agency.
     The accuracy of our estimate of the information collection 
burden.
     The quality, utility, and clarity of the information to be 
collected.
     Recommendations to minimize the information collection 
burden on the affected public, including automated collection 
techniques.
    Sections 413.65 and 419.42 of this proposed regulation contain 
information collection requirements that are subject to review by OMB 
under the Paperwork Reduction Act of 1995. However, Secs. 413.65 and 
419.42 have been approved by OMB under approval number 0938-0798, with 
a current expiration date of August 31, 2003 and OMB approval number 
0938-0802, with a current expiration date of August 31, 2001.

XIII. Response to Public Comments

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

Modification of 60-day Comment Period

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

XIV. Regulatory Impact Analysis

A. General

    We have examined the impacts of this proposed rule as required by 
Executive Order 12866 (September 1993, Regulatory Planning and Review) 
and the Regulatory Flexibility Act (RFA) (September 19, 1980 Public Law 
96-354). Executive Order 12866 directs agencies to assess all costs and 
benefits of available regulatory alternatives and, if regulation is 
necessary, to select regulatory approaches that maximize net benefits 
(including potential economic, environmental, public health and safety 
effects, distributive impacts, and equity). A regulatory impact 
analysis (RIA) must be prepared for major rules with economically 
significant effects ($100 million or more annually).
    The statutory effects of the provisions that would be implemented 
by this proposed rule result in expenditures exceeding $100 million per 
year. We estimate the total impact of these changes for CY 2002 
payments compared to CY 2001 payments to be approximately a $450 
million increase. Therefore, this proposed rule is an economically 
significant rule under Executive Order 12866, and a major rule under 5 
U.S.C. 804(2).
    The RFA requires agencies to determine whether a rule will have a 
significant economic impact on a substantial number of small entities. 
For purposes of the RFA, small entities include small businesses, 
nonprofit organizations and government agencies. Most hospitals and 
most other providers and suppliers are small entities, either by 
nonprofit status of by having revenues of $5 to $25 million or less 
annually (see 65 FR 69432). For purposes of the RFA, all providers of 
hospital outpatient services are considered small entities. Individuals 
and States are not included in the definition of a small entity.
    In addition, section 1102(b) of the Act requires us to prepare a 
regulatory impact analysis if a rule may have a significant impact on 
the operations of a substantial number of small rural hospitals. This 
analysis must conform to the provisions of section 603 of the RFA. With 
the exception of hospitals located in certain New England counties, for 
purposes of section 1102(b) of the Act, we define a small rural 
hospital as a hospital that is located outside of a Metropolitan 
Statistical Area (MSA) and has fewer than 100 beds, or New England 
County Metropolitan Area (NECMA). Section 601(g) of the Social Security 
Amendments of 1983 (Pub. L. 98-21) designated hospitals in certain New 
England counties as belonging to the adjacent NECMA. Thus, for purposes 
of the OPPS, we classify these hospitals as urban hospitals.
    It is clear that the changes in this proposed rule would affect 
both a substantial number of rural hospitals as well as other classes 
of hospitals, and the effects on some may be significant. Therefore, 
the discussion below, in combination with the rest of this proposed 
rule, constitutes a regulatory impact analysis.
    Section 202 of the Unfunded Mandate Reform Act of 1995 (Pub. L. 
104-4) also requires that agencies assess anticipated costs and 
benefits before issuing any rule that may result in an expenditure in 
any one year by State, local, or tribal governments, in the aggregate, 
or by the private sector, of $110 million. This proposed rule would not 
mandate any requirements for State, local, or tribal governments.
    Executive Order 13132 establishes certain requirements that an 
agency must meet when it publishes a proposed

[[Page 44714]]

rule (and subsequent final rule) that imposes substantial direct costs 
on State and local governments, preempts State law, or otherwise has 
Federalism implications.
    We have examined this proposed rule in accordance with Executive 
Order 13132, Federalism, and have determined that it will not have any 
negative impact on the rights, roles, and responsibilities of State, 
local or tribal governments.

B. Changes in This Proposed Rule

    We are proposing several changes to the OPPS that are required by 
the statute. We are required under section 1833(t)(3)(C)(ii) of the Act 
to update annually the conversion factor used to determine the APC 
payment rates. We are also required under section 1833(t)(8)(A) of the 
Act to revise, not less often than annually, the wage index and other 
adjustments. In addition, we must review the clinical integrity of 
payment groups and weights at least annually. Accordingly, in this 
proposed rule, we are updating the conversion factor and the wage index 
adjustment for hospital outpatient services furnished beginning January 
1, 2002. We are also proposing revisions to the relative APC payment 
weights based on claims data from July 1, 1999 through June 30, 2000. 
Finally, we are proposing to begin calculating outlier payments on an 
APC-specific basis rather than the current method of calculating 
outlier payments for each claim.
    The projected aggregate impact of updating the conversion factor is 
to increase total payments to hospitals by 2.3 percent. As described in 
the preamble, budget neutrality adjustments are made to the conversion 
factor and the weights to assure that the revisions in the wage index, 
APC groups, and relative weights do not affect aggregate payments. In 
addition, the determination of the parameters for outlier payments have 
been modified so that projected outlier payments for 2002 are 
equivalent to the established policy target of 2.0 percent of total 
payments. Because we are not revising the target percentage, there is 
no estimated aggregate impact from modifying the method of determining 
outlier payments.
    The impact of the wage, recalibration and outlier changes do vary 
somewhat by hospital group. Estimates of these impacts are displayed on 
Table 6.

C. Limitations of Our Analysis

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

D. Estimated Impacts of This Proposed Rule

    Column 5 in Table 6 represents the full impact on each hospital 
group of all the changes for 2002. Columns 2 through 4 in the table 
reflect the independent effects of the proposed change in the wage 
index, the APC reclassification and recalibration changes and the 
change in outlier method, respectively.
    In general, the wage index changes favor rural hospitals, 
particularly the largest in bed size and volume. The only rural 
hospitals that would experience a negative impact due to wage index 
changes are those in the Middle Atlantic and Pacific Regions, a 
decrease of 0.3 percent for each. Conversely, the urban hospitals are 
generally negatively affected by these changes, with the largest effect 
on those with 500 or more beds (0.6 percent decrease) and those in the 
Middle Atlantic (1.7 percent decrease) and West South Central Regions 
(1.5 percent decrease).
    We estimate that the APC reclassification and recalibration changes 
have generally an opposite impact from the wage index, causing 
increases for all urban hospitals except those with under 200 beds and 
volumes of fewer than 21,000 services per year and those located in the 
New England (a 0.1 percent decrease), Middle Atlantic (a 0.7 percent 
decrease), East North Central (a 0.55 percent decrease), and Puerto 
Rico (a 5.6 percent decrease) Regions.
    The change in outlier policy to an APC-specific payment has a 
slight negative effect on rural hospitals as a group (a 0.2 percent 
decrease), no effect on urban hospitals as a group, and slight negative 
effects on all smaller hospitals as well as those with lower volumes of 
services.
    The overall projected increase in payments for urban hospitals is 
slightly greater (2.4 percent) than the average increase for all 
hospitals while the increase for rural hospitals is somewhat less than 
the average increase (1.9 percent). Rural hospitals gain 1.2 percent 
from the wage index change, but lose a combined 1.7 percent from the 
APC changes and the change in method of determining outlier payments.
    In both urban and rural areas, hospitals that provide a higher 
volume of outpatient services are projected to receive a larger 
increase in payments than lower volume hospitals. In rural areas, 
hospitals with volumes of fewer than 5000 services are projected to 
experience a small decline in payments (-0.1 percent). The less 
favorable impact for the low volume hospitals is attributable to the 
APC changes and the change in outlier method. For example, rural 
hospitals providing fewer than 5000 services are projected to lose a 
combined 3 percent due to these changes.
    Urban hospitals in the Middle Atlantic region are projected to 
receive no increase in payments, and we estimate a decline of 0.1 
percent for rural hospitals in this region. Both the urban and rural 
hospitals lose 2.4 percent due to the wage index change and APC 
changes. The urban hospitals are affected more by the wage index change 
(-1.7 percent), while rural hospitals are affected more by the 
recalibration (-2.1 percent). Urban hospitals in the East South Central 
Region are projected to experience the largest increase in payments 
(5.5 percent).
    Major teaching hospitals are projected to experience a smaller 
increase in payments (1.3 percent) than the aggregate for all hospitals 
due to negative impacts of the wage index (-0.7 percent), recalibration 
(-0.1 percent), and outlier changes (-0.2 percent). Hospitals with less 
intensive teaching programs are projected to experience an overall 
increase (3.0 percent) that is larger than the average for all 
hospitals. This is attributable to the fact that there is no impact on 
this group for the wage index change and positive impacts for both the 
APC changes (0.6 percent) and outlier changes (0.1). There is little 
difference in impact among hospitals with varying shares of low-income 
patients.

[[Page 44715]]



             TABLE 6.--Impact of Changes for CY 2002 Hospital Outpatient Prospective Payment System
                          [Percent changes in total payments (program and beneficiary)]
----------------------------------------------------------------------------------------------------------------
                                     Number of    New wage index        APC         New outlier     All CY 2002
                                   hospitals \1\        \2\         recalib.\3\     policy \4\      changes \5\
                                             (1)             (2)             (3)             (4)             (5)
----------------------------------------------------------------------------------------------------------------
 
ALL HOSPITALS...................           5,077             0.0             0.0             0.0             2.3
NON-TEFRA HOSPITALS.............           4,701             0.0             0.0             0.0             2.3
URBAN HOSPS.....................           2,608            -0.3             0.4             0.0             2.4
LARGE URBAN (GT 1 MILL.)........           1,495            -0.5             0.1             0.0             1.9
OTHER URBAN (LE 1 MILL.)........           1,113            -0.1             0.7             0.1             3.1
RURAL HOSPS.....................           2,093             1.2            -1.5            -0.2             1.9
BEDS (URBAN):
    0-99 BEDS...................             661             0.0            -1.9            -0.1             0.3
    100-199 BEDS................             918            -0.3            -0.4             0.1             1.8
    200-299 BEDS................             510            -0.3             0.6             0.0             2.6
    300-499 BEDS................             374            -0.3             1.1             0.1             3.2
    500 + BEDS..................             145            -0.6             1.1             0.0             2.7
BEDS (RURAL):
    0--49 BEDS..................           1,249             0.4            -2.4            -0.6            -0.2
    50-99 BEDS..................             506             0.7            -2.2            -0.2             0.6
    100-149 BEDS................             198             1.6            -0.7             0.0             3.2
    150-199 BEDS................              74             1.6            -1.0            -0.1             2.8
    200 + BEDS..................              66             2.6            -0.2             0.1             4.8
VOLUME (URBAN):
    LT 5,000....................             363            -0.5            -0.5            -0.3             1.0
    5,000-10,999................             496            -0.3            -1.1             0.0             0.9
    11,000-20,999...............             605            -0.4            -0.4             0.1             1.7
    21,000-42,999...............             746            -0.4             0.6             0.1             2.6
    GT 42,999...................             398            -0.2             0.6             0.0             2.7
VOLUME (RURAL):
    LT 5,000....................           1,000             0.4            -2.0            -1.0            -0.1
    5,000-10,999................             569             0.5            -2.3            -0.2             0.2
    11,000-20,999...............             322             1.1            -1.7            -0.1             1.6
    21,000-42,999...............             171             1.7            -0.9             0.0             3.0
    GT 42,999...................              31             2.8            -0.3             0.0             4.8
REGION (URBAN):
    NEW ENGLAND.................             136             1.0            -0.1            -0.2             3.0
    MIDDLE ATLANTIC.............             380            -1.7            -0.7             0.0             0.0
    SOUTH ATLANTIC..............             429             0.4             1.3             0.1             4.1
    EAST NORTH CENT.............             444            -0.4            -0.5             0.1             1.5
    EAST SOUTH CENT.............             154             1.3             1.8             0.1             5.5
    WEST NORTH CENT.............             183            -0.1             0.2             0.1             2.5
    WEST SOUTH CENT.............             323            -1.5             1.6             0.0             2.3
    MOUNTAIN....................             129             0.1             1.2             0.0             3.6
    PACIFIC.....................             391            -0.2             0.4             0.0             2.5
    PUERTO RICO.................              39             1.2            -5.6            -0.2            -2.3
REGION (RURAL):
    NEW ENGLAND.................              51             0.4            -2.3            -0.4             0.0
    MIDDLE ATLANTIC.............              72            -0.3            -2.1             0.1            -0.1
    SOUTH ATLANTIC..............             276             1.8            -0.8            -0.1             3.2
    EAST NORTH CENT.............             275             1.5            -2.5            -0.1             1.2
    EAST SOUTH CENT.............             250             1.5            -0.9            -0.1             2.8
    WEST NORTH CENT.............             501             1.3            -2.1            -0.3             1.2
    WEST SOUTH CENT.............             326             1.4            -0.2            -0.2             3.2
    MOUNTAIN....................             200             1.6            -1.1            -0.5             2.4
    PACIFIC.....................             137            -0.3            -1.2            -0.2             0.6
    PUERTO RICO.................               5             4.2            -3.1            -0.3             3.0
TEACHING STATUS:
    NON-TEACHING................           3,594             0.2            -0.4             0.0             2.1
    MINOR.......................             812             0.0             0.6             0.1             3.0
    MAJOR.......................             294            -0.7            -0.1            -0.2             1.3
DSH PATIENT PERCENT:
    0...........................              27             0.0            -1.1            -0.7             0.7
    GT 0-0.10...................           1,298            -0.1            -0.3             0.0             2.0
    0.10-0.16...................           1,047             0.2            -0.2             0.1             2.3
    0.16-0.23...................             822            -0.1             0.3             0.0             2.5
    0.23-0.35...................             812             0.1             0.2             0.0             2.6
    GE 0.35.....................             695            -0.2             0.1            -0.3             2.0
URBAN IME/DSH:
    IME & DSH...................           1,012            -0.4             0.5             0.0             2.4
    IME/NO DSH..................               4            -0.1            -2.2            -1.2            -1.0
    NO IME/DSH..................           1,578            -0.2             0.2             0.1             2.4
    NO IME/NO DSH...............              14             0.1             0.9             0.7             4.0

[[Page 44716]]

 
RURAL HOSP. TYPES:
    NO SPECIAL STATUS...........             797             0.5            -2.0            -0.2             0.6
    RRC.........................             171             2.3            -0.5             0.1             4.2
    SCH/EACH....................             656             0.7            -2.2            -0.4             0.5
    MDH.........................             327             0.2            -2.5            -0.5            -0.4
    SCH AND RRC.................              70             2.1            -0.9            -0.1             3.4
TYPE OF OWNERSHIP:
    VOLUNTARY...................           2,808            -0.1            -0.1             0.0             2.2
    PROPRIETARY.................             761             0.0             0.9             0.2             3.4
    GOVERNMENT..................           1,132             0.4            -0.4            -0.2             2.1
SPECIALTY HOSPITALS:
    EYE AND EAR.................              12             0.1            -8.3             0.6            -5.3
    TRAUMA......................             154            -0.2            -0.1            -0.1             1.9
    CANCER......................              10            -1.7             2.3            -1.6             1.2
TEFRA HOSPITALS (NOT INCLUDED ON
 OTHER LINES):
    REHAB.......................             164            -1.8            10.0            -1.0             8.9
    PSYCH.......................              88            -1.4            -0.6            -3.5            -3.1
    LTC.........................              83            -0.7            -2.3            -0.2            -1.0
    CHILDREN....................              41            -0.6            -2.0            -2.2           -2.2
----------------------------------------------------------------------------------------------------------------
\1\ Some data necessary to classify hospitals by category were missing; thus, the total number of hospitals in
  each category may not equal the national total.
\2\ This column shows the impact of updating the wage index used to calculate payment using the proposed FY 2002
  hospital inpatient wage index after geographic reclassification by the Medicare Geographic Classification
  Review Board. The hospital inpatient proposed rule for FY 2002 was published in the Federal Register on May 4,
  2001.
\3\ This column shows the impact of recalibrating the APC weights based on 1999-2000 hospital claims data and of
  the reassignment of some HCPCs to APCs as discussed in this rule.
\4\ This column shows the difference in calculating outliers on an APC-specific rather than bill basis.
\5\ This column shows changes in total payment from CY 2001 to CY 2002. It incorporates all of the changes
  reflected in columns 2, 3, and 4. In addition, it shows the impact of the CY 2002 payment update. The sum of
  the columns may be different from the percentage changes shown here due to rounding.

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

List of Subjects

42 CFR Part 413

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

42 CFR Part 419

    Hospitals, Medicare, Reporting and recordkeeping requirements.

42 CFR Part 489

    Health facilities, Medicare, Reporting and recordkeeping 
requirements.

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

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

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

    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 B--Accounting Records and Reports

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


Sec. 413.24  Adequate cost data and cost finding.

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

[[Page 44717]]

must be reclassified to the main provider and allocated among the main 
provider's benefiting cost centers.
    Example: A provider-based complex is composed of a hospital and a 
hospital-based rural health clinic (RHC). The hospital furnishes the 
entirety of its own administrative and general costs internally. The 
RHC, however, is managed by an independent contractor through a 
management contract. The management contract provides a full array of 
administrative and general services, with the exception of patient 
billing. The hospital directly assigns the costs of the RHC's 
management contract to the RHC cost center (for example, Form HCFA 
2552-96, Worksheet A, Line 71). A full allocation of the hospital's 
administrative and general costs to the RHC cost center would duplicate 
most of the RHC's administrative and general costs. However, an 
allocation of the hospital's cost (included in hospital administrative 
and general costs) of its patient billing function to the RHC would be 
appropriate. Therefore, the hospital must include the costs of the 
patient billing function in a separate cost center to be allocated to 
the benefiting cost centers, including the RHC cost center. The 
remaining hospital administrative and general costs would be allocated 
to all cost centers, excluding the RHC cost center. If the hospital is 
unable to isolate the costs of the patient billing function, the costs 
of the RHC's management contract must be reclassified to the hospital 
administrative and general cost center to be allocated among all cost 
centers, as appropriate.
    (7) Costs of services furnished to free-standing entities. The 
costs that a provider incurs to furnish services to free-standing 
entities with which it is associated are not allowable costs of that 
provider. Any costs of services furnished to a free-standing entity 
must be identified and eliminated from the allowable costs of the 
servicing provider, to prevent Medicare payment to that provider for 
those costs. This may be done by including the free-standing entity on 
the cost report as a nonreimbursable cost center for the purpose of 
allocating overhead costs to that entity. If this method would not 
result in an accurate allocation of costs to the entity, the provider 
must develop detailed work papers showing how the cost of services 
furnished by the provider to the entity were determined. These costs 
are removed from the applicable cost centers of the servicing provider.
* * * * *

Subpart E--Payments to Providers

    3. Section 413.65 is amended as follows:
    A. Revising paragraph (a)(1).
    B. Revising the definition of ``Provider-based entity'' in 
paragraph (a)(2).
    C. Revising paragraph (b).
    D. Revising paragraph (c).
    E. Revising the introductory text to paragraph (d).
    F. Revising paragraph (d)(7).
    G. Revising paragraph (g)(7).
    H. Revising the introductory text to paragraph (i)(1).
    I. Revising paragraph (i)(1)(ii).
    J. Revising paragraph (i)(2).
    The revisions read as follows:


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

    (a) Scope and definitions. (1) Scope. (i) This section applies to 
all facilities for which provider-based status is sought, including 
remote locations of hospitals, as defined in paragraph (a)(2) of this 
section and satellite facilities as defined in Sec. 412.22(h)(1) and 
Sec. 412.25(e)(1) of this chapter, other than facilities described in 
paragraph (a)(1)(ii) of this section.
    (ii) This section does not apply to the following facilities:
    (A) Ambulatory surgical centers (ASCs).
    (B) Comprehensive outpatient rehabilitation facilities (CORFs).
    (C) Home health agencies (HHAs).
    (D) Skilled nursing facilities (SNFs).
    (E) Hospices.
    (F) Inpatient rehabilitation units that are excluded from the 
inpatient PPS for acute hospital services.
    (G) Independent diagnostic testing facilities and any other 
facilities that furnish only clinical diagnostic laboratory tests.
    (H) Facilities furnishing only physical, occupational, or speech 
therapy to ambulatory patients, for as long as the $1,500 annual cap on 
coverage of physical, occupational, and speech therapy, as described in 
section 1833(g)(2) of the Act, remains suspended by the action of 
subsequent legislation.
    (I) ESRD facilities (determinations for ESRD facilities are made 
under Sec. 413.174 of this chapter).
    (2) Definitions. * * *
* * * * *
    Provider-based entity means a provider of health care services, or 
an RHC 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.
* * * * *
    (b) Provider-based determinations. (1) A facility or organization 
is not entitled to be treated as provider-based simply because it or 
the main provider believe it is provider-based.
    (2) If a facility was treated as provider-based in relation to a 
hospital or CAH on October 1, 2000, it will continue to be considered 
provider-based in relation to that hospital or CAH until October 1, 
2002, and the requirements, limitations, and exclusions specified in 
paragraphs (d), (e), (f), and (h) of this section will not apply to 
that hospital or CAH for that facility until October 1, 2002. For 
purposes of this paragraph, a facility will be considered to have been 
treated as provider-based on October 1, 2000, if on that date it either 
had a written determination from CMS that it was provider-based as of 
that date, or was billing and being paid as a provider-based department 
or entity of the hospital.
    (3) Except as specified in paragraphs (b)(2) and (b)(5) of this 
section, a main provider or a facility must contact CMS, and the 
facility must be determined by CMS to be provider-based, before the 
main provider bills for services of the facility as if the facility 
were provider-based, or before it includes costs of those services on 
its cost report.
    (4) A facility that is not located on the campus of a hospital and 
that is used as a site where physician services of the kind ordinarily 
furnished in physician offices are furnished is presumed to be a free-
standing facility, unless it is determined by CMS to have provider-
based status.
    (5) A facility for which a determination of provider-based status 
in relation to a hospital or CAH is requested on or after October 1, 
2000 and before October 1, 2002 will be treated as provider-based in 
relation to the hospital or CAH from the first date on or after October 
1, 2000 on which the facility was licensed (to the extent required by 
the State), staffed and equipped to treat patients until the date on 
which CMS determines that the facility does not qualify for provider-
based status.
    (c) Reporting. A main provider that has had one or more facilities 
considered provider-based also must report to CMS any material change 
in the relationship between it and any

[[Page 44718]]

provider-based facility, such as a change in ownership of the facility 
or entry into a new or different management contract that could affect 
the provider-based status of the facility.
    (d) Requirements. An entity must meet all of the following 
requirements to be determined by CMS to have provider-based status.
* * * * *
    (7) Location in immediate vicinity. The facility or organization 
and the main provider are located on the same campus, except when the 
requirements in paragraphs (d)(7)(i), (d)(7)(ii), or (d)(7)(iii) of 
this section are met:
    (i) The facility or organization is located within a 35-mile radius 
of the main campus of the hospital or CAH that is the potential main 
provider;
    (ii) The facility or organization is owned and operated by a 
hospital or CAH that has a disproportionate share adjustment (as 
determined under Sec. 412.106 of this chapter) greater than 11.75 
percent or is described in Sec. 412.106(c)(2) of this chapter 
implementing section 1886(d)(5)(F)(i)(II) of the Act and is--
    (A) Owned or operated by a unit of State or local government;
    (B) A public or nonprofit corporation that is formally granted 
governmental powers by a unit of State or local government; or
    (C) A private hospital that has a contract with a State or local 
government that includes the operation of clinics located off the main 
campus of the hospital to assure access in a well-defined service area 
to health care services to low-income individuals who are not entitled 
to benefits under Medicare (or medical assistance under a Medicaid 
State plan).
    (iii) The facility or organization demonstrates a high level of 
integration with the main provider by showing that it meets all of the 
other provider-based criteria and demonstrates that it serves the same 
patient population as the main provider, by submitting records showing 
that, during the 12-month period immediately preceding the first day of 
the month in which the application for provider-based status is filed 
with CMS, and for each subsequent 12-month period--
    (A) At least 75 percent of the patients served by the facility or 
organization reside in the same zip code areas as at least 75 percent 
of the patients served by the main provider;
    (B) At least 75 percent of the patients served by the facility or 
organization who required the type of care furnished by the main 
provider received that care from that provider (for example, at least 
75 percent of the patients of an RHC seeking provider-based status 
received inpatient hospital services from the hospital that is the main 
provider); or
    (C) If the facility or organization is unable to meet the criteria 
in paragraph (d)(7)(i)(A) or (d)(7)(i)(B) of this section because it 
was not in operation during all of the 12-month period described in the 
previous sentence, the facility or organization is located in a zip 
code area included among those that, during all of the 12-month period 
described in the previous sentence, accounted for at least 75 percent 
of the patients served by the main provider.
    (iv) A facility or organization is not considered to be in the 
``immediate vicinity'' of the main provider unless the facility or 
organization and the main provider are located in the same State or, 
when consistent with the laws of both States, adjacent States.
    (v) An RHC that is otherwise qualified as a provider-based entity 
of a hospital that is located in a rural area, as defined in 
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 
criteria in paragraphs (d)(7)(i) through (d)(7)(iv) of this section.
* * * * *
    (g) Obligations of hospital outpatient departments and hospital-
based entities. * * *
* * * * *
    (7) When a Medicare beneficiary is treated in a hospital outpatient 
department or hospital-based entity (other than an RHC) that is not 
located on the main provider's campus, the hospital has a duty to 
provide written notice to the beneficiary, before the delivery of 
services, of the amount of the beneficiary's potential financial 
liability (that is, of the fact that the beneficiary will incur a 
coinsurance liability for an outpatient visit to the hospital as well 
as for the physician service, and of the amount of that liability). The 
notice must be one that the beneficiary can read and understand. If the 
exact type and extent of care needed is not known, the hospital may 
furnish a written notice to the patient that explains the fact that the 
beneficiary will incur a coinsurance liability to the hospital that he 
or she would not incur if the facility were not provider-based. The 
hospital may furnish an estimate based on typical or average charges 
for visits to the facility, while stating that the patient's actual 
liability will depend upon the actual services furnished by the 
hospital. If the beneficiary is unconscious, under great duress, or for 
any other reason unable to read a written notice and understand and act 
on his or her own rights, the notice must be provided, before the 
delivery of services, to the beneficiary's authorized representative.
* * * * *
    (i) Inappropriate treatment of a facility or organization as 
provider-based. (1) Determination and review. If CMS learns that a 
provider has treated a facility or organization as provider-based and 
the provider had not obtained a determination of provider-based status 
under this section, CMS will--
* * * * *
    (ii) Investigate and determine whether the requirements in 
paragraph (d) of this section (or, for periods before the beginning of 
the hospital's first cost reporting period beginning or or after 
January 10, 2001, the requirements in applicable program instructions) 
were met; and
* * * * *
    (2) Recovery of overpayments. If CMS finds that payments for 
services at the facility or organization have been made as if the 
facility or organization were provider-based, even though CMS had not 
previously determined that the facility or organization qualified for 
provider-based status, CMS will recover the difference between the 
amount of payments that actually were made and the amount of payments 
that CMS estimates should have been made in the absence of a 
determination of provider-based status, except that recovery will not 
be made for any period before the beginning of the hospital's first 
cost reporting period beginning or or after January 10, 2001 if during 
all of that period the management of the entity made a good faith 
effort to operate it as a provider-based facility or organization, as 
described in paragraph (h)(3) of this section.
* * * * *

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

    B. Part 419 is amended as set forth below:
    1. The authority citation for part 419 continues to read as 
follows:

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

Subpart A--General Provisions

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


Sec. 419.2  Basis of payment.

* * * * *

[[Page 44719]]

    (c) Determination of hospital outpatient prospective payment rates: 
Excluded costs. The following costs are excluded from the hospital 
outpatient prospective payment system.
    (1) The costs of direct graduate medical education activities as 
described in Sec. 413.86 of this chapter.
    (2) The costs of nursing and allied health programs as described in 
Sec. 413.85 of this chapter.
    (3) The costs associated with interns and residents not in approved 
teaching programs as described in Sec. 415.202 of this chapter.
    (4) The costs of teaching physicians attributable to Part B 
services for hospitals that elect cost-based reimbursement for teaching 
physicians under Sec. 415.160.
    (5) The reasonable costs of anesthesia services furnished to 
hospital outpatients by qualified nonphysician anesthetists (certified 
registered nurse anesthetists and anesthesiologists' assistants) 
employed by the hospital or obtained under arrangements, for hospitals 
that meet the requirements under Sec. 412.113(c) of this chapter.
    (6) Bad debts for uncollectible deductibles and coinsurances as 
described in Sec. 413.80(b) of this chapter.
    (7) Organ acquisition costs paid under Part B.
    (8) Corneal tissue acquisition costs.

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

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


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 August 1, 2000.
    (b) Hospitals excluded from the outpatient prospective payment 
system.
* * * * *
    (3) A hospital located outside one of the 50 States, the District 
of Columbia, and Puerto Rico is excluded from the hospital outpatient 
prospective payment system.
    (4) A hospital of the Indian Health Service.
    4. In Sec. 419.22, the introductory text is republished, and 
paragraph (r) is added to read as follows:


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

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

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


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

* * * * *
    (b) Conversion factor for calendar year 2000 and subsequent years. 
(1) Subject to paragraph (b)(2) of this section, the conversion factor 
for a calendar year is equal to the conversion factor calculated for 
the previous year adjusted as follows:
    (i) For calendar year 2000, by the hospital inpatient market basket 
percentage increase applicable under section 1886(b)(3)(B)(iii) of the 
Act reduced by one percentage point.
    (ii) For calendar year 2001--
    (A) For services furnished on or after January 1, 2001 and before 
April 1, 2001, by the hospital inpatient market basket percentage 
increase applicable under section 1886(b)(3)(B)(iii) of the Act reduced 
by one percentage point; and
    (B) For services furnished on or after April 1, 2001 and before 
January 1, 2002, by the hospital inpatient market basket percentage 
increase applicable under section 1886(b)(3)(B)(iii) of the Act, and 
increased by a transitional percentage allowance equal to 0.32 percent.
    (iii) For calendar year 2002, by the hospital inpatient market 
basket percentage increase applicable under section 1886(b)(3)(B)(iii) 
of the Act reduced by one percentage point, without taking into account 
the transitional percentage allowance referenced in 
Sec. 419.32(b)(ii)(B).
    (iv) For calendar year 2003 and subsequent years, by the hospital 
inpatient market basket percentage increase applicable under section 
1886(b)(3)(B)(iii) of the Act.
* * * * *

Subpart D--Payments to Hospitals

    6. In Sec. 419.40, the word ``coinsurance'' is removed and the word 
``copayment'' is added in its place as follows:


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 copayment 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 copayment amount, to the APC group payment rate, or 80 
percent.
    (3) Unadjusted copayment amount is calculated as 20 percent of the 
wage-adjusted national median of charges for services within an APC 
group furnished during 1996, updated to 1999 using an actuarial 
projection of charge increases for hospital outpatient department 
services during the period 1996 to 1999.
    (c) Limitation of copayment amount to inpatient hospital deductible 
amount. The copayment amount for a procedure performed in a year cannot 
exceed the amount of the inpatient hospital deductible established 
under section 1813(b) of the Act for that year.
    7. Amend Sec. 419.41 as follows:
    A. The section heading is revised.
    B. The word ``coinsurance'' is removed each time it appears, and 
the word ``copayment'' is added in its place.
    C. Paragraph (c)(4)(ii) is redesignated as paragraph (c)(4)(iv).
    D. Paragraphs (c)(4)(ii) and (c)(4)(iii) are added as follows:


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

    (c) * * *
    (4) * * *
    (i) Effective for services furnished from April 1, 2001 through 
December 31, 2001, the national unadjusted coinsurance rate for an APC 
cannot exceed 57 percent of the prospective payment rate for that APC.
    (ii) The national unadjusted coinsurance rate for an APC cannot 
exceed 55 percent in calendar years

[[Page 44720]]

2002 and 2003; 50 percent in calendar year 2004; 45 percent in calendar 
year 2005; and 40 percent in calendar year 2006 and thereafter.
* * * * *
    8. In Sec. 419.42 paragraph (a), (c), and (e) are revised as 
follows:


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 amounts for some, but not all, services within the same 
group.
* * * * *
    (c) The hospital's election must be properly documented. It must 
specifically identify the APCs to which it applies and the copayment 
amount (within the limits identified below) that the hospital has 
selected for each group.
* * * * *
    (e) In electing reduced coinsurance, a hospital may elect a 
copayment amount that is less than that year's wage-adjusted copayment 
amount for the group but not less than 20 percent of the APC payment 
rate as determined in Sec. 419.32.
* * * * *


Sec. 419.43  [Amended]

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

Subpart G--Transitional Corridors

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


Sec. 419.70  Transitional adjustment to limit decline in payment.

* * * * *
    (d) Hold harmless provisions * * *
* * * * *
    (2) Permanent treatment for cancer hospitals and children's 
hospitals. In the case of a hospital described in Sec. 412.23(d) or 
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.
* * * * *

PART 489--PROVIDER AGREEMENTS AND SUPPLIER APPROVAL

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

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


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

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

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


    Dated: August 3, 2001.
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.
    Approved: August 3, 2001.
Tommy G. Thompson,
Secretary.

Addendum A.--List of Ambulatory Payment Classifications (APCs) with Status Indicators, Relative Weights, Payment
                                 Rates, and Copayment Amounts Calendar Year 2002
----------------------------------------------------------------------------------------------------------------
                                                                                          National     Minimum
  APC            Group Title            Status  Indicator       Relative     Payment     Unadjusted   Unadjusted
                                                                 Weight        Rate      Copayment    Copayment
----------------------------------------------------------------------------------------------------------------
   0001  Photochemotherapy.........  S                               0.45       $22.88        $8.24        $4.58
   0002  Fine needle Biopsy/         T                               0.47       $23.90       $13.14        $4.78
          Aspiration.
   0003  Bone Marrow Biopsy/         T                               1.11       $56.43       $27.99       $11.29
          Aspiration.
   0004  Level I Needle Biopsy/      T                               3.00      $152.53       $32.57       $30.51
          Aspiration Except Bone
          Marrow.
   0005  Level II Needle Biopsy /    T                               6.71      $341.15      $119.75       $68.23
          Aspiration Except Bone
          Marrow.
   0006  Level I Incision &          T                               2.36      $119.99       $33.95       $24.00
          Drainage.
   0007  Level II Incision &         T                               7.28      $370.13       $74.03       $74.03
          Drainage.
   0008  Level III Incision and      T                              11.36      $577.57      $115.51      $115.51
          Drainage.
   0009  Nail Procedures...........  T                               0.68       $34.57        $8.99        $6.91
   0010  Level I Destruction of      T                               0.71       $36.10        $9.86        $7.22
          Lesion.
   0011  Level II Destruction of     T                               1.57       $79.82       $29.53       $15.96
          Lesion.
   0012  Level I Debridement &       T                               0.72       $36.61        $9.18        $7.32
          Destruction.
   0013  Level II Debridement &      T                               1.51       $76.77       $17.66       $15.35
          Destruction.
   0015  Level IV Debridement &      T                               2.29      $116.43       $31.20       $23.29
          Destruction.
   0016  Level V Debridement &       T                               3.31      $168.29       $70.68       $33.66
          Destruction.
   0017  Level VI Debridement &      T                              10.51      $534.35      $245.80      $106.87
          Destruction.
   0018  Biopsy of Skin/Puncture of  T                               1.16       $58.98       $17.66       $11.80
          Lesion.
   0019  Level I Excision/ Biopsy..  T                               4.56      $231.84       $78.91       $46.37
   0020  Level II Excision/ Biopsy.  T                               8.56      $435.21      $130.53       $87.04
   0021  Level IV Excision/ Biopsy.  T                              12.74      $647.73      $236.51      $129.55
   0022  Level V Excision/ Biopsy..  T                              15.07      $766.19      $292.94      $153.24
   0023  Exploration Penetrating     T                               2.18      $110.84       $40.37       $22.17
          Wound.
   0024  Level I Skin Repair.......  T                               2.48      $126.09       $44.50       $25.22
   0025  Level II Skin Repair......  T                               3.71      $188.62       $70.66       $37.72

[[Page 44721]]

 
   0026  Level III Skin Repair.....  T                              13.51      $686.88      $277.92      $137.38
   0027  Level IV Skin Repair......  T                              19.31      $981.76      $383.10      $196.35
   0028  Level I Incision/Excision   T                              14.95      $760.09      $303.74      $152.02
          Breast.
   0029  Level II Incision/Excision  T                              35.93    $1,826.75      $820.79      $365.35
          Breast.
   0030  Level I Breast              T                              25.95    $1,319.35      $646.48      $263.87
          Reconstruction.
   0032  Insertion of Central        T                               7.16      $364.03      $119.52       $72.81
          Venous/Arterial Catheter.
   0033  Partial Hospitalization...  P                               4.17      $212.01  ...........       $42.40
   0035  Placement of Arterial or    T                               0.13        $6.61        $2.18        $1.32
          Central Venous Catheter.
   0041  Arthroscopy...............  T                              26.18    $1,331.04      $592.08      $266.21
   0042  Arthroscopically-Aided      T                              39.39    $2,002.67      $804.74      $400.53
          Procedures.
   0043  Closed Treatment Fracture   T                               4.13      $209.98       $42.00       $42.00
          Finger/Toe/Trunk.
   0044  Closed Treatment Fracture/  T                               2.73      $138.80       $38.08       $27.76
          Dislocation Except Finger/
          Toe/Trunk.
   0045  Bone/Joint Manipulation     T                              12.91      $656.37      $277.12      $131.27
          Under Anesthesia.
   0046  Open/Percutaneous           T                              25.36    $1,289.35      $535.76      $257.87
          Treatment Fracture or
          Dislocation.
   0047  Arthroplasty without        T                              28.54    $1,451.03      $537.03      $290.21
          Prosthesis.
   0048  Arthroplasty with           T                              32.37    $1,645.76      $725.94      $329.15
          Prosthesis.
   0049  Level I Musculoskeletal     T                              17.07      $867.87      $356.95      $173.57
          Procedures Except Hand
          and Foot.
   0050  Level II Musculoskeletal    T                              22.31    $1,134.29      $513.86      $226.86
          Procedures Except Hand
          and Foot.
   0051  Level III Musculoskeletal   T                              30.94    $1,573.05      $675.24      $314.61
          Procedures Except Hand
          and Foot.
   0052  Level IV Musculoskeletal    T                              38.88    $1,976.74      $930.91      $395.35
          Procedures Except Hand
          and Foot.
   0053  Level I Hand                T                              12.67      $644.17      $253.49      $128.83
          Musculoskeletal
          Procedures.
   0054  Level II Hand               T                              20.84    $1,059.55      $472.33      $211.91
          Musculoskeletal
          Procedures.
   0055  Level I Foot                T                              16.77      $852.62      $355.34      $170.52
          Musculoskeletal
          Procedures.
   0056  Level II Foot               T                              19.20      $976.17      $405.81      $195.23
          Musculoskeletal
          Procedures.
   0057  Bunion Procedures.........  T                              21.11    $1,073.27      $496.65      $214.65
   0058  Level I Strapping and Cast  S                               1.36       $69.15       $19.27       $13.83
          Application.
   0059  Level II Strapping and      S                               2.34      $118.97       $29.59       $23.79
          Cast Application.
   0060  Manipulation Therapy......  S                               0.25       $12.71        $2.54        $2.54
   0068  CPAP Initiation...........  S                               3.33      $169.30       $93.12       $33.86
   0069  Thoracoscopy..............  T                              25.62    $1,302.57      $612.21      $260.51
   0070  Thoracentesis/Lavage        T                               4.11      $208.96       $79.60       $41.79
          Procedures.
   0071  Level I Endoscopy Upper     T                               1.08       $54.91       $14.22       $10.98
          Airway.
   0072  Level II Endoscopy Upper    T                               1.29       $65.59       $36.08       $13.12
          Airway.
   0073  Level III Endoscopy Upper   T                               3.54      $179.98       $79.19       $36.00
          Airway.
   0074  Level IV Endoscopy Upper    T                              14.62      $743.31      $347.54      $148.66
          Airway.
   0075  Level V Endoscopy Upper     T                              19.08      $970.07      $467.29      $194.01
          Airway.
   0076  Endoscopy Lower Airway....  T                               8.22      $417.92      $197.05       $83.58
   0077  Level I Pulmonary           S                               0.42       $21.35       $11.74        $4.27
          Treatment.
   0078  Level II Pulmonary          S                               0.93       $47.28       $20.33        $9.46
          Treatment.
   0079  Ventilation Initiation and  S                               0.62       $31.52       $17.34        $6.30
          Management.
   0080  Diagnostic Cardiac          T                              32.20    $1,637.11      $838.92      $327.42
          Catheterization.
   0081  Non-Coronary Angioplasty    T                              22.04    $1,120.56      $549.07      $224.11
          or Atherectomy.
   0082  Coronary Atherectomy......  T                             130.89    $6,654.71    $1,351.74    $1,330.94
   0083  Coronary Angioplasty......  T                              50.15    $2,549.73      $794.30      $509.95
   0084  Level I Electrophysiologic  S                               4.94      $251.16       $82.88       $50.23
          Evaluation.
   0085  Level II                    S                              27.39    $1,392.56      $654.48      $278.51
          Electrophysiologic
          Evaluation.
   0086  Ablate Heart Dysrhythm      S                              47.13    $2,396.18    $1,265.37      $479.24
          Focus.
   0087  Cardiac Electrophysiologic  S                              14.89      $757.04      $214.72      $151.41
          Recording/Mapping.
   0088  Thrombectomy..............  T                              29.11    $1,480.01      $678.68      $296.00
   0089  Insertion/Replacement of    T                              82.60    $4,199.55    $2,246.59      $839.91
          Permanent Pacemaker and
          Electrodes.
   0090  Insertion/Replacement of    T                              73.37    $3,730.28    $2,014.35      $746.06
          Pacemaker Pulse Generator.
   0091  Level I Vascular Ligation.  T                              22.17    $1,127.17      $348.23      $225.43
   0092  Level II Vascular Ligation  T                              21.43    $1,089.54      $505.37      $217.91
   0093  Vascular Repair/Fistula     T                              15.05      $765.17      $277.34      $153.03
          Construction.
   0094  Resuscitation and           S                               5.69      $289.29      $105.29       $57.86
          Cardioversion.
   0095  Cardiac Rehabilitation....  S                               0.66       $33.56       $16.98        $6.71
   0096  Non-Invasive Vascular       S                               1.87       $95.07       $52.29       $19.01
          Studies.
   0097  Cardiac Monitoring for 30   X                               0.87       $44.23       $24.33        $8.85
          days.
   0098  Injection of Sclerosing     T                               1.34       $68.13       $20.88       $13.63
          Solution.
   0099  Electrocardiograms........  S                               0.38       $19.32       $10.63        $3.86
   0100  Stress Tests and            X                               1.63       $82.87       $45.58       $16.57
          Continuous ECG.
   0101  Tilt Table Evaluation.....  S                               4.03      $204.89      $112.69       $40.98
   0103  Miscellaneous Vascular      T                              10.91      $554.69      $249.61      $110.94
          Procedures.
   0104  Transcatheter Placement of  T                              71.42    $3,631.14      $726.23      $726.23
          Intracoronary Stents.
   0105  Revision/Removal of         T                              16.56      $841.94      $372.32      $168.39
          Pacemakers, AICD, or
          Vascular Device.
   0106  Insertion/Replacement/      T                              15.82      $804.32      $426.29      $160.86
          Repair of Pacemaker and/
          or Electrodes.
   0107  Insertion of Cardioverter-  T                             155.27    $7,894.24    $4,224.27    $1,578.85
          Defibrillator.
   0108  Insertion/Replacement/      T                             159.42    $8,105.23    $4,214.72    $1,621.05
          Repair of Cardioverter-
          Defibrillator Leads.
   0109  Removal of Implanted        T                               6.57      $334.03      $133.51       $66.81
          Devices.
   0110  Transfusion...............  S                               5.76      $292.85      $122.70       $58.57
   0111  Blood Product Exchange....  S                              16.69      $848.55      $300.74      $169.71
   0112  Apheresis, Photopheresis,   S                              39.75    $2,020.97      $663.65      $404.19
          and Plasmapheresis.
   0113  Excision Lymphatic System.  T                              16.87      $857.70      $326.55      $171.54
   0114  Thyroid/Lymphadenectomy     T                              30.50    $1,550.68      $493.78      $310.14
          Procedures.
   0115  Cannula/Access Device       T                              19.06      $969.05      $503.91      $193.81
          Procedures.
   0116  Chemotherapy                S                               0.98       $49.83        $9.97        $9.97
          Administration by Other
          Technique Except Infusion.
   0117  Chemotherapy                S                               3.48      $176.93       $52.69       $35.39
          Administration by
          Infusion Only.
   0118  Chemotherapy                S                               3.52      $178.96       $72.03       $35.79
          Administration by Both
          Infusion and Other
          Technique.

[[Page 44722]]

 
   0119  Implantation of Devices...  T                              14.37      $730.60      $161.50      $146.12
   0120  Infusion Therapy Except     T                               2.35      $119.48       $42.67       $23.90
          Chemotherapy.
   0121  Level I Tube changes and    T                               2.42      $123.04       $52.53       $24.61
          Repositioning.
   0122  Level II Tube changes and   T                               5.69      $289.29      $114.93       $57.86
          Repositioning.
   0123  Bone Marrow Harvesting and  S                              10.12      $514.52      $102.90      $102.90
          Bone Marrow/Stem Cell
          Transplant.
   0124  Revision of Implanted       T                              25.84    $1,313.76      $722.57      $262.75
          Infusion Pump.
   0125  Refilling of Infusion Pump  T                               3.20      $162.69  ...........       $32.54
   0130  Level I Laparoscopy.......  T                              27.92    $1,419.51      $659.53      $283.90
   0131  Level II Laparoscopy......  T                              39.80    $2,023.51    $1,052.23      $404.70
   0132  Level III Laparoscopy.....  T                              60.31    $3,066.28    $1,239.22      $613.26
   0140  Esophageal Dilation         T                               5.73      $291.32      $107.24       $58.26
          without Endoscopy.
   0141  Upper GI Procedures.......  T                               7.46      $379.28      $184.67       $75.86
   0142  Small Intestine Endoscopy.  T                               7.61      $386.91      $162.42       $77.38
   0143  Lower GI Endoscopy........  T                               7.87      $400.13      $198.46       $80.03
   0144  Diagnostic Anoscopy.......  T                               1.97      $100.16       $44.07       $20.03
   0145  Therapeutic Anoscopy......  T                              12.11      $615.70      $179.39      $123.14
   0146  Level I Sigmoidoscopy.....  T                               2.95      $149.98       $65.15       $30.00
   0147  Level II Sigmoidoscopy....  T                               6.15      $312.68      $146.96       $62.54
   0148  Level I Anal/Rectal         T                               2.58      $131.17       $43.59       $26.23
          Procedure.
   0149  Level III Anal/Rectal       T                              14.49      $736.70      $293.06      $147.34
          Procedure.
   0150  Level IV Anal/Rectal        T                              19.58      $995.49      $437.12      $199.10
          Procedure.
   0151  Endoscopic Retrograde       T                              16.22      $824.66      $245.46      $164.93
          Cholangio-Pancreatography
          (ERCP).
   0152  Percutaneous Biliary        T                              17.44      $886.68      $207.38      $177.34
          Endoscopic Procedures.
   0153  Peritoneal and Abdominal    T                              22.44    $1,140.89      $496.31      $228.18
          Procedures.
   0154  Hernia/Hydrocele            T                              24.09    $1,224.78      $556.98      $244.96
          Procedures.
   0155  Level II Anal/Rectal        T                               5.73      $291.32       $96.14       $58.26
          Procedure.
   0156  Level II Urinary and Anal   T                               2.62      $133.21       $39.96       $26.64
          Procedures.
   0157  Colorectal Cancer           S                               2.14      $108.80  ...........       $27.20
          Screening: Barium Enema.
   0158  Colorectal Cancer           S                               7.00      $355.89  ...........       $88.97
          Screening: Colonoscopy.
   0159  Colorectal Cancer           S                               2.51      $127.61  ...........       $31.90
          Screening: Flexible
          Sigmoidoscopy.
   0160  Level I Cystourethroscopy   T                               5.98      $304.04      $110.11       $60.81
          and other Genitourinary
          Procedures.
   0161  Level II Cystourethroscopy  T                              16.45      $836.35      $249.36      $167.27
          and other Genitourinary
          Procedures.
   0162  Level III                   T                              19.86    $1,009.72      $427.49      $201.94
          Cystourethroscopy and
          other Genitourinary
          Procedures.
   0163  Level IV Cystourethroscopy  T                              30.27    $1,538.99      $792.58      $307.80
          and other Genitourinary
          Procedures.
   0164  Level I Urinary and Anal    T                               0.98       $49.83       $14.95        $9.97
          Procedures.
   0165  Level III Urinary and Anal  T                               5.36      $272.51       $91.76       $54.50
          Procedures.
   0166  Level I Urethral            T                              13.02      $661.96      $218.73      $132.39
          Procedures.
   0167  Level II Urethral           T                              24.18    $1,229.36      $555.84      $245.87
          Procedures.
   0168  Level III Urethral          T                              31.68    $1,610.67      $536.11      $322.13
          Procedures.
   0169  Lithotripsy...............  T                              42.65    $2,168.41    $1,192.63      $433.68
   0170  Dialysis for Other Than     S                               1.08       $54.91       $12.08       $10.98
          ESRD Patients.
   0180  Circumcision..............  T                              16.29      $828.22      $304.87      $165.64
   0181  Penile Procedures.........  T                              24.07    $1,223.77      $673.07      $244.75
   0182  Insertion of Penile         T                              85.94    $4,369.36    $1,492.28      $873.87
          Prosthesis.
   0183  Testes/Epididymis           T                              20.37    $1,035.65      $448.94      $207.13
          Procedures.
   0184  Prostate Biopsy...........  T                               5.23      $265.90      $122.96       $53.18
   0185  Removal or Repair of        T                              57.17    $2,906.64      $906.36      $581.33
          Penile Prosthesis.
   0187  Placement/Repositioning     T                               4.54      $230.82      $113.10       $46.16
          Misc Catheters.
   0188  Level II Female             T                               0.83       $42.20       $12.24        $8.44
          Reproductive Proc.
   0189  Level III Female            T                               1.38       $70.16       $17.54       $14.03
          Reproductive Proc.
   0190  Surgical Hysteroscopy.....  T                              18.27      $928.88      $443.89      $185.78
   0191  Level I Female              T                               0.27       $13.73        $3.98        $2.75
          Reproductive Proc.
   0192  Level IV Female             T                               2.73      $138.80       $35.33       $27.76
          Reproductive Proc.
   0193  Level V Female              T                              12.17      $618.75      $171.13      $123.75
          Reproductive Proc.
   0194  Level VI Female             T                              17.18      $873.47      $395.94      $174.69
          Reproductive Proc.
   0195  Level VII Female            T                              22.22    $1,129.71      $483.80      $225.94
          Reproductive Proc.
   0196  Dilation and Curettage....  T                              14.62      $743.31      $357.98      $148.66
   0197  Infertility Procedures....  T                               2.58      $131.17       $49.55       $26.23
   0198  Pregnancy and Neonatal      T                               1.42       $72.20       $33.03       $14.44
          Care Procedures.
   0199  Vaginal Delivery..........  T                               4.20      $213.54       $59.79       $42.71
   0200  Therapeutic Abortion......  T                              13.74      $698.57      $373.23      $139.71
   0201  Spontaneous Abortion......  T                              14.89      $757.04      $329.65      $151.41
   0202  Level VIII Female           T                              39.56    $2,011.31      $864.86      $402.26
          Reproductive Proc.
   0203  Level V Nerve Injections..  T                               7.62      $387.42      $166.59       $77.48
   0204  Level VI Nerve Injections.  T                               2.44      $124.05       $47.14       $24.81
   0206  Level III Nerve Injections  T                               3.88      $197.27       $82.85       $39.45
   0207  Level IV Nerve Injections.  T                               4.13      $209.98       $94.49       $42.00
   0208  Laminotomies and            T                              30.93    $1,572.54      $314.51      $314.51
          Laminectomies.
   0209  Extended EEG Studies and    S                              11.73      $596.38      $310.12      $119.28
          Sleep Studies, Level II.
   0212  Level II Nervous System     T                               4.17      $212.01       $88.78       $42.40
          Injections.
   0213  Extended EEG Studies and    S                               2.95      $149.98       $77.99       $30.00
          Sleep Studies, Level I.
   0214  Electroencephalogram......  S                               2.27      $115.41       $57.71       $23.08
   0215  Level I Nerve and Muscle    S                               0.66       $33.56       $17.45        $6.71
          Tests.
   0216  Level III Nerve and Muscle  S                               2.91      $147.95       $64.69       $29.59
          Tests.
   0218  Level II Nerve and Muscle   S                               1.09       $55.42       $23.83       $11.08
          Tests.
   0220  Level I Nerve Procedures..  T                              14.76      $750.43      $326.21      $150.09
   0221  Level II Nerve Procedures.  T                              22.68    $1,153.10      $463.62      $230.62
   0222  Implantation of             T                             112.50    $5,719.73    $2,688.27    $1,143.95
          Neurological Device.

[[Page 44723]]

 
   0223  Implantation of Pain        T                               8.87      $450.97      $154.27       $90.19
          Management Device.
   0224  Implantation of Reservoir/  T                              29.95    $1,522.72      $453.41      $304.54
          Pump/Shunt.
   0225  Implantation of             T                              33.75    $1,715.92      $408.33      $343.18
          Neurostimulator
          Electrodes.
   0226  Implantation of Drug        T                               8.91      $453.00      $109.42       $90.60
          Infusion Reservoir.
   0227  Implantation of Drug        T                              94.89    $4,824.40      $964.88      $964.88
          Infusion Device.
   0228  Creation of Lumbar          T                              47.98    $2,439.40      $696.46      $487.88
          Subarachnoid Shunt.
   0229  Transcatherter Placement    T                              60.07    $3,054.08      $996.86      $610.82
          of Intravascular Shunts.
   0230  Level I Eye Tests &         S                               0.64       $32.54       $14.97        $6.51
          Treatments.
   0231  Level III Eye Tests &       S                               2.27      $115.41       $51.94       $23.08
          Treatments.
   0232  Level I Anterior Segment    T                               3.69      $187.61       $82.55       $37.52
          Eye Procedures.
   0233  Level II Anterior Segment   T                              11.78      $598.92      $287.48      $119.78
          Eye Procedures.
   0234  Level III Anterior Segment  T                              20.56    $1,045.31      $502.16      $209.06
          Eye Procedures.
   0235  Level I Posterior Segment   T                               5.39      $274.04       $78.91       $54.81
          Eye Procedures.
   0236  Level II Posterior Segment  T                              17.75      $902.45      $180.49      $180.49
          Eye Procedures.
   0237  Level III Posterior         T                              33.56    $1,706.26      $852.68      $341.25
          Segment Eye Procedures.
   0238  Level I Repair and Plastic  T                               2.84      $144.39       $58.96       $28.88
          Eye Procedures.
   0239  Level II Repair and         T                               6.25      $317.76      $123.42       $63.55
          Plastic Eye Procedures.
   0240  Level III Repair and        T                              14.86      $755.51      $315.31      $151.10
          Plastic Eye Procedures.
   0241  Level IV Repair and         T                              19.20      $976.17      $384.47      $195.23
          Plastic Eye Procedures.
   0242  Level V Repair and Plastic  T                              25.31    $1,286.81      $597.36      $257.36
          Eye Procedures.
   0243  Strabismus/Muscle           T                              19.22      $977.18      $431.39      $195.44
          Procedures.
   0244  Corneal Transplant........  T                              41.43    $2,106.38      $851.42      $421.28
   0245  Level I Cataract            T                              10.75      $546.55      $256.88      $109.31
          Procedures without IOL
          Insert.
   0246  Cataract Procedures with    T                              22.36    $1,136.83      $534.31      $227.37
          IOL Insert.
   0247  Laser Eye Procedures        T                               4.73      $240.48      $110.62       $48.10
          Except Retinal.
   0248  Laser Retinal Procedures..  T                               4.15      $210.99       $94.05       $42.20
   0249  Level II Cataract           T                              23.51    $1,195.30      $561.79      $239.06
          Procedures without IOL
          Insert.
   0250  Nasal Cauterization/        T                               2.27      $115.41       $38.54       $23.08
          Packing.
   0251  Level I ENT Procedures....  T                               2.71      $137.78       $27.99       $27.56
   0252  Level II ENT Procedures...  T                               6.53      $332.00      $114.24       $66.40
   0253  Level III ENT Procedures..  T                              13.27      $674.67      $284.00      $134.93
   0254  Level IV ENT Procedures...  T                              19.11      $971.59      $272.41      $194.32
   0256  Level V ENT Procedures....  T                              28.82    $1,465.27      $623.05      $293.05
   0258  Tonsil and Adenoid          T                              18.86      $958.88      $462.81      $191.78
          Procedures.
   0259  Level VI ENT Procedures...  T                             306.15   $15,565.28    $6,537.42    $3,113.06
   0260  Level I Plain Film Except   X                               0.76       $38.64       $21.25        $7.73
          Teeth.
   0261  Level II Plain Film Except  X                               1.31       $66.60       $36.63       $13.32
          Teeth Including Bone
          Density Measurement.
   0262  Plain Film of Teeth.......  X                               0.66       $33.56       $10.90        $6.71
   0263  Level I Miscellaneous       X                               1.74       $88.47       $45.88       $17.69
          Radiology Procedures.
   0264  Level II Miscellaneous      X                               2.51      $127.61       $70.19       $25.52
          Radiology Procedures.
   0265  Level I Diagnostic          S                               1.02       $51.86       $28.52       $10.37
          Ultrasound Except
          Vascular.
   0266  Level II Diagnostic         S                               1.67       $84.91       $46.70       $16.98
          Ultrasound Except
          Vascular.
   0267  Vascular Ultrasound.......  S                               2.58      $131.17       $72.14       $26.23
   0269  Level I Echocardiogram      S                               4.31      $219.13      $113.95       $43.83
          Except Transesophageal.
   0270  Transesophageal             S                               5.83      $296.41      $150.26       $59.28
          Echocardiogram.
   0271  Mammography...............  S                               0.64       $32.54       $17.90        $6.51
   0272  Level I Fluoroscopy.......  X                               1.47       $74.74       $39.00       $14.95
   0274  Myelography...............  S                               5.69      $289.29      $128.12       $57.86
   0275  Arthrography..............  S                               2.82      $143.37       $72.26       $28.67
   0276  Level I Digestive           S                               1.63       $82.87       $45.58       $16.57
          Radiology.
   0277  Level II Digestive          S                               2.35      $119.48       $65.71       $23.90
          Radiology.
   0278  Diagnostic Urography......  S                               2.56      $130.16       $71.59       $26.03
   0279  Level I Angiography and     S                               8.37      $425.55      $174.57       $85.11
          Venography except
          Extremity.
   0280  Level II Angiography and    S                              14.40      $732.12      $373.38      $146.42
          Venography except
          Extremity.
   0281  Venography of Extremity...  S                               4.64      $235.91      $115.16       $47.18
   0282  Miscellaneous Computerized  S                               1.63       $82.87       $45.58       $16.57
          Axial Tomography.
   0283  Computerized Axial          S                               4.89      $248.62      $136.74       $49.72
          Tomography with Contrast
          Material.
   0284  Magnetic Resonance Imaging  S                               7.80      $396.57      $218.11       $79.31
          and Magnetic Resonance
          Angiography with Contrast
          Material.
   0285  Positron Emission           S                              20.07    $1,020.40      $415.21      $204.08
          Tomography (PET).
   0286  Myocardial Scans..........  S                               5.85      $297.43      $163.58       $59.49
   0287  Complex Venography........  S                               4.33      $220.15       $90.26       $44.03
   0288  CT, Bone Density..........  S                               1.27       $64.57       $35.51       $12.91
   0289  Needle Localization for     X                               1.22       $62.03       $32.25       $12.41
          Breast Biopsy.
   0290  Standard Non-Imaging        S                               1.91       $97.11       $53.41       $19.42
          Nuclear Medicine.
   0291  Level I Diagnostic Nuclear  S                               3.78      $192.18       $90.20       $38.44
          Medicine Excluding
          Myocardial Scans.
   0292  Level II Diagnostic         S                               4.56      $231.84      $124.85       $46.37
          Nuclear Medicine
          Excluding Myocardial
          Scans.
   0294  Level I Therapeutic         S                               5.45      $277.09      $144.06       $55.42
          Nuclear Medicine.
   0295  Level II Therapeutic        S                              13.97      $710.26      $390.64      $142.05
          Nuclear Medicine.
   0296  Level I Therapeutic         S                               3.52      $178.96       $98.43       $35.79
          Radiologic Procedures.
   0297  Level II Therapeutic        S                               7.80      $396.57      $172.51       $79.31
          Radiologic Procedures.
   0300  Level I Radiation Therapy.  S                               2.25      $114.39       $47.72       $22.88
   0301  Level II Radiation Therapy  S                               5.85      $297.43       $59.49       $59.49
   0302  Level III Radiation         S                              11.96      $608.07      $216.55      $121.61
          Therapy.
   0303  Treatment Device            X                               3.98      $202.35       $69.28       $40.47
          Construction.
   0304  Level I Therapeutic         X                               1.80       $91.52       $41.52       $18.30
          Radiation Treatment
          Preparation.
   0305  Level II Therapeutic        X                               4.40      $223.70       $97.50       $44.74
          Radiation Treatment
          Preparation.
   0310  Level III Therapeutic       X                              17.14      $871.43      $339.05      $174.29
          Radiation Treatment
          Preparation.

[[Page 44724]]

 
   0312  Radioelement Applications.  S                               7.77      $395.04      $109.65       $79.01
   0313  Brachytherapy.............  S                              16.31      $829.23      $165.85      $165.85
   0314  Hyperthermic Therapies....  S                               5.16      $262.34      $133.80       $52.47
   0320  Electroconvulsive Therapy.  S                               4.20      $213.54       $80.06       $42.71
   0321  Biofeedback and Other       S                               1.02       $51.86       $23.86       $10.37
          Training.
   0322  Brief Individual            S                               1.25       $63.55       $13.35       $12.71
          Psychotherapy.
   0323  Extended Individual         S                               1.89       $96.09       $22.48       $19.22
          Psychotherapy.
   0324  Family Psychotherapy......  S                               3.13      $159.14       $31.83       $31.83
   0325  Group Psychotherapy.......  S                               1.49       $75.75       $19.70       $15.15
   0330  Dental Procedures.........  S                               7.68      $390.47       $78.09       $78.09
   0332  Computerized Axial          S                               3.51      $178.46       $98.15       $35.69
          Tomography and
          Computerized Angiography
          without Contrast Material.
   0333  Computerized Axial          S                               5.66      $287.77      $158.27       $57.55
          Tomography and
          Computerized Angiography
          without Contrast Material
          followed by Contrast
          Material.
   0335  Magnetic Resonance          S                               5.91      $300.48      $165.26       $60.10
          Imaging, Miscellaneous.
   0336  Magnetic Resonance Imaging  S                               6.85      $348.27      $191.55       $69.65
          and Magnetic Resonance
          Angiography without
          Contrast Material.
   0337  Magnetic Resonance Imaging  S                               9.26      $470.80      $258.94       $94.16
          and Magnetic Resonance
          Angiography without
          Contrast Material
          followed by Contrast
          Material.
   0339  Observation...............  X                               7.38      $375.21  ...........       $75.04
   0340  Minor Ancillary Procedures  X                               0.91       $46.27       $11.57        $9.25
   0341  Immunology Tests..........  X                               0.11        $5.59        $3.08        $1.12
   0342  Level I Pathology.........  X                               0.22       $11.19        $6.15        $2.24
   0343  Level II Pathology........  X                               0.42       $21.35       $11.53        $4.27
   0344  Level III Pathology.......  X                               0.60       $30.51       $16.78        $6.10
   0345  Level I Transfusion         X                               0.29       $14.74        $5.37        $2.95
          Laboratory Procedures.
   0346  Level II Transfusion        X                               0.83       $42.20       $12.03        $8.44
          Laboratory Procedures.
   0347  Level III Transfusion       X                               1.73       $87.96       $20.13       $17.59
          Laboratory Procedures.
   0348  Fertility Laboratory        X                               0.85       $43.22        $8.64        $8.64
          Procedures.
   0349  Miscellaneous Laboratory    X                               0.34       $17.29        $3.46        $3.46
          Procedures.
   0352  Level II Injections.......  X                               0.45       $22.88        $4.58        $4.58
   0353  Level II Allergy            X                               0.27       $13.73        $2.75        $2.75
          Injections.
   0354  Administration of           K                               0.11        $5.59  ...........  ...........
          Influenza/Pneumonia
          Vaccine.
   0355  Level I Immunizations.....  K                               0.20       $10.17  ...........        $2.03
   0356  Level II Immunizations....  K                               1.20       $61.01  ...........       $12.20
   0359  Level II Injections.......  X                               1.91       $97.11       $19.42       $19.42
   0360  Level I Alimentary Tests..  X                               1.40       $71.18       $34.75       $14.24
   0361  Level II Alimentary Tests.  X                               3.52      $178.96       $88.09       $35.79
   0362  Fitting of Vision Aids....  X                               0.83       $42.20        $9.63        $8.44
   0363  Otorhinolaryngologic        X                               2.06      $104.73       $38.75       $20.95
          Function Tests.
   0364  Level I Audiometry........  X                               0.55       $27.96       $10.91        $5.59
   0365  Level II Audiometry.......  X                               1.42       $72.20       $21.66       $14.44
   0367  Level I Pulmonary Test....  X                               0.76       $38.64       $19.32        $7.73
   0368  Level II Pulmonary Tests..  X                               1.53       $77.79       $39.67       $15.56
   0369  Level III Pulmonary Tests.  X                               3.99      $202.86       $58.50       $40.57
   0370  Allergy Tests.............  X                               0.87       $44.23       $11.81        $8.85
   0371  Level I Allergy Injections  X                               0.76       $38.64        $7.73        $7.73
   0372  Therapeutic Phlebotomy....  X                               0.57       $28.98       $10.09        $5.80
   0373  Neuropsychological Testing  X                               1.11       $56.43       $15.80       $11.29
   0374  Monitoring Psychiatric      X                               0.96       $48.81       $10.74        $9.76
          Drugs.
   0600  Low Level Clinic Visits...  V                               0.93       $47.28        $9.46        $9.46
   0601  Mid Level Clinic Visits...  V                               1.02       $51.86       $10.37       $10.37
   0602  High Level Clinic Visits..  V                               1.49       $75.75       $15.15       $15.15
   0610  Low Level Emergency Visits  V                               1.34       $68.13       $20.65       $13.63
   0611  Mid Level Emergency Visits  V                               2.33      $118.46       $36.47       $23.69
   0612  High Level Emergency        V                               3.75      $190.66       $54.14       $38.13
          Visits.
   0620  Critical Care.............  S                               9.13      $464.19      $152.78       $92.84
   0689  Electronic Analysis of      S                               0.49       $24.91       $13.70        $4.98
          Cardioverter-
          defibrillators.
   0690  Electronic Analysis of      S                               0.40       $20.34       $11.19        $4.07
          Pacemakers and other
          Cardiac Devices.
   0691  Electronic Analysis of      S                               3.36      $170.83       $93.96       $34.17
          Programmable Shunts/Pumps.
   0692  Electronic Analysis of      S                               1.73       $87.96       $48.38       $17.59
          Neurostimulator Pulse
          Generators.
   0693  Level II Breast             T                              33.16    $1,685.92      $826.10      $337.18
          Reconstruction.
   0694  Level III Excision/Biopsy.  T                               4.28      $217.60       $65.28       $43.52
   0695  Level VII Debridement &     T                              17.06      $867.36      $398.99      $173.47
          Destruction.
   0697  Level II Echocardiogram     S                               2.00      $101.68       $52.88       $20.34
          Except Transesophageal.
   0698  Level II Eye Tests &        S                               1.09       $55.42       $24.94       $11.08
          Treatments.
   0699  Level IV Eye Tests &        T                               6.91      $351.32      $158.09       $70.26
          Treatment.
   0701  SR 89 chloride, per mCi...  G                        ...........      $963.42  ...........      $137.92
   0702  SM 153 lexidronam, 50 mCi.  G                        ...........    $1,020.00  ...........      $146.02
   0704  IN 111 Satumomab pendetide  G                        ...........      $831.25  ...........      $119.00
          per dose.
   0705  TC 99M tetrofosmin, per     G                        ...........      $129.96  ...........       $18.60
          dose.
   0725  Leucovorin calcium inj, 50  G                        ...........        $4.98  ...........         $.45
          mg.
   0726  Dexrazoxane hcl injection,  G                        ...........      $194.53  ...........       $27.85
          250 mg.
   0727  Etidronate disodium inj     G                        ...........       $63.65  ...........        $9.11
          300 mg.
   0728  Filgrastim 300 mcg          G                        ...........      $179.08  ...........       $25.64
          injection.
   0730  Pamidronate disodium , 30   G                        ...........      $253.68  ...........       $32.58
          mg.
   0731  Sargramostim injection 50   G                        ...........       $29.06  ...........        $4.16
          mcg.
   0732  Mesna injection 200 mg....  G                        ...........       $40.44  ...........        $5.79

[[Page 44725]]

 
   0733  Non esrd epoetin alpha      G                        ...........       $11.85  ...........        $1.52
          inj, 1000 u.
   0750  Dolasetron mesylate, 10 mg  G                        ...........       $16.45  ...........        $2.11
   0754  Metoclopramide hcl          G                        ...........        $1.55  ...........         $.20
          injection up to 10 mg.
   0755  Thiethylperazine maleate    G                        ...........        $5.43  ...........         $.70
          inj up to 10 mg.
   0762  Dronabinol 2.5mg oral.....  G                        ...........        $3.28  ...........         $.42
   0763  Dolasetron mesylate oral,   G                        ...........       $69.64  ...........        $8.94
          100 mg.
   0764  Granisetron hcl injection   G                        ...........       $18.54  ...........        $2.38
          10 mcg.
   0765  Granisetron hcl 1 mg oral.  G                        ...........       $44.70  ...........        $5.74
   0768  Ondansetron hcl injection   G                        ...........        $3.92  ...........         $.50
          1 mg.
   0769  Ondansetron hcl 8mg oral..  G                        ...........       $25.15  ...........        $3.23
   0800  Leuprolide acetate, 3.75    G                        ...........       $81.60  ...........        $7.39
          mg.
   0801  Cyclophosphamide oral 25    G                        ...........        $2.23  ...........         $.32
          mg.
   0802  Etoposide oral 50 mg......  G                        ...........       $50.89  ...........        $7.29
   0803  Melphalan oral 2 mg.......  G                        ...........        $2.18  ...........         $.31
   0807  Aldesleukin/single use      G                        ...........      $641.25  ...........       $91.80
          vial.
   0809  Bcg live intravesical vac.  G                        ...........      $166.44  ...........       $21.37
   0810  Goserelin acetate implant   G                        ...........      $446.49  ...........       $63.92
          3.6 mg.
   0811  Carboplatin injection 50    G                        ...........      $111.11  ...........       $15.91
          mg.
   0812  Carmus bischl nitro inj     G                        ...........      $114.41  ...........       $16.38
          100 mg.
   0813  Cisplatin 10 mg injection.  G                        ...........       $47.12  ...........        $6.75
   0814  Asparaginase injection      G                        ...........       $59.70  ...........        $8.55
          10,000 u.
   0815  Cyclophosphamide 100 mg     G                        ...........        $5.98  ...........         $.77
          inj.
   0816  Cyclophosphamide            G                        ...........        $6.13  ...........         $.79
          lyophilized 100 mg.
   0817  Cytarabine hcl 100 mg inj.  G                        ...........        $4.75  ...........         $.43
   0818  Dactinomycin 0.5 mg.......  G                        ...........       $13.23  ...........        $1.89
   0819  Dacarbazine 100 mg inj....  G                        ...........       $11.28  ...........        $1.02
   0820  Daunorubicin 10 mg........  G                        ...........       $76.62  ...........        $6.94
   0821  Daunorubicin citrate        G                        ...........       $64.60  ...........        $9.25
          liposom 10 mg.
   0822  Diethylstilbestrol          G                        ...........        $3.99  ...........         $.57
          injection 250 mg.
   0823  Docetaxel, 20 mg..........  G                        ...........      $297.83  ...........       $42.64
   0824  Etoposide 10 mg inj.......  G                        ...........        $3.86  ...........         $.35
   0826  Methotrexate Oral 2.5 mg..  G                        ...........        $2.73  ...........         $.25
   0827  Floxuridine injection 500   G                        ...........      $129.56  ...........       $11.73
          mg.
   0828  Gemcitabine HCL 200 mg....  G                        ...........      $102.13  ...........       $14.62
   0830  Irinotecan injection 20 mg  G                        ...........      $125.47  ...........       $17.96
   0831  Ifosfomide injection 1 gm.  G                        ...........      $156.65  ...........       $22.43
   0832  Idarubicin hcl injection 5  G                        ...........      $412.21  ...........       $59.01
          mg.
   0833  Interferon alfacon-1, 1     G                        ...........        $4.10  ...........         $.59
          mcg.
   0834  Interferon alfa-2a inj      G                        ...........       $34.87  ...........        $4.99
          recombinant 3 million u.
   0836  Interferon alfa-2b inj      G                        ...........       $12.98  ...........        $1.67
          recombinant, 1 million.
   0838  Interferon gamma 1-b inj,   G                        ...........      $285.64  ...........       $40.89
          3 million u.
   0839  Mechlorethamine hcl inj 10  G                        ...........       $11.88  ...........        $1.70
          mg.
   0840  Melphalan hydrochl 50 mg..  G                        ...........      $381.65  ...........       $54.64
   0841  Methotrexate sodium inj 5   G                        ...........         $.41  ...........         $.04
          mg.
   0842  Fludarabine phosphate inj   G                        ...........      $258.88  ...........       $37.06
          50 mg.
   0843  Pegaspargase, singl dose    G                        ...........    $1,255.57  ...........      $179.74
          vial.
   0844  Pentostatin injection, 10   G                        ...........    $1,654.14  ...........      $236.80
          mg.
   0847  Doxorubicin hcl 10 mg vl    G                        ...........        $9.00  ...........        $1.29
          chemo.
   0849  Rituximab, 100 mg.........  G                        ...........      $454.55  ...........       $65.07
   0850  Streptozocin injection, 1   G                        ...........      $117.64  ...........       $16.84
          gm.
   0851  Thiotepa injection, 15 mg.  G                        ...........      $116.97  ...........       $16.75
   0852  Topotecan, 4 mg...........  G                        ...........      $632.56  ...........       $90.56
   0853  Vinblastine sulfate inj, 1  G                        ...........        $4.11  ...........         $.37
          mg.
   0854  Vincristine sulfate 1 mg    G                        ...........       $30.16  ...........        $2.73
          inj.
   0855  Vinorelbine tartrate, 10    G                        ...........       $79.28  ...........       $11.35
          mg.
   0856  Porfimer sodium, 75 mg....  G                        ...........    $2,603.67  ...........      $372.74
   0857  Bleomycin sulfate           G                        ...........      $289.37  ...........       $41.43
          injection 15 u.
   0858  Cladribine, 1mg...........  G                        ...........       $56.08  ...........        $8.03
   0859  Fluorouracil injection 500  G                        ...........        $1.48  ...........         $.13
          mg.
   0860  Plicamycin (mithramycin)    G                        ...........       $93.80  ...........       $13.43
          inj 2.5 mg.
   0861  Leuprolide acetate          G                        ...........       $26.15  ...........        $2.37
          injection 1 mg.
   0862  Mitomycin 5 mg inj........  G                        ...........      $121.65  ...........       $11.01
   0863  Paclitaxel injection, 30    G                        ...........      $164.08  ...........       $21.07
          mg.
   0864  Mitoxantrone hcl, 5 mg....  G                        ...........      $244.20  ...........       $34.96
   0865  Interferon alfa-n3 inj,     G                        ...........        $7.86  ...........        $1.12
          human leukocyte derived,
          250,000 iu.
   0884  Rho d immune globulin inj,  G                        ...........       $34.11  ...........        $4.38
          1 dose pkg.
   0886  Azathioprine oral 50mg....  G                        ...........        $1.24  ...........         $.16
   0887  Azathioprine parenteral     G                        ...........         $.75  ...........         $.10
          100 mg.
   0888  Cyclosporine oral 100 mg..  G                        ...........        $5.23  ...........         $.47
   0889  Cyclosporin parenteral      G                        ...........       $25.08  ...........        $2.27
          250mg.
   0890  Lymphocyte immune globulin  G                        ...........      $249.47  ...........       $32.04
          250 mg.
   0891  Tacrolimus oral per 1 mg..  G                        ...........        $2.91  ...........         $.42
   0900  Alglucerase injection, per  G                        ...........       $37.53  ...........        $5.37
          10 u.
   0901  Alpha 1 proteinase          G                        ...........        $2.09  ...........         $.30
          inhibitor, 10 mg.
   0902  Botulinum toxin a, per      G                        ...........        $4.39  ...........         $.56
          unit.
   0903  Cytomegalovirus imm IV, 50  G                        ...........      $656.27  ...........       $84.28
          mg.
   0905  Immune globulin 500 mg....  G                        ...........       $25.92  ...........        $3.33
   0906  RSV-ivig, 50 mg...........  G                        ...........      $406.34  ...........       $58.17

[[Page 44726]]

 
   0907  Ganciclovir Sodium 500 mg   K                               0.46       $23.39  ...........        $4.51
          injection.
   0908  Tetanus immune globulin     G                        ...........      $102.60  ...........       $14.69
          inj up to 250 u.
   0909  Interferon beta-1a, 33 mcg  G                        ...........      $225.23  ...........       $32.24
   0910  Interferon beta-1b , .25    G                        ...........       $54.15  ...........        $7.75
          mg.
   0911  Streptokinase per 250,000   K                               1.80       $91.52  ...........       $17.68
          iu.
   0913  Ganciclovir long act        G                        ...........    $4,750.00  ...........      $680.00
          implant 4.5 mg.
   0916  Imiglucerase, unit........  G                        ...........        $3.75  ...........         $.54
   0917  Pharmacologic stressors...  K                               0.37       $18.81  ...........        $3.62
   0925  Factor viii per iu........  G                        ...........         $.87  ...........         $.11
   0926  Factor VIII (porcine) per   G                        ...........        $2.09  ...........         $.30
          iu.
   0927  Factor viii recombinant     G                        ...........        $1.19  ...........         $.15
          per iu.
   0928  Factor ix complex per iu..  G                        ...........         $.68  ...........         $.09
   0929  Anti-inhibitor per iu.....  G                        ...........        $1.43  ...........         $.18
   0930  Antithrombin iii injection  G                        ...........        $1.05  ...........         $.15
          per iu.
   0931  Factor IX non-recombinant,  G                        ...........         $.76  ...........         $.10
          per iu.
   0932  Factor IX recombinant, per  G                        ...........        $1.12  ...........         $.16
          iu.
   0949  Plasma, Pooled Multiple     K                               3.00      $152.53  ...........       $30.51
          Donor, Solvent/Detergent
          Treated, Frozen.
   0950  Blood (Whole) For           K                               2.13      $108.29  ...........       $21.66
          Transfusion.
   0952  Cryoprecipitate...........  K                               0.72       $36.61  ...........        $7.32
   0954  RBC leukocytes reduced....  K                               2.89      $146.93  ...........       $29.39
   0955  Plasma, Fresh Frozen......  K                               2.31      $117.45  ...........       $23.49
   0956  Plasma Protein Fraction...  K                               1.29       $65.59  ...........       $13.12
   0957  Platelet Concentrate......  K                               1.00       $50.84  ...........       $10.17
   0958  Platelet Rich Plasma......  K                               1.19       $60.50  ...........       $12.10
   0959  Red Blood Cells...........  K                               2.09      $106.26  ...........       $21.25
   0960  Washed Red Blood Cells....  K                               3.89      $197.78  ...........       $39.56
   0961  Infusion, Albumin (Human)   K                               2.24      $113.89  ...........       $22.78
          5%, 50 ml.
   0962  Infusion, Albumin (Human)   K                               1.12       $56.94  ...........       $11.39
          25%, 10 ml.
   0970  New Technology - Level I    T                               0.47       $23.90  ...........        $4.78
          ($0 - $50).
   0971  New Technology - Level II   S                               1.42       $72.20  ...........       $14.44
          ($50 - $100).
   0972  New Technology - Level III  T                               2.84      $144.39  ...........       $28.88
          ($100 - $200).
   0973  New Technology - Level IV   T                               4.73      $240.48  ...........       $48.10
          ($200 - $300).
   0974  New Technology - Level V    S                               7.57      $384.87  ...........       $76.97
          ($300 - $500).
   0975  New Technology - Level VI   T                              11.83      $601.46  ...........      $120.29
          ($500 - $750).
   0976  New Technology - Level VII  S                              16.56      $841.94  ...........      $168.39
          ($750 - $1000).
   0977  New Technology - Level      T                              21.30    $1,082.93  ...........      $216.59
          VIII ($1000 - $1250).
   0978  New Technology - Level IX   T                              26.03    $1,323.42  ...........      $264.68
          ($1250 - $1500).
   0979  New Technology - Level X    T                              30.76    $1,563.90  ...........      $312.78
          ($1500 - $1750).
   0980  New Technology - Level XI   T                              35.49    $1,804.38  ...........      $360.88
          ($1750 - $2000).
   0981  New Technology - Level XII  S                              42.59    $2,165.36  ...........      $433.07
          ($2000 - $2500).
   0982  New Technology - Level      T                              52.06    $2,646.83  ...........      $529.37
          XIII ($2500 - $3000).
   0983  New Technology-Level XIV    T                              61.52    $3,127.80  ...........  ...........
          ($3000- $3500).
   0984  New Technology - Level XV   T                              80.45    $4,090.24  ...........      $818.05
          ($3500 - $5000).
   0985  New Technology - Level XVI  T                             104.11    $5,293.16  ...........    $1,058.63
          ($5000 - $6000).
   1002  Cochlear Implant System...  H                        ...........  ...........  ...........  ...........
   1009  Cryoprecip reduced plasma.  K                               0.88       $44.74  ...........        $8.95
   1010  Blood, L/R, CMV-neg.......  K                               2.94      $149.48  ...........       $29.90
   1011  Platelets, HLA-m, L/R,      K                              12.12      $616.21  ...........      $123.24
          unit.
   1012  Platelet concentrate, L/R,  K                               1.96       $99.65  ...........       $19.93
          irradiated, unit.
   1013  Platelet concentrate, L/R,  K                               1.20       $61.01  ...........       $12.20
          unit.
   1014  Platelets, aph/pher, L/R,   K                               9.13      $464.19  ...........       $92.84
          unit.
   1016  Blood, L/R, froz/           K                               7.31      $371.66  ...........       $74.33
          deglycerol/washed.
   1017  Platelets, aph/pher, L/R,   K                               9.53      $484.52  ...........       $96.90
          CMV-neg, unit.
   1018  Blood, L/R, irradiated....  K                               3.20      $162.69  ...........       $32.54
   1019  Platelets, aph/pher, L/R,   K                               9.85      $500.79  ...........      $100.16
          irradiated, unit.
   1024  Quinupristin/dalfopristin.  G                        ...........      $102.05  ...........       $14.61
   1045  Iobenguane sulfate i-131..  G                        ...........      $495.65  ...........       $44.87
   1059  Cultured chondrocytes       G                        ...........   $14,250.00  ...........    $2,040.00
          implnt.
   1079  CO 57/58 0.5 mCi..........  G                        ...........      $253.84  ...........       $36.34
   1084  Denileukin diftitox, 300    G                        ...........      $999.88  ...........      $143.14
          MCG.
   1086  Temozolomide,oral 5 mg....  G                        ...........        $5.93  ...........         $.85
   1087  I-123 per uci, dx use.....  G                        ...........         $.65  ...........         $.09
   1089  Cyanocobalamin cobalt co57  G                        ...........       $97.85  ...........       $14.01
   1090  IN 111 Chloride, per mCi..  G                        ...........      $152.00  ...........       $21.76
   1091  IN 111 Oxyquinoline, per 5  G                        ...........      $482.84  ...........       $69.12
          mCi.
   1092  IN 111 Pentetate, per 1.5   G                        ...........      $769.50  ...........      $110.16
          mCi.
   1094  TC 99M Albumin aggr, per    G                        ...........       $33.09  ...........        $4.74
          vial.
   1095  TC 99M Depreotide, per      G                        ...........      $760.00  ...........      $108.80
          vial.
   1096  TC 99M Exametazime, per     G                        ...........      $423.04  ...........       $60.56
          dose.
   1097  TC 99M Mebrofenin, per      G                        ...........       $51.43  ...........        $7.36
          vial.
   1098  TC 99M Pentetate, per vial  G                        ...........       $22.64  ...........        $2.76
   1099  TC 99M Pyrophosphate, per   G                        ...........       $42.75  ...........        $6.12
          vial.
   1122  TC 99M arcitumomab, per     G                        ...........    $1,235.00  ...........      $176.80
          vial.
   1166  Cytarabine liposomal, 10    G                        ...........      $371.45  ...........       $53.18
          mg.
   1167  Epirubicin hcl, 2 mg......  G                        ...........       $24.94  ...........        $3.57
   1178  Busulfan IV, 6 mg.........  G                        ...........       $26.49  ...........        $3.79
   1188  I-131 per uci, dx use.....  G                        ...........         $.78  ...........         $.10
   1200  TC 99M Sodium               G                        ...........      $107.40  ...........       $15.37
          Glucoheptonate, per vial.

[[Page 44727]]

 
   1201  TC 99M succimer, per vial.  G                        ...........      $135.66  ...........       $19.42
   1202  TC 99M Sulfur Colloid, per  G                        ...........       $36.10  ...........        $3.27
          dose.
   1203  Verteporfin for injection.  G                        ...........    $1,458.25  ...........      $208.76
   1205  Technetium tc99m disofenin  G                        ...........       $85.50  ...........        $7.74
   1207  Octreotide acetate depot    G                        ...........      $140.37  ...........       $20.10
          1mg.
   1305  Apligraf..................  G                        ...........    $1,157.81  ...........      $165.75
   1348  I-131 per mci sol, rx use.  G                        ...........      $146.57  ...........       $20.98
   1400  Diphenhydramine hcl 50mg..  G                        ...........         $.12  ...........         $.01
   1401  Prochlorperazine maleate    G                        ...........         $.57  ...........         $.05
          5mg.
   1402  Promethazine hcl 12.5mg     G                        ...........         $.03  ...........         $.00
          oral.
   1403  Chlorpromazine hcl 10mg     G                        ...........         $.07  ...........         $.01
          oral.
   1404  Trimethobenzamide hcl       G                        ...........         $.36  ...........         $.03
          250mg.
   1405  Thiethylperazine            G                        ...........         $.56  ...........         $.08
          maleate10mg.
   1406  Perphenazine 4mg oral.....  G                        ...........         $.62  ...........         $.06
   1407  Hydroxyzine pamoate 25mg..  G                        ...........         $.20  ...........         $.02
   1409  Factor viia recombinant,    G                        ...........    $1,596.00  ...........      $228.48
          per 1.2 mg.
   1600  TC 99M sestamibi, per       G                        ...........      $115.90  ...........       $16.59
          syringe.
   1601  TC 99M medronate, per dose  G                        ...........       $36.46  ...........        $3.30
   1602  TC 99M apcitide, per vial.  G                        ...........       $45.13  ...........        $6.46
   1603  TL 201, mCi...............  G                        ...........       $29.45  ...........        $3.78
   1604  IN 111 capromab pendetide,  G                        ...........    $1,128.13  ...........      $161.50
          per dose.
   1605  Abciximab injection, 10 mg  G                        ...........      $513.02  ...........       $73.44
   1606  Anistreplase, 30 u........  G                        ...........    $2,559.11  ...........      $366.36
   1607  Eptifibatide injection, 5   G                        ...........       $13.58  ...........        $1.94
          mg.
   1608  Etanercept injection, 25    G                        ...........      $140.98  ...........       $20.18
          mg.
   1609  Rho(D) immune globulin h,   G                        ...........       $20.64  ...........        $2.65
          sd, 100 iu.
   1611  Hylan G-F 20 injection, 16  G                        ...........      $213.86  ...........       $30.62
          mg.
   1612  Daclizumab, parenteral, 25  G                        ...........      $397.29  ...........       $56.88
          mg.
   1613  Trastuzumab, 10 mg........  G                        ...........       $52.83  ...........        $7.56
   1614  Valrubicin, 200 mg........  G                        ...........      $423.23  ...........       $60.59
   1615  Basiliximab, 20 mg........  G                        ...........    $1,348.76  ...........      $193.09
   1616  Histrelin Acetate, 0.5 mg.  G                        ...........       $14.16  ...........        $2.03
   1617  Lepirdin, 50 mg...........  G                        ...........      $131.96  ...........       $18.89
   1618  Von Willebrand factor, per  G                        ...........         $.95  ...........         $.14
          iu.
   1619  Ga 67, per mCi............  G                        ...........       $24.38  ...........        $3.13
   1620  TC 99M Bicisate, per vial.  G                        ...........      $384.75  ...........       $55.08
   1621  Xe 133, per mCi...........  G                        ...........       $29.93  ...........        $3.84
   1622  TC 99M Mertiatide, per      G                        ...........      $176.53  ...........       $25.27
          vial.
   1623  TC 99M Gluceptate.........  G                        ...........       $22.61  ...........        $3.24
   1624  P32 sodium, per mCi.......  G                        ...........       $81.10  ...........       $11.61
   1625  IN 111 Pentetreotide, per   G                        ...........      $935.75  ...........      $133.96
          mCi.
   1626  TC 99M Oxidronate, per      G                        ...........       $36.74  ...........        $5.26
          vial.
   1627  TC-99 labeled red blood     G                        ...........       $40.90  ...........        $5.85
          cell, per test.
   1628  P32 phosphate chromic, per  G                        ...........      $150.86  ...........       $21.60
          mCi.
   1713  Anchor/screw bn/bn,tis/bn.  H                        ...........  ...........  ...........  ...........
   1714  Cath, trans atherectomy,    H                        ...........  ...........  ...........  ...........
          dir.
   1715  Brachytherapy needle......  H                        ...........  ...........  ...........  ...........
   1716  Brachytx seed, Gold 198...  H                        ...........  ...........  ...........  ...........
   1717  Brachytx seed, HDR Ir-192.  H                        ...........  ...........  ...........  ...........
   1718  Brachytx seed, Iodine 125.  H                        ...........  ...........  ...........  ...........
   1719  Brachytxseed, Non-HDR Ir-   H                        ...........  ...........  ...........  ...........
          192.
   1720  Brachytx seed, Palladium    H                        ...........  ...........  ...........  ...........
          103.
   1721  AICD, dual chamber........  H                        ...........  ...........  ...........  ...........
   1722  AICD, single chamber......  H                        ...........  ...........  ...........  ...........
   1723  Cath, ablation, non-        H                        ...........  ...........  ...........  ...........
          cardiac.
   1724  Cath, trans                 H                        ...........  ...........  ...........  ...........
          atherec,rotation.
   1725  Cath, translumin non-laser  H                        ...........  ...........  ...........  ...........
   1726  Cath, bal dil, non-         H                        ...........  ...........  ...........  ...........
          vascular.
   1727  Cath, bal tis dis, non-vas  H                        ...........  ...........  ...........  ...........
   1728  Cath, brachytx seed adm...  H                        ...........  ...........  ...........  ...........
   1729  Cath, drainage............  H                        ...........  ...........  ...........  ...........
   1730  Cath, EP, 19 or fewer       H                        ...........  ...........  ...........  ...........
          elect.
   1731  Cath, EP, 20 or more elec.  H                        ...........  ...........  ...........  ...........
   1732  Cath, EP, diag/abl, 3D/     H                        ...........  ...........  ...........  ...........
          vect.
   1733  Cath, EP, othr than cool-   H                        ...........  ...........  ...........  ...........
          tip.
   1750  Cath, hemodialysis,long-    H                        ...........  ...........  ...........  ...........
          term.
   1751  Cath, inf, per/cent/        H                        ...........  ...........  ...........  ...........
          midline.
   1752  Cath, hemodialysis,short-   H                        ...........  ...........  ...........  ...........
          term.
   1753  Cath, intravas ultrasound.  H                        ...........  ...........  ...........  ...........
   1754  Catheter, intradiscal.....  H                        ...........  ...........  ...........  ...........
   1755  Catheter, intraspinal.....  H                        ...........  ...........  ...........  ...........
   1756  Cath, pacing, transesoph..  H                        ...........  ...........  ...........  ...........
   1757  Cath, thrombectomy/         H                        ...........  ...........  ...........  ...........
          embolect.
   1758  Cath, ureteral............  H                        ...........  ...........  ...........  ...........
   1759  Cath, intra                 H                        ...........  ...........  ...........  ...........
          echocardiography.
   1760  Closure dev, vasc, imp/     H                        ...........  ...........  ...........  ...........
          insert.
   1762  Conn tiss, human (inc       H                        ...........  ...........  ...........  ...........
          fascia).
   1763  Conn tiss, non-human......  H                        ...........  ...........  ...........  ...........

[[Page 44728]]

 
   1764  Event recorder, cardiac...  H                        ...........  ...........  ...........  ...........
   1765  Adhesion barrier..........  H                        ...........  ...........  ...........  ...........
   1766  Intro/sheath,strble,non-    H                        ...........  ...........  ...........  ...........
          peel.
   1767  Generator, neurostim, imp.  H                        ...........  ...........  ...........  ...........
   1768  Graft, vascular...........  H                        ...........  ...........  ...........  ...........
   1769  Guide wire................  H                        ...........  ...........  ...........  ...........
   1770  Imaging coil, MR,           H                        ...........  ...........  ...........  ...........
          insertable.
   1771  Rep dev, urinary, w/sling.  H                        ...........  ...........  ...........  ...........
   1772  Infusion pump,              H                        ...........  ...........  ...........  ...........
          programmable.
   1773  Retrieval dev, insert.....  H                        ...........  ...........  ...........  ...........
   1776  Joint device (implantable)  H                        ...........  ...........  ...........  ...........
   1777  Lead, AICD, endo single     H                        ...........  ...........  ...........  ...........
          coil.
   1778  Lead, neurostimulator.....  H                        ...........  ...........  ...........  ...........
   1779  Lead, pmkr, transvenous     H                        ...........  ...........  ...........  ...........
          VDD.
   1780  Lens, intraocular.........  H                        ...........  ...........  ...........  ...........
   1781  Mesh (implantable)........  H                        ...........  ...........  ...........  ...........
   1782  Morcellator...............  H                        ...........  ...........  ...........  ...........
   1784  Ocular dev, intraop, det    H                        ...........  ...........  ...........  ...........
          ret.
   1785  Pmkr, dual, rate-resp.....  H                        ...........  ...........  ...........  ...........
   1786  Pmkr, single, rate-resp...  H                        ...........  ...........  ...........  ...........
   1787  Patient progr, neurostim..  H                        ...........  ...........  ...........  ...........
   1788  Port, indwelling, imp.....  H                        ...........  ...........  ...........  ...........
   1789  Prosthesis, breast, imp...  H                        ...........  ...........  ...........  ...........
   1813  Prosthesis, penile,         H                        ...........  ...........  ...........  ...........
          inflatab.
   1815  Pros, urinary sph, imp....  H                        ...........  ...........  ...........  ...........
   1816  Receiver/transmitter,       H                        ...........  ...........  ...........  ...........
          neuro.
   1817  Septal defect imp sys.....  H                        ...........  ...........  ...........  ...........
   1874  Stent, coated/cov w/del     H                        ...........  ...........  ...........  ...........
          sys.
   1875  Stent, coated/cov w/o del   H                        ...........  ...........  ...........  ...........
          sy.
   1876  Stent, non-coa/no-cov w/    H                        ...........  ...........  ...........  ...........
          del.
   1877  Stent, non-coat/cov w/o     H                        ...........  ...........  ...........  ...........
          del.
   1878  Matrl for vocal cord......  H                        ...........  ...........  ...........  ...........
   1879  Tissue marker, imp........  H                        ...........  ...........  ...........  ...........
   1880  Vena cava filter..........  H                        ...........  ...........  ...........  ...........
   1881  Dialysis access system....  H                        ...........  ...........  ...........  ...........
   1882  AICD, other than sing/dual  H                        ...........  ...........  ...........  ...........
   1883  Adapt/ext, pacing/neuro     H                        ...........  ...........  ...........  ...........
          lead.
   1885  Cath, translumin angio      H                        ...........  ...........  ...........  ...........
          laser.
   1887  Catheter, guiding.........  H                        ...........  ...........  ...........  ...........
   1891  Infusion pump,non-          H                        ...........  ...........  ...........  ...........
          prog,perm.
   1892  Intro/sheath,fixed,peel-    H                        ...........  ...........  ...........  ...........
          away.
   1893  Intro/sheath,fixed,non-     H                        ...........  ...........  ...........  ...........
          peel.
   1894  Intro/sheath, non-laser...  H                        ...........  ...........  ...........  ...........
   1895  Lead, AICD, endo dual coil  H                        ...........  ...........  ...........  ...........
   1896  Lead, AICD, non sing/dual.  H                        ...........  ...........  ...........  ...........
   1897  Lead, neurostim test kit..  H                        ...........  ...........  ...........  ...........
   1898  Lead, pmkr, other than      H                        ...........  ...........  ...........  ...........
          trans.
   1899  Lead, pmkr/AICD             H                        ...........  ...........  ...........  ...........
          combination.
   2615  Sealant, pulmonary, liquid  H                        ...........  ...........  ...........  ...........
   2616  Brachytx seed, Yttrium-90.  H                        ...........  ...........  ...........  ...........
   2617  Stent, non-cor, tem w/o     H                        ...........  ...........  ...........  ...........
          del.
   2618  Probe, cryoablation.......  H                        ...........  ...........  ...........  ...........
   2619  Pmkr, dual, non rate-resp.  H                        ...........  ...........  ...........  ...........
   2620  Pmkr, single, non rate-     H                        ...........  ...........  ...........  ...........
          resp.
   2621  Pmkr, other than sing/dual  H                        ...........  ...........  ...........  ...........
   2622  Prosthesis, penile, non-    H                        ...........  ...........  ...........  ...........
          inf.
   2625  Stent, non-cor, tem w/del   H                        ...........  ...........  ...........  ...........
          sys.
   2626  Infusion pump, non-         H                        ...........  ...........  ...........  ...........
          prog,temp.
   2627  Cath, suprapubic/           H                        ...........  ...........  ...........  ...........
          cystoscopic.
   2628  Catheter, occlusion.......  H                        ...........  ...........  ...........  ...........
   2629  Intro/sheath, laser.......  H                        ...........  ...........  ...........  ...........
   2630  Cath, EP, cool-tip........  H                        ...........  ...........  ...........  ...........
   2631  Rep dev, urinary, w/o       H                        ...........  ...........  ...........  ...........
          sling.
   7000  Amifostine, 500 mg........  G                        ...........      $392.06  ...........       $56.13
   7001  Amphotericin B lipid        G                        ...........      $109.25  ...........       $15.64
          complex, 50 mg.
   7003  Epoprostenol injection 0.5  G                        ...........       $17.37  ...........        $2.49
          mg.
   7005  Gonadorelin hydroch, 100    G                        ...........       $38.47  ...........        $5.51
          mcg.
   7007  Milrinone lactate, per 5    K                               0.48       $24.40  ...........        $4.88
          ml, inj.
   7010  Morphine sulfate            G                        ...........        $7.41  ...........         $.95
          (preservative free) 10 mg.
   7011  Oprelvekin injection, 5 mg  G                        ...........      $236.31  ...........       $33.83
   7014  Fentanyl citrate inj up 2   G                        ...........        $1.40  ...........         $.18
          ml.
   7015  Busulfan, oral, 2 mg......  G                        ...........        $1.81  ...........         $.23
   7019  Aprotinin, 10,000 kiu.....  G                        ...........        $2.06  ...........         $.30
   7022  Elliot's B solution, per    G                        ...........       $14.25  ...........        $2.04
          ml.
   7023  Treatment for bladder       G                        ...........       $24.70  ...........        $3.54
          calculi, per 500 ml.
   7024  Corticorelin ovine          G                        ...........      $368.03  ...........       $52.69
          triflutate, per 0.1 mg.
   7025  Digoxin immune FAB          G                        ...........      $551.66  ...........       $78.97
          (Ovine), 40 mg vial.
   7026  Ethanolamine oleate, 100    G                        ...........       $39.73  ...........        $5.69
          mg.

[[Page 44729]]

 
   7027  Fomepizole, 1.5 mg........  G                        ...........        $1.09  ...........         $.16
   7028  Fosphenytoin, 50 mg.......  G                        ...........        $9.55  ...........        $1.37
   7029  Glatiramer acetate, 20 mg.  G                        ...........       $30.07  ...........        $4.30
   7030  Hemin, 1 mg...............  G                        ...........         $.99  ...........         $.14
   7031  Octreotide acetate          G                        ...........      $125.65  ...........       $17.99
          injection 1mg.
   7032  Sermorelin acetate, 0.5 mg  G                        ...........       $15.78  ...........        $2.26
   7033  Somatrem, 5 mg............  G                        ...........      $209.48  ...........       $29.99
   7034  Somatropin, 1 mg (any       G                        ...........       $39.90  ...........        $5.12
          derivation).
   7035  Teniposide, 50 mg.........  G                        ...........      $216.32  ...........       $30.97
   7037  Urofollitropin, 75 I.U....  G                        ...........       $73.29  ...........        $9.41
   7038  Muromonab-CD3, 5 mg.......  G                        ...........      $777.31  ...........      $111.28
   7039  Pegademase bovine inj 25    G                        ...........      $139.33  ...........       $19.95
          I.U.
   7040  Pentastarch 10% inj, 100    G                        ...........       $15.11  ...........        $2.16
          ml.
   7041  Tirofiban hydrochloride     G                        ...........      $435.27  ...........       $62.31
          12.5 mg.
   7042  Capecitabine, oral, 150 mg  G                        ...........        $2.43  ...........         $.35
   7043  Infliximab injection 10 mg  G                        ...........       $63.23  ...........        $9.05
   7045  Trimetrexate glucoronate    G                        ...........       $86.09  ...........       $12.32
          25 mg.
   7046  Doxorubicin hcl liposome    G                        ...........      $358.95  ...........       $51.39
          inj 10 mg.
   7047  Droperidol/fentanyl inj...  G                        ...........        $6.67  ...........         $.95
   7048  Alteplase recombinant.....  K                               0.39       $19.83  ...........        $3.97
   7049  Filgrastim 480 mcg          G                        ...........      $285.38  ...........       $40.85
          injection.
   7050  Prednisone oral...........  G                        ...........         $.07  ...........         $.01
   7315  Sodium hyaluronate, 20 mg.  G                        ...........      $136.80  ...........       $19.58
   9000  Na chromate Cr51, per       G                        ...........         $.32  ...........         $.05
          0.25mCi.
   9001  Linezolid inj, 200mg......  G                        ...........       $34.14  ...........        $4.89
   9002  Tenecteplase, 50mg/vial...  G                        ...........    $2,612.50  ...........      $374.00
   9003  Palivizumab, per 50mg.....  G                        ...........      $664.49  ...........       $95.13
   9004  Gemtuzumab ozogamicin       G                        ...........    $1,929.69  ...........      $276.25
          inj,5mg.
   9005  Reteplase injection.......  G                        ...........    $1,306.25  ...........      $187.00
   9006  Tacrolimus inj, per 5mg (1  G                        ...........      $113.15  ...........       $16.20
          amp).
   9007  Baclofen Intrathecal kit-   G                        ...........       $79.80  ...........       $11.42
          1amp.
   9008  Baclofen Refill Kit--       G                        ...........      $233.70  ...........       $33.46
          500mcg.
   9009  Baclofen Refill Kit--       G                        ...........      $491.15  ...........       $70.31
          2000mcg.
   9010  Baclofen Refill Kit--       G                        ...........      $861.65  ...........      $123.35
          4000mcg.
   9011  Caffeine Citrate, inj, 1ml  G                        ...........       $12.22  ...........        $1.75
   9012  Arsenic Trioxide, 1mg/kg..  G                        ...........      $237.50  ...........       $34.00
   9013  Co 57 Cobaltous Cl, 1 ml..  G                        ...........       $10.02  ...........        $1.43
   9015  Mycophenolate mofetil oral  G                        ...........        $2.40  ...........         $.34
   9016  Echocardiography contrast.  G                        ...........       $39.58  ...........        $5.67
   9018  Botulinum tox B, per 100 u  G                        ...........        $8.79  ...........        $1.26
   9019  Caspofungin acetate, 50 mg  G                        ...........       $34.20  ...........        $4.90
   9020  Sirolimus tablet, 1 mg....  G                        ...........        $6.51  ...........         $.89
   9100  Iodinated I-131 Albumin...  G                        ...........        $9.84  ...........        $1.41
   9102  51 Na chromate, 50mCi.....  G                        ...........         $.65  ...........         $.09
   9103  Na Iothalamate I-125,       G                        ...........       $11.66  ...........        $1.67
          10uCi.
   9104  Anti-thymocyte              G                        ...........      $251.75  ...........       $36.04
          globulin,25mg.
   9105  Hep B imm glob, per 1 ml..  G                        ...........      $135.43  ...........       $12.26
   9106  Sirolimus, oral...........  G                        ...........        $6.51  ...........         $.93
   9108  Thyrotropin alfa, 1.1 mg..  G                        ...........      $531.05  ...........       $76.02
   9109  Tirofliban hcl, 6.25 mg...  G                        ...........      $217.64  ...........       $31.16
   9217  Leuprolide acetate          G                        ...........      $564.92  ...........       $51.14
          suspnsion.
   9500  Platelets, irradiated.....  K                               1.81       $92.02  ...........       $18.40
   9501  Platelets, pheresis.......  K                               9.91      $503.84  ...........      $100.77
   9502  Platelet pheresis           K                              10.75      $546.55  ...........      $109.31
          irradiated.
   9503  Fresh frozen plasma, ea     K                               1.69       $85.92  ...........       $17.18
          unit.
   9504  RBC deglycerolized........  K                               4.45      $226.25  ...........       $45.25
   9505  RBC irradiated............  K                               2.64      $134.22  ...........       $26.84
----------------------------------------------------------------------------------------------------------------


          Addendum D.--Payment Status Indicators for the Hospital Outpatient Prospective Payment System
----------------------------------------------------------------------------------------------------------------
       Indicator                     Service                                      Status
----------------------------------------------------------------------------------------------------------------
A......................  Pulmonary Rehabilitation         Not Paid Under Outpatient PPS
                          Clinical Trial.
A......................  Durable Medical Equipment,       DMEPOS Fee Schedule
                          Prosthetics and Orthotics.
A......................  Physical, Occupational and       Physician Fee Schedule
                          Speech Therapy.
A......................  Ambulance......................  Ambulance Fee Schedule
A......................  EPO for ESRD Patients..........  National Rate
A......................  Clinical Diagnostic Laboratory   Laboratory Fee Schedule
                          Services.
A......................  Physician Services for ESRD      Physician Fee Schedule
                          Patients.
A......................  Screening Mammography..........  Lower of Charges or National Rate
C......................  Inpatient Procedures...........  Admit Patient
E......................  Non-Covered Items and Services.  Not Paid Under Outpatient PPS
F......................  Acquisition of Corneal Tissue..  Paid at Reasonable Cost
G......................  Drug/Biological Pass-Through...  Additional Payment
H......................  Device Pass-Through............  Additional Payment
K......................  Non Pass-Through Drug/           Paid Under Outpatient PPS
                          Biological.
N......................  Incidental Services, packaged    Packaged
                          into APC Rate.
P......................  Partial Hospitalization........  Paid Per Diem APC

[[Page 44730]]

 
S......................  Significant Procedure, Not       Paid Under Outpatient PPS
                          Discounted When Multiple.
T......................  Significant Procedure, Multiple  Paid Under Outpatient PPS
                          Procedure Reduction Applies.
V......................  Visit to Clinic or Emergency     Paid Under Outpatient PPS
                          Department.
X......................  Ancillary Service..............  Paid Under Outpatient PPS
----------------------------------------------------------------------------------------------------------------

    --------------------
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 44730]]



              Addendum B.--Payment Status by HCPCS Code and Related Information Calender Year 2002
----------------------------------------------------------------------------------------------------------------
                                                                                          National     Minimum
  CPT/      HOPD Status         Description          APC        Relative     Payment     Unadjusted   Unadjusted
  HCPCS      Indicator                                           Weight        Rate      Copayment    Copayment
----------------------------------------------------------------------------------------------------------------
   00100  N                Anesth, salivary      ...........  ...........  ...........  ...........  ...........
                            gland.
   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,               ...........  ...........  ...........  ...........  ...........
                            vitreoretinal surg.
   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  N                Anesth, pharyngeal    ...........  ...........  ...........  ...........  ...........
                            surgery.
   00176  N                Anesth, pharyngeal    ...........  ...........  ...........  ...........  ...........
                            surgery.
   00190  N                Anesth, face/skull    ...........  ...........  ...........  ...........  ...........
                            bone surg.
   00192  N                Anesth, facial bone   ...........  ...........  ...........  ...........  ...........
                            surgery.
   00210  N                Anesth, open head     ...........  ...........  ...........  ...........  ...........
                            surgery.
   00212  N                Anesth, skull         ...........  ...........  ...........  ...........  ...........
                            drainage.
   00214  N                Anesth, skull         ...........  ...........  ...........  ...........  ...........
                            drainage.
   00215  N                Anesth, skull repair/ ...........  ...........  ...........  ...........  ...........
                            fract.
   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  N                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            breast.
   00406  N                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            breast.
   00410  N                Anesth, correct       ...........  ...........  ...........  ...........  ...........
                            heart rhythm.
   00450  N                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            shoulder.
   00452  N                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            shoulder.
   00454  N                Anesth, collar bone   ...........  ...........  ...........  ...........  ...........
                            biopsy.
   00470  N                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            rib.
   00472  N                Anesth, chest wall    ...........  ...........  ...........  ...........  ...........
                            repair.
   00474  N                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            rib(s).
   00500  N                Anesth, esophageal    ...........  ...........  ...........  ...........  ...........
                            surgery.
   00520  N                Anesth, chest         ...........  ...........  ...........  ...........  ...........
                            procedure.
   00522  N                Anesth, chest lining  ...........  ...........  ...........  ...........  ...........
                            biopsy.
   00524  N                Anesth, chest         ...........  ...........  ...........  ...........  ...........
                            drainage.
   00528  N                Anesth, chest         ...........  ...........  ...........  ...........  ...........
                            partition view.
   00530  N                Anesth, pacemaker     ...........  ...........  ...........  ...........  ...........
                            insertion.
   00532  N                Anesth, vascular      ...........  ...........  ...........  ...........  ...........
                            access.
   00534  N                Anesth, cardioverter/ ...........  ...........  ...........  ...........  ...........
                            defib.
   00537  N                Anesth, cardiac       ...........  ...........  ...........  ...........  ...........
                            electrophys.
   00540  N                Anesth, chest         ...........  ...........  ...........  ...........  ...........
                            surgery.
   00542  N                Anesth, release of    ...........  ...........  ...........  ...........  ...........
                            lung.
   00544  N                Anesth, chest lining  ...........  ...........  ...........  ...........  ...........
                            removal.
   00546  N                Anesth, lung,chest    ...........  ...........  ...........  ...........  ...........
                            wall surg.
   00548  N                Anesth,               ...........  ...........  ...........  ...........  ...........
                            trachea,bronchi
                            surg.
   00550  N                Anesth, sternal       ...........  ...........  ...........  ...........  ...........
                            debridement.
   00560  N                Anesth, open heart    ...........  ...........  ...........  ...........  ...........
                            surgery.
   00562  N                Anesth, open heart    ...........  ...........  ...........  ...........  ...........
                            surgery.
   00563  N                Anesth, heart proc w/ ...........  ...........  ...........  ...........  ...........
                            pump.
   00566  N                Anesth, cabg w/o      ...........  ...........  ...........  ...........  ...........
                            pump.
   00580  N                Anesth heart/lung     ...........  ...........  ...........  ...........  ...........
                            transplant.

[[Page 44731]]

 
   00600  N                Anesth, spine, cord   ...........  ...........  ...........  ...........  ...........
                            surgery.
   00604  N                Anesth, sitting       ...........  ...........  ...........  ...........  ...........
                            procedure.
   00620  N                Anesth, spine, cord   ...........  ...........  ...........  ...........  ...........
                            surgery.
   00622  N                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            nerves.
   00630  N                Anesth, spine, cord   ...........  ...........  ...........  ...........  ...........
                            surgery.
   00632  N                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            nerves.
   00634  N                Anesth for            ...........  ...........  ...........  ...........  ...........
                            chemonucleolysis.
   00635  N                Anesth, lumbar        ...........  ...........  ...........  ...........  ...........
                            puncture.
   00670  N                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  N                Anesth, hemorr/       ...........  ...........  ...........  ...........  ...........
                            excise liver.
   00794  N                Anesth, pancreas      ...........  ...........  ...........  ...........  ...........
                            removal.
   00796  N                Anesth, for liver     ...........  ...........  ...........  ...........  ...........
                            transplant.
   00800  N                Anesth, abdominal     ...........  ...........  ...........  ...........  ...........
                            wall surg.
   00802  N                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  N                Anesth, pelvis        ...........  ...........  ...........  ...........  ...........
                            surgery.
   00846  N                Anesth, hysterectomy  ...........  ...........  ...........  ...........  ...........
   00848  N                Anesth, pelvic organ  ...........  ...........  ...........  ...........  ...........
                            surg.
   00850  N                Anesth, cesarean      ...........  ...........  ...........  ...........  ...........
                            section.
   00855  N                Anesth, hysterectomy  ...........  ...........  ...........  ...........  ...........
   00857  N                Analgesia, labor & c- ...........  ...........  ...........  ...........  ...........
                            section.
   00860  N                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            abdomen.
   00862  N                Anesth, kidney/       ...........  ...........  ...........  ...........  ...........
                            ureter surg.
   00864  N                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            bladder.
   00865  N                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            prostate.
   00866  N                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            adrenal.
   00868  N                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  N                Anesth, major vein    ...........  ...........  ...........  ...........  ...........
                            ligation.
   00884  N                Anesth, major vein    ...........  ...........  ...........  ...........  ...........
                            revision.
   00902  N                Anesth, anorectal     ...........  ...........  ...........  ...........  ...........
                            surgery.
   00904  N                Anesth, perineal      ...........  ...........  ...........  ...........  ...........
                            surgery.
   00906  N                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            vulva.
   00908  N                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  N                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            testis.
   00930  N                Anesth, testis        ...........  ...........  ...........  ...........  ...........
                            suspension.
   00932  N                Anesth, amputation    ...........  ...........  ...........  ...........  ...........
                            of penis.
   00934  N                Anesth, penis, nodes  ...........  ...........  ...........  ...........  ...........
                            removal.
   00936  N                Anesth, penis, nodes  ...........  ...........  ...........  ...........  ...........
                            removal.
   00938  N                Anesth, insert penis  ...........  ...........  ...........  ...........  ...........
                            device.
   00940  N                Anesth, vaginal       ...........  ...........  ...........  ...........  ...........
                            procedures.
   00942  N                Anesth, surg on vag/  ...........  ...........  ...........  ...........  ...........
                            urethal.
   00944  N                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  N                Analgesia, vaginal    ...........  ...........  ...........  ...........  ...........
                            delivery.

[[Page 44732]]

 
   01112  N                Anesth, bone          ...........  ...........  ...........  ...........  ...........
                            aspirate/bx.
   01120  N                Anesth, pelvis        ...........  ...........  ...........  ...........  ...........
                            surgery.
   01130  N                Anesth, body cast     ...........  ...........  ...........  ...........  ...........
                            procedure.
   01140  N                Anesth, amputation    ...........  ...........  ...........  ...........  ...........
                            at pelvis.
   01150  N                Anesth, pelvic tumor  ...........  ...........  ...........  ...........  ...........
                            surgery.
   01160  N                Anesth, pelvis        ...........  ...........  ...........  ...........  ...........
                            procedure.
   01170  N                Anesth, pelvis        ...........  ...........  ...........  ...........  ...........
                            surgery.
   01180  N                Anesth, pelvis nerve  ...........  ...........  ...........  ...........  ...........
                            removal.
   01190  N                Anesth, pelvis nerve  ...........  ...........  ...........  ...........  ...........
                            removal.
   01200  N                Anesth, hip joint     ...........  ...........  ...........  ...........  ...........
                            procedure.
   01202  N                Anesth, arthroscopy   ...........  ...........  ...........  ...........  ...........
                            of hip.
   01210  N                Anesth, hip joint     ...........  ...........  ...........  ...........  ...........
                            surgery.
   01212  N                Anesth, hip           ...........  ...........  ...........  ...........  ...........
                            disarticulation.
   01214  N                Anesth, replacement   ...........  ...........  ...........  ...........  ...........
                            of hip.
   01215  N                Anesth, revise hip    ...........  ...........  ...........  ...........  ...........
                            repair.
   01220  N                Anesth, procedure on  ...........  ...........  ...........  ...........  ...........
                            femur.
   01230  N                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            femur.
   01232  N                Anesth, amputation    ...........  ...........  ...........  ...........  ...........
                            of femur.
   01234  N                Anesth, radical       ...........  ...........  ...........  ...........  ...........
                            femur surg.
   01250  N                Anesth, upper leg     ...........  ...........  ...........  ...........  ...........
                            surgery.
   01260  N                Anesth, upper leg     ...........  ...........  ...........  ...........  ...........
                            veins surg.
   01270  N                Anesth, thigh         ...........  ...........  ...........  ...........  ...........
                            arteries surg.
   01272  N                Anesth, femoral       ...........  ...........  ...........  ...........  ...........
                            artery surg.
   01274  N                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  N                Anesth, replacement   ...........  ...........  ...........  ...........  ...........
                            of knee.
   01404  N                Anesth, amputation    ...........  ...........  ...........  ...........  ...........
                            at knee.
   01420  N                Anesth, knee joint    ...........  ...........  ...........  ...........  ...........
                            casting.
   01430  N                Anesth, knee veins    ...........  ...........  ...........  ...........  ...........
                            surgery.
   01432  N                Anesth, knee vessel   ...........  ...........  ...........  ...........  ...........
                            surg.
   01440  N                Anesth, knee          ...........  ...........  ...........  ...........  ...........
                            arteries surg.
   01442  N                Anesth, knee artery   ...........  ...........  ...........  ...........  ...........
                            surg.
   01444  N                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  N                Anesth, ankle         ...........  ...........  ...........  ...........  ...........
                            replacement.
   01490  N                Anesth, lower leg     ...........  ...........  ...........  ...........  ...........
                            casting.
   01500  N                Anesth, leg arteries  ...........  ...........  ...........  ...........  ...........
                            surg.
   01502  N                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  N                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            shoulder.
   01634  N                Anesth, shoulder      ...........  ...........  ...........  ...........  ...........
                            joint amput.
   01636  N                Anesth, forequarter   ...........  ...........  ...........  ...........  ...........
                            amput.
   01638  N                Anesth, shoulder      ...........  ...........  ...........  ...........  ...........
                            replacement.
   01650  N                Anesth, shoulder      ...........  ...........  ...........  ...........  ...........
                            artery surg.
   01652  N                Anesth, shoulder      ...........  ...........  ...........  ...........  ...........
                            vessel surg.
   01654  N                Anesth, shoulder      ...........  ...........  ...........  ...........  ...........
                            vessel surg.
   01656  N                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.

[[Page 44733]]

 
   01740  N                Anesth, upper arm     ...........  ...........  ...........  ...........  ...........
                            surgery.
   01742  N                Anesth, humerus       ...........  ...........  ...........  ...........  ...........
                            surgery.
   01744  N                Anesth, humerus       ...........  ...........  ...........  ...........  ...........
                            repair.
   01756  N                Anesth, radical       ...........  ...........  ...........  ...........  ...........
                            humerus surg.
   01758  N                Anesth, humeral       ...........  ...........  ...........  ...........  ...........
                            lesion surg.
   01760  N                Anesth, elbow         ...........  ...........  ...........  ...........  ...........
                            replacement.
   01770  N                Anesth, uppr arm      ...........  ...........  ...........  ...........  ...........
                            artery surg.
   01772  N                Anesth, uppr arm      ...........  ...........  ...........  ...........  ...........
                            embolectomy.
   01780  N                Anesth, upper arm     ...........  ...........  ...........  ...........  ...........
                            vein surg.
   01782  N                Anesth, uppr arm      ...........  ...........  ...........  ...........  ...........
                            vein 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  N                Anesth, lwr arm       ...........  ...........  ...........  ...........  ...........
                            embolectomy.
   01844  N                Anesth, vascular      ...........  ...........  ...........  ...........  ...........
                            shunt surg.
   01850  N                Anesth, lower arm     ...........  ...........  ...........  ...........  ...........
                            vein surg.
   01852  N                Anesth, lwr arm vein  ...........  ...........  ...........  ...........  ...........
                            repair.
   01860  N                Anesth, lower arm     ...........  ...........  ...........  ...........  ...........
                            casting.
   01904  N                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.
   01951  N                Anesth, burn, less 1  ...........  ...........  ...........  ...........  ...........
                            percent.
   01952  N                Anesth, burn, 1-9     ...........  ...........  ...........  ...........  ...........
                            percent.
   01953  N                Anesth, burn, each 9  ...........  ...........  ...........  ...........  ...........
                            percent.
   01990  N                Support for organ     ...........  ...........  ...........  ...........  ...........
                            donor.
   01995  N                Regional anesthesia,  ...........  ...........  ...........  ...........  ...........
                            limb.
   01996  N                Manage daily drug     ...........  ...........  ...........  ...........  ...........
                            therapy.
   01999  N                Unlisted anesth       ...........  ...........  ...........  ...........  ...........
                            procedure.
   10040  T                Acne surgery of skin         0006         2.36      $119.99       $33.95       $24.00
                            abscess.
   10060  T                Drainage of skin             0006         2.36      $119.99       $33.95       $24.00
                            abscess.
   10061  T                Drainage of skin             0006         2.36      $119.99       $33.95       $24.00
                            abscess.
   10080  T                Drainage of                  0006         2.36      $119.99       $33.95       $24.00
                            pilonidal cyst.
   10081  T                Drainage of                  0007         7.28      $370.13       $74.03       $74.03
                            pilonidal cyst.
   10120  T                Remove foreign body.         0006         2.36      $119.99       $33.95       $24.00
   10121  T                Remove foreign body.         0020         8.56      $435.21      $130.53       $87.04
   10140  T                Drainage of hematoma/        0007         7.28      $370.13       $74.03       $74.03
                            fluid.
   10160  T                Puncture drainage of         0018         1.16       $58.98       $17.66       $11.80
                            lesion.
   10180  T                Complex drainage,            0007         7.28      $370.13       $74.03       $74.03
                            wound.
   11000  T                Debride infected             0015         2.29      $116.43       $31.20       $23.29
                            skin.
   11001  T                Debride infected             0013         1.51       $76.77       $17.66       $15.35
                            skin add-on.
   11010  T                Debride skin, fx....         0022        15.07      $766.19      $292.94      $153.24
   11011  T                Debride skin/muscle,         0022        15.07      $766.19      $292.94      $153.24
                            fx.
   11012  T                Debride skin/muscle/         0022        15.07      $766.19      $292.94      $153.24
                            bone, fx.
   11040  T                Debride skin,                0015         2.29      $116.43       $31.20       $23.29
                            partial.
   11041  T                Debride skin, full..         0015         2.29      $116.43       $31.20       $23.29
   11042  T                Debride skin/tissue.         0016         3.31      $168.29       $70.68       $33.66
   11043  T                Debride tissue/              0016         3.31      $168.29       $70.68       $33.66
                            muscle.
   11044  T                Debride tissue/              0017        10.51      $534.35      $245.80      $106.87
                            muscle/bone.
   11055  T                Trim skin lesion....         0012         0.72       $36.61        $9.18        $7.32
   11056  T                Trim skin lesions, 2         0012         0.72       $36.61        $9.18        $7.32
                            to 4.
   11057  T                Trim skin lesions,           0012         0.72       $36.61        $9.18        $7.32
                            over 4.
   11100  T                Biopsy of skin               0018         1.16       $58.98       $17.66       $11.80
                            lesion.
   11101  T                Biopsy, skin add-on.         0018         1.16       $58.98       $17.66       $11.80
   11200  T                Removal of skin tags         0013         1.51       $76.77       $17.66       $15.35
   11201  T                Remove skin tags add-        0015         2.29      $116.43       $31.20       $23.29
                            on.
   11300  T                Shave skin lesion...         0012         0.72       $36.61        $9.18        $7.32
   11301  T                Shave skin lesion...         0012         0.72       $36.61        $9.18        $7.32
   11302  T                Shave skin lesion...         0013         1.51       $76.77       $17.66       $15.35
   11303  T                Shave skin lesion...         0015         2.29      $116.43       $31.20       $23.29
   11305  T                Shave skin lesion...         0013         1.51       $76.77       $17.66       $15.35
   11306  T                Shave skin lesion...         0013         1.51       $76.77       $17.66       $15.35
   11307  T                Shave skin lesion...         0013         1.51       $76.77       $17.66       $15.35
   11308  T                Shave skin lesion...         0013         1.51       $76.77       $17.66       $15.35
   11310  T                Shave skin lesion...         0013         1.51       $76.77       $17.66       $15.35
   11311  T                Shave skin lesion...         0013         1.51       $76.77       $17.66       $15.35

[[Page 44734]]

 
   11312  T                Shave skin lesion...         0013         1.51       $76.77       $17.66       $15.35
   11313  T                Shave skin lesion...         0016         3.31      $168.29       $70.68       $33.66
   11400  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11401  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11402  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11403  T                Removal of skin              0020         8.56      $435.21      $130.53       $87.04
                            lesion.
   11404  T                Removal of skin              0020         8.56      $435.21      $130.53       $87.04
                            lesion.
   11406  T                Removal of skin              0021        12.74      $647.73      $236.51      $129.55
                            lesion.
   11420  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11421  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11422  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11423  T                Removal of skin              0020         8.56      $435.21      $130.53       $87.04
                            lesion.
   11424  T                Removal of skin              0020         8.56      $435.21      $130.53       $87.04
                            lesion.
   11426  T                Removal of skin              0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   11440  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11441  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11442  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11443  T                Removal of skin              0020         8.56      $435.21      $130.53       $87.04
                            lesion.
   11444  T                Removal of skin              0020         8.56      $435.21      $130.53       $87.04
                            lesion.
   11446  T                Removal of skin              0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   11450  T                Removal, sweat gland         0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   11451  T                Removal, sweat gland         0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   11462  T                Removal, sweat gland         0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   11463  T                Removal, sweat gland         0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   11470  T                Removal, sweat gland         0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   11471  T                Removal, sweat gland         0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   11600  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11601  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11602  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11603  T                Removal of skin              0020         8.56      $435.21      $130.53       $87.04
                            lesion.
   11604  T                Removal of skin              0020         8.56      $435.21      $130.53       $87.04
                            lesion.
   11606  T                Removal of skin              0021        12.74      $647.73      $236.51      $129.55
                            lesion.
   11620  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11621  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11622  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11623  T                Removal of skin              0020         8.56      $435.21      $130.53       $87.04
                            lesion.
   11624  T                Removal of skin              0020         8.56      $435.21      $130.53       $87.04
                            lesion.
   11626  T                Removal of skin              0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   11640  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11641  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11642  T                Removal of skin              0019         4.56      $231.84       $78.91       $46.37
                            lesion.
   11643  T                Removal of skin              0020         8.56      $435.21      $130.53       $87.04
                            lesion.
   11644  T                Removal of skin              0020         8.56      $435.21      $130.53       $87.04
                            lesion.
   11646  T                Removal of skin              0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   11719  T                Trim nail(s)........         0009         0.68       $34.57        $8.99        $6.91
   11720  T                Debride nail, 1-5...         0009         0.68       $34.57        $8.99        $6.91
   11721  T                Debride nail, 6 or           0009         0.68       $34.57        $8.99        $6.91
                            more.
   11730  T                Removal of nail              0013         1.51       $76.77       $17.66       $15.35
                            plate.
   11732  T                Remove nail plate,           0012         0.72       $36.61        $9.18        $7.32
                            add-on.
   11740  T                Drain blood from             0009         0.68       $34.57        $8.99        $6.91
                            under nail.
   11750  T                Removal of nail bed.         0019         4.56      $231.84       $78.91       $46.37
   11752  T                Remove nail bed/             0022        15.07      $766.19      $292.94      $153.24
                            finger tip.
   11755  T                Biopsy, nail unit...         0019         4.56      $231.84       $78.91       $46.37
   11760  T                Repair of nail bed..         0024         2.48      $126.09       $44.50       $25.22
   11762  T                Reconstruction of            0024         2.48      $126.09       $44.50       $25.22
                            nail bed.
   11765  T                Excision of nail             0015         2.29      $116.43       $31.20       $23.29
                            fold, toe.
   11770  T                Removal of pilonidal         0021        12.74      $647.73      $236.51      $129.55
                            lesion.
   11771  T                Removal of pilonidal         0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   11772  T                Removal of pilonidal         0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   11900  T                Injection into skin          0012         0.72       $36.61        $9.18        $7.32
                            lesions.
   11901  T                Added skin lesions           0012         0.72       $36.61        $9.18        $7.32
                            injection.
   11920  T                Correct skin color           0024         2.48      $126.09       $44.50       $25.22
                            defects.
   11921  T                Correct skin color           0024         2.48      $126.09       $44.50       $25.22
                            defects.
   11922  T                Correct skin color           0024         2.48      $126.09       $44.50       $25.22
                            defects.
   11950  T                Therapy for contour          0024         2.48      $126.09       $44.50       $25.22
                            defects.
   11951  T                Therapy for contour          0024         2.48      $126.09       $44.50       $25.22
                            defects.
   11952  T                Therapy for contour          0024         2.48      $126.09       $44.50       $25.22
                            defects.
   11954  T                Therapy for contour          0024         2.48      $126.09       $44.50       $25.22
                            defects.
   11960  T                Insert tissue                0026        13.51      $686.88      $277.92      $137.38
                            expander(s).
   11970  T                Replace tissue               0026        13.51      $686.88      $277.92      $137.38
                            expander.
   11971  T                Remove tissue                0022        15.07      $766.19      $292.94      $153.24
                            expander(s).
   11975  E                Insert contraceptive  ...........  ...........  ...........  ...........  ...........
                            cap.
   11976  T                Removal of                   0019         4.56      $231.84       $78.91       $46.37
                            contraceptive cap.
   11977  E                Removal/reinsert      ...........  ...........  ...........  ...........  ...........
                            contra cap.
   11980  X                Implant hormone              0340         0.91       $46.27       $11.57        $9.25
                            pellet(s).

[[Page 44735]]

 
   12001  T                Repair superficial           0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12002  T                Repair superficial           0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12004  T                Repair superficial           0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12005  T                Repair superficial           0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12006  T                Repair superficial           0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12007  T                Repair superficial           0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12011  T                Repair superficial           0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12013  T                Repair superficial           0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12014  T                Repair superficial           0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12015  T                Repair superficial           0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12016  T                Repair superficial           0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12017  T                Repair superficial           0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12018  T                Repair superficial           0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12020  T                Closure of split             0024         2.48      $126.09       $44.50       $25.22
                            wound.
   12021  T                Closure of split             0024         2.48      $126.09       $44.50       $25.22
                            wound.
   12031  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12032  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12034  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12035  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12036  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12037  T                Layer closure of             0026        13.51      $686.88      $277.92      $137.38
                            wound(s).
   12041  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12042  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12044  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12045  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12046  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12047  T                Layer closure of             0026        13.51      $686.88      $277.92      $137.38
                            wound(s).
   12051  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12052  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12053  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12054  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12055  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12056  T                Layer closure of             0024         2.48      $126.09       $44.50       $25.22
                            wound(s).
   12057  T                Layer closure of             0026        13.51      $686.88      $277.92      $137.38
                            wound(s).
   13100  T                Repair of wound or           0025         3.71      $188.62       $70.66       $37.72
                            lesion.
   13101  T                Repair of wound or           0025         3.71      $188.62       $70.66       $37.72
                            lesion.
   13102  T                Repair wound/lesion          0025         3.71      $188.62       $70.66       $37.72
                            add-on.
   13120  T                Repair of wound or           0025         3.71      $188.62       $70.66       $37.72
                            lesion.
   13121  T                Repair of wound or           0025         3.71      $188.62       $70.66       $37.72
                            lesion.
   13122  T                Repair wound/lesion          0025         3.71      $188.62       $70.66       $37.72
                            add-on.
   13131  T                Repair of wound or           0025         3.71      $188.62       $70.66       $37.72
                            lesion.
   13132  T                Repair of wound or           0025         3.71      $188.62       $70.66       $37.72
                            lesion.
   13133  T                Repair wound/lesion          0025         3.71      $188.62       $70.66       $37.72
                            add-on.
   13150  T                Repair of wound or           0026        13.51      $686.88      $277.92      $137.38
                            lesion.
   13151  T                Repair of wound or           0025         3.71      $188.62       $70.66       $37.72
                            lesion.
   13152  T                Repair of wound or           0025         3.71      $188.62       $70.66       $37.72
                            lesion.
   13153  T                Repair wound/lesion          0025         3.71      $188.62       $70.66       $37.72
                            add-on.
   13160  T                Late closure of              0026        13.51      $686.88      $277.92      $137.38
                            wound.
   14000  T                Skin tissue                  0026        13.51      $686.88      $277.92      $137.38
                            rearrangement.
   14001  T                Skin tissue                  0026        13.51      $686.88      $277.92      $137.38
                            rearrangement.
   14020  T                Skin tissue                  0026        13.51      $686.88      $277.92      $137.38
                            rearrangement.
   14021  T                Skin tissue                  0026        13.51      $686.88      $277.92      $137.38
                            rearrangement.
   14040  T                Skin tissue                  0026        13.51      $686.88      $277.92      $137.38
                            rearrangement.
   14041  T                Skin tissue                  0026        13.51      $686.88      $277.92      $137.38
                            rearrangement.
   14060  T                Skin tissue                  0026        13.51      $686.88      $277.92      $137.38
                            rearrangement.
   14061  T                Skin tissue                  0026        13.51      $686.88      $277.92      $137.38
                            rearrangement.
   14300  T                Skin tissue                  0026        13.51      $686.88      $277.92      $137.38
                            rearrangement.
   14350  T                Skin tissue                  0026        13.51      $686.88      $277.92      $137.38
                            rearrangement.
   15000  T                Skin graft..........         0026        13.51      $686.88      $277.92      $137.38
   15001  T                Skin graft add-on...         0026        13.51      $686.88      $277.92      $137.38
   15050  T                Skin pinch graft....         0026        13.51      $686.88      $277.92      $137.38
   15100  T                Skin split graft....         0026        13.51      $686.88      $277.92      $137.38
   15101  T                Skin split graft add-        0026        13.51      $686.88      $277.92      $137.38
                            on.
   15120  T                Skin split graft....         0026        13.51      $686.88      $277.92      $137.38
   15121  T                Skin split graft add-        0026        13.51      $686.88      $277.92      $137.38
                            on.
   15200  T                Skin full graft.....         0026        13.51      $686.88      $277.92      $137.38
   15201  T                Skin full graft add-         0026        13.51      $686.88      $277.92      $137.38
                            on.
   15220  T                Skin full graft.....         0026        13.51      $686.88      $277.92      $137.38
   15221  T                Skin full graft add-         0026        13.51      $686.88      $277.92      $137.38
                            on.
   15240  T                Skin full graft.....         0026        13.51      $686.88      $277.92      $137.38
   15241  T                Skin full graft add-         0026        13.51      $686.88      $277.92      $137.38
                            on.
   15260  T                Skin full graft.....         0026        13.51      $686.88      $277.92      $137.38
   15261  T                Skin full graft add-         0026        13.51      $686.88      $277.92      $137.38
                            on.
   15342  T                Cultured skin graft,         0025         3.71      $188.62       $70.66       $37.72
                            25 cm.
   15343  T                Culture skn graft            0025         3.71      $188.62       $70.66       $37.72
                            addl 25 cm.

[[Page 44736]]

 
   15350  T                Skin homograft......         0026        13.51      $686.88      $277.92      $137.38
   15351  T                Skin homograft add-          0026        13.51      $686.88      $277.92      $137.38
                            on.
   15400  T                Skin heterograft....         0026        13.51      $686.88      $277.92      $137.38
   15401  T                Skin heterograft add-        0026        13.51      $686.88      $277.92      $137.38
                            on.
   15570  T                Form skin pedicle            0026        13.51      $686.88      $277.92      $137.38
                            flap.
   15572  T                Form skin pedicle            0026        13.51      $686.88      $277.92      $137.38
                            flap.
   15574  T                Form skin pedicle            0026        13.51      $686.88      $277.92      $137.38
                            flap.
   15576  T                Form skin pedicle            0026        13.51      $686.88      $277.92      $137.38
                            flap.
   15600  T                Skin graft..........         0026        13.51      $686.88      $277.92      $137.38
   15610  T                Skin graft..........         0026        13.51      $686.88      $277.92      $137.38
   15620  T                Skin graft..........         0026        13.51      $686.88      $277.92      $137.38
   15630  T                Skin graft..........         0026        13.51      $686.88      $277.92      $137.38
   15650  T                Transfer skin                0026        13.51      $686.88      $277.92      $137.38
                            pedicle flap.
   15732  T                Muscle-skin graft,           0027        19.31      $981.76      $383.10      $196.35
                            head/neck.
   15734  T                Muscle-skin graft,           0027        19.31      $981.76      $383.10      $196.35
                            trunk.
   15736  T                Muscle-skin graft,           0027        19.31      $981.76      $383.10      $196.35
                            arm.
   15738  T                Muscle-skin graft,           0027        19.31      $981.76      $383.10      $196.35
                            leg.
   15740  T                Island pedicle flap          0027        19.31      $981.76      $383.10      $196.35
                            graft.
   15750  T                Neurovascular                0027        19.31      $981.76      $383.10      $196.35
                            pedicle graft.
   15756  C                Free muscle flap,     ...........  ...........  ...........  ...........  ...........
                            microvasc.
   15757  C                Free skin flap,       ...........  ...........  ...........  ...........  ...........
                            microvasc.
   15758  C                Free fascial flap,    ...........  ...........  ...........  ...........  ...........
                            microvasc.
   15760  T                Composite skin graft         0027        19.31      $981.76      $383.10      $196.35
   15770  T                Derma-fat-fascia             0027        19.31      $981.76      $383.10      $196.35
                            graft.
   15775  T                Hair transplant              0026        13.51      $686.88      $277.92      $137.38
                            punch grafts.
   15776  T                Hair transplant              0026        13.51      $686.88      $277.92      $137.38
                            punch grafts.
   15780  T                Abrasion treatment           0022        15.07      $766.19      $292.94      $153.24
                            of skin.
   15781  T                Abrasion treatment           0022        15.07      $766.19      $292.94      $153.24
                            of skin.
   15782  T                Abrasion treatment           0022        15.07      $766.19      $292.94      $153.24
                            of skin.
   15783  T                Abrasion treatment           0016         3.31      $168.29       $70.68       $33.66
                            of skin.
   15786  T                Abrasion, lesion,            0013         1.51       $76.77       $17.66       $15.35
                            single.
   15787  T                Abrasion, lesions,           0013         1.51       $76.77       $17.66       $15.35
                            add-on.
   15788  T                Chemical peel, face,         0012         0.72       $36.61        $9.18        $7.32
                            epiderm.
   15789  T                Chemical peel, face,         0015         2.29      $116.43       $31.20       $23.29
                            dermal.
   15792  T                Chemical peel,               0012         0.72       $36.61        $9.18        $7.32
                            nonfacial.
   15793  T                Chemical peel,               0013         1.51       $76.77       $17.66       $15.35
                            nonfacial.
   15810  T                Salabrasion.........         0016         3.31      $168.29       $70.68       $33.66
   15811  T                Salabrasion.........         0016         3.31      $168.29       $70.68       $33.66
   15819  T                Plastic surgery,             0026        13.51      $686.88      $277.92      $137.38
                            neck.
   15820  T                Revision of lower            0026        13.51      $686.88      $277.92      $137.38
                            eyelid.
   15821  T                Revision of lower            0026        13.51      $686.88      $277.92      $137.38
                            eyelid.
   15822  T                Revision of upper            0026        13.51      $686.88      $277.92      $137.38
                            eyelid.
   15823  T                Revision of upper            0026        13.51      $686.88      $277.92      $137.38
                            eyelid.
   15824  T                Removal of forehead          0027        19.31      $981.76      $383.10      $196.35
                            wrinkles.
   15825  T                Removal of neck              0026        13.51      $686.88      $277.92      $137.38
                            wrinkles.
   15826  T                Removal of brow              0026        13.51      $686.88      $277.92      $137.38
                            wrinkles.
   15828  T                Removal of face              0027        19.31      $981.76      $383.10      $196.35
                            wrinkles.
   15829  T                Removal of skin              0026        13.51      $686.88      $277.92      $137.38
                            wrinkles.
   15831  T                Excise excessive             0022        15.07      $766.19      $292.94      $153.24
                            skin tissue.
   15832  T                Excise excessive             0022        15.07      $766.19      $292.94      $153.24
                            skin tissue.
   15833  T                Excise excessive             0022        15.07      $766.19      $292.94      $153.24
                            skin tissue.
   15834  T                Excise excessive             0022        15.07      $766.19      $292.94      $153.24
                            skin tissue.
   15835  T                Excise excessive             0026        13.51      $686.88      $277.92      $137.38
                            skin tissue.
   15836  T                Excise excessive             0019         4.56      $231.84       $78.91       $46.37
                            skin tissue.
   15837  T                Excise excessive             0019         4.56      $231.84       $78.91       $46.37
                            skin tissue.
   15838  T                Excise excessive             0019         4.56      $231.84       $78.91       $46.37
                            skin tissue.
   15839  T                Excise excessive             0019         4.56      $231.84       $78.91       $46.37
                            skin tissue.
   15840  T                Graft for face nerve         0027        19.31      $981.76      $383.10      $196.35
                            palsy.
   15841  T                Graft for face nerve         0027        19.31      $981.76      $383.10      $196.35
                            palsy.
   15842  T                Flap for face nerve          0027        19.31      $981.76      $383.10      $196.35
                            palsy.
   15845  T                Skin and muscle              0027        19.31      $981.76      $383.10      $196.35
                            repair, face.
   15850  T                Removal of sutures..         0016         3.31      $168.29       $70.68       $33.66
   15851  T                Removal of sutures..         0013         1.51       $76.77       $17.66       $15.35
   15852  T                Dressing change,not          0013         1.51       $76.77       $17.66       $15.35
                            for burn.
   15860  N                Test for blood flow   ...........  ...........  ...........  ...........  ...........
                            in graft.
   15876  T                Suction assisted             0027        19.31      $981.76      $383.10      $196.35
                            lipectomy.
   15877  T                Suction assisted             0027        19.31      $981.76      $383.10      $196.35
                            lipectomy.
   15878  T                Suction assisted             0027        19.31      $981.76      $383.10      $196.35
                            lipectomy.
   15879  T                Suction assisted             0027        19.31      $981.76      $383.10      $196.35
                            lipectomy.
   15920  T                Removal of tail bone         0022        15.07      $766.19      $292.94      $153.24
                            ulcer.
   15922  T                Removal of tail bone         0027        19.31      $981.76      $383.10      $196.35
                            ulcer.
   15931  T                Remove sacrum                0022        15.07      $766.19      $292.94      $153.24
                            pressure sore.
   15933  T                Remove sacrum                0022        15.07      $766.19      $292.94      $153.24
                            pressure sore.
   15934  T                Remove sacrum                0027        19.31      $981.76      $383.10      $196.35
                            pressure sore.
   15935  T                Remove sacrum                0027        19.31      $981.76      $383.10      $196.35
                            pressure sore.

[[Page 44737]]

 
   15936  T                Remove sacrum                0027        19.31      $981.76      $383.10      $196.35
                            pressure sore.
   15937  T                Remove sacrum                0027        19.31      $981.76      $383.10      $196.35
                            pressure sore.
   15940  T                Remove hip pressure          0022        15.07      $766.19      $292.94      $153.24
                            sore.
   15941  T                Remove hip pressure          0022        15.07      $766.19      $292.94      $153.24
                            sore.
   15944  T                Remove hip pressure          0027        19.31      $981.76      $383.10      $196.35
                            sore.
   15945  T                Remove hip pressure          0027        19.31      $981.76      $383.10      $196.35
                            sore.
   15946  T                Remove hip pressure          0027        19.31      $981.76      $383.10      $196.35
                            sore.
   15950  T                Remove thigh                 0022        15.07      $766.19      $292.94      $153.24
                            pressure sore.
   15951  T                Remove thigh                 0022        15.07      $766.19      $292.94      $153.24
                            pressure sore.
   15952  T                Remove thigh                 0027        19.31      $981.76      $383.10      $196.35
                            pressure sore.
   15953  T                Remove thigh                 0027        19.31      $981.76      $383.10      $196.35
                            pressure sore.
   15956  T                Remove thigh                 0027        19.31      $981.76      $383.10      $196.35
                            pressure sore.
   15958  T                Remove thigh                 0027        19.31      $981.76      $383.10      $196.35
                            pressure sore.
   15999  T                Removal of pressure          0022        15.07      $766.19      $292.94      $153.24
                            sore.
   16000  T                Initial treatment of         0013         1.51       $76.77       $17.66       $15.35
                            burn(s).
   16010  T                Treatment of burn(s)         0016         3.31      $168.29       $70.68       $33.66
   16015  T                Treatment of burn(s)         0017        10.51      $534.35      $245.80      $106.87
   16020  T                Treatment of burn(s)         0013         1.51       $76.77       $17.66       $15.35
   16025  T                Treatment of burn(s)         0013         1.51       $76.77       $17.66       $15.35
   16030  T                Treatment of burn(s)         0015         2.29      $116.43       $31.20       $23.29
   16035  C                Incision of burn      ...........  ...........  ...........  ...........  ...........
                            scab, initi.
   16036  C                Incise burn scab,     ...........  ...........  ...........  ...........  ...........
                            addl incis.
   17000  T                Destroy benign/              0010         0.71       $36.10        $9.86        $7.22
                            premal lesion.
   17003  T                Destroy lesions, 2-          0010         0.71       $36.10        $9.86        $7.22
                            14.
   17004  T                Destroy lesions, 15          0011         1.57       $79.82       $29.53       $15.96
                            or more.
   17106  T                Destruction of skin          0011         1.57       $79.82       $29.53       $15.96
                            lesions.
   17107  T                Destruction of skin          0011         1.57       $79.82       $29.53       $15.96
                            lesions.
   17108  T                Destruction of skin          0011         1.57       $79.82       $29.53       $15.96
                            lesions.
   17110  T                Destruct lesion, 1-          0010         0.71       $36.10        $9.86        $7.22
                            14.
   17111  T                Destruct lesion, 15          0011         1.57       $79.82       $29.53       $15.96
                            or more.
   17250  T                Chemical cautery,            0013         1.51       $76.77       $17.66       $15.35
                            tissue.
   17260  T                Destruction of skin          0013         1.51       $76.77       $17.66       $15.35
                            lesions.
   17261  T                Destruction of skin          0013         1.51       $76.77       $17.66       $15.35
                            lesions.
   17262  T                Destruction of skin          0013         1.51       $76.77       $17.66       $15.35
                            lesions.
   17263  T                Destruction of skin          0013         1.51       $76.77       $17.66       $15.35
                            lesions.
   17264  T                Destruction of skin          0013         1.51       $76.77       $17.66       $15.35
                            lesions.
   17266  T                Destruction of skin          0016         3.31      $168.29       $70.68       $33.66
                            lesions.
   17270  T                Destruction of skin          0013         1.51       $76.77       $17.66       $15.35
                            lesions.
   17271  T                Destruction of skin          0012         0.72       $36.61        $9.18        $7.32
                            lesions.
   17272  T                Destruction of skin          0013         1.51       $76.77       $17.66       $15.35
                            lesions.
   17273  T                Destruction of skin          0015         2.29      $116.43       $31.20       $23.29
                            lesions.
   17274  T                Destruction of skin          0016         3.31      $168.29       $70.68       $33.66
                            lesions.
   17276  T                Destruction of skin          0016         3.31      $168.29       $70.68       $33.66
                            lesions.
   17280  T                Destruction of skin          0013         1.51       $76.77       $17.66       $15.35
                            lesions.
   17281  T                Destruction of skin          0013         1.51       $76.77       $17.66       $15.35
                            lesions.
   17282  T                Destruction of skin          0015         2.29      $116.43       $31.20       $23.29
                            lesions.
   17283  T                Destruction of skin          0015         2.29      $116.43       $31.20       $23.29
                            lesions.
   17284  T                Destruction of skin          0016         3.31      $168.29       $70.68       $33.66
                            lesions.
   17286  T                Destruction of skin          0013         1.51       $76.77       $17.66       $15.35
                            lesions.
   17304  T                Chemosurgery of skin         0694         4.28      $217.60       $65.28       $43.52
                            lesion.
   17305  T                2nd stage                    0694         4.28      $217.60       $65.28       $43.52
                            chemosurgery.
   17306  T                3rd stage                    0694         4.28      $217.60       $65.28       $43.52
                            chemosurgery.
   17307  T                Followup skin lesion         0694         4.28      $217.60       $65.28       $43.52
                            therapy.
   17310  T                Extensive skin               0694         4.28      $217.60       $65.28       $43.52
                            chemosurgery.
   17340  T                Cryotherapy of skin.         0012         0.72       $36.61        $9.18        $7.32
   17360  T                Skin peel therapy...         0012         0.72       $36.61        $9.18        $7.32
   17380  T                Hair removal by              0017        10.51      $534.35      $245.80      $106.87
                            electrolysis.
   17999  T                Skin tissue                  0004         3.00      $152.53       $32.57       $30.51
                            procedure.
   19000  T                Drainage of breast           0004         3.00      $152.53       $32.57       $30.51
                            lesion.
   19001  T                Drain breast lesion          0004         3.00      $152.53       $32.57       $30.51
                            add-on.
   19020  T                Incision of breast           0008        11.36      $577.57      $115.51      $115.51
                            lesion.
   19030  N                Injection for breast  ...........  ...........  ...........  ...........  ...........
                            x-ray.
   19100  T                Bx breast percut w/o         0005         6.71      $341.15      $119.75       $68.23
                            image.
   19101  T                Biopsy of breast,            0028        14.95      $760.09      $303.74      $152.02
                            open.
   19102  T                Bx breast percut w/          0005         6.71      $341.15      $119.75       $68.23
                            image.
   19103  S                Bx breast percut w/          0974         7.57      $384.87  ...........       $76.97
                            device.
   19110  T                Nipple exploration..         0028        14.95      $760.09      $303.74      $152.02
   19112  T                Excise breast duct           0028        14.95      $760.09      $303.74      $152.02
                            fistula.
   19120  T                Removal of breast            0028        14.95      $760.09      $303.74      $152.02
                            lesion.
   19125  T                Excision, breast             0028        14.95      $760.09      $303.74      $152.02
                            lesion.
   19126  T                Excision, addl               0028        14.95      $760.09      $303.74      $152.02
                            breast lesion.
   19140  T                Removal of breast            0028        14.95      $760.09      $303.74      $152.02
                            tissue.
   19160  T                Removal of breast            0028        14.95      $760.09      $303.74      $152.02
                            tissue.
   19162  T                Remove breast                0693        33.16    $1,685.92      $826.10      $337.18
                            tissue, nodes.
   19180  T                Removal of breast...         0030        25.95    $1,319.35      $646.48      $263.87

[[Page 44738]]

 
   19182  T                Removal of breast...         0030        25.95    $1,319.35      $646.48      $263.87
   19200  C                Removal of breast...  ...........  ...........  ...........  ...........  ...........
   19220  C                Removal of breast...  ...........  ...........  ...........  ...........  ...........
   19240  T                Removal of breast...         0029        35.93    $1,826.75      $820.79      $365.35
   19260  T                Removal of chest             0021        12.74      $647.73      $236.51      $129.55
                            wall lesion.
   19271  C                Revision of chest     ...........  ...........  ...........  ...........  ...........
                            wall.
   19272  C                Extensive chest wall  ...........  ...........  ...........  ...........  ...........
                            surgery.
   19290  N                Place needle wire,    ...........  ...........  ...........  ...........  ...........
                            breast.
   19291  N                Place needle wire,    ...........  ...........  ...........  ...........  ...........
                            breast.
   19295  N                Place breast clip,    ...........  ...........  ...........  ...........  ...........
                            percut.
   19316  T                Suspension of breast         0030        25.95    $1,319.35      $646.48      $263.87
   19318  T                Reduction of large           0693        33.16    $1,685.92      $826.10      $337.18
                            breast.
   19324  T                Enlarge breast......         0693        33.16    $1,685.92      $826.10      $337.18
   19325  T                Enlarge breast with          0693        33.16    $1,685.92      $826.10      $337.18
                            implant.
   19328  T                Removal of breast            0030        25.95    $1,319.35      $646.48      $263.87
                            implant.
   19330  T                Removal of implant           0030        25.95    $1,319.35      $646.48      $263.87
                            material.
   19340  T                Immediate breast             0030        25.95    $1,319.35      $646.48      $263.87
                            prosthesis.
   19342  T                Delayed breast               0693        33.16    $1,685.92      $826.10      $337.18
                            prosthesis.
   19350  T                Breast                       0030        25.95    $1,319.35      $646.48      $263.87
                            reconstruction.
   19355  T                Correct inverted             0030        25.95    $1,319.35      $646.48      $263.87
                            nipple(s).
   19357  T                Breast                       0693        33.16    $1,685.92      $826.10      $337.18
                            reconstruction.
   19361  C                Breast                ...........  ...........  ...........  ...........  ...........
                            reconstruction.
   19364  C                Breast                ...........  ...........  ...........  ...........  ...........
                            reconstruction.
   19366  T                Breast                       0030        25.95    $1,319.35      $646.48      $263.87
                            reconstruction.
   19367  C                Breast                ...........  ...........  ...........  ...........  ...........
                            reconstruction.
   19368  C                Breast                ...........  ...........  ...........  ...........  ...........
                            reconstruction.
   19369  C                Breast                ...........  ...........  ...........  ...........  ...........
                            reconstruction.
   19370  T                Surgery of breast            0030        25.95    $1,319.35      $646.48      $263.87
                            capsule.
   19371  T                Removal of breast            0030        25.95    $1,319.35      $646.48      $263.87
                            capsule.
   19380  T                Revise breast                0030        25.95    $1,319.35      $646.48      $263.87
                            reconstruction.
   19396  T                Design custom breast         0029        35.93    $1,826.75      $820.79      $365.35
                            implant.
   19499  T                Breast surgery               0029        35.93    $1,826.75      $820.79      $365.35
                            procedure.
   20000  T                Incision of abscess.         0006         2.36      $119.99       $33.95       $24.00
   20005  T                Incision of deep             0049        17.07      $867.87      $356.95      $173.57
                            abscess.
   20100  T                Explore wound, neck.         0023         2.18      $110.84       $40.37       $22.17
   20101  T                Explore wound, chest         0026        13.51      $686.88      $277.92      $137.38
   20102  T                Explore wound,               0026        13.51      $686.88      $277.92      $137.38
                            abdomen.
   20103  T                Explore wound,               0023         2.18      $110.84       $40.37       $22.17
                            extremity.
   20150  T                Excise epiphyseal            0051        30.94    $1,573.05      $675.24      $314.61
                            bar.
   20200  T                Muscle biopsy.......         0020         8.56      $435.21      $130.53       $87.04
   20205  T                Deep muscle biopsy..         0021        12.74      $647.73      $236.51      $129.55
   20206  T                Needle biopsy,               0005         6.71      $341.15      $119.75       $68.23
                            muscle.
   20220  T                Bone biopsy, trocar/         0019         4.56      $231.84       $78.91       $46.37
                            needle.
   20225  T                Bone biopsy, trocar/         0020         8.56      $435.21      $130.53       $87.04
                            needle.
   20240  T                Bone biopsy,                 0022        15.07      $766.19      $292.94      $153.24
                            excisional.
   20245  T                Bone biopsy,                 0022        15.07      $766.19      $292.94      $153.24
                            excisional.
   20250  T                Open bone biopsy....         0049        17.07      $867.87      $356.95      $173.57
   20251  T                Open bone biopsy....         0049        17.07      $867.87      $356.95      $173.57
   20500  T                Injection of sinus           0251         2.71      $137.78       $27.99       $27.56
                            tract.
   20501  N                Inject sinus tract    ...........  ...........  ...........  ...........  ...........
                            for x-ray.
   20520  T                Removal of foreign           0019         4.56      $231.84       $78.91       $46.37
                            body.
   20525  T                Removal of foreign           0022        15.07      $766.19      $292.94      $153.24
                            body.
   20550  T                Inject tendon/               0204         2.44      $124.05       $47.14       $24.81
                            ligament/cyst.
   20600  T                Drain/inject, joint/         0204         2.44      $124.05       $47.14       $24.81
                            bursa.
   20605  T                Drain/inject, joint/         0204         2.44      $124.05       $47.14       $24.81
                            bursa.
   20610  T                Drain/inject, joint/         0204         2.44      $124.05       $47.14       $24.81
                            bursa.
   20615  T                Treatment of bone            0004         3.00      $152.53       $32.57       $30.51
                            cyst.
   20650  T                Insert and remove            0049        17.07      $867.87      $356.95      $173.57
                            bone pin.
   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           0021        12.74      $647.73      $236.51      $129.55
                            implant.
   20680  T                Removal of support           0022        15.07      $766.19      $292.94      $153.24
                            implant.
   20690  T                Apply bone fixation          0050        22.31    $1,134.29      $513.86      $226.86
                            device.
   20692  T                Apply bone fixation          0050        22.31    $1,134.29      $513.86      $226.86
                            device.
   20693  T                Adjust bone fixation         0049        17.07      $867.87      $356.95      $173.57
                            device.
   20694  T                Remove bone fixation         0049        17.07      $867.87      $356.95      $173.57
                            device.
   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.

[[Page 44739]]

 
   20824  C                Replantation thumb,   ...........  ...........  ...........  ...........  ...........
                            complete.
   20827  C                Replantation thumb,   ...........  ...........  ...........  ...........  ...........
                            complete.
   20838  C                Replantation foot,    ...........  ...........  ...........  ...........  ...........
                            complete.
   20900  T                Removal of bone for          0050        22.31    $1,134.29      $513.86      $226.86
                            graft.
   20902  T                Removal of bone for          0050        22.31    $1,134.29      $513.86      $226.86
                            graft.
   20910  T                Remove cartilage for         0026        13.51      $686.88      $277.92      $137.38
                            graft.
   20912  T                Remove cartilage for         0026        13.51      $686.88      $277.92      $137.38
                            graft.
   20920  T                Removal of fascia            0026        13.51      $686.88      $277.92      $137.38
                            for graft.
   20922  T                Removal of fascia            0026        13.51      $686.88      $277.92      $137.38
                            for graft.
   20924  T                Removal of tendon            0050        22.31    $1,134.29      $513.86      $226.86
                            for graft.
   20926  T                Removal of tissue            0026        13.51      $686.88      $277.92      $137.38
                            for graft.
   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,              0008        11.36      $577.57      $115.51      $115.51
                            muscle.
   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              0049        17.07      $867.87      $356.95      $173.57
                            stimulation.
   20979  E                Us bone stimulation.  ...........  ...........  ...........  ...........  ...........
   20999  N                Musculoskeletal       ...........  ...........  ...........  ...........  ...........
                            surgery.
   21010  T                Incision of jaw              0254        19.11      $971.59      $272.41      $194.32
                            joint.
   21015  T                Resection of facial          0252         6.53      $332.00      $114.24       $66.40
                            tumor.
   21025  T                Excision of bone,            0256        28.82    $1,465.27      $623.05      $293.05
                            lower jaw.
   21026  T                Excision of facial           0256        28.82    $1,465.27      $623.05      $293.05
                            bone(s).
   21029  T                Contour of face bone         0256        28.82    $1,465.27      $623.05      $293.05
                            lesion.
   21030  T                Removal of face bone         0254        19.11      $971.59      $272.41      $194.32
                            lesion.
   21031  T                Remove exostosis,            0254        19.11      $971.59      $272.41      $194.32
                            mandible.
   21032  T                Remove exostosis,            0254        19.11      $971.59      $272.41      $194.32
                            maxilla.
   21034  T                Removal of face bone         0256        28.82    $1,465.27      $623.05      $293.05
                            lesion.
   21040  T                Removal of jaw bone          0254        19.11      $971.59      $272.41      $194.32
                            lesion.
   21041  T                Removal of jaw bone          0256        28.82    $1,465.27      $623.05      $293.05
                            lesion.
   21044  T                Removal of jaw bone          0256        28.82    $1,465.27      $623.05      $293.05
                            lesion.
   21045  C                Extensive jaw         ...........  ...........  ...........  ...........  ...........
                            surgery.
   21050  T                Removal of jaw joint         0256        28.82    $1,465.27      $623.05      $293.05
   21060  T                Remove jaw joint             0256        28.82    $1,465.27      $623.05      $293.05
                            cartilage.
   21070  T                Remove coronoid              0256        28.82    $1,465.27      $623.05      $293.05
                            process.
   21076  T                Prepare face/oral            0254        19.11      $971.59      $272.41      $194.32
                            prosthesis.
   21077  T                Prepare face/oral            0256        28.82    $1,465.27      $623.05      $293.05
                            prosthesis.
   21079  T                Prepare face/oral            0256        28.82    $1,465.27      $623.05      $293.05
                            prosthesis.
   21080  T                Prepare face/oral            0256        28.82    $1,465.27      $623.05      $293.05
                            prosthesis.
   21081  T                Prepare face/oral            0256        28.82    $1,465.27      $623.05      $293.05
                            prosthesis.
   21082  T                Prepare face/oral            0256        28.82    $1,465.27      $623.05      $293.05
                            prosthesis.
   21083  T                Prepare face/oral            0256        28.82    $1,465.27      $623.05      $293.05
                            prosthesis.
   21084  T                Prepare face/oral            0256        28.82    $1,465.27      $623.05      $293.05
                            prosthesis.
   21085  T                Prepare face/oral            0253        13.27      $674.67      $284.00      $134.93
                            prosthesis.
   21086  T                Prepare face/oral            0256        28.82    $1,465.27      $623.05      $293.05
                            prosthesis.
   21087  T                Prepare face/oral            0256        28.82    $1,465.27      $623.05      $293.05
                            prosthesis.
   21088  T                Prepare face/oral            0256        28.82    $1,465.27      $623.05      $293.05
                            prosthesis.
   21089  T                Prepare face/oral            0253        13.27      $674.67      $284.00      $134.93
                            prosthesis.
   21100  T                Maxillofacial                0256        28.82    $1,465.27      $623.05      $293.05
                            fixation.
   21110  T                Interdental fixation         0252         6.53      $332.00      $114.24       $66.40
   21116  N                Injection, jaw joint  ...........  ...........  ...........  ...........  ...........
                            x-ray.
   21120  T                Reconstruction of            0254        19.11      $971.59      $272.41      $194.32
                            chin.
   21121  T                Reconstruction of            0254        19.11      $971.59      $272.41      $194.32
                            chin.
   21122  T                Reconstruction of            0254        19.11      $971.59      $272.41      $194.32
                            chin.
   21123  T                Reconstruction of            0254        19.11      $971.59      $272.41      $194.32
                            chin.
   21125  T                Augmentation, lower          0254        19.11      $971.59      $272.41      $194.32
                            jaw bone.
   21127  T                Augmentation, lower          0256        28.82    $1,465.27      $623.05      $293.05
                            jaw bone.
   21137  T                Reduction of                 0254        19.11      $971.59      $272.41      $194.32
                            forehead.
   21138  T                Reduction of                 0256        28.82    $1,465.27      $623.05      $293.05
                            forehead.
   21139  T                Reduction of                 0256        28.82    $1,465.27      $623.05      $293.05
                            forehead.
   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.

[[Page 44740]]

 
   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         0254        19.11      $971.59      $272.41      $194.32
                            lesion.
   21182  C                Reconstruct cranial   ...........  ...........  ...........  ...........  ...........
                            bone.
   21183  C                Reconstruct cranial   ...........  ...........  ...........  ...........  ...........
                            bone.
   21184  C                Reconstruct cranial   ...........  ...........  ...........  ...........  ...........
                            bone.
   21188  C                Reconstruction of     ...........  ...........  ...........  ...........  ...........
                            midface.
   21193  C                Reconst lwr jaw w/o   ...........  ...........  ...........  ...........  ...........
                            graft.
   21194  C                Reconst lwr jaw w/    ...........  ...........  ...........  ...........  ...........
                            graft.
   21195  C                Reconst lwr jaw w/o   ...........  ...........  ...........  ...........  ...........
                            fixation.
   21196  C                Reconst lwr jaw w/    ...........  ...........  ...........  ...........  ...........
                            fixation.
   21198  T                Reconstr lwr jaw             0256        28.82    $1,465.27      $623.05      $293.05
                            segment.
   21199  T                Reconstr lwr jaw w/          0256        28.82    $1,465.27      $623.05      $293.05
                            advance.
   21206  T                Reconstruct upper            0256        28.82    $1,465.27      $623.05      $293.05
                            jaw bone.
   21208  T                Augmentation of              0256        28.82    $1,465.27      $623.05      $293.05
                            facial bones.
   21209  T                Reduction of facial          0256        28.82    $1,465.27      $623.05      $293.05
                            bones.
   21210  T                Face bone graft.....         0256        28.82    $1,465.27      $623.05      $293.05
   21215  T                Lower jaw bone graft         0256        28.82    $1,465.27      $623.05      $293.05
   21230  T                Rib cartilage graft.         0256        28.82    $1,465.27      $623.05      $293.05
   21235  T                Ear cartilage graft.         0254        19.11      $971.59      $272.41      $194.32
   21240  T                Reconstruction of            0256        28.82    $1,465.27      $623.05      $293.05
                            jaw joint.
   21242  T                Reconstruction of            0256        28.82    $1,465.27      $623.05      $293.05
                            jaw joint.
   21243  T                Reconstruction of            0256        28.82    $1,465.27      $623.05      $293.05
                            jaw joint.
   21244  T                Reconstruction of            0256        28.82    $1,465.27      $623.05      $293.05
                            lower jaw.
   21245  T                Reconstruction of            0256        28.82    $1,465.27      $623.05      $293.05
                            jaw.
   21246  T                Reconstruction of            0256        28.82    $1,465.27      $623.05      $293.05
                            jaw.
   21247  C                Reconstruct lower     ...........  ...........  ...........  ...........  ...........
                            jaw bone.
   21248  T                Reconstruction of            0256        28.82    $1,465.27      $623.05      $293.05
                            jaw.
   21249  T                Reconstruction of            0256        28.82    $1,465.27      $623.05      $293.05
                            jaw.
   21255  C                Reconstruct lower     ...........  ...........  ...........  ...........  ...........
                            jaw bone.
   21256  C                Reconstruction of     ...........  ...........  ...........  ...........  ...........
                            orbit.
   21260  T                Revise eye sockets..         0256        28.82    $1,465.27      $623.05      $293.05
   21261  T                Revise eye sockets..         0256        28.82    $1,465.27      $623.05      $293.05
   21263  T                Revise eye sockets..         0256        28.82    $1,465.27      $623.05      $293.05
   21267  T                Revise eye sockets..         0256        28.82    $1,465.27      $623.05      $293.05
   21268  C                Revise eye sockets..  ...........  ...........  ...........  ...........  ...........
   21270  T                Augmentation, cheek          0256        28.82    $1,465.27      $623.05      $293.05
                            bone.
   21275  T                Revision,                    0256        28.82    $1,465.27      $623.05      $293.05
                            orbitofacial bones.
   21280  T                Revision of eyelid..         0256        28.82    $1,465.27      $623.05      $293.05
   21282  T                Revision of eyelid..         0253        13.27      $674.67      $284.00      $134.93
   21295  T                Revision of jaw              0252         6.53      $332.00      $114.24       $66.40
                            muscle/bone.
   21296  T                Revision of jaw              0254        19.11      $971.59      $272.41      $194.32
                            muscle/bone.
   21299  T                Cranio/maxillofacial         0253        13.27      $674.67      $284.00      $134.93
                            surgery.
   21300  T                Treatment of skull           0253        13.27      $674.67      $284.00      $134.93
                            fracture.
   21310  T                Treatment of nose            0253        13.27      $674.67      $284.00      $134.93
                            fracture.
   21315  T                Treatment of nose            0253        13.27      $674.67      $284.00      $134.93
                            fracture.
   21320  T                Treatment of nose            0253        13.27      $674.67      $284.00      $134.93
                            fracture.
   21325  T                Treatment of nose            0254        19.11      $971.59      $272.41      $194.32
                            fracture.
   21330  T                Treatment of nose            0254        19.11      $971.59      $272.41      $194.32
                            fracture.
   21335  T                Treatment of nose            0254        19.11      $971.59      $272.41      $194.32
                            fracture.
   21336  T                Treat nasal septal           0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   21337  T                Treat nasal septal           0253        13.27      $674.67      $284.00      $134.93
                            fracture.
   21338  T                Treat nasoethmoid            0254        19.11      $971.59      $272.41      $194.32
                            fracture.
   21339  T                Treat nasoethmoid            0254        19.11      $971.59      $272.41      $194.32
                            fracture.
   21340  T                Treatment of nose            0256        28.82    $1,465.27      $623.05      $293.05
                            fracture.
   21343  C                Treatment of sinus    ...........  ...........  ...........  ...........  ...........
                            fracture.
   21344  C                Treatment of sinus    ...........  ...........  ...........  ...........  ...........
                            fracture.
   21345  T                Treat nose/jaw               0254        19.11      $971.59      $272.41      $194.32
                            fracture.
   21346  C                Treat nose/jaw        ...........  ...........  ...........  ...........  ...........
                            fracture.
   21347  C                Treat nose/jaw        ...........  ...........  ...........  ...........  ...........
                            fracture.
   21348  C                Treat nose/jaw        ...........  ...........  ...........  ...........  ...........
                            fracture.
   21355  T                Treat cheek bone             0256        28.82    $1,465.27      $623.05      $293.05
                            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.

[[Page 44741]]

 
   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             0252         6.53      $332.00      $114.24       $66.40
                            fracture.
   21401  T                Treat eye socket             0253        13.27      $674.67      $284.00      $134.93
                            fracture.
   21406  T                Treat eye socket             0256        28.82    $1,465.27      $623.05      $293.05
                            fracture.
   21407  T                Treat eye socket             0256        28.82    $1,465.27      $623.05      $293.05
                            fracture.
   21408  C                Treat eye socket      ...........  ...........  ...........  ...........  ...........
                            fracture.
   21421  T                Treat mouth roof             0254        19.11      $971.59      $272.41      $194.32
                            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.
   21440  T                Treat dental ridge           0254        19.11      $971.59      $272.41      $194.32
                            fracture.
   21445  T                Treat dental ridge           0254        19.11      $971.59      $272.41      $194.32
                            fracture.
   21450  T                Treat lower jaw              0251         2.71      $137.78       $27.99       $27.56
                            fracture.
   21451  T                Treat lower jaw              0252         6.53      $332.00      $114.24       $66.40
                            fracture.
   21452  T                Treat lower jaw              0253        13.27      $674.67      $284.00      $134.93
                            fracture.
   21453  T                Treat lower jaw              0256        28.82    $1,465.27      $623.05      $293.05
                            fracture.
   21454  T                Treat lower jaw              0254        19.11      $971.59      $272.41      $194.32
                            fracture.
   21461  T                Treat lower jaw              0256        28.82    $1,465.27      $623.05      $293.05
                            fracture.
   21462  T                Treat lower jaw              0256        28.82    $1,465.27      $623.05      $293.05
                            fracture.
   21465  T                Treat lower jaw              0256        28.82    $1,465.27      $623.05      $293.05
                            fracture.
   21470  T                Treat lower jaw              0256        28.82    $1,465.27      $623.05      $293.05
                            fracture.
   21480  T                Reset dislocated jaw         0251         2.71      $137.78       $27.99       $27.56
   21485  T                Reset dislocated jaw         0253        13.27      $674.67      $284.00      $134.93
   21490  T                Repair dislocated            0256        28.82    $1,465.27      $623.05      $293.05
                            jaw.
   21493  T                Treat hyoid bone             0252         6.53      $332.00      $114.24       $66.40
                            fracture.
   21494  T                Treat hyoid bone             0252         6.53      $332.00      $114.24       $66.40
                            fracture.
   21495  C                Treat hyoid bone      ...........  ...........  ...........  ...........  ...........
                            fracture.
   21497  T                Interdental wiring..         0253        13.27      $674.67      $284.00      $134.93
   21499  T                Head surgery                 0253        13.27      $674.67      $284.00      $134.93
                            procedure.
   21501  T                Drain neck/chest             0008        11.36      $577.57      $115.51      $115.51
                            lesion.
   21502  T                Drain chest lesion..         0049        17.07      $867.87      $356.95      $173.57
   21510  C                Drainage of bone      ...........  ...........  ...........  ...........  ...........
                            lesion.
   21550  T                Biopsy of neck/chest         0019         4.56      $231.84       $78.91       $46.37
   21555  T                Remove lesion, neck/         0022        15.07      $766.19      $292.94      $153.24
                            chest.
   21556  T                Remove lesion, neck/         0022        15.07      $766.19      $292.94      $153.24
                            chest.
   21557  C                Remove tumor, neck/   ...........  ...........  ...........  ...........  ...........
                            chest.
   21600  T                Partial removal of           0050        22.31    $1,134.29      $513.86      $226.86
                            rib.
   21610  T                Partial removal of           0050        22.31    $1,134.29      $513.86      $226.86
                            rib.
   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             0008        11.36      $577.57      $115.51      $115.51
                            muscle.
   21705  C                Revision of neck      ...........  ...........  ...........  ...........  ...........
                            muscle/rib.
   21720  T                Revision of neck             0008        11.36      $577.57      $115.51      $115.51
                            muscle.
   21725  T                Revision of neck             0008        11.36      $577.57      $115.51      $115.51
                            muscle.
   21740  C                Reconstruction of     ...........  ...........  ...........  ...........  ...........
                            sternum.
   21750  C                Repair of sternum     ...........  ...........  ...........  ...........  ...........
                            separation.
   21800  T                Treatment of rib             0043         4.13      $209.98       $42.00       $42.00
                            fracture.
   21805  T                Treatment of rib             0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   21810  C                Treatment of rib      ...........  ...........  ...........  ...........  ...........
                            fracture(s).
   21820  T                Treat sternum                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   21825  C                Treat sternum         ...........  ...........  ...........  ...........  ...........
                            fracture.
   21899  T                Neck/chest surgery           0252         6.53      $332.00      $114.24       $66.40
                            procedure.
   21920  T                Biopsy soft tissue           0020         8.56      $435.21      $130.53       $87.04
                            of back.
   21925  T                Biopsy soft tissue           0022        15.07      $766.19      $292.94      $153.24
                            of back.
   21930  T                Remove lesion, back          0022        15.07      $766.19      $292.94      $153.24
                            or flank.
   21935  T                Remove tumor, back..         0022        15.07      $766.19      $292.94      $153.24
   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.

[[Page 44742]]

 
   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          0043         4.13      $209.98       $42.00       $42.00
                            fracture.
   22310  T                Treat spine fracture         0043         4.13      $209.98       $42.00       $42.00
   22315  T                Treat spine fracture         0043         4.13      $209.98       $42.00       $42.00
   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              0045        12.91      $656.37      $277.12      $131.27
                            spine.
   22520  T                Percut                       0050        22.31    $1,134.29      $513.86      $226.86
                            vertebroplasty thor.
   22521  T                Percut                       0050        22.31    $1,134.29      $513.86      $226.86
                            vertebroplasty lumb.
   22522  T                Percut                       0050        22.31    $1,134.29      $513.86      $226.86
                            vertebroplasty addl.
   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.
   22899  T                Spine surgery                0043         4.13      $209.98       $42.00       $42.00
                            procedure.
   22900  T                Remove abdominal             0022        15.07      $766.19      $292.94      $153.24
                            wall lesion.
   22999  T                Abdomen surgery              0022        15.07      $766.19      $292.94      $153.24
                            procedure.
   23000  T                Removal of calcium           0021        12.74      $647.73      $236.51      $129.55
                            deposits.
   23020  T                Release shoulder             0051        30.94    $1,573.05      $675.24      $314.61
                            joint.
   23030  T                Drain shoulder               0008        11.36      $577.57      $115.51      $115.51
                            lesion.
   23031  T                Drain shoulder bursa         0008        11.36      $577.57      $115.51      $115.51
   23035  C                Drain shoulder bone   ...........  ...........  ...........  ...........  ...........
                            lesion.
   23040  T                Exploratory shoulder         0050        22.31    $1,134.29      $513.86      $226.86
                            surgery.
   23044  T                Exploratory shoulder         0050        22.31    $1,134.29      $513.86      $226.86
                            surgery.
   23065  T                Biopsy shoulder              0021        12.74      $647.73      $236.51      $129.55
                            tissues.
   23066  T                Biopsy shoulder              0022        15.07      $766.19      $292.94      $153.24
                            tissues.
   23075  T                Removal of shoulder          0021        12.74      $647.73      $236.51      $129.55
                            lesion.
   23076  T                Removal of shoulder          0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   23077  T                Remove tumor of              0022        15.07      $766.19      $292.94      $153.24
                            shoulder.
   23100  T                Biopsy of shoulder           0049        17.07      $867.87      $356.95      $173.57
                            joint.
   23101  T                Shoulder joint               0050        22.31    $1,134.29      $513.86      $226.86
                            surgery.

[[Page 44743]]

 
   23105  T                Remove shoulder              0050        22.31    $1,134.29      $513.86      $226.86
                            joint lining.
   23106  T                Incision of                  0050        22.31    $1,134.29      $513.86      $226.86
                            collarbone joint.
   23107  T                Explore treat                0050        22.31    $1,134.29      $513.86      $226.86
                            shoulder joint.
   23120  T                Partial removal,             0051        30.94    $1,573.05      $675.24      $314.61
                            collar bone.
   23125  C                Removal of collar     ...........  ...........  ...........  ...........  ...........
                            bone.
   23130  T                Remove shoulder              0051        30.94    $1,573.05      $675.24      $314.61
                            bone, part.
   23140  T                Removal of bone              0049        17.07      $867.87      $356.95      $173.57
                            lesion.
   23145  T                Removal of bone              0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   23146  T                Removal of bone              0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   23150  T                Removal of humerus           0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   23155  T                Removal of humerus           0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   23156  T                Removal of humerus           0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   23170  T                Remove collar bone           0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   23172  T                Remove shoulder              0050        22.31    $1,134.29      $513.86      $226.86
                            blade lesion.
   23174  T                Remove humerus               0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   23180  T                Remove collar bone           0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   23182  T                Remove shoulder              0050        22.31    $1,134.29      $513.86      $226.86
                            blade lesion.
   23184  T                Remove humerus               0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   23190  T                Partial removal of           0050        22.31    $1,134.29      $513.86      $226.86
                            scapula.
   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.
   23330  T                Remove shoulder              0019         4.56      $231.84       $78.91       $46.37
                            foreign body.
   23331  T                Remove shoulder              0022        15.07      $766.19      $292.94      $153.24
                            foreign body.
   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 &         0050        22.31    $1,134.29      $513.86      $226.86
                            muscle.
   23406  T                Incise tendon(s) &           0050        22.31    $1,134.29      $513.86      $226.86
                            muscle(s).
   23410  T                Repair of tendon(s).         0052        38.88    $1,976.74      $930.91      $395.35
   23412  T                Repair of tendon(s).         0052        38.88    $1,976.74      $930.91      $395.35
   23415  T                Release of shoulder          0051        30.94    $1,573.05      $675.24      $314.61
                            ligament.
   23420  T                Repair of shoulder..         0052        38.88    $1,976.74      $930.91      $395.35
   23430  T                Repair biceps tendon         0052        38.88    $1,976.74      $930.91      $395.35
   23440  C                Remove/transplant     ...........  ...........  ...........  ...........  ...........
                            tendon.
   23450  T                Repair shoulder              0052        38.88    $1,976.74      $930.91      $395.35
                            capsule.
   23455  T                Repair shoulder              0052        38.88    $1,976.74      $930.91      $395.35
                            capsule.
   23460  T                Repair shoulder              0052        38.88    $1,976.74      $930.91      $395.35
                            capsule.
   23462  T                Repair shoulder              0052        38.88    $1,976.74      $930.91      $395.35
                            capsule.
   23465  T                Repair shoulder              0052        38.88    $1,976.74      $930.91      $395.35
                            capsule.
   23466  T                Repair shoulder              0052        38.88    $1,976.74      $930.91      $395.35
                            capsule.
   23470  C                Reconstruct shoulder  ...........  ...........  ...........  ...........  ...........
                            joint.
   23472  C                Reconstruct shoulder  ...........  ...........  ...........  ...........  ...........
                            joint.
   23480  T                Revision of collar           0051        30.94    $1,573.05      $675.24      $314.61
                            bone.
   23485  T                Revision of collar           0051        30.94    $1,573.05      $675.24      $314.61
                            bone.
   23490  T                Reinforce clavicle..         0051        30.94    $1,573.05      $675.24      $314.61
   23491  T                Reinforce shoulder           0051        30.94    $1,573.05      $675.24      $314.61
                            bones.
   23500  T                Treat clavicle               0043         4.13      $209.98       $42.00       $42.00
                            fracture.
   23505  T                Treat clavicle               0043         4.13      $209.98       $42.00       $42.00
                            fracture.
   23515  T                Treat clavicle               0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   23520  T                Treat clavicle               0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   23525  T                Treat clavicle               0043         4.13      $209.98       $42.00       $42.00
                            dislocation.
   23530  T                Treat clavicle               0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   23532  T                Treat clavicle               0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   23540  T                Treat clavicle               0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   23545  T                Treat clavicle               0043         4.13      $209.98       $42.00       $42.00
                            dislocation.
   23550  T                Treat clavicle               0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   23552  T                Treat clavicle               0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   23570  T                Treat shoulder blade         0043         4.13      $209.98       $42.00       $42.00
                            fx.
   23575  T                Treat shoulder blade         0044         2.73      $138.80       $38.08       $27.76
                            fx.
   23585  T                Treat scapula                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   23600  T                Treat humerus                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   23605  T                Treat humerus                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   23615  T                Treat humerus                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   23616  T                Treat humerus                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   23620  T                Treat humerus                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   23625  T                Treat humerus                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   23630  T                Treat humerus                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   23650  T                Treat shoulder               0043         4.13      $209.98       $42.00       $42.00
                            dislocation.
   23655  T                Treat shoulder               0045        12.91      $656.37      $277.12      $131.27
                            dislocation.

[[Page 44744]]

 
   23660  T                Treat shoulder               0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   23665  T                Treat dislocation/           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   23670  T                Treat dislocation/           0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   23675  T                Treat dislocation/           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   23680  T                Treat dislocation/           0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   23700  T                Fixation of shoulder         0045        12.91      $656.37      $277.12      $131.27
   23800  T                Fusion of shoulder           0051        30.94    $1,573.05      $675.24      $314.61
                            joint.
   23802  T                Fusion of shoulder           0051        30.94    $1,573.05      $675.24      $314.61
                            joint.
   23900  C                Amputation of arm &   ...........  ...........  ...........  ...........  ...........
                            girdle.
   23920  C                Amputation at         ...........  ...........  ...........  ...........  ...........
                            shoulder joint.
   23921  T                Amputation follow-up         0026        13.51      $686.88      $277.92      $137.38
                            surgery.
   23929  T                Shoulder surgery             0043         4.13      $209.98       $42.00       $42.00
                            procedure.
   23930  T                Drainage of arm              0008        11.36      $577.57      $115.51      $115.51
                            lesion.
   23931  T                Drainage of arm              0008        11.36      $577.57      $115.51      $115.51
                            bursa.
   23935  T                Drain arm/elbow bone         0049        17.07      $867.87      $356.95      $173.57
                            lesion.
   24000  T                Exploratory elbow            0050        22.31    $1,134.29      $513.86      $226.86
                            surgery.
   24006  T                Release elbow joint.         0050        22.31    $1,134.29      $513.86      $226.86
   24065  T                Biopsy arm/elbow             0020         8.56      $435.21      $130.53       $87.04
                            soft tissue.
   24066  T                Biopsy arm/elbow             0021        12.74      $647.73      $236.51      $129.55
                            soft tissue.
   24075  T                Remove arm/elbow             0021        12.74      $647.73      $236.51      $129.55
                            lesion.
   24076  T                Remove arm/elbow             0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   24077  T                Remove tumor of arm/         0022        15.07      $766.19      $292.94      $153.24
                            elbow.
   24100  T                Biopsy elbow joint           0049        17.07      $867.87      $356.95      $173.57
                            lining.
   24101  T                Explore/treat elbow          0050        22.31    $1,134.29      $513.86      $226.86
                            joint.
   24102  T                Remove elbow joint           0050        22.31    $1,134.29      $513.86      $226.86
                            lining.
   24105  T                Removal of elbow             0049        17.07      $867.87      $356.95      $173.57
                            bursa.
   24110  T                Remove humerus               0049        17.07      $867.87      $356.95      $173.57
                            lesion.
   24115  T                Remove/graft bone            0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   24116  T                Remove/graft bone            0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   24120  T                Remove elbow lesion.         0049        17.07      $867.87      $356.95      $173.57
   24125  T                Remove/graft bone            0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   24126  T                Remove/graft bone            0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   24130  T                Removal of head of           0050        22.31    $1,134.29      $513.86      $226.86
                            radius.
   24134  T                Removal of arm bone          0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   24136  T                Remove radius bone           0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   24138  T                Remove elbow bone            0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   24140  T                Partial removal of           0050        22.31    $1,134.29      $513.86      $226.86
                            arm bone.
   24145  T                Partial removal of           0050        22.31    $1,134.29      $513.86      $226.86
                            radius.
   24147  T                Partial removal of           0050        22.31    $1,134.29      $513.86      $226.86
                            elbow.
   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             0051        30.94    $1,573.05      $675.24      $314.61
                            joint.
   24160  T                Remove elbow joint           0050        22.31    $1,134.29      $513.86      $226.86
                            implant.
   24164  T                Remove radius head           0050        22.31    $1,134.29      $513.86      $226.86
                            implant.
   24200  T                Removal of arm               0019         4.56      $231.84       $78.91       $46.37
                            foreign body.
   24201  T                Removal of arm               0021        12.74      $647.73      $236.51      $129.55
                            foreign body.
   24220  N                Injection for elbow   ...........  ...........  ...........  ...........  ...........
                            x-ray.
   24301  T                Muscle/tendon                0050        22.31    $1,134.29      $513.86      $226.86
                            transfer.
   24305  T                Arm tendon                   0050        22.31    $1,134.29      $513.86      $226.86
                            lengthening.
   24310  T                Revision of arm              0049        17.07      $867.87      $356.95      $173.57
                            tendon.
   24320  T                Repair of arm tendon         0051        30.94    $1,573.05      $675.24      $314.61
   24330  T                Revision of arm              0051        30.94    $1,573.05      $675.24      $314.61
                            muscles.
   24331  T                Revision of arm              0051        30.94    $1,573.05      $675.24      $314.61
                            muscles.
   24340  T                Repair of biceps             0051        30.94    $1,573.05      $675.24      $314.61
                            tendon.
   24341  T                Repair arm tendon/           0051        30.94    $1,573.05      $675.24      $314.61
                            muscle.
   24342  T                Repair of ruptured           0051        30.94    $1,573.05      $675.24      $314.61
                            tendon.
   24350  T                Repair of tennis             0050        22.31    $1,134.29      $513.86      $226.86
                            elbow.
   24351  T                Repair of tennis             0050        22.31    $1,134.29      $513.86      $226.86
                            elbow.
   24352  T                Repair of tennis             0050        22.31    $1,134.29      $513.86      $226.86
                            elbow.
   24354  T                Repair of tennis             0050        22.31    $1,134.29      $513.86      $226.86
                            elbow.
   24356  T                Revision of tennis           0050        22.31    $1,134.29      $513.86      $226.86
                            elbow.
   24360  T                Reconstruct elbow            0047        28.54    $1,451.03      $537.03      $290.21
                            joint.
   24361  T                Reconstruct elbow            0048        32.37    $1,645.76      $725.94      $329.15
                            joint.
   24362  T                Reconstruct elbow            0048        32.37    $1,645.76      $725.94      $329.15
                            joint.
   24363  T                Replace elbow joint.         0048        32.37    $1,645.76      $725.94      $329.15
   24365  T                Reconstruct head of          0047        28.54    $1,451.03      $537.03      $290.21
                            radius.
   24366  T                Reconstruct head of          0048        32.37    $1,645.76      $725.94      $329.15
                            radius.
   24400  T                Revision of humerus.         0050        22.31    $1,134.29      $513.86      $226.86
   24410  T                Revision of humerus.         0050        22.31    $1,134.29      $513.86      $226.86
   24420  T                Revision of humerus.         0051        30.94    $1,573.05      $675.24      $314.61
   24430  T                Repair of humerus...         0051        30.94    $1,573.05      $675.24      $314.61
   24435  T                Repair humerus with          0051        30.94    $1,573.05      $675.24      $314.61
                            graft.

[[Page 44745]]

 
   24470  T                Revision of elbow            0051        30.94    $1,573.05      $675.24      $314.61
                            joint.
   24495  T                Decompression of             0050        22.31    $1,134.29      $513.86      $226.86
                            forearm.
   24498  T                Reinforce humerus...         0051        30.94    $1,573.05      $675.24      $314.61
   24500  T                Treat humerus                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   24505  T                Treat humerus                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   24515  T                Treat humerus                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   24516  T                Treat humerus                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   24530  T                Treat humerus                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   24535  T                Treat humerus                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   24538  T                Treat humerus                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   24545  T                Treat humerus                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   24546  T                Treat humerus                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   24560  T                Treat humerus                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   24565  T                Treat humerus                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   24566  T                Treat humerus                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   24575  T                Treat humerus                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   24576  T                Treat humerus                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   24577  T                Treat humerus                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   24579  T                Treat humerus                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   24582  T                Treat humerus                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   24586  T                Treat elbow fracture         0046        25.36    $1,289.35      $535.76      $257.87
   24587  T                Treat elbow fracture         0046        25.36    $1,289.35      $535.76      $257.87
   24600  T                Treat elbow                  0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   24605  T                Treat elbow                  0045        12.91      $656.37      $277.12      $131.27
                            dislocation.
   24615  T                Treat elbow                  0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   24620  T                Treat elbow fracture         0044         2.73      $138.80       $38.08       $27.76
   24635  T                Treat elbow fracture         0046        25.36    $1,289.35      $535.76      $257.87
   24640  T                Treat elbow                  0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   24650  T                Treat radius                 0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   24655  T                Treat radius                 0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   24665  T                Treat radius                 0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   24666  T                Treat radius                 0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   24670  T                Treat ulnar fracture         0044         2.73      $138.80       $38.08       $27.76
   24675  T                Treat ulnar fracture         0044         2.73      $138.80       $38.08       $27.76
   24685  T                Treat ulnar fracture         0046        25.36    $1,289.35      $535.76      $257.87
   24800  T                Fusion of elbow              0051        30.94    $1,573.05      $675.24      $314.61
                            joint.
   24802  T                Fusion/graft of              0051        30.94    $1,573.05      $675.24      $314.61
                            elbow joint.
   24900  C                Amputation of upper   ...........  ...........  ...........  ...........  ...........
                            arm.
   24920  C                Amputation of upper   ...........  ...........  ...........  ...........  ...........
                            arm.
   24925  T                Amputation follow-up         0049        17.07      $867.87      $356.95      $173.57
                            surgery.
   24930  C                Amputation follow-up  ...........  ...........  ...........  ...........  ...........
                            surgery.
   24931  C                Amputate upper arm &  ...........  ...........  ...........  ...........  ...........
                            implant.
   24935  T                Revision of                  0052        38.88    $1,976.74      $930.91      $395.35
                            amputation.
   24940  C                Revision of upper     ...........  ...........  ...........  ...........  ...........
                            arm.
   24999  T                Upper arm/elbow              0044         2.73      $138.80       $38.08       $27.76
                            surgery.
   25000  T                Incision of tendon           0049        17.07      $867.87      $356.95      $173.57
                            sheath.
   25020  T                Decompression of             0049        17.07      $867.87      $356.95      $173.57
                            forearm.
   25023  T                Decompression of             0050        22.31    $1,134.29      $513.86      $226.86
                            forearm.
   25028  T                Drainage of forearm          0049        17.07      $867.87      $356.95      $173.57
                            lesion.
   25031  T                Drainage of forearm          0049        17.07      $867.87      $356.95      $173.57
                            bursa.
   25035  T                Treat forearm bone           0049        17.07      $867.87      $356.95      $173.57
                            lesion.
   25040  T                Explore/treat wrist          0050        22.31    $1,134.29      $513.86      $226.86
                            joint.
   25065  T                Biopsy forearm soft          0021        12.74      $647.73      $236.51      $129.55
                            tissues.
   25066  T                Biopsy forearm soft          0022        15.07      $766.19      $292.94      $153.24
                            tissues.
   25075  T                Removal of forearm           0020         8.56      $435.21      $130.53       $87.04
                            lesion.
   25076  T                Removal of forearm           0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   25077  T                Remove tumor,                0022        15.07      $766.19      $292.94      $153.24
                            forearm/wrist.
   25085  T                Incision of wrist            0049        17.07      $867.87      $356.95      $173.57
                            capsule.
   25100  T                Biopsy of wrist              0049        17.07      $867.87      $356.95      $173.57
                            joint.
   25101  T                Explore/treat wrist          0050        22.31    $1,134.29      $513.86      $226.86
                            joint.
   25105  T                Remove wrist joint           0050        22.31    $1,134.29      $513.86      $226.86
                            lining.
   25107  T                Remove wrist joint           0050        22.31    $1,134.29      $513.86      $226.86
                            cartilage.
   25110  T                Remove wrist tendon          0049        17.07      $867.87      $356.95      $173.57
                            lesion.
   25111  T                Remove wrist tendon          0053        12.67      $644.17      $253.49      $128.83
                            lesion.
   25112  T                Reremove wrist               0053        12.67      $644.17      $253.49      $128.83
                            tendon lesion.
   25115  T                Remove wrist/forearm         0049        17.07      $867.87      $356.95      $173.57
                            lesion.
   25116  T                Remove wrist/forearm         0049        17.07      $867.87      $356.95      $173.57
                            lesion.
   25118  T                Excise wrist tendon          0050        22.31    $1,134.29      $513.86      $226.86
                            sheath.
   25119  T                Partial removal of           0050        22.31    $1,134.29      $513.86      $226.86
                            ulna.
   25120  T                Removal of forearm           0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   25125  T                Remove/graft forearm         0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   25126  T                Remove/graft forearm         0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   25130  T                Removal of wrist             0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   25135  T                Remove & graft wrist         0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   25136  T                Remove & graft wrist         0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.

[[Page 44746]]

 
   25145  T                Remove forearm bone          0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   25150  T                Partial removal of           0050        22.31    $1,134.29      $513.86      $226.86
                            ulna.
   25151  T                Partial removal of           0050        22.31    $1,134.29      $513.86      $226.86
                            radius.
   25170  C                Extensive forearm     ...........  ...........  ...........  ...........  ...........
                            surgery.
   25210  T                Removal of wrist             0054        20.84    $1,059.55      $472.33      $211.91
                            bone.
   25215  T                Removal of wrist             0054        20.84    $1,059.55      $472.33      $211.91
                            bones.
   25230  T                Partial removal of           0050        22.31    $1,134.29      $513.86      $226.86
                            radius.
   25240  T                Partial removal of           0050        22.31    $1,134.29      $513.86      $226.86
                            ulna.
   25246  N                Injection for wrist   ...........  ...........  ...........  ...........  ...........
                            x-ray.
   25248  T                Remove forearm               0049        17.07      $867.87      $356.95      $173.57
                            foreign body.
   25250  T                Removal of wrist             0050        22.31    $1,134.29      $513.86      $226.86
                            prosthesis.
   25251  T                Removal of wrist             0050        22.31    $1,134.29      $513.86      $226.86
                            prosthesis.
   25260  T                Repair forearm               0050        22.31    $1,134.29      $513.86      $226.86
                            tendon/muscle.
   25263  T                Repair forearm               0050        22.31    $1,134.29      $513.86      $226.86
                            tendon/muscle.
   25265  T                Repair forearm               0050        22.31    $1,134.29      $513.86      $226.86
                            tendon/muscle.
   25270  T                Repair forearm               0050        22.31    $1,134.29      $513.86      $226.86
                            tendon/muscle.
   25272  T                Repair forearm               0050        22.31    $1,134.29      $513.86      $226.86
                            tendon/muscle.
   25274  T                Repair forearm               0050        22.31    $1,134.29      $513.86      $226.86
                            tendon/muscle.
   25280  T                Revise wrist/forearm         0050        22.31    $1,134.29      $513.86      $226.86
                            tendon.
   25290  T                Incise wrist/forearm         0050        22.31    $1,134.29      $513.86      $226.86
                            tendon.
   25295  T                Release wrist/               0049        17.07      $867.87      $356.95      $173.57
                            forearm tendon.
   25300  T                Fusion of tendons at         0050        22.31    $1,134.29      $513.86      $226.86
                            wrist.
   25301  T                Fusion of tendons at         0050        22.31    $1,134.29      $513.86      $226.86
                            wrist.
   25310  T                Transplant forearm           0051        30.94    $1,573.05      $675.24      $314.61
                            tendon.
   25312  T                Transplant forearm           0051        30.94    $1,573.05      $675.24      $314.61
                            tendon.
   25315  T                Revise palsy hand            0051        30.94    $1,573.05      $675.24      $314.61
                            tendon(s).
   25316  T                Revise palsy hand            0051        30.94    $1,573.05      $675.24      $314.61
                            tendon(s).
   25320  T                Repair/revise wrist          0051        30.94    $1,573.05      $675.24      $314.61
                            joint.
   25332  T                Revise wrist joint..         0047        28.54    $1,451.03      $537.03      $290.21
   25335  T                Realignment of hand.         0051        30.94    $1,573.05      $675.24      $314.61
   25337  T                Reconstruct ulna/            0051        30.94    $1,573.05      $675.24      $314.61
                            radioulnar.
   25350  T                Revision of radius..         0051        30.94    $1,573.05      $675.24      $314.61
   25355  T                Revision of radius..         0051        30.94    $1,573.05      $675.24      $314.61
   25360  T                Revision of ulna....         0050        22.31    $1,134.29      $513.86      $226.86
   25365  T                Revise radius & ulna         0050        22.31    $1,134.29      $513.86      $226.86
   25370  T                Revise radius or             0051        30.94    $1,573.05      $675.24      $314.61
                            ulna.
   25375  T                Revise radius & ulna         0051        30.94    $1,573.05      $675.24      $314.61
   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             0050        22.31    $1,134.29      $513.86      $226.86
                            ulna.
   25405  T                Repair/graft radius          0050        22.31    $1,134.29      $513.86      $226.86
                            or ulna.
   25415  T                Repair radius & ulna         0050        22.31    $1,134.29      $513.86      $226.86
   25420  C                Repair/graft radius   ...........  ...........  ...........  ...........  ...........
                            & ulna.
   25425  T                Repair/graft radius          0051        30.94    $1,573.05      $675.24      $314.61
                            or ulna.
   25426  T                Repair/graft radius          0051        30.94    $1,573.05      $675.24      $314.61
                            & ulna.
   25440  T                Repair/graft wrist           0051        30.94    $1,573.05      $675.24      $314.61
                            bone.
   25441  T                Reconstruct wrist            0048        32.37    $1,645.76      $725.94      $329.15
                            joint.
   25442  T                Reconstruct wrist            0048        32.37    $1,645.76      $725.94      $329.15
                            joint.
   25443  T                Reconstruct wrist            0048        32.37    $1,645.76      $725.94      $329.15
                            joint.
   25444  T                Reconstruct wrist            0048        32.37    $1,645.76      $725.94      $329.15
                            joint.
   25445  T                Reconstruct wrist            0048        32.37    $1,645.76      $725.94      $329.15
                            joint.
   25446  T                Wrist replacement...         0048        32.37    $1,645.76      $725.94      $329.15
   25447  T                Repair wrist                 0047        28.54    $1,451.03      $537.03      $290.21
                            joint(s).
   25449  T                Remove wrist joint           0047        28.54    $1,451.03      $537.03      $290.21
                            implant.
   25450  T                Revision of wrist            0051        30.94    $1,573.05      $675.24      $314.61
                            joint.
   25455  T                Revision of wrist            0051        30.94    $1,573.05      $675.24      $314.61
                            joint.
   25490  T                Reinforce radius....         0051        30.94    $1,573.05      $675.24      $314.61
   25491  T                Reinforce ulna......         0051        30.94    $1,573.05      $675.24      $314.61
   25492  T                Reinforce radius and         0051        30.94    $1,573.05      $675.24      $314.61
                            ulna.
   25500  T                Treat fracture of            0044         2.73      $138.80       $38.08       $27.76
                            radius.
   25505  T                Treat fracture of            0044         2.73      $138.80       $38.08       $27.76
                            radius.
   25515  T                Treat fracture of            0046        25.36    $1,289.35      $535.76      $257.87
                            radius.
   25520  T                Treat fracture of            0044         2.73      $138.80       $38.08       $27.76
                            radius.
   25525  T                Treat fracture of            0046        25.36    $1,289.35      $535.76      $257.87
                            radius.
   25526  T                Treat fracture of            0046        25.36    $1,289.35      $535.76      $257.87
                            radius.
   25530  T                Treat fracture of            0044         2.73      $138.80       $38.08       $27.76
                            ulna.
   25535  T                Treat fracture of            0044         2.73      $138.80       $38.08       $27.76
                            ulna.
   25545  T                Treat fracture of            0046        25.36    $1,289.35      $535.76      $257.87
                            ulna.
   25560  T                Treat fracture               0044         2.73      $138.80       $38.08       $27.76
                            radius & ulna.
   25565  T                Treat fracture               0044         2.73      $138.80       $38.08       $27.76
                            radius & ulna.
   25574  T                Treat fracture               0046        25.36    $1,289.35      $535.76      $257.87
                            radius & ulna.
   25575  T                Treat fracture               0046        25.36    $1,289.35      $535.76      $257.87
                            radius/ulna.
   25600  T                Treat fracture               0044         2.73      $138.80       $38.08       $27.76
                            radius/ulna.

[[Page 44747]]

 
   25605  T                Treat fracture               0044         2.73      $138.80       $38.08       $27.76
                            radius/ulna.
   25611  T                Treat fracture               0046        25.36    $1,289.35      $535.76      $257.87
                            radius/ulna.
   25620  T                Treat fracture               0046        25.36    $1,289.35      $535.76      $257.87
                            radius/ulna.
   25622  T                Treat wrist bone             0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   25624  T                Treat wrist bone             0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   25628  T                Treat wrist bone             0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   25630  T                Treat wrist bone             0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   25635  T                Treat wrist bone             0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   25645  T                Treat wrist bone             0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   25650  T                Treat wrist bone             0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   25660  T                Treat wrist                  0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   25670  T                Treat wrist                  0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   25675  T                Treat wrist                  0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   25676  T                Treat wrist                  0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   25680  T                Treat wrist fracture         0044         2.73      $138.80       $38.08       $27.76
   25685  T                Treat wrist fracture         0046        25.36    $1,289.35      $535.76      $257.87
   25690  T                Treat wrist                  0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   25695  T                Treat wrist                  0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   25800  T                Fusion of wrist              0051        30.94    $1,573.05      $675.24      $314.61
                            joint.
   25805  T                Fusion/graft of              0051        30.94    $1,573.05      $675.24      $314.61
                            wrist joint.
   25810  T                Fusion/graft of              0051        30.94    $1,573.05      $675.24      $314.61
                            wrist joint.
   25820  T                Fusion of hand bones         0053        12.67      $644.17      $253.49      $128.83
   25825  T                Fuse hand bones with         0054        20.84    $1,059.55      $472.33      $211.91
                            graft.
   25830  T                Fusion, radioulnar           0051        30.94    $1,573.05      $675.24      $314.61
                            jnt/ulna.
   25900  C                Amputation of         ...........  ...........  ...........  ...........  ...........
                            forearm.
   25905  C                Amputation of         ...........  ...........  ...........  ...........  ...........
                            forearm.
   25907  T                Amputation follow-up         0049        17.07      $867.87      $356.95      $173.57
                            surgery.
   25909  C                Amputation follow-up  ...........  ...........  ...........  ...........  ...........
                            surgery.
   25915  C                Amputation of         ...........  ...........  ...........  ...........  ...........
                            forearm.
   25920  C                Amputate hand at      ...........  ...........  ...........  ...........  ...........
                            wrist.
   25922  T                Amputate hand at             0049        17.07      $867.87      $356.95      $173.57
                            wrist.
   25924  C                Amputation follow-up  ...........  ...........  ...........  ...........  ...........
                            surgery.
   25927  C                Amputation of hand..  ...........  ...........  ...........  ...........  ...........
   25929  T                Amputation follow-up         0026        13.51      $686.88      $277.92      $137.38
                            surgery.
   25931  C                Amputation follow-up  ...........  ...........  ...........  ...........  ...........
                            surgery.
   25999  T                Forearm or wrist             0044         2.73      $138.80       $38.08       $27.76
                            surgery.
   26010  T                Drainage of finger           0006         2.36      $119.99       $33.95       $24.00
                            abscess.
   26011  T                Drainage of finger           0007         7.28      $370.13       $74.03       $74.03
                            abscess.
   26020  T                Drain hand tendon            0053        12.67      $644.17      $253.49      $128.83
                            sheath.
   26025  T                Drainage of palm             0053        12.67      $644.17      $253.49      $128.83
                            bursa.
   26030  T                Drainage of palm             0053        12.67      $644.17      $253.49      $128.83
                            bursa(s).
   26034  T                Treat hand bone              0053        12.67      $644.17      $253.49      $128.83
                            lesion.
   26035  T                Decompress fingers/          0053        12.67      $644.17      $253.49      $128.83
                            hand.
   26037  T                Decompress fingers/          0053        12.67      $644.17      $253.49      $128.83
                            hand.
   26040  T                Release palm                 0054        20.84    $1,059.55      $472.33      $211.91
                            contracture.
   26045  T                Release palm                 0054        20.84    $1,059.55      $472.33      $211.91
                            contracture.
   26055  T                Incise finger tendon         0053        12.67      $644.17      $253.49      $128.83
                            sheath.
   26060  T                Incision of finger           0053        12.67      $644.17      $253.49      $128.83
                            tendon.
   26070  T                Explore/treat hand           0053        12.67      $644.17      $253.49      $128.83
                            joint.
   26075  T                Explore/treat finger         0053        12.67      $644.17      $253.49      $128.83
                            joint.
   26080  T                Explore/treat finger         0053        12.67      $644.17      $253.49      $128.83
                            joint.
   26100  T                Biopsy hand joint            0053        12.67      $644.17      $253.49      $128.83
                            lining.
   26105  T                Biopsy finger joint          0053        12.67      $644.17      $253.49      $128.83
                            lining.
   26110  T                Biopsy finger joint          0053        12.67      $644.17      $253.49      $128.83
                            lining.
   26115  T                Removal of hand              0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   26116  T                Removal of hand              0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   26117  T                Remove tumor, hand/          0022        15.07      $766.19      $292.94      $153.24
                            finger.
   26121  T                Release palm                 0054        20.84    $1,059.55      $472.33      $211.91
                            contracture.
   26123  T                Release palm                 0054        20.84    $1,059.55      $472.33      $211.91
                            contracture.
   26125  T                Release palm                 0054        20.84    $1,059.55      $472.33      $211.91
                            contracture.
   26130  T                Remove wrist joint           0053        12.67      $644.17      $253.49      $128.83
                            lining.
   26135  T                Revise finger joint,         0054        20.84    $1,059.55      $472.33      $211.91
                            each.
   26140  T                Revise finger joint,         0053        12.67      $644.17      $253.49      $128.83
                            each.
   26145  T                Tendon excision,             0053        12.67      $644.17      $253.49      $128.83
                            palm/finger.
   26160  T                Remove tendon sheath         0053        12.67      $644.17      $253.49      $128.83
                            lesion.
   26170  T                Removal of palm              0053        12.67      $644.17      $253.49      $128.83
                            tendon, each.
   26180  T                Removal of finger            0053        12.67      $644.17      $253.49      $128.83
                            tendon.
   26185  T                Remove finger bone..         0053        12.67      $644.17      $253.49      $128.83
   26200  T                Remove hand bone             0053        12.67      $644.17      $253.49      $128.83
                            lesion.
   26205  T                Remove/graft bone            0054        20.84    $1,059.55      $472.33      $211.91
                            lesion.
   26210  T                Removal of finger            0053        12.67      $644.17      $253.49      $128.83
                            lesion.
   26215  T                Remove/graft finger          0053        12.67      $644.17      $253.49      $128.83
                            lesion.
   26230  T                Partial removal of           0053        12.67      $644.17      $253.49      $128.83
                            hand bone.
   26235  T                Partial removal,             0053        12.67      $644.17      $253.49      $128.83
                            finger bone.
   26236  T                Partial removal,             0053        12.67      $644.17      $253.49      $128.83
                            finger bone.

[[Page 44748]]

 
   26250  T                Extensive hand               0053        12.67      $644.17      $253.49      $128.83
                            surgery.
   26255  T                Extensive hand               0054        20.84    $1,059.55      $472.33      $211.91
                            surgery.
   26260  T                Extensive finger             0053        12.67      $644.17      $253.49      $128.83
                            surgery.
   26261  T                Extensive finger             0053        12.67      $644.17      $253.49      $128.83
                            surgery.
   26262  T                Partial removal of           0053        12.67      $644.17      $253.49      $128.83
                            finger.
   26320  T                Removal of implant           0020         8.56      $435.21      $130.53       $87.04
                            from hand.
   26350  T                Repair finger/hand           0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26352  T                Repair/graft hand            0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26356  T                Repair finger/hand           0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26357  T                Repair finger/hand           0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26358  T                Repair/graft hand            0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26370  T                Repair finger/hand           0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26372  T                Repair/graft hand            0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26373  T                Repair finger/hand           0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26390  T                Revise hand/finger           0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26392  T                Repair/graft hand            0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26410  T                Repair hand tendon..         0053        12.67      $644.17      $253.49      $128.83
   26412  T                Repair/graft hand            0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26415  T                Excision, hand/              0054        20.84    $1,059.55      $472.33      $211.91
                            finger tendon.
   26416  T                Graft hand or finger         0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26418  T                Repair finger tendon         0053        12.67      $644.17      $253.49      $128.83
   26420  T                Repair/graft finger          0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26426  T                Repair finger/hand           0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26428  T                Repair/graft finger          0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26432  T                Repair finger tendon         0053        12.67      $644.17      $253.49      $128.83
   26433  T                Repair finger tendon         0053        12.67      $644.17      $253.49      $128.83
   26434  T                Repair/graft finger          0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26437  T                Realignment of               0053        12.67      $644.17      $253.49      $128.83
                            tendons.
   26440  T                Release palm/finger          0053        12.67      $644.17      $253.49      $128.83
                            tendon.
   26442  T                Release palm &               0054        20.84    $1,059.55      $472.33      $211.91
                            finger tendon.
   26445  T                Release hand/finger          0053        12.67      $644.17      $253.49      $128.83
                            tendon.
   26449  T                Release forearm/hand         0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26450  T                Incision of palm             0053        12.67      $644.17      $253.49      $128.83
                            tendon.
   26455  T                Incision of finger           0053        12.67      $644.17      $253.49      $128.83
                            tendon.
   26460  T                Incise hand/finger           0053        12.67      $644.17      $253.49      $128.83
                            tendon.
   26471  T                Fusion of finger             0053        12.67      $644.17      $253.49      $128.83
                            tendons.
   26474  T                Fusion of finger             0053        12.67      $644.17      $253.49      $128.83
                            tendons.
   26476  T                Tendon lengthening..         0053        12.67      $644.17      $253.49      $128.83
   26477  T                Tendon shortening...         0053        12.67      $644.17      $253.49      $128.83
   26478  T                Lengthening of hand          0053        12.67      $644.17      $253.49      $128.83
                            tendon.
   26479  T                Shortening of hand           0053        12.67      $644.17      $253.49      $128.83
                            tendon.
   26480  T                Transplant hand              0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26483  T                Transplant/graft             0054        20.84    $1,059.55      $472.33      $211.91
                            hand tendon.
   26485  T                Transplant palm              0054        20.84    $1,059.55      $472.33      $211.91
                            tendon.
   26489  T                Transplant/graft             0054        20.84    $1,059.55      $472.33      $211.91
                            palm tendon.
   26490  T                Revise thumb tendon.         0054        20.84    $1,059.55      $472.33      $211.91
   26492  T                Tendon transfer with         0054        20.84    $1,059.55      $472.33      $211.91
                            graft.
   26494  T                Hand tendon/muscle           0054        20.84    $1,059.55      $472.33      $211.91
                            transfer.
   26496  T                Revise thumb tendon.         0054        20.84    $1,059.55      $472.33      $211.91
   26497  T                Finger tendon                0054        20.84    $1,059.55      $472.33      $211.91
                            transfer.
   26498  T                Finger tendon                0054        20.84    $1,059.55      $472.33      $211.91
                            transfer.
   26499  T                Revision of finger..         0054        20.84    $1,059.55      $472.33      $211.91
   26500  T                Hand tendon                  0053        12.67      $644.17      $253.49      $128.83
                            reconstruction.
   26502  T                Hand tendon                  0054        20.84    $1,059.55      $472.33      $211.91
                            reconstruction.
   26504  T                Hand tendon                  0054        20.84    $1,059.55      $472.33      $211.91
                            reconstruction.
   26508  T                Release thumb                0053        12.67      $644.17      $253.49      $128.83
                            contracture.
   26510  T                Thumb tendon                 0054        20.84    $1,059.55      $472.33      $211.91
                            transfer.
   26516  T                Fusion of knuckle            0054        20.84    $1,059.55      $472.33      $211.91
                            joint.
   26517  T                Fusion of knuckle            0054        20.84    $1,059.55      $472.33      $211.91
                            joints.
   26518  T                Fusion of knuckle            0054        20.84    $1,059.55      $472.33      $211.91
                            joints.
   26520  T                Release knuckle              0053        12.67      $644.17      $253.49      $128.83
                            contracture.
   26525  T                Release finger               0053        12.67      $644.17      $253.49      $128.83
                            contracture.
   26530  T                Revise knuckle joint         0047        28.54    $1,451.03      $537.03      $290.21
   26531  T                Revise knuckle with          0048        32.37    $1,645.76      $725.94      $329.15
                            implant.
   26535  T                Revise finger joint.         0047        28.54    $1,451.03      $537.03      $290.21
   26536  T                Revise/implant               0048        32.37    $1,645.76      $725.94      $329.15
                            finger joint.
   26540  T                Repair hand joint...         0053        12.67      $644.17      $253.49      $128.83
   26541  T                Repair hand joint            0054        20.84    $1,059.55      $472.33      $211.91
                            with graft.
   26542  T                Repair hand joint            0053        12.67      $644.17      $253.49      $128.83
                            with graft.
   26545  T                Reconstruct finger           0054        20.84    $1,059.55      $472.33      $211.91
                            joint.
   26546  T                Repair nonunion hand         0054        20.84    $1,059.55      $472.33      $211.91
   26548  T                Reconstruct finger           0054        20.84    $1,059.55      $472.33      $211.91
                            joint.
   26550  T                Construct thumb              0054        20.84    $1,059.55      $472.33      $211.91
                            replacement.
   26551  C                Great toe-hand        ...........  ...........  ...........  ...........  ...........
                            transfer.
   26553  C                Single transfer, toe- ...........  ...........  ...........  ...........  ...........
                            hand.

[[Page 44749]]

 
   26554  C                Double transfer, toe- ...........  ...........  ...........  ...........  ...........
                            hand.
   26555  T                Positional change of         0054        20.84    $1,059.55      $472.33      $211.91
                            finger.
   26556  C                Toe joint transfer..  ...........  ...........  ...........  ...........  ...........
   26560  T                Repair of web finger         0053        12.67      $644.17      $253.49      $128.83
   26561  T                Repair of web finger         0054        20.84    $1,059.55      $472.33      $211.91
   26562  T                Repair of web finger         0054        20.84    $1,059.55      $472.33      $211.91
   26565  T                Correct metacarpal           0054        20.84    $1,059.55      $472.33      $211.91
                            flaw.
   26567  T                Correct finger               0054        20.84    $1,059.55      $472.33      $211.91
                            deformity.
   26568  T                Lengthen metacarpal/         0054        20.84    $1,059.55      $472.33      $211.91
                            finger.
   26580  T                Repair hand                  0054        20.84    $1,059.55      $472.33      $211.91
                            deformity.
   26585  T                Repair finger                0054        20.84    $1,059.55      $472.33      $211.91
                            deformity.
   26587  T                Reconstruct extra            0053        12.67      $644.17      $253.49      $128.83
                            finger.
   26590  T                Repair finger                0054        20.84    $1,059.55      $472.33      $211.91
                            deformity.
   26591  T                Repair muscles of            0054        20.84    $1,059.55      $472.33      $211.91
                            hand.
   26593  T                Release muscles of           0053        12.67      $644.17      $253.49      $128.83
                            hand.
   26596  T                Excision                     0054        20.84    $1,059.55      $472.33      $211.91
                            constricting tissue.
   26597  T                Release of scar              0054        20.84    $1,059.55      $472.33      $211.91
                            contracture.
   26600  T                Treat metacarpal             0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   26605  T                Treat metacarpal             0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   26607  T                Treat metacarpal             0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   26608  T                Treat metacarpal             0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   26615  T                Treat metacarpal             0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   26641  T                Treat thumb                  0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   26645  T                Treat thumb fracture         0044         2.73      $138.80       $38.08       $27.76
   26650  T                Treat thumb fracture         0046        25.36    $1,289.35      $535.76      $257.87
   26665  T                Treat thumb fracture         0046        25.36    $1,289.35      $535.76      $257.87
   26670  T                Treat hand                   0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   26675  T                Treat hand                   0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   26676  T                Pin hand dislocation         0046        25.36    $1,289.35      $535.76      $257.87
   26685  T                Treat hand                   0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   26686  T                Treat hand                   0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   26700  T                Treat knuckle                0043         4.13      $209.98       $42.00       $42.00
                            dislocation.
   26705  T                Treat knuckle                0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   26706  T                Pin knuckle                  0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   26715  T                Treat knuckle                0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   26720  T                Treat finger                 0043         4.13      $209.98       $42.00       $42.00
                            fracture, each.
   26725  T                Treat finger                 0043         4.13      $209.98       $42.00       $42.00
                            fracture, each.
   26727  T                Treat finger                 0046        25.36    $1,289.35      $535.76      $257.87
                            fracture, each.
   26735  T                Treat finger                 0046        25.36    $1,289.35      $535.76      $257.87
                            fracture, each.
   26740  T                Treat finger                 0043         4.13      $209.98       $42.00       $42.00
                            fracture, each.
   26742  T                Treat finger                 0044         2.73      $138.80       $38.08       $27.76
                            fracture, each.
   26746  T                Treat finger                 0046        25.36    $1,289.35      $535.76      $257.87
                            fracture, each.
   26750  T                Treat finger                 0043         4.13      $209.98       $42.00       $42.00
                            fracture, each.
   26755  T                Treat finger                 0043         4.13      $209.98       $42.00       $42.00
                            fracture, each.
   26756  T                Pin finger fracture,         0046        25.36    $1,289.35      $535.76      $257.87
                            each.
   26765  T                Treat finger                 0046        25.36    $1,289.35      $535.76      $257.87
                            fracture, each.
   26770  T                Treat finger                 0043         4.13      $209.98       $42.00       $42.00
                            dislocation.
   26775  T                Treat finger                 0045        12.91      $656.37      $277.12      $131.27
                            dislocation.
   26776  T                Pin finger                   0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   26785  T                Treat finger                 0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   26820  T                Thumb fusion with            0054        20.84    $1,059.55      $472.33      $211.91
                            graft.
   26841  T                Fusion of thumb.....         0054        20.84    $1,059.55      $472.33      $211.91
   26842  T                Thumb fusion with            0054        20.84    $1,059.55      $472.33      $211.91
                            graft.
   26843  T                Fusion of hand joint         0054        20.84    $1,059.55      $472.33      $211.91
   26844  T                Fusion/graft of hand         0054        20.84    $1,059.55      $472.33      $211.91
                            joint.
   26850  T                Fusion of knuckle...         0054        20.84    $1,059.55      $472.33      $211.91
   26852  T                Fusion of knuckle            0054        20.84    $1,059.55      $472.33      $211.91
                            with graft.
   26860  T                Fusion of finger             0054        20.84    $1,059.55      $472.33      $211.91
                            joint.
   26861  T                Fusion of finger             0054        20.84    $1,059.55      $472.33      $211.91
                            jnt, add-on.
   26862  T                Fusion/graft of              0054        20.84    $1,059.55      $472.33      $211.91
                            finger joint.
   26863  T                Fuse/graft added             0054        20.84    $1,059.55      $472.33      $211.91
                            joint.
   26910  T                Amputate metacarpal          0054        20.84    $1,059.55      $472.33      $211.91
                            bone.
   26951  T                Amputation of finger/        0053        12.67      $644.17      $253.49      $128.83
                            thumb.
   26952  T                Amputation of finger/        0053        12.67      $644.17      $253.49      $128.83
                            thumb.
   26989  T                Hand/finger surgery.         0043         4.13      $209.98       $42.00       $42.00
   26990  T                Drainage of pelvis           0049        17.07      $867.87      $356.95      $173.57
                            lesion.
   26991  T                Drainage of pelvis           0049        17.07      $867.87      $356.95      $173.57
                            bursa.
   26992  C                Drainage of bone      ...........  ...........  ...........  ...........  ...........
                            lesion.
   27000  T                Incision of hip              0049        17.07      $867.87      $356.95      $173.57
                            tendon.
   27001  T                Incision of hip              0050        22.31    $1,134.29      $513.86      $226.86
                            tendon.
   27003  T                Incision of hip              0050        22.31    $1,134.29      $513.86      $226.86
                            tendon.
   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.

[[Page 44750]]

 
   27033  T                Exploration of hip           0051        30.94    $1,573.05      $675.24      $314.61
                            joint.
   27035  C                Denervation of hip    ...........  ...........  ...........  ...........  ...........
                            joint.
   27036  C                Excision of hip       ...........  ...........  ...........  ...........  ...........
                            joint/muscle.
   27040  T                Biopsy of soft               0021        12.74      $647.73      $236.51      $129.55
                            tissues.
   27041  T                Biopsy of soft               0022        15.07      $766.19      $292.94      $153.24
                            tissues.
   27047  T                Remove hip/pelvis            0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   27048  T                Remove hip/pelvis            0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   27049  T                Remove tumor, hip/           0022        15.07      $766.19      $292.94      $153.24
                            pelvis.
   27050  T                Biopsy of sacroiliac         0049        17.07      $867.87      $356.95      $173.57
                            joint.
   27052  T                Biopsy of hip joint.         0049        17.07      $867.87      $356.95      $173.57
   27054  C                Removal of hip joint  ...........  ...........  ...........  ...........  ...........
                            lining.
   27060  T                Removal of ischial           0049        17.07      $867.87      $356.95      $173.57
                            bursa.
   27062  T                Remove femur lesion/         0049        17.07      $867.87      $356.95      $173.57
                            bursa.
   27065  T                Removal of hip bone          0049        17.07      $867.87      $356.95      $173.57
                            lesion.
   27066  T                Removal of hip bone          0050        22.31    $1,134.29      $513.86      $226.86
                            lesion.
   27067  T                Remove/graft hip             0050        22.31    $1,134.29      $513.86      $226.86
                            bone lesion.
   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        22.31    $1,134.29      $513.86      $226.86
   27086  T                Remove hip foreign           0019         4.56      $231.84       $78.91       $46.37
                            body.
   27087  T                Remove hip foreign           0049        17.07      $867.87      $356.95      $173.57
                            body.
   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              0050        22.31    $1,134.29      $513.86      $226.86
                            tendon.
   27098  T                Transfer tendon to           0050        22.31    $1,134.29      $513.86      $226.86
                            pelvis.
   27100  T                Transfer of                  0051        30.94    $1,573.05      $675.24      $314.61
                            abdominal muscle.
   27105  T                Transfer of spinal           0051        30.94    $1,573.05      $675.24      $314.61
                            muscle.
   27110  T                Transfer of                  0051        30.94    $1,573.05      $675.24      $314.61
                            iliopsoas muscle.
   27111  T                Transfer of                  0051        30.94    $1,573.05      $675.24      $314.61
                            iliopsoas muscle.
   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            0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27194  T                Treat pelvic ring            0045        12.91      $656.37      $277.12      $131.27
                            fracture.
   27200  T                Treat tail bone              0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27202  T                Treat tail bone              0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   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             0044         2.73      $138.80       $38.08       $27.76
                            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).

[[Page 44751]]

 
   27230  T                Treat thigh fracture         0044         2.73      $138.80       $38.08       $27.76
   27232  C                Treat thigh fracture  ...........  ...........  ...........  ...........  ...........
   27235  C                Treat thigh fracture  ...........  ...........  ...........  ...........  ...........
   27236  C                Treat thigh fracture  ...........  ...........  ...........  ...........  ...........
   27238  T                Treat thigh fracture         0044         2.73      $138.80       $38.08       $27.76
   27240  C                Treat thigh fracture  ...........  ...........  ...........  ...........  ...........
   27244  C                Treat thigh fracture  ...........  ...........  ...........  ...........  ...........
   27245  C                Treat thigh fracture  ...........  ...........  ...........  ...........  ...........
   27246  T                Treat thigh fracture         0043         4.13      $209.98       $42.00       $42.00
   27248  C                Treat thigh fracture  ...........  ...........  ...........  ...........  ...........
   27250  T                Treat hip                    0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   27252  T                Treat hip                    0045        12.91      $656.37      $277.12      $131.27
                            dislocation.
   27253  C                Treat hip             ...........  ...........  ...........  ...........  ...........
                            dislocation.
   27254  C                Treat hip             ...........  ...........  ...........  ...........  ...........
                            dislocation.
   27256  T                Treat hip                    0043         4.13      $209.98       $42.00       $42.00
                            dislocation.
   27257  T                Treat hip                    0045        12.91      $656.37      $277.12      $131.27
                            dislocation.
   27258  C                Treat hip             ...........  ...........  ...........  ...........  ...........
                            dislocation.
   27259  C                Treat hip             ...........  ...........  ...........  ...........  ...........
                            dislocation.
   27265  T                Treat hip                    0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   27266  T                Treat hip                    0047        28.54    $1,451.03      $537.03      $290.21
                            dislocation.
   27275  T                Manipulation of hip          0045        12.91      $656.37      $277.12      $131.27
                            joint.
   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             0043         4.13      $209.98       $42.00       $42.00
                            surgery.
   27301  T                Drain thigh/knee             0008        11.36      $577.57      $115.51      $115.51
                            lesion.
   27303  C                Drainage of bone      ...........  ...........  ...........  ...........  ...........
                            lesion.
   27305  T                Incise thigh tendon          0049        17.07      $867.87      $356.95      $173.57
                            & fascia.
   27306  T                Incision of thigh            0049        17.07      $867.87      $356.95      $173.57
                            tendon.
   27307  T                Incision of thigh            0049        17.07      $867.87      $356.95      $173.57
                            tendons.
   27310  T                Exploration of knee          0050        22.31    $1,134.29      $513.86      $226.86
                            joint.
   27315  T                Partial removal,             0220        14.76      $750.43      $326.21      $150.09
                            thigh nerve.
   27320  T                Partial removal,             0220        14.76      $750.43      $326.21      $150.09
                            thigh nerve.
   27323  T                Biopsy, thigh soft           0021        12.74      $647.73      $236.51      $129.55
                            tissues.
   27324  T                Biopsy, thigh soft           0022        15.07      $766.19      $292.94      $153.24
                            tissues.
   27327  T                Removal of thigh             0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   27328  T                Removal of thigh             0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   27329  T                Remove tumor, thigh/         0022        15.07      $766.19      $292.94      $153.24
                            knee.
   27330  T                Biopsy, knee joint           0050        22.31    $1,134.29      $513.86      $226.86
                            lining.
   27331  T                Explore/treat knee           0050        22.31    $1,134.29      $513.86      $226.86
                            joint.
   27332  T                Removal of knee              0050        22.31    $1,134.29      $513.86      $226.86
                            cartilage.
   27333  T                Removal of knee              0050        22.31    $1,134.29      $513.86      $226.86
                            cartilage.
   27334  T                Remove knee joint            0050        22.31    $1,134.29      $513.86      $226.86
                            lining.
   27335  T                Remove knee joint            0050        22.31    $1,134.29      $513.86      $226.86
                            lining.
   27340  T                Removal of kneecap           0049        17.07      $867.87      $356.95      $173.57
                            bursa.
   27345  T                Removal of knee cyst         0049        17.07      $867.87      $356.95      $173.57
   27347  T                Remove knee cyst....         0049        17.07      $867.87      $356.95      $173.57
   27350  T                Removal of kneecap..         0050        22.31    $1,134.29      $513.86      $226.86
   27355  T                Remove femur lesion.         0050        22.31    $1,134.29      $513.86      $226.86
   27356  T                Remove femur lesion/         0050        22.31    $1,134.29      $513.86      $226.86
                            graft.
   27357  T                Remove femur lesion/         0050        22.31    $1,134.29      $513.86      $226.86
                            graft.
   27358  T                Remove femur lesion/         0050        22.31    $1,134.29      $513.86      $226.86
                            fixation.
   27360  T                Partial removal, leg         0050        22.31    $1,134.29      $513.86      $226.86
                            bone(s).
   27365  C                Extensive leg         ...........  ...........  ...........  ...........  ...........
                            surgery.
   27370  N                Injection for knee x- ...........  ...........  ...........  ...........  ...........
                            ray.
   27372  T                Removal of foreign           0022        15.07      $766.19      $292.94      $153.24
                            body.
   27380  T                Repair of kneecap            0049        17.07      $867.87      $356.95      $173.57
                            tendon.
   27381  T                Repair/graft kneecap         0049        17.07      $867.87      $356.95      $173.57
                            tendon.
   27385  T                Repair of thigh              0049        17.07      $867.87      $356.95      $173.57
                            muscle.
   27386  T                Repair/graft of              0049        17.07      $867.87      $356.95      $173.57
                            thigh muscle.
   27390  T                Incision of thigh            0049        17.07      $867.87      $356.95      $173.57
                            tendon.
   27391  T                Incision of thigh            0049        17.07      $867.87      $356.95      $173.57
                            tendons.
   27392  T                Incision of thigh            0049        17.07      $867.87      $356.95      $173.57
                            tendons.
   27393  T                Lengthening of thigh         0050        22.31    $1,134.29      $513.86      $226.86
                            tendon.
   27394  T                Lengthening of thigh         0050        22.31    $1,134.29      $513.86      $226.86
                            tendons.
   27395  T                Lengthening of thigh         0051        30.94    $1,573.05      $675.24      $314.61
                            tendons.
   27396  T                Transplant of thigh          0050        22.31    $1,134.29      $513.86      $226.86
                            tendon.
   27397  T                Transplants of thigh         0051        30.94    $1,573.05      $675.24      $314.61
                            tendons.
   27400  T                Revise thigh muscles/        0051        30.94    $1,573.05      $675.24      $314.61
                            tendons.
   27403  T                Repair of knee               0050        22.31    $1,134.29      $513.86      $226.86
                            cartilage.
   27405  T                Repair of knee               0051        30.94    $1,573.05      $675.24      $314.61
                            ligament.
   27407  T                Repair of knee               0051        30.94    $1,573.05      $675.24      $314.61
                            ligament.

[[Page 44752]]

 
   27409  T                Repair of knee               0051        30.94    $1,573.05      $675.24      $314.61
                            ligaments.
   27418  T                Repair degenerated           0051        30.94    $1,573.05      $675.24      $314.61
                            kneecap.
   27420  T                Revision of unstable         0051        30.94    $1,573.05      $675.24      $314.61
                            kneecap.
   27422  T                Revision of unstable         0051        30.94    $1,573.05      $675.24      $314.61
                            kneecap.
   27424  T                Revision/removal of          0051        30.94    $1,573.05      $675.24      $314.61
                            kneecap.
   27425  T                Lateral retinacular          0050        22.31    $1,134.29      $513.86      $226.86
                            release.
   27427  T                Reconstruction, knee         0052        38.88    $1,976.74      $930.91      $395.35
   27428  T                Reconstruction, knee         0052        38.88    $1,976.74      $930.91      $395.35
   27429  T                Reconstruction, knee         0052        38.88    $1,976.74      $930.91      $395.35
   27430  T                Revision of thigh            0051        30.94    $1,573.05      $675.24      $314.61
                            muscles.
   27435  T                Incision of knee             0051        30.94    $1,573.05      $675.24      $314.61
                            joint.
   27437  T                Revise kneecap......         0047        28.54    $1,451.03      $537.03      $290.21
   27438  T                Revise kneecap with          0048        32.37    $1,645.76      $725.94      $329.15
                            implant.
   27440  T                Revision of knee             0047        28.54    $1,451.03      $537.03      $290.21
                            joint.
   27441  T                Revision of knee             0047        28.54    $1,451.03      $537.03      $290.21
                            joint.
   27442  T                Revision of knee             0047        28.54    $1,451.03      $537.03      $290.21
                            joint.
   27443  T                Revision of knee             0047        28.54    $1,451.03      $537.03      $290.21
                            joint.
   27445  C                Revision of knee      ...........  ...........  ...........  ...........  ...........
                            joint.
   27446  T                Revision of knee             0047        28.54    $1,451.03      $537.03      $290.21
                            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             0049        17.07      $867.87      $356.95      $173.57
                            thigh/knee.
   27497  T                Decompression of             0049        17.07      $867.87      $356.95      $173.57
                            thigh/knee.
   27498  T                Decompression of             0049        17.07      $867.87      $356.95      $173.57
                            thigh/knee.
   27499  T                Decompression of             0049        17.07      $867.87      $356.95      $173.57
                            thigh/knee.
   27500  T                Treatment of thigh           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27501  T                Treatment of thigh           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27502  T                Treatment of thigh           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27503  T                Treatment of thigh           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27506  C                Treatment of thigh    ...........  ...........  ...........  ...........  ...........
                            fracture.
   27507  C                Treatment of thigh    ...........  ...........  ...........  ...........  ...........
                            fracture.
   27508  T                Treatment of thigh           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27509  T                Treatment of thigh           0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   27510  T                Treatment of thigh           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27511  C                Treatment of thigh    ...........  ...........  ...........  ...........  ...........
                            fracture.
   27513  C                Treatment of thigh    ...........  ...........  ...........  ...........  ...........
                            fracture.
   27514  C                Treatment of thigh    ...........  ...........  ...........  ...........  ...........
                            fracture.
   27516  T                Treat thigh fx               0044         2.73      $138.80       $38.08       $27.76
                            growth plate.
   27517  T                Treat thigh fx               0043         4.13      $209.98       $42.00       $42.00
                            growth plate.
   27519  C                Treat thigh fx        ...........  ...........  ...........  ...........  ...........
                            growth plate.
   27520  T                Treat kneecap                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27524  T                Treat kneecap                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   27530  T                Treat knee fracture.         0044         2.73      $138.80       $38.08       $27.76
   27532  T                Treat knee fracture.         0044         2.73      $138.80       $38.08       $27.76
   27535  C                Treat knee fracture.  ...........  ...........  ...........  ...........  ...........
   27536  C                Treat knee fracture.  ...........  ...........  ...........  ...........  ...........
   27538  T                Treat knee                   0043         4.13      $209.98       $42.00       $42.00
                            fracture(s).
   27540  C                Treat knee fracture.  ...........  ...........  ...........  ...........  ...........
   27550  T                Treat knee                   0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   27552  T                Treat knee                   0045        12.91      $656.37      $277.12      $131.27
                            dislocation.
   27556  C                Treat knee            ...........  ...........  ...........  ...........  ...........
                            dislocation.
   27557  C                Treat knee            ...........  ...........  ...........  ...........  ...........
                            dislocation.
   27558  C                Treat knee            ...........  ...........  ...........  ...........  ...........
                            dislocation.
   27560  T                Treat kneecap                0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   27562  T                Treat kneecap                0045        12.91      $656.37      $277.12      $131.27
                            dislocation.
   27566  T                Treat kneecap                0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   27570  T                Fixation of knee             0045        12.91      $656.37      $277.12      $131.27
                            joint.
   27580  C                Fusion of knee......  ...........  ...........  ...........  ...........  ...........

[[Page 44753]]

 
   27590  C                Amputate leg at       ...........  ...........  ...........  ...........  ...........
                            thigh.
   27591  C                Amputate leg at       ...........  ...........  ...........  ...........  ...........
                            thigh.
   27592  C                Amputate leg at       ...........  ...........  ...........  ...........  ...........
                            thigh.
   27594  T                Amputation follow-up         0049        17.07      $867.87      $356.95      $173.57
                            surgery.
   27596  C                Amputation follow-up  ...........  ...........  ...........  ...........  ...........
                            surgery.
   27598  C                Amputate lower leg    ...........  ...........  ...........  ...........  ...........
                            at knee.
   27599  T                Leg surgery                  0044         2.73      $138.80       $38.08       $27.76
                            procedure.
   27600  T                Decompression of             0049        17.07      $867.87      $356.95      $173.57
                            lower leg.
   27601  T                Decompression of             0049        17.07      $867.87      $356.95      $173.57
                            lower leg.
   27602  T                Decompression of             0049        17.07      $867.87      $356.95      $173.57
                            lower leg.
   27603  T                Drain lower leg              0008        11.36      $577.57      $115.51      $115.51
                            lesion.
   27604  T                Drain lower leg              0049        17.07      $867.87      $356.95      $173.57
                            bursa.
   27605  T                Incision of achilles         0055        16.77      $852.62      $355.34      $170.52
                            tendon.
   27606  T                Incision of achilles         0049        17.07      $867.87      $356.95      $173.57
                            tendon.
   27607  T                Treat lower leg bone         0049        17.07      $867.87      $356.95      $173.57
                            lesion.
   27610  T                Explore/treat ankle          0050        22.31    $1,134.29      $513.86      $226.86
                            joint.
   27612  T                Exploration of ankle         0050        22.31    $1,134.29      $513.86      $226.86
                            joint.
   27613  T                Biopsy lower leg             0020         8.56      $435.21      $130.53       $87.04
                            soft tissue.
   27614  T                Biopsy lower leg             0022        15.07      $766.19      $292.94      $153.24
                            soft tissue.
   27615  T                Remove tumor, lower          0046        25.36    $1,289.35      $535.76      $257.87
                            leg.
   27618  T                Remove lower leg             0021        12.74      $647.73      $236.51      $129.55
                            lesion.
   27619  T                Remove lower leg             0022        15.07      $766.19      $292.94      $153.24
                            lesion.
   27620  T                Explore/treat ankle          0050        22.31    $1,134.29      $513.86      $226.86
                            joint.
   27625  T                Remove ankle joint           0050        22.31    $1,134.29      $513.86      $226.86
                            lining.
   27626  T                Remove ankle joint           0050        22.31    $1,134.29      $513.86      $226.86
                            lining.
   27630  T                Removal of tendon            0049        17.07      $867.87      $356.95      $173.57
                            lesion.
   27635  T                Remove lower leg             0050        22.31    $1,134.29      $513.86      $226.86
                            bone lesion.
   27637  T                Remove/graft leg             0050        22.31    $1,134.29      $513.86      $226.86
                            bone lesion.
   27638  T                Remove/graft leg             0050        22.31    $1,134.29      $513.86      $226.86
                            bone lesion.
   27640  T                Partial removal of           0051        30.94    $1,573.05      $675.24      $314.61
                            tibia.
   27641  T                Partial removal of           0050        22.31    $1,134.29      $513.86      $226.86
                            fibula.
   27645  C                Extensive lower leg   ...........  ...........  ...........  ...........  ...........
                            surgery.
   27646  C                Extensive lower leg   ...........  ...........  ...........  ...........  ...........
                            surgery.
   27647  T                Extensive ankle/heel         0051        30.94    $1,573.05      $675.24      $314.61
                            surgery.
   27648  N                Injection for ankle   ...........  ...........  ...........  ...........  ...........
                            x-ray.
   27650  T                Repair achilles              0051        30.94    $1,573.05      $675.24      $314.61
                            tendon.
   27652  T                Repair/graft                 0051        30.94    $1,573.05      $675.24      $314.61
                            achilles tendon.
   27654  T                Repair of achilles           0051        30.94    $1,573.05      $675.24      $314.61
                            tendon.
   27656  T                Repair leg fascia            0049        17.07      $867.87      $356.95      $173.57
                            defect.
   27658  T                Repair of leg                0049        17.07      $867.87      $356.95      $173.57
                            tendon, each.
   27659  T                Repair of leg                0049        17.07      $867.87      $356.95      $173.57
                            tendon, each.
   27664  T                Repair of leg                0049        17.07      $867.87      $356.95      $173.57
                            tendon, each.
   27665  T                Repair of leg                0050        22.31    $1,134.29      $513.86      $226.86
                            tendon, each.
   27675  T                Repair lower leg             0049        17.07      $867.87      $356.95      $173.57
                            tendons.
   27676  T                Repair lower leg             0050        22.31    $1,134.29      $513.86      $226.86
                            tendons.
   27680  T                Release of lower leg         0050        22.31    $1,134.29      $513.86      $226.86
                            tendon.
   27681  T                Release of lower leg         0050        22.31    $1,134.29      $513.86      $226.86
                            tendons.
   27685  T                Revision of lower            0050        22.31    $1,134.29      $513.86      $226.86
                            leg tendon.
   27686  T                Revise lower leg             0050        22.31    $1,134.29      $513.86      $226.86
                            tendons.
   27687  T                Revision of calf             0050        22.31    $1,134.29      $513.86      $226.86
                            tendon.
   27690  T                Revise lower leg             0051        30.94    $1,573.05      $675.24      $314.61
                            tendon.
   27691  T                Revise lower leg             0051        30.94    $1,573.05      $675.24      $314.61
                            tendon.
   27692  T                Revise additional            0051        30.94    $1,573.05      $675.24      $314.61
                            leg tendon.
   27695  T                Repair of ankle              0050        22.31    $1,134.29      $513.86      $226.86
                            ligament.
   27696  T                Repair of ankle              0050        22.31    $1,134.29      $513.86      $226.86
                            ligaments.
   27698  T                Repair of ankle              0050        22.31    $1,134.29      $513.86      $226.86
                            ligament.
   27700  T                Revision of ankle            0047        28.54    $1,451.03      $537.03      $290.21
                            joint.
   27702  C                Reconstruct ankle     ...........  ...........  ...........  ...........  ...........
                            joint.
   27703  C                Reconstruction,       ...........  ...........  ...........  ...........  ...........
                            ankle joint.
   27704  T                Removal of ankle             0049        17.07      $867.87      $356.95      $173.57
                            implant.
   27705  T                Incision of tibia...         0051        30.94    $1,573.05      $675.24      $314.61
   27707  T                Incision of fibula..         0049        17.07      $867.87      $356.95      $173.57
   27709  T                Incision of tibia &          0050        22.31    $1,134.29      $513.86      $226.86
                            fibula.
   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              0050        22.31    $1,134.29      $513.86      $226.86
                            epiphysis.
   27732  T                Repair of fibula             0050        22.31    $1,134.29      $513.86      $226.86
                            epiphysis.
   27734  T                Repair lower leg             0050        22.31    $1,134.29      $513.86      $226.86
                            epiphyses.
   27740  T                Repair of leg                0050        22.31    $1,134.29      $513.86      $226.86
                            epiphyses.
   27742  T                Repair of leg                0051        30.94    $1,573.05      $675.24      $314.61
                            epiphyses.

[[Page 44754]]

 
   27745  T                Reinforce tibia.....         0051        30.94    $1,573.05      $675.24      $314.61
   27750  T                Treatment of tibia           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27752  T                Treatment of tibia           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27756  T                Treatment of tibia           0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   27758  T                Treatment of tibia           0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   27759  T                Treatment of tibia           0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   27760  T                Treatment of ankle           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27762  T                Treatment of ankle           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27766  T                Treatment of ankle           0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   27780  T                Treatment of fibula          0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27781  T                Treatment of fibula          0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27784  T                Treatment of fibula          0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   27786  T                Treatment of ankle           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27788  T                Treatment of ankle           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27792  T                Treatment of ankle           0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   27808  T                Treatment of ankle           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27810  T                Treatment of ankle           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27814  T                Treatment of ankle           0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   27816  T                Treatment of ankle           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27818  T                Treatment of ankle           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27822  T                Treatment of ankle           0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   27823  T                Treatment of ankle           0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   27824  T                Treat lower leg              0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27825  T                Treat lower leg              0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   27826  T                Treat lower leg              0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   27827  T                Treat lower leg              0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   27828  T                Treat lower leg              0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   27829  T                Treat lower leg              0046        25.36    $1,289.35      $535.76      $257.87
                            joint.
   27830  T                Treat lower leg              0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   27831  T                Treat lower leg              0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   27832  T                Treat lower leg              0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   27840  T                Treat ankle                  0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   27842  T                Treat ankle                  0045        12.91      $656.37      $277.12      $131.27
                            dislocation.
   27846  T                Treat ankle                  0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   27848  T                Treat ankle                  0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   27860  T                Fixation of ankle            0045        12.91      $656.37      $277.12      $131.27
                            joint.
   27870  T                Fusion of ankle              0051        30.94    $1,573.05      $675.24      $314.61
                            joint.
   27871  T                Fusion of                    0051        30.94    $1,573.05      $675.24      $314.61
                            tibiofibular joint.
   27880  C                Amputation of lower   ...........  ...........  ...........  ...........  ...........
                            leg.
   27881  C                Amputation of lower   ...........  ...........  ...........  ...........  ...........
                            leg.
   27882  C                Amputation of lower   ...........  ...........  ...........  ...........  ...........
                            leg.
   27884  T                Amputation follow-up         0049        17.07      $867.87      $356.95      $173.57
                            surgery.
   27886  C                Amputation follow-up  ...........  ...........  ...........  ...........  ...........
                            surgery.
   27888  C                Amputation of foot    ...........  ...........  ...........  ...........  ...........
                            at ankle.
   27889  T                Amputation of foot           0050        22.31    $1,134.29      $513.86      $226.86
                            at ankle.
   27892  T                Decompression of leg         0049        17.07      $867.87      $356.95      $173.57
   27893  T                Decompression of leg         0049        17.07      $867.87      $356.95      $173.57
   27894  T                Decompression of leg         0049        17.07      $867.87      $356.95      $173.57
   27899  T                Leg/ankle surgery            0044         2.73      $138.80       $38.08       $27.76
                            procedure.
   28001  T                Drainage of bursa of         0008        11.36      $577.57      $115.51      $115.51
                            foot.
   28002  T                Treatment of foot            0049        17.07      $867.87      $356.95      $173.57
                            infection.
   28003  T                Treatment of foot            0049        17.07      $867.87      $356.95      $173.57
                            infection.
   28005  T                Treat foot bone              0055        16.77      $852.62      $355.34      $170.52
                            lesion.
   28008  T                Incision of foot             0055        16.77      $852.62      $355.34      $170.52
                            fascia.
   28010  T                Incision of toe              0055        16.77      $852.62      $355.34      $170.52
                            tendon.
   28011  T                Incision of toe              0055        16.77      $852.62      $355.34      $170.52
                            tendons.
   28020  T                Exploration of foot          0055        16.77      $852.62      $355.34      $170.52
                            joint.
   28022  T                Exploration of foot          0055        16.77      $852.62      $355.34      $170.52
                            joint.
   28024  T                Exploration of toe           0055        16.77      $852.62      $355.34      $170.52
                            joint.
   28030  T                Removal of foot              0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   28035  T                Decompression of             0220        14.76      $750.43      $326.21      $150.09
                            tibia nerve.
   28043  T                Excision of foot             0021        12.74      $647.73      $236.51      $129.55
                            lesion.
   28045  T                Excision of foot             0055        16.77      $852.62      $355.34      $170.52
                            lesion.
   28046  T                Resection of tumor,          0055        16.77      $852.62      $355.34      $170.52
                            foot.
   28050  T                Biopsy of foot joint         0055        16.77      $852.62      $355.34      $170.52
                            lining.
   28052  T                Biopsy of foot joint         0055        16.77      $852.62      $355.34      $170.52
                            lining.
   28054  T                Biopsy of toe joint          0055        16.77      $852.62      $355.34      $170.52
                            lining.
   28060  T                Partial removal,             0056        19.20      $976.17      $405.81      $195.23
                            foot fascia.
   28062  T                Removal of foot              0056        19.20      $976.17      $405.81      $195.23
                            fascia.
   28070  T                Removal of foot              0056        19.20      $976.17      $405.81      $195.23
                            joint lining.
   28072  T                Removal of foot              0056        19.20      $976.17      $405.81      $195.23
                            joint lining.
   28080  T                Removal of foot              0055        16.77      $852.62      $355.34      $170.52
                            lesion.
   28086  T                Excise foot tendon           0055        16.77      $852.62      $355.34      $170.52
                            sheath.
   28088  T                Excise foot tendon           0055        16.77      $852.62      $355.34      $170.52
                            sheath.
   28090  T                Removal of foot              0055        16.77      $852.62      $355.34      $170.52
                            lesion.

[[Page 44755]]

 
   28092  T                Removal of toe               0055        16.77      $852.62      $355.34      $170.52
                            lesions.
   28100  T                Removal of ankle/            0055        16.77      $852.62      $355.34      $170.52
                            heel lesion.
   28102  T                Remove/graft foot            0056        19.20      $976.17      $405.81      $195.23
                            lesion.
   28103  T                Remove/graft foot            0056        19.20      $976.17      $405.81      $195.23
                            lesion.
   28104  T                Removal of foot              0055        16.77      $852.62      $355.34      $170.52
                            lesion.
   28106  T                Remove/graft foot            0056        19.20      $976.17      $405.81      $195.23
                            lesion.
   28107  T                Remove/graft foot            0056        19.20      $976.17      $405.81      $195.23
                            lesion.
   28108  T                Removal of toe               0055        16.77      $852.62      $355.34      $170.52
                            lesions.
   28110  T                Part removal of              0057        21.11    $1,073.27      $496.65      $214.65
                            metatarsal.
   28111  T                Part removal of              0055        16.77      $852.62      $355.34      $170.52
                            metatarsal.
   28112  T                Part removal of              0055        16.77      $852.62      $355.34      $170.52
                            metatarsal.
   28113  T                Part removal of              0055        16.77      $852.62      $355.34      $170.52
                            metatarsal.
   28114  T                Removal of                   0055        16.77      $852.62      $355.34      $170.52
                            metatarsal heads.
   28116  T                Revision of foot....         0055        16.77      $852.62      $355.34      $170.52
   28118  T                Removal of heel bone         0055        16.77      $852.62      $355.34      $170.52
   28119  T                Removal of heel spur         0055        16.77      $852.62      $355.34      $170.52
   28120  T                Part removal of              0055        16.77      $852.62      $355.34      $170.52
                            ankle/heel.
   28122  T                Partial removal of           0055        16.77      $852.62      $355.34      $170.52
                            foot bone.
   28124  T                Partial removal of           0055        16.77      $852.62      $355.34      $170.52
                            toe.
   28126  T                Partial removal of           0055        16.77      $852.62      $355.34      $170.52
                            toe.
   28130  T                Removal of ankle             0055        16.77      $852.62      $355.34      $170.52
                            bone.
   28140  T                Removal of                   0055        16.77      $852.62      $355.34      $170.52
                            metatarsal.
   28150  T                Removal of toe......         0055        16.77      $852.62      $355.34      $170.52
   28153  T                Partial removal of           0055        16.77      $852.62      $355.34      $170.52
                            toe.
   28160  T                Partial removal of           0055        16.77      $852.62      $355.34      $170.52
                            toe.
   28171  T                Extensive foot               0055        16.77      $852.62      $355.34      $170.52
                            surgery.
   28173  T                Extensive foot               0055        16.77      $852.62      $355.34      $170.52
                            surgery.
   28175  T                Extensive foot               0055        16.77      $852.62      $355.34      $170.52
                            surgery.
   28190  T                Removal of foot              0019         4.56      $231.84       $78.91       $46.37
                            foreign body.
   28192  T                Removal of foot              0021        12.74      $647.73      $236.51      $129.55
                            foreign body.
   28193  T                Removal of foot              0021        12.74      $647.73      $236.51      $129.55
                            foreign body.
   28200  T                Repair of foot               0055        16.77      $852.62      $355.34      $170.52
                            tendon.
   28202  T                Repair/graft of foot         0056        19.20      $976.17      $405.81      $195.23
                            tendon.
   28208  T                Repair of foot               0055        16.77      $852.62      $355.34      $170.52
                            tendon.
   28210  T                Repair/graft of foot         0055        16.77      $852.62      $355.34      $170.52
                            tendon.
   28220  T                Release of foot              0055        16.77      $852.62      $355.34      $170.52
                            tendon.
   28222  T                Release of foot              0055        16.77      $852.62      $355.34      $170.52
                            tendons.
   28225  T                Release of foot              0055        16.77      $852.62      $355.34      $170.52
                            tendon.
   28226  T                Release of foot              0055        16.77      $852.62      $355.34      $170.52
                            tendons.
   28230  T                Incision of foot             0055        16.77      $852.62      $355.34      $170.52
                            tendon(s).
   28232  T                Incision of toe              0055        16.77      $852.62      $355.34      $170.52
                            tendon.
   28234  T                Incision of foot             0055        16.77      $852.62      $355.34      $170.52
                            tendon.
   28238  T                Revision of foot             0056        19.20      $976.17      $405.81      $195.23
                            tendon.
   28240  T                Release of big toe..         0055        16.77      $852.62      $355.34      $170.52
   28250  T                Revision of foot             0056        19.20      $976.17      $405.81      $195.23
                            fascia.
   28260  T                Release of midfoot           0056        19.20      $976.17      $405.81      $195.23
                            joint.
   28261  T                Revision of foot             0056        19.20      $976.17      $405.81      $195.23
                            tendon.
   28262  T                Revision of foot and         0056        19.20      $976.17      $405.81      $195.23
                            ankle.
   28264  T                Release of midfoot           0056        19.20      $976.17      $405.81      $195.23
                            joint.
   28270  T                Release of foot              0055        16.77      $852.62      $355.34      $170.52
                            contracture.
   28272  T                Release of toe               0055        16.77      $852.62      $355.34      $170.52
                            joint, each.
   28280  T                Fusion of toes......         0055        16.77      $852.62      $355.34      $170.52
   28285  T                Repair of hammertoe.         0055        16.77      $852.62      $355.34      $170.52
   28286  T                Repair of hammertoe.         0055        16.77      $852.62      $355.34      $170.52
   28288  T                Partial removal of           0056        19.20      $976.17      $405.81      $195.23
                            foot bone.
   28289  T                Repair hallux                0056        19.20      $976.17      $405.81      $195.23
                            rigidus.
   28290  T                Correction of bunion         0057        21.11    $1,073.27      $496.65      $214.65
   28292  T                Correction of bunion         0057        21.11    $1,073.27      $496.65      $214.65
   28293  T                Correction of bunion         0057        21.11    $1,073.27      $496.65      $214.65
   28294  T                Correction of bunion         0057        21.11    $1,073.27      $496.65      $214.65
   28296  T                Correction of bunion         0057        21.11    $1,073.27      $496.65      $214.65
   28297  T                Correction of bunion         0057        21.11    $1,073.27      $496.65      $214.65
   28298  T                Correction of bunion         0057        21.11    $1,073.27      $496.65      $214.65
   28299  T                Correction of bunion         0057        21.11    $1,073.27      $496.65      $214.65
   28300  T                Incision of heel             0056        19.20      $976.17      $405.81      $195.23
                            bone.
   28302  T                Incision of ankle            0056        19.20      $976.17      $405.81      $195.23
                            bone.
   28304  T                Incision of midfoot          0056        19.20      $976.17      $405.81      $195.23
                            bones.
   28305  T                Incise/graft midfoot         0056        19.20      $976.17      $405.81      $195.23
                            bones.
   28306  T                Incision of                  0056        19.20      $976.17      $405.81      $195.23
                            metatarsal.
   28307  T                Incision of                  0056        19.20      $976.17      $405.81      $195.23
                            metatarsal.
   28308  T                Incision of                  0056        19.20      $976.17      $405.81      $195.23
                            metatarsal.
   28309  T                Incision of                  0056        19.20      $976.17      $405.81      $195.23
                            metatarsals.
   28310  T                Revision of big toe.         0055        16.77      $852.62      $355.34      $170.52
   28312  T                Revision of toe.....         0055        16.77      $852.62      $355.34      $170.52
   28313  T                Repair deformity of          0055        16.77      $852.62      $355.34      $170.52
                            toe.

[[Page 44756]]

 
   28315  T                Removal of sesamoid          0055        16.77      $852.62      $355.34      $170.52
                            bone.
   28320  T                Repair of foot bones         0056        19.20      $976.17      $405.81      $195.23
   28322  T                Repair of                    0056        19.20      $976.17      $405.81      $195.23
                            metatarsals.
   28340  T                Resect enlarged toe          0055        16.77      $852.62      $355.34      $170.52
                            tissue.
   28341  T                Resect enlarged toe.         0055        16.77      $852.62      $355.34      $170.52
   28344  T                Repair extra toe(s).         0056        19.20      $976.17      $405.81      $195.23
   28345  T                Repair webbed toe(s)         0056        19.20      $976.17      $405.81      $195.23
   28360  T                Reconstruct cleft            0056        19.20      $976.17      $405.81      $195.23
                            foot.
   28400  T                Treatment of heel            0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   28405  T                Treatment of heel            0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   28406  T                Treatment of heel            0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   28415  T                Treat heel fracture.         0046        25.36    $1,289.35      $535.76      $257.87
   28420  T                Treat/graft heel             0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   28430  T                Treatment of ankle           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   28435  T                Treatment of ankle           0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   28436  T                Treatment of ankle           0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   28445  T                Treat ankle fracture         0046        25.36    $1,289.35      $535.76      $257.87
   28450  T                Treat midfoot                0044         2.73      $138.80       $38.08       $27.76
                            fracture, each.
   28455  T                Treat midfoot                0044         2.73      $138.80       $38.08       $27.76
                            fracture, each.
   28456  T                Treat midfoot                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   28465  T                Treat midfoot                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture, each.
   28470  T                Treat metatarsal             0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   28475  T                Treat metatarsal             0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   28476  T                Treat metatarsal             0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   28485  T                Treat metatarsal             0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   28490  T                Treat big toe                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   28495  T                Treat big toe                0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   28496  T                Treat big toe                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   28505  T                Treat big toe                0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   28510  T                Treatment of toe             0043         4.13      $209.98       $42.00       $42.00
                            fracture.
   28515  T                Treatment of toe             0043         4.13      $209.98       $42.00       $42.00
                            fracture.
   28525  T                Treat toe fracture..         0046        25.36    $1,289.35      $535.76      $257.87
   28530  T                Treat sesamoid bone          0044         2.73      $138.80       $38.08       $27.76
                            fracture.
   28531  T                Treat sesamoid bone          0046        25.36    $1,289.35      $535.76      $257.87
                            fracture.
   28540  T                Treat foot                   0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   28545  T                Treat foot                   0045        12.91      $656.37      $277.12      $131.27
                            dislocation.
   28546  T                Treat foot                   0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   28555  T                Repair foot                  0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   28570  T                Treat foot                   0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   28575  T                Treat foot                   0043         4.13      $209.98       $42.00       $42.00
                            dislocation.
   28576  T                Treat foot                   0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   28585  T                Repair foot                  0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   28600  T                Treat foot                   0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   28605  T                Treat foot                   0043         4.13      $209.98       $42.00       $42.00
                            dislocation.
   28606  T                Treat foot                   0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   28615  T                Repair foot                  0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   28630  T                Treat toe                    0044         2.73      $138.80       $38.08       $27.76
                            dislocation.
   28635  T                Treat toe                    0045        12.91      $656.37      $277.12      $131.27
                            dislocation.
   28636  T                Treat toe                    0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   28645  T                Repair toe                   0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   28660  T                Treat toe                    0043         4.13      $209.98       $42.00       $42.00
                            dislocation.
   28665  T                Treat toe                    0045        12.91      $656.37      $277.12      $131.27
                            dislocation.
   28666  T                Treat toe                    0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   28675  T                Repair of toe                0046        25.36    $1,289.35      $535.76      $257.87
                            dislocation.
   28705  T                Fusion of foot bones         0056        19.20      $976.17      $405.81      $195.23
   28715  T                Fusion of foot bones         0056        19.20      $976.17      $405.81      $195.23
   28725  T                Fusion of foot bones         0056        19.20      $976.17      $405.81      $195.23
   28730  T                Fusion of foot bones         0056        19.20      $976.17      $405.81      $195.23
   28735  T                Fusion of foot bones         0056        19.20      $976.17      $405.81      $195.23
   28737  T                Revision of foot             0055        16.77      $852.62      $355.34      $170.52
                            bones.
   28740  T                Fusion of foot bones         0056        19.20      $976.17      $405.81      $195.23
   28750  T                Fusion of big toe            0055        16.77      $852.62      $355.34      $170.52
                            joint.
   28755  T                Fusion of big toe            0055        16.77      $852.62      $355.34      $170.52
                            joint.
   28760  T                Fusion of big toe            0056        19.20      $976.17      $405.81      $195.23
                            joint.
   28800  C                Amputation of         ...........  ...........  ...........  ...........  ...........
                            midfoot.
   28805  C                Amputation thru       ...........  ...........  ...........  ...........  ...........
                            metatarsal.
   28810  T                Amputation toe &             0055        16.77      $852.62      $355.34      $170.52
                            metatarsal.
   28820  T                Amputation of toe...         0055        16.77      $852.62      $355.34      $170.52
   28825  T                Partial amputation           0055        16.77      $852.62      $355.34      $170.52
                            of toe.
   28899  T                Foot/toes surgery            0043         4.13      $209.98       $42.00       $42.00
                            procedure.
   29000  S                Application of body          0059         2.34      $118.97       $29.59       $23.79
                            cast.
   29010  S                Application of body          0059         2.34      $118.97       $29.59       $23.79
                            cast.
   29015  S                Application of body          0059         2.34      $118.97       $29.59       $23.79
                            cast.
   29020  S                Application of body          0059         2.34      $118.97       $29.59       $23.79
                            cast.
   29025  S                Application of body          0059         2.34      $118.97       $29.59       $23.79
                            cast.

[[Page 44757]]

 
   29035  S                Application of body          0058         1.36       $69.15       $19.27       $13.83
                            cast.
   29040  S                Application of body          0059         2.34      $118.97       $29.59       $23.79
                            cast.
   29044  S                Application of body          0059         2.34      $118.97       $29.59       $23.79
                            cast.
   29046  S                Application of body          0059         2.34      $118.97       $29.59       $23.79
                            cast.
   29049  S                Application of               0059         2.34      $118.97       $29.59       $23.79
                            figure eight.
   29055  S                Application of               0059         2.34      $118.97       $29.59       $23.79
                            shoulder cast.
   29058  S                Application of               0059         2.34      $118.97       $29.59       $23.79
                            shoulder cast.
   29065  S                Application of long          0059         2.34      $118.97       $29.59       $23.79
                            arm cast.
   29075  S                Application of               0058         1.36       $69.15       $19.27       $13.83
                            forearm cast.
   29085  S                Apply hand/wrist             0058         1.36       $69.15       $19.27       $13.83
                            cast.
   29105  S                Apply long arm               0058         1.36       $69.15       $19.27       $13.83
                            splint.
   29125  S                Apply forearm splint         0058         1.36       $69.15       $19.27       $13.83
   29126  S                Apply forearm splint         0058         1.36       $69.15       $19.27       $13.83
   29130  S                Application of               0058         1.36       $69.15       $19.27       $13.83
                            finger splint.
   29131  S                Application of               0058         1.36       $69.15       $19.27       $13.83
                            finger splint.
   29200  S                Strapping of chest..         0058         1.36       $69.15       $19.27       $13.83
   29220  S                Strapping of low             0059         2.34      $118.97       $29.59       $23.79
                            back.
   29240  S                Strapping of                 0058         1.36       $69.15       $19.27       $13.83
                            shoulder.
   29260  S                Strapping of elbow           0058         1.36       $69.15       $19.27       $13.83
                            or wrist.
   29280  S                Strapping of hand or         0058         1.36       $69.15       $19.27       $13.83
                            finger.
   29305  S                Application of hip           0058         1.36       $69.15       $19.27       $13.83
                            cast.
   29325  S                Application of hip           0059         2.34      $118.97       $29.59       $23.79
                            casts.
   29345  S                Application of long          0059         2.34      $118.97       $29.59       $23.79
                            leg cast.
   29355  S                Application of long          0059         2.34      $118.97       $29.59       $23.79
                            leg cast.
   29358  S                Apply long leg cast          0059         2.34      $118.97       $29.59       $23.79
                            brace.
   29365  S                Application of long          0059         2.34      $118.97       $29.59       $23.79
                            leg cast.
   29405  S                Apply short leg cast         0058         1.36       $69.15       $19.27       $13.83
   29425  S                Apply short leg cast         0059         2.34      $118.97       $29.59       $23.79
   29435  S                Apply short leg cast         0058         1.36       $69.15       $19.27       $13.83
   29440  S                Addition of walker           0059         2.34      $118.97       $29.59       $23.79
                            to cast.
   29445  S                Apply rigid leg cast         0059         2.34      $118.97       $29.59       $23.79
   29450  S                Application of leg           0059         2.34      $118.97       $29.59       $23.79
                            cast.
   29505  S                Application, long            0059         2.34      $118.97       $29.59       $23.79
                            leg splint.
   29515  S                Application lower            0059         2.34      $118.97       $29.59       $23.79
                            leg splint.
   29520  S                Strapping of hip....         0058         1.36       $69.15       $19.27       $13.83
   29530  S                Strapping of knee...         0058         1.36       $69.15       $19.27       $13.83
   29540  S                Strapping of ankle..         0058         1.36       $69.15       $19.27       $13.83
   29550  S                Strapping of toes...         0058         1.36       $69.15       $19.27       $13.83
   29580  S                Application of paste         0058         1.36       $69.15       $19.27       $13.83
                            boot.
   29590  S                Application of foot          0058         1.36       $69.15       $19.27       $13.83
                            splint.
   29700  S                Removal/revision of          0058         1.36       $69.15       $19.27       $13.83
                            cast.
   29705  S                Removal/revision of          0058         1.36       $69.15       $19.27       $13.83
                            cast.
   29710  S                Removal/revision of          0058         1.36       $69.15       $19.27       $13.83
                            cast.
   29715  S                Removal/revision of          0058         1.36       $69.15       $19.27       $13.83
                            cast.
   29720  S                Repair of body cast.         0058         1.36       $69.15       $19.27       $13.83
   29730  S                Windowing of cast...         0058         1.36       $69.15       $19.27       $13.83
   29740  S                Wedging of cast.....         0058         1.36       $69.15       $19.27       $13.83
   29750  S                Wedging of clubfoot          0058         1.36       $69.15       $19.27       $13.83
                            cast.
   29799  N                Casting/strapping     ...........  ...........  ...........  ...........  ...........
                            procedure.
   29800  T                Jaw arthroscopy/             0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29804  T                Jaw arthroscopy/             0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29815  T                Shoulder arthroscopy         0041        26.18    $1,331.04      $592.08      $266.21
   29819  T                Shoulder arthroscopy/        0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29820  T                Shoulder arthroscopy/        0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29821  T                Shoulder arthroscopy/        0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29822  T                Shoulder arthroscopy/        0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29823  T                Shoulder arthroscopy/        0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29825  T                Shoulder arthroscopy/        0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29826  T                Shoulder arthroscopy/        0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29830  T                Elbow arthroscopy...         0041        26.18    $1,331.04      $592.08      $266.21
   29834  T                Elbow arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29835  T                Elbow arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29836  T                Elbow arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29837  T                Elbow arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29838  T                Elbow arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29840  T                Wrist arthroscopy...         0041        26.18    $1,331.04      $592.08      $266.21
   29843  T                Wrist arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29844  T                Wrist arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29845  T                Wrist arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29846  T                Wrist arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29847  T                Wrist arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29848  T                Wrist endoscopy/             0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29850  T                Knee arthroscopy/            0042        39.39    $2,002.67      $804.74      $400.53
                            surgery.
   29851  T                Knee arthroscopy/            0042        39.39    $2,002.67      $804.74      $400.53
                            surgery.
   29855  T                Tibial arthroscopy/          0042        39.39    $2,002.67      $804.74      $400.53
                            surgery.

[[Page 44758]]

 
   29856  T                Tibial arthroscopy/          0042        39.39    $2,002.67      $804.74      $400.53
                            surgery.
   29860  T                Hip arthroscopy, dx.         0041        26.18    $1,331.04      $592.08      $266.21
   29861  T                Hip arthroscopy/             0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29862  T                Hip arthroscopy/             0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29863  T                Hip arthroscopy/             0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29870  T                Knee arthroscopy, dx         0041        26.18    $1,331.04      $592.08      $266.21
   29871  T                Knee arthroscopy/            0041        26.18    $1,331.04      $592.08      $266.21
                            drainage.
   29874  T                Knee arthroscopy/            0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29875  T                Knee arthroscopy/            0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29876  T                Knee arthroscopy/            0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29877  T                Knee arthroscopy/            0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29879  T                Knee arthroscopy/            0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29880  T                Knee arthroscopy/            0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29881  T                Knee arthroscopy/            0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29882  T                Knee arthroscopy/            0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29883  T                Knee arthroscopy/            0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29884  T                Knee arthroscopy/            0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29885  T                Knee arthroscopy/            0042        39.39    $2,002.67      $804.74      $400.53
                            surgery.
   29886  T                Knee arthroscopy/            0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29887  T                Knee arthroscopy/            0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29888  T                Knee arthroscopy/            0042        39.39    $2,002.67      $804.74      $400.53
                            surgery.
   29889  T                Knee arthroscopy/            0042        39.39    $2,002.67      $804.74      $400.53
                            surgery.
   29891  T                Ankle arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29892  T                Ankle arthroscopy/           0042        39.39    $2,002.67      $804.74      $400.53
                            surgery.
   29893  T                Scope, plantar               0055        16.77      $852.62      $355.34      $170.52
                            fasciotomy.
   29894  T                Ankle arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29895  T                Ankle arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29897  T                Ankle arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29898  T                Ankle arthroscopy/           0041        26.18    $1,331.04      $592.08      $266.21
                            surgery.
   29909  T                Arthroscopy of joint         0041        26.18    $1,331.04      $592.08      $266.21
   30000  T                Drainage of nose             0251         2.71      $137.78       $27.99       $27.56
                            lesion.
   30020  T                Drainage of nose             0251         2.71      $137.78       $27.99       $27.56
                            lesion.
   30100  T                Intranasal biopsy...         0252         6.53      $332.00      $114.24       $66.40
   30110  T                Removal of nose              0253        13.27      $674.67      $284.00      $134.93
                            polyp(s).
   30115  T                Removal of nose              0253        13.27      $674.67      $284.00      $134.93
                            polyp(s).
   30117  T                Removal of                   0253        13.27      $674.67      $284.00      $134.93
                            intranasal lesion.
   30118  T                Removal of                   0254        19.11      $971.59      $272.41      $194.32
                            intranasal lesion.
   30120  T                Revision of nose....         0253        13.27      $674.67      $284.00      $134.93
   30124  T                Removal of nose              0252         6.53      $332.00      $114.24       $66.40
                            lesion.
   30125  T                Removal of nose              0256        28.82    $1,465.27      $623.05      $293.05
                            lesion.
   30130  T                Removal of turbinate         0253        13.27      $674.67      $284.00      $134.93
                            bones.
   30140  T                Removal of turbinate         0254        19.11      $971.59      $272.41      $194.32
                            bones.
   30150  T                Partial removal of           0256        28.82    $1,465.27      $623.05      $293.05
                            nose.
   30160  T                Removal of nose.....         0256        28.82    $1,465.27      $623.05      $293.05
   30200  T                Injection treatment          0253        13.27      $674.67      $284.00      $134.93
                            of nose.
   30210  T                Nasal sinus therapy.         0252         6.53      $332.00      $114.24       $66.40
   30220  T                Insert nasal septal          0252         6.53      $332.00      $114.24       $66.40
                            button.
   30300  X                Remove nasal foreign         0340         0.91       $46.27       $11.57        $9.25
                            body.
   30310  T                Remove nasal foreign         0253        13.27      $674.67      $284.00      $134.93
                            body.
   30320  T                Remove nasal foreign         0253        13.27      $674.67      $284.00      $134.93
                            body.
   30400  T                Reconstruction of            0256        28.82    $1,465.27      $623.05      $293.05
                            nose.
   30410  T                Reconstruction of            0256        28.82    $1,465.27      $623.05      $293.05
                            nose.
   30420  T                Reconstruction of            0256        28.82    $1,465.27      $623.05      $293.05
                            nose.
   30430  T                Revision of nose....         0254        19.11      $971.59      $272.41      $194.32
   30435  T                Revision of nose....         0256        28.82    $1,465.27      $623.05      $293.05
   30450  T                Revision of nose....         0256        28.82    $1,465.27      $623.05      $293.05
   30460  T                Revision of nose....         0256        28.82    $1,465.27      $623.05      $293.05
   30462  T                Revision of nose....         0256        28.82    $1,465.27      $623.05      $293.05
   30465  T                Repair nasal                 0256        28.82    $1,465.27      $623.05      $293.05
                            stenosis.
   30520  T                Repair of nasal              0256        28.82    $1,465.27      $623.05      $293.05
                            septum.
   30540  T                Repair nasal defect.         0256        28.82    $1,465.27      $623.05      $293.05
   30545  T                Repair nasal defect.         0256        28.82    $1,465.27      $623.05      $293.05
   30560  T                Release of nasal             0251         2.71      $137.78       $27.99       $27.56
                            adhesions.
   30580  T                Repair upper jaw             0256        28.82    $1,465.27      $623.05      $293.05
                            fistula.
   30600  T                Repair mouth/nose            0256        28.82    $1,465.27      $623.05      $293.05
                            fistula.
   30620  T                Intranasal                   0256        28.82    $1,465.27      $623.05      $293.05
                            reconstruction.
   30630  T                Repair nasal septum          0254        19.11      $971.59      $272.41      $194.32
                            defect.
   30801  T                Cauterization, inner         0252         6.53      $332.00      $114.24       $66.40
                            nose.
   30802  T                Cauterization, inner         0253        13.27      $674.67      $284.00      $134.93
                            nose.
   30901  T                Control of nosebleed         0250         2.27      $115.41       $38.54       $23.08
   30903  T                Control of nosebleed         0250         2.27      $115.41       $38.54       $23.08
   30905  T                Control of nosebleed         0250         2.27      $115.41       $38.54       $23.08
   30906  T                Repeat control of            0250         2.27      $115.41       $38.54       $23.08
                            nosebleed.
   30915  T                Ligation, nasal              0091        22.17    $1,127.17      $348.23      $225.43
                            sinus artery.
   30920  T                Ligation, upper jaw          0092        21.43    $1,089.54      $505.37      $217.91
                            artery.

[[Page 44759]]

 
   30930  T                Therapy, fracture of         0253        13.27      $674.67      $284.00      $134.93
                            nose.
   30999  T                Nasal surgery                0251         2.71      $137.78       $27.99       $27.56
                            procedure.
   31000  T                Irrigation,                  0251         2.71      $137.78       $27.99       $27.56
                            maxillary sinus.
   31002  T                Irrigation, sphenoid         0252         6.53      $332.00      $114.24       $66.40
                            sinus.
   31020  T                Exploration,                 0254        19.11      $971.59      $272.41      $194.32
                            maxillary sinus.
   31030  T                Exploration,                 0256        28.82    $1,465.27      $623.05      $293.05
                            maxillary sinus.
   31032  T                Explore sinus,remove         0256        28.82    $1,465.27      $623.05      $293.05
                            polyps.
   31040  T                Exploration behind           0254        19.11      $971.59      $272.41      $194.32
                            upper jaw.
   31050  T                Exploration,                 0256        28.82    $1,465.27      $623.05      $293.05
                            sphenoid sinus.
   31051  T                Sphenoid sinus               0256        28.82    $1,465.27      $623.05      $293.05
                            surgery.
   31070  T                Exploration of               0254        19.11      $971.59      $272.41      $194.32
                            frontal sinus.
   31075  T                Exploration of               0256        28.82    $1,465.27      $623.05      $293.05
                            frontal sinus.
   31080  T                Removal of frontal           0256        28.82    $1,465.27      $623.05      $293.05
                            sinus.
   31081  T                Removal of frontal           0256        28.82    $1,465.27      $623.05      $293.05
                            sinus.
   31084  T                Removal of frontal           0256        28.82    $1,465.27      $623.05      $293.05
                            sinus.
   31085  T                Removal of frontal           0256        28.82    $1,465.27      $623.05      $293.05
                            sinus.
   31086  T                Removal of frontal           0256        28.82    $1,465.27      $623.05      $293.05
                            sinus.
   31087  T                Removal of frontal           0256        28.82    $1,465.27      $623.05      $293.05
                            sinus.
   31090  T                Exploration of               0256        28.82    $1,465.27      $623.05      $293.05
                            sinuses.
   31200  T                Removal of ethmoid           0256        28.82    $1,465.27      $623.05      $293.05
                            sinus.
   31201  T                Removal of ethmoid           0256        28.82    $1,465.27      $623.05      $293.05
                            sinus.
   31205  T                Removal of ethmoid           0256        28.82    $1,465.27      $623.05      $293.05
                            sinus.
   31225  C                Removal of upper jaw  ...........  ...........  ...........  ...........  ...........
   31230  C                Removal of upper jaw  ...........  ...........  ...........  ...........  ...........
   31231  T                Nasal endoscopy, dx.         0071         1.08       $54.91       $14.22       $10.98
   31233  T                Nasal/sinus                  0072         1.29       $65.59       $36.08       $13.12
                            endoscopy, dx.
   31235  T                Nasal/sinus                  0074        14.62      $743.31      $347.54      $148.66
                            endoscopy, dx.
   31237  T                Nasal/sinus                  0074        14.62      $743.31      $347.54      $148.66
                            endoscopy, surg.
   31238  T                Nasal/sinus                  0074        14.62      $743.31      $347.54      $148.66
                            endoscopy, surg.
   31239  T                Nasal/sinus                  0075        19.08      $970.07      $467.29      $194.01
                            endoscopy, surg.
   31240  T                Nasal/sinus                  0074        14.62      $743.31      $347.54      $148.66
                            endoscopy, surg.
   31254  T                Revision of ethmoid          0075        19.08      $970.07      $467.29      $194.01
                            sinus.
   31255  T                Removal of ethmoid           0075        19.08      $970.07      $467.29      $194.01
                            sinus.
   31256  T                Exploration                  0075        19.08      $970.07      $467.29      $194.01
                            maxillary sinus.
   31267  T                Endoscopy, maxillary         0075        19.08      $970.07      $467.29      $194.01
                            sinus.
   31276  T                Sinus endoscopy,             0075        19.08      $970.07      $467.29      $194.01
                            surgical.
   31287  T                Nasal/sinus                  0075        19.08      $970.07      $467.29      $194.01
                            endoscopy, surg.
   31288  T                Nasal/sinus                  0075        19.08      $970.07      $467.29      $194.01
                            endoscopy, surg.
   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                0252         6.53      $332.00      $114.24       $66.40
                            procedure.
   31300  T                Removal of larynx            0256        28.82    $1,465.27      $623.05      $293.05
                            lesion.
   31320  T                Diagnostic incision,         0256        28.82    $1,465.27      $623.05      $293.05
                            larynx.
   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  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.
   31400  T                Revision of larynx..         0256        28.82    $1,465.27      $623.05      $293.05
   31420  T                Removal of                   0256        28.82    $1,465.27      $623.05      $293.05
                            epiglottis.
   31500  S                Insert emergency             0094         5.69      $289.29      $105.29       $57.86
                            airway.
   31502  T                Change of windpipe           0121         2.42      $123.04       $52.53       $24.61
                            airway.
   31505  T                Diagnostic                   0072         1.29       $65.59       $36.08       $13.12
                            laryngoscopy.
   31510  T                Laryngoscopy with            0074        14.62      $743.31      $347.54      $148.66
                            biopsy.
   31511  T                Remove foreign body,         0072         1.29       $65.59       $36.08       $13.12
                            larynx.
   31512  T                Removal of larynx            0074        14.62      $743.31      $347.54      $148.66
                            lesion.
   31513  T                Injection into vocal         0073         3.54      $179.98       $79.19       $36.00
                            cord.
   31515  T                Laryngoscopy for             0074        14.62      $743.31      $347.54      $148.66
                            aspiration.
   31520  T                Diagnostic                   0072         1.29       $65.59       $36.08       $13.12
                            laryngoscopy.
   31525  T                Diagnostic                   0074        14.62      $743.31      $347.54      $148.66
                            laryngoscopy.
   31526  T                Diagnostic                   0074        14.62      $743.31      $347.54      $148.66
                            laryngoscopy.
   31527  T                Laryngoscopy for             0075        19.08      $970.07      $467.29      $194.01
                            treatment.
   31528  T                Laryngoscopy and             0074        14.62      $743.31      $347.54      $148.66
                            dilatation.
   31529  T                Laryngoscopy and             0074        14.62      $743.31      $347.54      $148.66
                            dilatation.
   31530  T                Operative                    0075        19.08      $970.07      $467.29      $194.01
                            laryngoscopy.
   31531  T                Operative                    0075        19.08      $970.07      $467.29      $194.01
                            laryngoscopy.
   31535  T                Operative                    0075        19.08      $970.07      $467.29      $194.01
                            laryngoscopy.

[[Page 44760]]

 
   31536  T                Operative                    0075        19.08      $970.07      $467.29      $194.01
                            laryngoscopy.
   31540  T                Operative                    0075        19.08      $970.07      $467.29      $194.01
                            laryngoscopy.
   31541  T                Operative                    0075        19.08      $970.07      $467.29      $194.01
                            laryngoscopy.
   31560  T                Operative                    0075        19.08      $970.07      $467.29      $194.01
                            laryngoscopy.
   31561  T                Operative                    0075        19.08      $970.07      $467.29      $194.01
                            laryngoscopy.
   31570  T                Laryngoscopy with            0074        14.62      $743.31      $347.54      $148.66
                            injection.
   31571  T                Laryngoscopy with            0075        19.08      $970.07      $467.29      $194.01
                            injection.
   31575  T                Diagnostic                   0071         1.08       $54.91       $14.22       $10.98
                            laryngoscopy.
   31576  T                Laryngoscopy with            0074        14.62      $743.31      $347.54      $148.66
                            biopsy.
   31577  T                Remove foreign body,         0073         3.54      $179.98       $79.19       $36.00
                            larynx.
   31578  T                Removal of larynx            0075        19.08      $970.07      $467.29      $194.01
                            lesion.
   31579  T                Diagnostic                   0073         3.54      $179.98       $79.19       $36.00
                            laryngoscopy.
   31580  T                Revision of larynx..         0256        28.82    $1,465.27      $623.05      $293.05
   31582  C                Revision of larynx..  ...........  ...........  ...........  ...........  ...........
   31584  C                Treat larynx          ...........  ...........  ...........  ...........  ...........
                            fracture.
   31585  T                Treat larynx                 0253        13.27      $674.67      $284.00      $134.93
                            fracture.
   31586  T                Treat larynx                 0256        28.82    $1,465.27      $623.05      $293.05
                            fracture.
   31587  C                Revision of larynx..  ...........  ...........  ...........  ...........  ...........
   31588  T                Revision of larynx..         0256        28.82    $1,465.27      $623.05      $293.05
   31590  T                Reinnervate larynx..         0256        28.82    $1,465.27      $623.05      $293.05
   31595  T                Larynx nerve surgery         0256        28.82    $1,465.27      $623.05      $293.05
   31599  T                Larynx surgery               0254        19.11      $971.59      $272.41      $194.32
                            procedure.
   31600  T                Incision of windpipe         0254        19.11      $971.59      $272.41      $194.32
   31601  T                Incision of windpipe         0254        19.11      $971.59      $272.41      $194.32
   31603  T                Incision of windpipe         0252         6.53      $332.00      $114.24       $66.40
   31605  T                Incision of windpipe         0253        13.27      $674.67      $284.00      $134.93
   31610  T                Incision of windpipe         0254        19.11      $971.59      $272.41      $194.32
   31611  T                Surgery/speech               0254        19.11      $971.59      $272.41      $194.32
                            prosthesis.
   31612  T                Puncture/clear               0254        19.11      $971.59      $272.41      $194.32
                            windpipe.
   31613  T                Repair windpipe              0254        19.11      $971.59      $272.41      $194.32
                            opening.
   31614  T                Repair windpipe              0256        28.82    $1,465.27      $623.05      $293.05
                            opening.
   31615  T                Visualization of             0076         8.22      $417.92      $197.05       $83.58
                            windpipe.
   31622  T                Dx bronchoscope/wash         0076         8.22      $417.92      $197.05       $83.58
   31623  T                Dx bronchoscope/             0076         8.22      $417.92      $197.05       $83.58
                            brush.
   31624  T                Dx bronchoscope/             0076         8.22      $417.92      $197.05       $83.58
                            lavage.
   31625  T                Bronchoscopy with            0076         8.22      $417.92      $197.05       $83.58
                            biopsy.
   31628  T                Bronchoscopy with            0076         8.22      $417.92      $197.05       $83.58
                            biopsy.
   31629  T                Bronchoscopy with            0076         8.22      $417.92      $197.05       $83.58
                            biopsy.
   31630  T                Bronchoscopy with            0076         8.22      $417.92      $197.05       $83.58
                            repair.
   31631  T                Bronchoscopy with            0076         8.22      $417.92      $197.05       $83.58
                            dilation.
   31635  T                Remove foreign body,         0076         8.22      $417.92      $197.05       $83.58
                            airway.
   31640  T                Bronchoscopy &               0076         8.22      $417.92      $197.05       $83.58
                            remove lesion.
   31641  T                Bronchoscopy, treat          0076         8.22      $417.92      $197.05       $83.58
                            blockage.
   31643  T                Diag bronchoscope/           0076         8.22      $417.92      $197.05       $83.58
                            catheter.
   31645  T                Bronchoscopy, clear          0076         8.22      $417.92      $197.05       $83.58
                            airways.
   31646  T                Bronchoscopy,                0076         8.22      $417.92      $197.05       $83.58
                            reclear airway.
   31656  T                Bronchoscopy, inj            0076         8.22      $417.92      $197.05       $83.58
                            for xray.
   31700  T                Insertion of airway          0072         1.29       $65.59       $36.08       $13.12
                            catheter.
   31708  N                Instill airway        ...........  ...........  ...........  ...........  ...........
                            contrast dye.
   31710  N                Insertion of airway   ...........  ...........  ...........  ...........  ...........
                            catheter.
   31715  N                Injection for         ...........  ...........  ...........  ...........  ...........
                            bronchus x-ray.
   31717  T                Bronchial brush              0073         3.54      $179.98       $79.19       $36.00
                            biopsy.
   31720  T                Clearance of airways         0072         1.29       $65.59       $36.08       $13.12
   31725  C                Clearance of airways  ...........  ...........  ...........  ...........  ...........
   31730  T                Intro, windpipe wire/        0073         3.54      $179.98       $79.19       $36.00
                            tube.
   31750  T                Repair of windpipe..         0256        28.82    $1,465.27      $623.05      $293.05
   31755  T                Repair of windpipe..         0256        28.82    $1,465.27      $623.05      $293.05
   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.
   31820  T                Closure of windpipe          0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   31825  T                Repair of windpipe           0254        19.11      $971.59      $272.41      $194.32
                            defect.
   31830  T                Revise windpipe scar         0254        19.11      $971.59      $272.41      $194.32
   31899  T                Airways surgical             0076         8.22      $417.92      $197.05       $83.58
                            procedure.
   32000  T                Drainage of chest...         0070         4.11      $208.96       $79.60       $41.79
   32002  T                Treatment of                 0070         4.11      $208.96       $79.60       $41.79
                            collapsed lung.
   32005  T                Treat lung lining            0070         4.11      $208.96       $79.60       $41.79
                            chemically.
   32020  T                Insertion of chest           0070         4.11      $208.96       $79.60       $41.79
                            tube.

[[Page 44761]]

 
   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          0005         6.71      $341.15      $119.75       $68.23
                            lining.
   32402  C                Open biopsy chest     ...........  ...........  ...........  ...........  ...........
                            lining.
   32405  T                Biopsy, lung or              0005         6.71      $341.15      $119.75       $68.23
                            mediastinum.
   32420  T                Puncture/clear lung.         0070         4.11      $208.96       $79.60       $41.79
   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,                0069        25.62    $1,302.57      $612.21      $260.51
                            diagnostic.
   32602  T                Thoracoscopy,                0069        25.62    $1,302.57      $612.21      $260.51
                            diagnostic.
   32603  T                Thoracoscopy,                0069        25.62    $1,302.57      $612.21      $260.51
                            diagnostic.
   32604  T                Thoracoscopy,                0069        25.62    $1,302.57      $612.21      $260.51
                            diagnostic.
   32605  T                Thoracoscopy,                0069        25.62    $1,302.57      $612.21      $260.51
                            diagnostic.
   32606  T                Thoracoscopy,                0069        25.62    $1,302.57      $612.21      $260.51
                            diagnostic.
   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....  ...........  ...........  ...........  ...........  ...........
   32960  T                Therapeutic                  0070         4.11      $208.96       $79.60       $41.79
                            pneumothorax.
   32997  C                Total lung lavage...  ...........  ...........  ...........  ...........  ...........

[[Page 44762]]

 
   32999  T                Chest surgery                0070         4.11      $208.96       $79.60       $41.79
                            procedure.
   33010  T                Drainage of heart            0070         4.11      $208.96       $79.60       $41.79
                            sac.
   33011  T                Repeat drainage of           0070         4.11      $208.96       $79.60       $41.79
                            heart sac.
   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).
   33141  C                Heart tmr w/other     ...........  ...........  ...........  ...........  ...........
                            procedure.
   33200  C                Insertion of heart    ...........  ...........  ...........  ...........  ...........
                            pacemaker.
   33201  C                Insertion of heart    ...........  ...........  ...........  ...........  ...........
                            pacemaker.
   33206  T                Insertion of heart           0089        82.60    $4,199.55    $2,246.59      $839.91
                            pacemaker.
   33207  T                Insertion of heart           0089        82.60    $4,199.55    $2,246.59      $839.91
                            pacemaker.
   33208  T                Insertion of heart           0089        82.60    $4,199.55    $2,246.59      $839.91
                            pacemaker.
   33210  T                Insertion of heart           0106        15.82      $804.32      $426.29      $160.86
                            electrode.
   33211  T                Insertion of heart           0106        15.82      $804.32      $426.29      $160.86
                            electrode.
   33212  T                Insertion of pulse           0090        73.37    $3,730.28    $2,014.35      $746.06
                            generator.
   33213  T                Insertion of pulse           0090        73.37    $3,730.28    $2,014.35      $746.06
                            generator.
   33214  T                Upgrade of pacemaker         0089        82.60    $4,199.55    $2,246.59      $839.91
                            system.
   33216  T                Revise eltrd pacing-         0106        15.82      $804.32      $426.29      $160.86
                            defib.
   33217  T                Revise eltrd pacing-         0106        15.82      $804.32      $426.29      $160.86
                            defib.
   33218  T                Revise eltrd pacing-         0106        15.82      $804.32      $426.29      $160.86
                            defib.
   33220  T                Revise eltrd pacing-         0106        15.82      $804.32      $426.29      $160.86
                            defib.
   33222  T                Revise pocket,               0026        13.51      $686.88      $277.92      $137.38
                            pacemaker.
   33223  T                Revise pocket,               0026        13.51      $686.88      $277.92      $137.38
                            pacing-defib.
   33233  T                Removal of pacemaker         0105        16.56      $841.94      $372.32      $168.39
                            system.
   33234  T                Removal of pacemaker         0105        16.56      $841.94      $372.32      $168.39
                            system.
   33235  T                Removal pacemaker            0105        16.56      $841.94      $372.32      $168.39
                            electrode.
   33236  C                Remove electrode/     ...........  ...........  ...........  ...........  ...........
                            thoracotomy.
   33237  C                Remove electrode/     ...........  ...........  ...........  ...........  ...........
                            thoracotomy.
   33238  C                Remove electrode/     ...........  ...........  ...........  ...........  ...........
                            thoracotomy.
   33240  T                Insert pulse                 0107       155.27    $7,894.24    $4,224.27    $1,578.85
                            generator.
   33241  T                Remove pulse                 0105        16.56      $841.94      $372.32      $168.39
                            generator.
   33243  C                Remove eltrd/         ...........  ...........  ...........  ...........  ...........
                            thoracotomy.
   33244  T                Remove eltrd,                0105        16.56      $841.94      $372.32      $168.39
                            transven.
   33245  C                Insert epic eltrd     ...........  ...........  ...........  ...........  ...........
                            pace-defib.
   33246  C                Insert epic eltrd/    ...........  ...........  ...........  ...........  ...........
                            generator.
   33249  T                Eltrd/insert pace-           0108       159.42    $8,105.23    $4,214.72    $1,621.05
                            defib.
   33250  C                Ablate heart          ...........  ...........  ...........  ...........  ...........
                            dysrhythm focus.
   33251  C                Ablate heart          ...........  ...........  ...........  ...........  ...........
                            dysrhythm focus.
   33253  C                Reconstruct atria...  ...........  ...........  ...........  ...........  ...........
   33261  C                Ablate heart          ...........  ...........  ...........  ...........  ...........
                            dysrhythm focus.
   33282  S                Implant pat-active           0974         7.57      $384.87  ...........       $76.97
                            ht record.
   33284  T                Remove pat-active ht         0109         6.57      $334.03      $133.51       $66.81
                            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.

[[Page 44763]]

 
   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, modified      ...........  ...........  ...........  ...........  ...........
                            fontan.
   33617  C                Repair single         ...........  ...........  ...........  ...........  ...........
                            ventricle.
   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.

[[Page 44764]]

 
   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.
   33999  T                Cardiac surgery              0070         4.11      $208.96       $79.60       $41.79
                            procedure.
   34001  C                Removal of artery     ...........  ...........  ...........  ...........  ...........
                            clot.
   34051  C                Removal of artery     ...........  ...........  ...........  ...........  ...........
                            clot.
   34101  T                Removal of artery            0088        29.11    $1,480.01      $678.68      $296.00
                            clot.
   34111  T                Removal of arm               0088        29.11    $1,480.01      $678.68      $296.00
                            artery clot.
   34151  C                Removal of artery     ...........  ...........  ...........  ...........  ...........
                            clot.
   34201  T                Removal of artery            0088        29.11    $1,480.01      $678.68      $296.00
                            clot.
   34203  T                Removal of leg               0088        29.11    $1,480.01      $678.68      $296.00
                            artery clot.
   34401  C                Removal of vein clot  ...........  ...........  ...........  ...........  ...........
   34421  T                Removal of vein clot         0088        29.11    $1,480.01      $678.68      $296.00
   34451  C                Removal of vein clot  ...........  ...........  ...........  ...........  ...........
   34471  T                Removal of vein clot         0088        29.11    $1,480.01      $678.68      $296.00
   34490  T                Removal of vein clot         0088        29.11    $1,480.01      $678.68      $296.00
   34501  T                Repair valve,                0088        29.11    $1,480.01      $678.68      $296.00
                            femoral vein.

[[Page 44765]]

 
   34502  C                Reconstruct vena      ...........  ...........  ...........  ...........  ...........
                            cava.
   34510  T                Transposition of             0088        29.11    $1,480.01      $678.68      $296.00
                            vein valve.
   34520  T                Cross-over vein              0088        29.11    $1,480.01      $678.68      $296.00
                            graft.
   34530  T                Leg vein fusion.....         0088        29.11    $1,480.01      $678.68      $296.00
   34800  C                Endovasc abdo repair  ...........  ...........  ...........  ...........  ...........
                            w/tube.
   34802  C                Endovasc abdo repr w/ ...........  ...........  ...........  ...........  ...........
                            device.
   34804  C                Endovasc abdo repr w/ ...........  ...........  ...........  ...........  ...........
                            device.
   34808  C                Endovasc abdo occlud  ...........  ...........  ...........  ...........  ...........
                            device.
   34812  C                Xpose for             ...........  ...........  ...........  ...........  ...........
                            endoprosth, aortic.
   34813  C                Xpose for             ...........  ...........  ...........  ...........  ...........
                            endoprosth, femorl.
   34820  C                Xpose for             ...........  ...........  ...........  ...........  ...........
                            endoprosth, iliac.
   34825  C                Endovasc extend       ...........  ...........  ...........  ...........  ...........
                            prosth, init.
   34826  C                Endovasc exten        ...........  ...........  ...........  ...........  ...........
                            prosth, addl.
   34830  C                Open aortic tube      ...........  ...........  ...........  ...........  ...........
                            prosth repr.
   34831  C                Open aortoiliac       ...........  ...........  ...........  ...........  ...........
                            prosth repr.
   34832  C                Open aortofemor       ...........  ...........  ...........  ...........  ...........
                            prosth repr.
   35001  C                Repair defect of      ...........  ...........  ...........  ...........  ...........
                            artery.
   35002  C                Repair artery         ...........  ...........  ...........  ...........  ...........
                            rupture, neck.
   35005  C                Repair defect of      ...........  ...........  ...........  ...........  ...........
                            artery.
   35011  T                Repair defect of             0093        15.05      $765.17      $277.34      $153.03
                            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          0093        15.05      $765.17      $277.34      $153.03
                            lesion.
   35182  C                Repair blood vessel   ...........  ...........  ...........  ...........  ...........
                            lesion.
   35184  T                Repair blood vessel          0093        15.05      $765.17      $277.34      $153.03
                            lesion.
   35188  T                Repair blood vessel          0088        29.11    $1,480.01      $678.68      $296.00
                            lesion.
   35189  C                Repair blood vessel   ...........  ...........  ...........  ...........  ...........
                            lesion.
   35190  T                Repair blood vessel          0093        15.05      $765.17      $277.34      $153.03
                            lesion.
   35201  T                Repair blood vessel          0093        15.05      $765.17      $277.34      $153.03
                            lesion.
   35206  T                Repair blood vessel          0093        15.05      $765.17      $277.34      $153.03
                            lesion.
   35207  T                Repair blood vessel          0088        29.11    $1,480.01      $678.68      $296.00
                            lesion.
   35211  C                Repair blood vessel   ...........  ...........  ...........  ...........  ...........
                            lesion.
   35216  C                Repair blood vessel   ...........  ...........  ...........  ...........  ...........
                            lesion.
   35221  C                Repair blood vessel   ...........  ...........  ...........  ...........  ...........
                            lesion.
   35226  T                Repair blood vessel          0093        15.05      $765.17      $277.34      $153.03
                            lesion.
   35231  T                Repair blood vessel          0093        15.05      $765.17      $277.34      $153.03
                            lesion.
   35236  T                Repair blood vessel          0093        15.05      $765.17      $277.34      $153.03
                            lesion.
   35241  C                Repair blood vessel   ...........  ...........  ...........  ...........  ...........
                            lesion.
   35246  C                Repair blood vessel   ...........  ...........  ...........  ...........  ...........
                            lesion.
   35251  C                Repair blood vessel   ...........  ...........  ...........  ...........  ...........
                            lesion.
   35256  T                Repair blood vessel          0093        15.05      $765.17      $277.34      $153.03
                            lesion.
   35261  T                Repair blood vessel          0093        15.05      $765.17      $277.34      $153.03
                            lesion.
   35266  T                Repair blood vessel          0093        15.05      $765.17      $277.34      $153.03
                            lesion.
   35271  C                Repair blood vessel   ...........  ...........  ...........  ...........  ...........
                            lesion.
   35276  C                Repair blood vessel   ...........  ...........  ...........  ...........  ...........
                            lesion.
   35281  C                Repair blood vessel   ...........  ...........  ...........  ...........  ...........
                            lesion.
   35286  T                Repair blood vessel          0093        15.05      $765.17      $277.34      $153.03
                            lesion.
   35301  C                Rechanneling of       ...........  ...........  ...........  ...........  ...........
                            artery.
   35311  C                Rechanneling of       ...........  ...........  ...........  ...........  ...........
                            artery.
   35321  T                Rechanneling of              0093        15.05      $765.17      $277.34      $153.03
                            artery.
   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.

[[Page 44766]]

 
   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  T                Repair arterial              0081        22.04    $1,120.56      $549.07      $224.11
                            blockage.
   35459  T                Repair arterial              0081        22.04    $1,120.56      $549.07      $224.11
                            blockage.
   35460  T                Repair venous                0081        22.04    $1,120.56      $549.07      $224.11
                            blockage.
   35470  T                Repair arterial              0081        22.04    $1,120.56      $549.07      $224.11
                            blockage.
   35471  T                Repair arterial              0081        22.04    $1,120.56      $549.07      $224.11
                            blockage.
   35472  T                Repair arterial              0081        22.04    $1,120.56      $549.07      $224.11
                            blockage.
   35473  T                Repair arterial              0081        22.04    $1,120.56      $549.07      $224.11
                            blockage.
   35474  T                Repair arterial              0081        22.04    $1,120.56      $549.07      $224.11
                            blockage.
   35475  T                Repair arterial              0081        22.04    $1,120.56      $549.07      $224.11
                            blockage.
   35476  T                Repair venous                0081        22.04    $1,120.56      $549.07      $224.11
                            blockage.
   35480  C                Atherectomy, open...  ...........  ...........  ...........  ...........  ...........
   35481  T                Atherectomy, open...         0081        22.04    $1,120.56      $549.07      $224.11
   35482  C                Atherectomy, open...  ...........  ...........  ...........  ...........  ...........
   35483  C                Atherectomy, open...  ...........  ...........  ...........  ...........  ...........
   35484  T                Atherectomy, open...         0081        22.04    $1,120.56      $549.07      $224.11
   35485  T                Atherectomy, open...         0081        22.04    $1,120.56      $549.07      $224.11
   35490  T                Atherectomy,                 0081        22.04    $1,120.56      $549.07      $224.11
                            percutaneous.
   35491  T                Atherectomy,                 0081        22.04    $1,120.56      $549.07      $224.11
                            percutaneous.
   35492  T                Atherectomy,                 0081        22.04    $1,120.56      $549.07      $224.11
                            percutaneous.
   35493  T                Atherectomy,                 0081        22.04    $1,120.56      $549.07      $224.11
                            percutaneous.
   35494  T                Atherectomy,                 0081        22.04    $1,120.56      $549.07      $224.11
                            percutaneous.
   35495  T                Atherectomy,                 0081        22.04    $1,120.56      $549.07      $224.11
                            percutaneous.
   35500  T                Harvest vein for             0081        22.04    $1,120.56      $549.07      $224.11
                            bypass.
   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...  ...........  ...........  ...........  ...........  ...........
   35600  C                Harvest artery for    ...........  ...........  ...........  ...........  ...........
                            cabg.
   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.  ...........  ...........  ...........  ...........  ...........

[[Page 44767]]

 
   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  T                Exploration of               0115        19.06      $969.05      $503.91      $193.81
                            artery/vein.
   35800  C                Explore neck vessels  ...........  ...........  ...........  ...........  ...........
   35820  C                Explore chest         ...........  ...........  ...........  ...........  ...........
                            vessels.
   35840  C                Explore abdominal     ...........  ...........  ...........  ...........  ...........
                            vessels.
   35860  T                Explore limb vessels         0093        15.05      $765.17      $277.34      $153.03
   35870  C                Repair vessel graft   ...........  ...........  ...........  ...........  ...........
                            defect.
   35875  T                Removal of clot in           0088        29.11    $1,480.01      $678.68      $296.00
                            graft.
   35876  T                Removal of clot in           0088        29.11    $1,480.01      $678.68      $296.00
                            graft.
   35879  T                Revise graft w/vein.         0088        29.11    $1,480.01      $678.68      $296.00
   35881  T                Revise graft w/vein.         0088        29.11    $1,480.01      $678.68      $296.00
   35901  C                Excision, graft,      ...........  ...........  ...........  ...........  ...........
                            neck.
   35903  T                Excision, graft,             0115        19.06      $969.05      $503.91      $193.81
                            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                 0119        14.37      $730.60      $161.50      $146.12
                            infusion pump.
   36261  T                Revision of infusion         0124        25.84    $1,313.76      $722.57      $262.75
                            pump.
   36262  T                Removal of infusion          0109         6.57      $334.03      $133.51       $66.81
                            pump.
   36299  N                Vessel injection      ...........  ...........  ...........  ...........  ...........
                            procedure.
   36400  N                Drawing blood.......  ...........  ...........  ...........  ...........  ...........
   36405  N                Drawing blood.......  ...........  ...........  ...........  ...........  ...........
   36406  N                Drawing blood.......  ...........  ...........  ...........  ...........  ...........
   36410  N                Drawing blood.......  ...........  ...........  ...........  ...........  ...........
   36415  E                Drawing blood.......  ...........  ...........  ...........  ...........  ...........
   36420  T                Establish access to          0035         0.13        $6.61        $2.18        $1.32
                            vein.
   36425  T                Establish access to          0035         0.13        $6.61        $2.18        $1.32
                            vein.
   36430  S                Blood transfusion            0110         5.76      $292.85      $122.70       $58.57
                            service.
   36440  S                Blood transfusion            0110         5.76      $292.85      $122.70       $58.57
                            service.
   36450  S                Exchange transfusion         0110         5.76      $292.85      $122.70       $58.57
                            service.
   36455  S                Exchange transfusion         0110         5.76      $292.85      $122.70       $58.57
                            service.
   36460  S                Transfusion service,         0110         5.76      $292.85      $122.70       $58.57
                            fetal.
   36468  T                Injection(s), spider         0098         1.34       $68.13       $20.88       $13.63
                            veins.

[[Page 44768]]

 
   36469  T                Injection(s), spider         0098         1.34       $68.13       $20.88       $13.63
                            veins.
   36470  T                Injection therapy of         0098         1.34       $68.13       $20.88       $13.63
                            vein.
   36471  T                Injection therapy of         0098         1.34       $68.13       $20.88       $13.63
                            veins.
   36481  N                Insertion of          ...........  ...........  ...........  ...........  ...........
                            catheter, vein.
   36488  T                Insertion of                 0032         7.16      $364.03      $119.52       $72.81
                            catheter, vein.
   36489  T                Insertion of                 0032         7.16      $364.03      $119.52       $72.81
                            catheter, vein.
   36490  T                Insertion of                 0032         7.16      $364.03      $119.52       $72.81
                            catheter, vein.
   36491  T                Insertion of                 0032         7.16      $364.03      $119.52       $72.81
                            catheter, vein.
   36493  T                Repositioning of cvc         0187         4.54      $230.82      $113.10       $46.16
   36500  N                Insertion of          ...........  ...........  ...........  ...........  ...........
                            catheter, vein.
   36510  C                Insertion of          ...........  ...........  ...........  ...........  ...........
                            catheter, vein.
   36520  S                Plasma and/or cell           0111        16.69      $848.55      $300.74      $169.71
                            exchange.
   36521  S                Apheresis w/ adsorp/         0112        39.75    $2,020.97      $663.65      $404.19
                            reinfuse.
   36522  S                Photopheresis.......         0112        39.75    $2,020.97      $663.65      $404.19
   36530  T                Insertion of                 0119        14.37      $730.60      $161.50      $146.12
                            infusion pump.
   36531  T                Revision of infusion         0124        25.84    $1,313.76      $722.57      $262.75
                            pump.
   36532  T                Removal of infusion          0109         6.57      $334.03      $133.51       $66.81
                            pump.
   36533  T                Insertion of access          0115        19.06      $969.05      $503.91      $193.81
                            device.
   36534  T                Revision of access           0103        10.91      $554.69      $249.61      $110.94
                            device.
   36535  T                Removal of access            0109         6.57      $334.03      $133.51       $66.81
                            device.
   36540  N                Collect blood venous  ...........  ...........  ...........  ...........  ...........
                            device.
   36550  T                Declot vascular              0970         0.47       $23.90  ...........        $4.78
                            device.
   36600  N                Withdrawal of         ...........  ...........  ...........  ...........  ...........
                            arterial blood.
   36620  N                Insertion catheter,   ...........  ...........  ...........  ...........  ...........
                            artery.
   36625  N                Insertion catheter,   ...........  ...........  ...........  ...........  ...........
                            artery.
   36640  T                Insertion catheter,          0032         7.16      $364.03      $119.52       $72.81
                            artery.
   36660  C                Insertion catheter,   ...........  ...........  ...........  ...........  ...........
                            artery.
   36680  T                Insert needle, bone          0120         2.35      $119.48       $42.67       $23.90
                            cavity.
   36800  T                Insertion of cannula         0115        19.06      $969.05      $503.91      $193.81
   36810  T                Insertion of cannula         0115        19.06      $969.05      $503.91      $193.81
   36815  T                Insertion of cannula         0115        19.06      $969.05      $503.91      $193.81
   36819  T                Av fusion by basilic         0088        29.11    $1,480.01      $678.68      $296.00
                            vein.
   36821  T                Av fusion direct any         0088        29.11    $1,480.01      $678.68      $296.00
                            site.
   36822  C                Insertion of          ...........  ...........  ...........  ...........  ...........
                            cannula(s).
   36823  C                Insertion of          ...........  ...........  ...........  ...........  ...........
                            cannula(s).
   36825  T                Artery-vein graft...         0088        29.11    $1,480.01      $678.68      $296.00
   36830  T                Artery-vein graft...         0088        29.11    $1,480.01      $678.68      $296.00
   36831  T                Av fistula excision,         0088        29.11    $1,480.01      $678.68      $296.00
                            open.
   36832  T                Av fistula revision,         0088        29.11    $1,480.01      $678.68      $296.00
                            open.
   36833  T                Av fistula revision.         0088        29.11    $1,480.01      $678.68      $296.00
   36834  T                Repair A-V aneurysm.         0088        29.11    $1,480.01      $678.68      $296.00
   36835  T                Artery to vein shunt         0115        19.06      $969.05      $503.91      $193.81
   36860  T                External cannula             0115        19.06      $969.05      $503.91      $193.81
                            declotting.
   36861  T                Cannula declotting..         0115        19.06      $969.05      $503.91      $193.81
   36870  T                Av fistula revision,         0093        15.05      $765.17      $277.34      $153.03
                            open.
   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  T                Transcatheter biopsy         0005         6.71      $341.15      $119.75       $68.23
   37201  T                Transcatheter                0120         2.35      $119.48       $42.67       $23.90
                            therapy infuse.
   37202  T                Transcatheter                0120         2.35      $119.48       $42.67       $23.90
                            therapy infuse.
   37203  T                Transcatheter                0103        10.91      $554.69      $249.61      $110.94
                            retrieval.
   37204  T                Transcatheter                0103        10.91      $554.69      $249.61      $110.94
                            occlusion.
   37205  T                Transcatheter stent.         0229        60.07    $3,054.08      $996.86      $610.82
   37206  T                Transcatheter stent          0229        60.07    $3,054.08      $996.86      $610.82
                            add-on.
   37207  T                Transcatheter stent.         0229        60.07    $3,054.08      $996.86      $610.82
   37208  T                Transcatheter stent          0229        60.07    $3,054.08      $996.86      $610.82
                            add-on.
   37209  T                Exchange arterial            0103        10.91      $554.69      $249.61      $110.94
                            catheter.
   37250  T                Iv us first vessel           0103        10.91      $554.69      $249.61      $110.94
                            add-on.
   37251  T                Iv us each add               0103        10.91      $554.69      $249.61      $110.94
                            vessel add-on.
   37565  T                Ligation of neck             0093        15.05      $765.17      $277.34      $153.03
                            vein.
   37600  T                Ligation of neck             0093        15.05      $765.17      $277.34      $153.03
                            artery.
   37605  T                Ligation of neck             0091        22.17    $1,127.17      $348.23      $225.43
                            artery.
   37606  T                Ligation of neck             0091        22.17    $1,127.17      $348.23      $225.43
                            artery.
   37607  T                Ligation of a-v              0092        21.43    $1,089.54      $505.37      $217.91
                            fistula.
   37609  T                Temporal artery              0020         8.56      $435.21      $130.53       $87.04
                            procedure.
   37615  T                Ligation of neck             0091        22.17    $1,127.17      $348.23      $225.43
                            artery.
   37616  C                Ligation of chest     ...........  ...........  ...........  ...........  ...........
                            artery.
   37617  C                Ligation of abdomen   ...........  ...........  ...........  ...........  ...........
                            artery.
   37618  C                Ligation of           ...........  ...........  ...........  ...........  ...........
                            extremity artery.
   37620  T                Revision of major            0091        22.17    $1,127.17      $348.23      $225.43
                            vein.
   37650  T                Revision of major            0091        22.17    $1,127.17      $348.23      $225.43
                            vein.

[[Page 44769]]

 
   37660  C                Revision of major     ...........  ...........  ...........  ...........  ...........
                            vein.
   37700  T                Revise leg vein.....         0091        22.17    $1,127.17      $348.23      $225.43
   37720  T                Removal of leg vein.         0092        21.43    $1,089.54      $505.37      $217.91
   37730  T                Removal of leg veins         0092        21.43    $1,089.54      $505.37      $217.91
   37735  T                Removal of leg veins/        0092        21.43    $1,089.54      $505.37      $217.91
                            lesion.
   37760  T                Revision of leg              0091        22.17    $1,127.17      $348.23      $225.43
                            veins.
   37780  T                Revision of leg vein         0091        22.17    $1,127.17      $348.23      $225.43
   37785  T                Revise secondary             0091        22.17    $1,127.17      $348.23      $225.43
                            varicosity.
   37788  C                Revascularization,    ...........  ...........  ...........  ...........  ...........
                            penis.
   37790  T                Penile venous                0181        24.07    $1,223.77      $673.07      $244.75
                            occlusion.
   37799  T                Vascular surgery             0020         8.56      $435.21      $130.53       $87.04
                            procedure.
   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,                 0131        39.80    $2,023.51    $1,052.23      $404.70
                            splenectomy.
   38129  T                Laparoscope proc,            0130        27.92    $1,419.51      $659.53      $283.90
                            spleen.
   38200  N                Injection for spleen  ...........  ...........  ...........  ...........  ...........
                            x-ray.
   38230  S                Bone marrow                  0123        10.12      $514.52      $102.90      $102.90
                            collection.
   38231  S                Stem cell collection         0111        16.69      $848.55      $300.74      $169.71
   38240  S                Bone marrow/stem             0123        10.12      $514.52      $102.90      $102.90
                            transplant.
   38241  S                Bone marrow/stem             0123        10.12      $514.52      $102.90      $102.90
                            transplant.
   38300  T                Drainage, lymph node         0008        11.36      $577.57      $115.51      $115.51
                            lesion.
   38305  T                Drainage, lymph node         0008        11.36      $577.57      $115.51      $115.51
                            lesion.
   38308  T                Incision of lymph            0113        16.87      $857.70      $326.55      $171.54
                            channels.
   38380  C                Thoracic duct         ...........  ...........  ...........  ...........  ...........
                            procedure.
   38381  C                Thoracic duct         ...........  ...........  ...........  ...........  ...........
                            procedure.
   38382  C                Thoracic duct         ...........  ...........  ...........  ...........  ...........
                            procedure.
   38500  T                Biopsy/removal,              0113        16.87      $857.70      $326.55      $171.54
                            lymph nodes.
   38505  T                Needle biopsy, lymph         0005         6.71      $341.15      $119.75       $68.23
                            nodes.
   38510  T                Biopsy/removal,              0113        16.87      $857.70      $326.55      $171.54
                            lymph nodes.
   38520  T                Biopsy/removal,              0113        16.87      $857.70      $326.55      $171.54
                            lymph nodes.
   38525  T                Biopsy/removal,              0113        16.87      $857.70      $326.55      $171.54
                            lymph nodes.
   38530  T                Biopsy/removal,              0113        16.87      $857.70      $326.55      $171.54
                            lymph nodes.
   38542  T                Explore deep                 0114        30.50    $1,550.68      $493.78      $310.14
                            node(s), neck.
   38550  T                Removal, neck/armpit         0113        16.87      $857.70      $326.55      $171.54
                            lesion.
   38555  T                Removal, neck/armpit         0114        30.50    $1,550.68      $493.78      $310.14
                            lesion.
   38562  C                Removal, pelvic       ...........  ...........  ...........  ...........  ...........
                            lymph nodes.
   38564  C                Removal, abdomen      ...........  ...........  ...........  ...........  ...........
                            lymph nodes.
   38570  T                Laparoscopy, lymph           0131        39.80    $2,023.51    $1,052.23      $404.70
                            node biop.
   38571  T                Laparoscopy,                 0132        60.31    $3,066.28    $1,239.22      $613.26
                            lymphadenectomy.
   38572  T                Laparoscopy,                 0131        39.80    $2,023.51    $1,052.23      $404.70
                            lymphadenectomy.
   38589  T                Laparoscope proc,            0130        27.92    $1,419.51      $659.53      $283.90
                            lymphatic.
   38700  C                Removal of lymph      ...........  ...........  ...........  ...........  ...........
                            nodes, neck.
   38720  T                Removal of lymph             0114        30.50    $1,550.68      $493.78      $310.14
                            nodes, neck.
   38724  C                Removal of lymph      ...........  ...........  ...........  ...........  ...........
                            nodes, neck.
   38740  T                Remove armpit lymph          0114        30.50    $1,550.68      $493.78      $310.14
                            nodes.
   38745  T                Remove armpit lymph          0114        30.50    $1,550.68      $493.78      $310.14
                            nodes.
   38746  C                Remove thoracic       ...........  ...........  ...........  ...........  ...........
                            lymph nodes.
   38747  C                Remove abdominal      ...........  ...........  ...........  ...........  ...........
                            lymph nodes.
   38760  T                Remove groin lymph           0114        30.50    $1,550.68      $493.78      $310.14
                            nodes.
   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           0008        11.36      $577.57      $115.51      $115.51
                            procedure.
   39000  C                Exploration of chest  ...........  ...........  ...........  ...........  ...........
   39010  C                Exploration of chest  ...........  ...........  ...........  ...........  ...........
   39200  C                Removal chest lesion  ...........  ...........  ...........  ...........  ...........
   39220  C                Removal chest lesion  ...........  ...........  ...........  ...........  ...........
   39400  T                Visualization of             0069        25.62    $1,302.57      $612.21      $260.51
                            chest.
   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.

[[Page 44770]]

 
   39599  C                Diaphragm surgery     ...........  ...........  ...........  ...........  ...........
                            procedure.
   40490  T                Biopsy of lip.......         0251         2.71      $137.78       $27.99       $27.56
   40500  T                Partial excision of          0253        13.27      $674.67      $284.00      $134.93
                            lip.
   40510  T                Partial excision of          0254        19.11      $971.59      $272.41      $194.32
                            lip.
   40520  T                Partial excision of          0253        13.27      $674.67      $284.00      $134.93
                            lip.
   40525  T                Reconstruct lip with         0254        19.11      $971.59      $272.41      $194.32
                            flap.
   40527  T                Reconstruct lip with         0254        19.11      $971.59      $272.41      $194.32
                            flap.
   40530  T                Partial removal of           0254        19.11      $971.59      $272.41      $194.32
                            lip.
   40650  T                Repair lip..........         0252         6.53      $332.00      $114.24       $66.40
   40652  T                Repair lip..........         0252         6.53      $332.00      $114.24       $66.40
   40654  T                Repair lip..........         0252         6.53      $332.00      $114.24       $66.40
   40700  T                Repair cleft lip/            0256        28.82    $1,465.27      $623.05      $293.05
                            nasal.
   40701  T                Repair cleft lip/            0256        28.82    $1,465.27      $623.05      $293.05
                            nasal.
   40702  T                Repair cleft lip/            0256        28.82    $1,465.27      $623.05      $293.05
                            nasal.
   40720  T                Repair cleft lip/            0256        28.82    $1,465.27      $623.05      $293.05
                            nasal.
   40761  T                Repair cleft lip/            0256        28.82    $1,465.27      $623.05      $293.05
                            nasal.
   40799  T                Lip surgery                  0253        13.27      $674.67      $284.00      $134.93
                            procedure.
   40800  T                Drainage of mouth            0251         2.71      $137.78       $27.99       $27.56
                            lesion.
   40801  T                Drainage of mouth            0252         6.53      $332.00      $114.24       $66.40
                            lesion.
   40804  X                Removal, foreign             0340         0.91       $46.27       $11.57        $9.25
                            body, mouth.
   40805  T                Removal, foreign             0252         6.53      $332.00      $114.24       $66.40
                            body, mouth.
   40806  T                Incision of lip fold         0251         2.71      $137.78       $27.99       $27.56
   40808  T                Biopsy of mouth              0251         2.71      $137.78       $27.99       $27.56
                            lesion.
   40810  T                Excision of mouth            0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   40812  T                Excise/repair mouth          0252         6.53      $332.00      $114.24       $66.40
                            lesion.
   40814  T                Excise/repair mouth          0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   40816  T                Excision of mouth            0254        19.11      $971.59      $272.41      $194.32
                            lesion.
   40818  T                Excise oral mucosa           0251         2.71      $137.78       $27.99       $27.56
                            for graft.
   40819  T                Excise lip or cheek          0252         6.53      $332.00      $114.24       $66.40
                            fold.
   40820  T                Treatment of mouth           0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   40830  T                Repair mouth                 0251         2.71      $137.78       $27.99       $27.56
                            laceration.
   40831  T                Repair mouth                 0252         6.53      $332.00      $114.24       $66.40
                            laceration.
   40840  T                Reconstruction of            0254        19.11      $971.59      $272.41      $194.32
                            mouth.
   40842  T                Reconstruction of            0254        19.11      $971.59      $272.41      $194.32
                            mouth.
   40843  T                Reconstruction of            0254        19.11      $971.59      $272.41      $194.32
                            mouth.
   40844  T                Reconstruction of            0256        28.82    $1,465.27      $623.05      $293.05
                            mouth.
   40845  T                Reconstruction of            0256        28.82    $1,465.27      $623.05      $293.05
                            mouth.
   40899  T                Mouth surgery                0252         6.53      $332.00      $114.24       $66.40
                            procedure.
   41000  T                Drainage of mouth            0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   41005  T                Drainage of mouth            0251         2.71      $137.78       $27.99       $27.56
                            lesion.
   41006  T                Drainage of mouth            0254        19.11      $971.59      $272.41      $194.32
                            lesion.
   41007  T                Drainage of mouth            0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   41008  T                Drainage of mouth            0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   41009  T                Drainage of mouth            0251         2.71      $137.78       $27.99       $27.56
                            lesion.
   41010  T                Incision of tongue           0253        13.27      $674.67      $284.00      $134.93
                            fold.
   41015  T                Drainage of mouth            0251         2.71      $137.78       $27.99       $27.56
                            lesion.
   41016  T                Drainage of mouth            0252         6.53      $332.00      $114.24       $66.40
                            lesion.
   41017  T                Drainage of mouth            0252         6.53      $332.00      $114.24       $66.40
                            lesion.
   41018  T                Drainage of mouth            0252         6.53      $332.00      $114.24       $66.40
                            lesion.
   41100  T                Biopsy of tongue....         0252         6.53      $332.00      $114.24       $66.40
   41105  T                Biopsy of tongue....         0253        13.27      $674.67      $284.00      $134.93
   41108  T                Biopsy of floor of           0252         6.53      $332.00      $114.24       $66.40
                            mouth.
   41110  T                Excision of tongue           0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   41112  T                Excision of tongue           0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   41113  T                Excision of tongue           0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   41114  T                Excision of tongue           0254        19.11      $971.59      $272.41      $194.32
                            lesion.
   41115  T                Excision of tongue           0252         6.53      $332.00      $114.24       $66.40
                            fold.
   41116  T                Excision of mouth            0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   41120  T                Partial removal of           0256        28.82    $1,465.27      $623.05      $293.05
                            tongue.
   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.
   41250  T                Repair tongue                0251         2.71      $137.78       $27.99       $27.56
                            laceration.
   41251  T                Repair tongue                0252         6.53      $332.00      $114.24       $66.40
                            laceration.
   41252  T                Repair tongue                0252         6.53      $332.00      $114.24       $66.40
                            laceration.
   41500  T                Fixation of tongue..         0254        19.11      $971.59      $272.41      $194.32
   41510  T                Tongue to lip                0253        13.27      $674.67      $284.00      $134.93
                            surgery.
   41520  T                Reconstruction,              0252         6.53      $332.00      $114.24       $66.40
                            tongue fold.
   41599  T                Tongue and mouth             0251         2.71      $137.78       $27.99       $27.56
                            surgery.
   41800  T                Drainage of gum              0251         2.71      $137.78       $27.99       $27.56
                            lesion.
   41805  T                Removal foreign              0254        19.11      $971.59      $272.41      $194.32
                            body, gum.

[[Page 44771]]

 
   41806  T                Removal foreign              0253        13.27      $674.67      $284.00      $134.93
                            body,jawbone.
   41820  T                Excision, gum, each          0252         6.53      $332.00      $114.24       $66.40
                            quadrant.
   41821  T                Excision of gum flap         0252         6.53      $332.00      $114.24       $66.40
   41822  T                Excision of gum              0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   41823  T                Excision of gum              0254        19.11      $971.59      $272.41      $194.32
                            lesion.
   41825  T                Excision of gum              0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   41826  T                Excision of gum              0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   41827  T                Excision of gum              0254        19.11      $971.59      $272.41      $194.32
                            lesion.
   41828  T                Excision of gum              0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   41830  T                Removal of gum               0253        13.27      $674.67      $284.00      $134.93
                            tissue.
   41850  T                Treatment of gum             0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   41870  T                Gum graft...........         0254        19.11      $971.59      $272.41      $194.32
   41872  T                Repair gum..........         0253        13.27      $674.67      $284.00      $134.93
   41874  T                Repair tooth socket.         0254        19.11      $971.59      $272.41      $194.32
   41899  T                Dental surgery               0253        13.27      $674.67      $284.00      $134.93
                            procedure.
   42000  T                Drainage mouth roof          0251         2.71      $137.78       $27.99       $27.56
                            lesion.
   42100  T                Biopsy roof of mouth         0252         6.53      $332.00      $114.24       $66.40
   42104  T                Excision lesion,             0253        13.27      $674.67      $284.00      $134.93
                            mouth roof.
   42106  T                Excision lesion,             0253        13.27      $674.67      $284.00      $134.93
                            mouth roof.
   42107  T                Excision lesion,             0254        19.11      $971.59      $272.41      $194.32
                            mouth roof.
   42120  T                Remove palate/lesion         0256        28.82    $1,465.27      $623.05      $293.05
   42140  T                Excision of uvula...         0252         6.53      $332.00      $114.24       $66.40
   42145  T                Repair palate,               0254        19.11      $971.59      $272.41      $194.32
                            pharynx/uvula.
   42160  T                Treatment mouth roof         0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   42180  T                Repair palate.......         0251         2.71      $137.78       $27.99       $27.56
   42182  T                Repair palate.......         0256        28.82    $1,465.27      $623.05      $293.05
   42200  T                Reconstruct cleft            0256        28.82    $1,465.27      $623.05      $293.05
                            palate.
   42205  T                Reconstruct cleft            0256        28.82    $1,465.27      $623.05      $293.05
                            palate.
   42210  T                Reconstruct cleft            0256        28.82    $1,465.27      $623.05      $293.05
                            palate.
   42215  T                Reconstruct cleft            0256        28.82    $1,465.27      $623.05      $293.05
                            palate.
   42220  T                Reconstruct cleft            0256        28.82    $1,465.27      $623.05      $293.05
                            palate.
   42225  T                Reconstruct cleft            0256        28.82    $1,465.27      $623.05      $293.05
                            palate.
   42226  T                Lengthening of               0256        28.82    $1,465.27      $623.05      $293.05
                            palate.
   42227  T                Lengthening of               0256        28.82    $1,465.27      $623.05      $293.05
                            palate.
   42235  T                Repair palate.......         0253        13.27      $674.67      $284.00      $134.93
   42260  T                Repair nose to lip           0254        19.11      $971.59      $272.41      $194.32
                            fistula.
   42280  T                Preparation, palate          0251         2.71      $137.78       $27.99       $27.56
                            mold.
   42281  T                Insertion, palate            0253        13.27      $674.67      $284.00      $134.93
                            prosthesis.
   42299  T                Palate/uvula surgery         0251         2.71      $137.78       $27.99       $27.56
   42300  T                Drainage of salivary         0253        13.27      $674.67      $284.00      $134.93
                            gland.
   42305  T                Drainage of salivary         0253        13.27      $674.67      $284.00      $134.93
                            gland.
   42310  T                Drainage of salivary         0251         2.71      $137.78       $27.99       $27.56
                            gland.
   42320  T                Drainage of salivary         0251         2.71      $137.78       $27.99       $27.56
                            gland.
   42325  T                Create salivary cyst         0251         2.71      $137.78       $27.99       $27.56
                            drain.
   42326  T                Create salivary cyst         0252         6.53      $332.00      $114.24       $66.40
                            drain.
   42330  T                Removal of salivary          0252         6.53      $332.00      $114.24       $66.40
                            stone.
   42335  T                Removal of salivary          0253        13.27      $674.67      $284.00      $134.93
                            stone.
   42340  T                Removal of salivary          0253        13.27      $674.67      $284.00      $134.93
                            stone.
   42400  T                Biopsy of salivary           0004         3.00      $152.53       $32.57       $30.51
                            gland.
   42405  T                Biopsy of salivary           0253        13.27      $674.67      $284.00      $134.93
                            gland.
   42408  T                Excision of salivary         0253        13.27      $674.67      $284.00      $134.93
                            cyst.
   42409  T                Drainage of salivary         0253        13.27      $674.67      $284.00      $134.93
                            cyst.
   42410  T                Excise parotid gland/        0256        28.82    $1,465.27      $623.05      $293.05
                            lesion.
   42415  T                Excise parotid gland/        0256        28.82    $1,465.27      $623.05      $293.05
                            lesion.
   42420  T                Excise parotid gland/        0256        28.82    $1,465.27      $623.05      $293.05
                            lesion.
   42425  T                Excise parotid gland/        0256        28.82    $1,465.27      $623.05      $293.05
                            lesion.
   42426  C                Excise parotid gland/ ...........  ...........  ...........  ...........  ...........
                            lesion.
   42440  T                Excise submaxillary          0256        28.82    $1,465.27      $623.05      $293.05
                            gland.
   42450  T                Excise sublingual            0254        19.11      $971.59      $272.41      $194.32
                            gland.
   42500  T                Repair salivary duct         0254        19.11      $971.59      $272.41      $194.32
   42505  T                Repair salivary duct         0256        28.82    $1,465.27      $623.05      $293.05
   42507  T                Parotid duct                 0256        28.82    $1,465.27      $623.05      $293.05
                            diversion.
   42508  T                Parotid duct                 0256        28.82    $1,465.27      $623.05      $293.05
                            diversion.
   42509  T                Parotid duct                 0256        28.82    $1,465.27      $623.05      $293.05
                            diversion.
   42510  T                Parotid duct                 0256        28.82    $1,465.27      $623.05      $293.05
                            diversion.
   42550  N                Injection for         ...........  ...........  ...........  ...........  ...........
                            salivary x-ray.
   42600  T                Closure of salivary          0253        13.27      $674.67      $284.00      $134.93
                            fistula.
   42650  T                Dilation of salivary         0252         6.53      $332.00      $114.24       $66.40
                            duct.
   42660  T                Dilation of salivary         0252         6.53      $332.00      $114.24       $66.40
                            duct.
   42665  T                Ligation of salivary         0254        19.11      $971.59      $272.41      $194.32
                            duct.
   42699  T                Salivary surgery             0253        13.27      $674.67      $284.00      $134.93
                            procedure.
   42700  T                Drainage of tonsil           0251         2.71      $137.78       $27.99       $27.56
                            abscess.
   42720  T                Drainage of throat           0253        13.27      $674.67      $284.00      $134.93
                            abscess.
   42725  T                Drainage of throat           0256        28.82    $1,465.27      $623.05      $293.05
                            abscess.
   42800  T                Biopsy of throat....         0252         6.53      $332.00      $114.24       $66.40

[[Page 44772]]

 
   42802  T                Biopsy of throat....         0253        13.27      $674.67      $284.00      $134.93
   42804  T                Biopsy of upper nose/        0253        13.27      $674.67      $284.00      $134.93
                            throat.
   42806  T                Biopsy of upper nose/        0254        19.11      $971.59      $272.41      $194.32
                            throat.
   42808  T                Excise pharynx               0253        13.27      $674.67      $284.00      $134.93
                            lesion.
   42809  X                Remove pharynx               0340         0.91       $46.27       $11.57        $9.25
                            foreign body.
   42810  T                Excision of neck             0254        19.11      $971.59      $272.41      $194.32
                            cyst.
   42815  T                Excision of neck             0256        28.82    $1,465.27      $623.05      $293.05
                            cyst.
   42820  T                Remove tonsils and           0258        18.86      $958.88      $462.81      $191.78
                            adenoids.
   42821  T                Remove tonsils and           0258        18.86      $958.88      $462.81      $191.78
                            adenoids.
   42825  T                Removal of tonsils..         0258        18.86      $958.88      $462.81      $191.78
   42826  T                Removal of tonsils..         0258        18.86      $958.88      $462.81      $191.78
   42830  T                Removal of adenoids.         0258        18.86      $958.88      $462.81      $191.78
   42831  T                Removal of adenoids.         0258        18.86      $958.88      $462.81      $191.78
   42835  T                Removal of adenoids.         0258        18.86      $958.88      $462.81      $191.78
   42836  T                Removal of adenoids.         0258        18.86      $958.88      $462.81      $191.78
   42842  C                Extensive surgery of  ...........  ...........  ...........  ...........  ...........
                            throat.
   42844  T                Extensive surgery of         0256        28.82    $1,465.27      $623.05      $293.05
                            throat.
   42845  C                Extensive surgery of  ...........  ...........  ...........  ...........  ...........
                            throat.
   42860  T                Excision of tonsil           0258        18.86      $958.88      $462.81      $191.78
                            tags.
   42870  T                Excision of lingual          0258        18.86      $958.88      $462.81      $191.78
                            tonsil.
   42890  T                Partial removal of           0256        28.82    $1,465.27      $623.05      $293.05
                            pharynx.
   42892  T                Revision of                  0256        28.82    $1,465.27      $623.05      $293.05
                            pharyngeal walls.
   42894  C                Revision of           ...........  ...........  ...........  ...........  ...........
                            pharyngeal walls.
   42900  T                Repair throat wound.         0252         6.53      $332.00      $114.24       $66.40
   42950  T                Reconstruction of            0254        19.11      $971.59      $272.41      $194.32
                            throat.
   42953  C                Repair throat,        ...........  ...........  ...........  ...........  ...........
                            esophagus.
   42955  T                Surgical opening of          0254        19.11      $971.59      $272.41      $194.32
                            throat.
   42960  T                Control throat               0250         2.27      $115.41       $38.54       $23.08
                            bleeding.
   42961  C                Control throat        ...........  ...........  ...........  ...........  ...........
                            bleeding.
   42962  T                Control throat               0256        28.82    $1,465.27      $623.05      $293.05
                            bleeding.
   42970  T                Control nose/throat          0250         2.27      $115.41       $38.54       $23.08
                            bleeding.
   42971  C                Control nose/throat   ...........  ...........  ...........  ...........  ...........
                            bleeding.
   42972  T                Control nose/throat          0253        13.27      $674.67      $284.00      $134.93
                            bleeding.
   42999  T                Throat surgery               0252         6.53      $332.00      $114.24       $66.40
                            procedure.
   43020  T                Incision of                  0252         6.53      $332.00      $114.24       $66.40
                            esophagus.
   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  T                Removal of esophagus         0254        19.11      $971.59      $272.41      $194.32
                            pouch.
   43135  C                Removal of esophagus  ...........  ...........  ...........  ...........  ...........
                            pouch.
   43200  T                Esophagus endoscopy.         0141         7.46      $379.28      $184.67       $75.86
   43202  T                Esophagus endoscopy,         0141         7.46      $379.28      $184.67       $75.86
                            biopsy.
   43204  T                Esophagus endoscopy          0141         7.46      $379.28      $184.67       $75.86
                            & inject.
   43205  T                Esophagus endoscopy/         0141         7.46      $379.28      $184.67       $75.86
                            ligation.
   43215  T                Esophagus endoscopy.         0141         7.46      $379.28      $184.67       $75.86
   43216  T                Esophagus endoscopy/         0141         7.46      $379.28      $184.67       $75.86
                            lesion.
   43217  T                Esophagus endoscopy.         0141         7.46      $379.28      $184.67       $75.86
   43219  T                Esophagus endoscopy.         0141         7.46      $379.28      $184.67       $75.86
   43220  T                Esoph endoscopy,             0141         7.46      $379.28      $184.67       $75.86
                            dilation.
   43226  T                Esoph endoscopy,             0141         7.46      $379.28      $184.67       $75.86
                            dilation.
   43227  T                Esoph endoscopy,             0141         7.46      $379.28      $184.67       $75.86
                            repair.
   43228  T                Esoph endoscopy,             0141         7.46      $379.28      $184.67       $75.86
                            ablation.
   43231  T                Esoph endoscopy w/us         0141         7.46      $379.28      $184.67       $75.86
                            exam.
   43232  T                Esoph endoscopy w/us         0141         7.46      $379.28      $184.67       $75.86
                            fn bx.
   43234  T                Upper GI endoscopy,          0141         7.46      $379.28      $184.67       $75.86
                            exam.
   43235  T                Uppr gi endoscopy,           0141         7.46      $379.28      $184.67       $75.86
                            diagnosis.
   43239  T                Upper GI endoscopy,          0141         7.46      $379.28      $184.67       $75.86
                            biopsy.
   43240  T                Esoph endoscope w/           0141         7.46      $379.28      $184.67       $75.86
                            drain cyst.
   43241  T                Upper GI endoscopy           0141         7.46      $379.28      $184.67       $75.86
                            with tube.
   43242  T                Uppr gi endoscopy w/         0141         7.46      $379.28      $184.67       $75.86
                            us fn bx.
   43243  T                Upper gi endoscopy &         0141         7.46      $379.28      $184.67       $75.86
                            inject.
   43244  T                Upper GI endoscopy/          0141         7.46      $379.28      $184.67       $75.86
                            ligation.
   43245  T                Operative upper GI           0141         7.46      $379.28      $184.67       $75.86
                            endoscopy.

[[Page 44773]]

 
   43246  T                Place gastrostomy            0141         7.46      $379.28      $184.67       $75.86
                            tube.
   43247  T                Operative upper GI           0141         7.46      $379.28      $184.67       $75.86
                            endoscopy.
   43248  T                Uppr gi endoscopy/           0141         7.46      $379.28      $184.67       $75.86
                            guide wire.
   43249  T                Esoph endoscopy,             0141         7.46      $379.28      $184.67       $75.86
                            dilation.
   43250  T                Upper GI endoscopy/          0141         7.46      $379.28      $184.67       $75.86
                            tumor.
   43251  T                Operative upper GI           0141         7.46      $379.28      $184.67       $75.86
                            endoscopy.
   43255  T                Operative upper GI           0141         7.46      $379.28      $184.67       $75.86
                            endoscopy.
   43256  T                Uppr gi endoscopy w          0141         7.46      $379.28      $184.67       $75.86
                            stent.
   43258  T                Operative upper GI           0141         7.46      $379.28      $184.67       $75.86
                            endoscopy.
   43259  T                Endoscopic                   0141         7.46      $379.28      $184.67       $75.86
                            ultrasound exam.
   43260  T                Endo                         0151        16.22      $824.66      $245.46      $164.93
                            cholangiopancreatog
                            raph.
   43261  T                Endo                         0151        16.22      $824.66      $245.46      $164.93
                            cholangiopancreatog
                            raph.
   43262  T                Endo                         0151        16.22      $824.66      $245.46      $164.93
                            cholangiopancreatog
                            raph.
   43263  T                Endo                         0151        16.22      $824.66      $245.46      $164.93
                            cholangiopancreatog
                            raph.
   43264  T                Endo                         0151        16.22      $824.66      $245.46      $164.93
                            cholangiopancreatog
                            raph.
   43265  T                Endo                         0151        16.22      $824.66      $245.46      $164.93
                            cholangiopancreatog
                            raph.
   43267  T                Endo                         0151        16.22      $824.66      $245.46      $164.93
                            cholangiopancreatog
                            raph.
   43268  T                Endo                         0151        16.22      $824.66      $245.46      $164.93
                            cholangiopancreatog
                            raph.
   43269  T                Endo                         0151        16.22      $824.66      $245.46      $164.93
                            cholangiopancreatog
                            raph.
   43271  T                Endo                         0151        16.22      $824.66      $245.46      $164.93
                            cholangiopancreatog
                            raph.
   43272  T                Endo                         0151        16.22      $824.66      $245.46      $164.93
                            cholangiopancreatog
                            raph.
   43280  T                Laparoscopy,                 0132        60.31    $3,066.28    $1,239.22      $613.26
                            fundoplasty.
   43289  T                Laparoscope proc,            0130        27.92    $1,419.51      $659.53      $283.90
                            esoph.
   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         5.73      $291.32      $107.24       $58.26
   43453  T                Dilate esophagus....         0140         5.73      $291.32      $107.24       $58.26
   43456  T                Dilate esophagus....         0140         5.73      $291.32      $107.24       $58.26
   43458  T                Dilate esophagus....         0140         5.73      $291.32      $107.24       $58.26
   43460  C                Pressure treatment    ...........  ...........  ...........  ...........  ...........
                            esophagus.
   43496  C                Free jejunum flap,    ...........  ...........  ...........  ...........  ...........
                            microvasc.
   43499  T                Esophagus surgery            0140         5.73      $291.32      $107.24       $58.26
                            procedure.
   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         7.46      $379.28      $184.67       $75.86
   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.

[[Page 44774]]

 
   43651  T                Laparoscopy, vagus           0132        60.31    $3,066.28    $1,239.22      $613.26
                            nerve.
   43652  T                Laparoscopy, vagus           0132        60.31    $3,066.28    $1,239.22      $613.26
                            nerve.
   43653  T                Laparoscopy,                 0131        39.80    $2,023.51    $1,052.23      $404.70
                            gastrostomy.
   43659  T                Laparoscope proc,            0130        27.92    $1,419.51      $659.53      $283.90
                            stom.
   43750  T                Place gastrostomy            0141         7.46      $379.28      $184.67       $75.86
                            tube.
   43752  E                Nasal/orogastric w/   ...........  ...........  ...........  ...........  ...........
                            stent.
   43760  T                Change gastrostomy           0121         2.42      $123.04       $52.53       $24.61
                            tube.
   43761  T                Reposition                   0121         2.42      $123.04       $52.53       $24.61
                            gastrostomy tube.
   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            0141         7.46      $379.28      $184.67       $75.86
                            tube.
   43831  T                Place gastrostomy            0141         7.46      $379.28      $184.67       $75.86
                            tube.
   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               0025         3.71      $188.62       $70.66       $37.72
                            opening.
   43880  C                Repair stomach-bowel  ...........  ...........  ...........  ...........  ...........
                            fistula.
   43999  T                Stomach surgery              0121         2.42      $123.04       $52.53       $24.61
                            procedure.
   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         7.46      $379.28      $184.67       $75.86
   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.
   44132  C                Enterectomy, cadaver  ...........  ...........  ...........  ...........  ...........
                            donor.
   44133  C                Enterectomy, live     ...........  ...........  ...........  ...........  ...........
                            donor.
   44135  C                Intestine transplnt,  ...........  ...........  ...........  ...........  ...........
                            cadaver.
   44136  C                Intestine             ...........  ...........  ...........  ...........  ...........
                            transplant, live.
   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,                 0131        39.80    $2,023.51    $1,052.23      $404.70
                            enterolysis.
   44201  T                Laparoscopy,                 0131        39.80    $2,023.51    $1,052.23      $404.70
                            jejunostomy.
   44202  C                Laparo, resect        ...........  ...........  ...........  ...........  ...........
                            intestine.
   44209  T                Laparoscope proc,            0130        27.92    $1,419.51      $659.53      $283.90
                            intestine.
   44300  C                Open bowel to skin..  ...........  ...........  ...........  ...........  ...........
   44310  C                Ileostomy/            ...........  ...........  ...........  ...........  ...........
                            jejunostomy.
   44312  T                Revision of                  0026        13.51      $686.88      $277.92      $137.38
                            ileostomy.
   44314  C                Revision of           ...........  ...........  ...........  ...........  ...........
                            ileostomy.
   44316  C                Devise bowel pouch..  ...........  ...........  ...........  ...........  ...........
   44320  C                Colostomy...........  ...........  ...........  ...........  ...........  ...........
   44322  C                Colostomy with        ...........  ...........  ...........  ...........  ...........
                            biopsies.
   44340  T                Revision of                  0026        13.51      $686.88      $277.92      $137.38
                            colostomy.
   44345  C                Revision of           ...........  ...........  ...........  ...........  ...........
                            colostomy.

[[Page 44775]]

 
   44346  C                Revision of           ...........  ...........  ...........  ...........  ...........
                            colostomy.
   44360  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy.
   44361  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy/biopsy.
   44363  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy.
   44364  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy.
   44365  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy.
   44366  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy.
   44369  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy.
   44370  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy/stent.
   44372  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy.
   44373  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy.
   44376  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy.
   44377  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy/biopsy.
   44378  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy.
   44379  T                S bowel endoscope w/         0142         7.61      $386.91      $162.42       $77.38
                            stent.
   44380  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy.
   44382  T                Small bowel                  0142         7.61      $386.91      $162.42       $77.38
                            endoscopy.
   44383  T                Ileoscopy w/stent...         0142         7.61      $386.91      $162.42       $77.38
   44385  T                Endoscopy of bowel           0143         7.87      $400.13      $198.46       $80.03
                            pouch.
   44386  T                Endoscopy, bowel             0143         7.87      $400.13      $198.46       $80.03
                            pouch/biop.
   44388  T                Colon endoscopy.....         0143         7.87      $400.13      $198.46       $80.03
   44389  T                Colonoscopy with             0143         7.87      $400.13      $198.46       $80.03
                            biopsy.
   44390  T                Colonoscopy for              0143         7.87      $400.13      $198.46       $80.03
                            foreign body.
   44391  T                Colonoscopy for              0143         7.87      $400.13      $198.46       $80.03
                            bleeding.
   44392  T                Colonoscopy &                0143         7.87      $400.13      $198.46       $80.03
                            polypectomy.
   44393  T                Colonoscopy, lesion          0143         7.87      $400.13      $198.46       $80.03
                            removal.
   44394  T                Colonoscopy w/snare.         0143         7.87      $400.13      $198.46       $80.03
   44397  T                Colonoscopy w stent.         0143         7.87      $400.13      $198.46       $80.03
   44500  T                Intro,                       0121         2.42      $123.04       $52.53       $24.61
                            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            0142         7.61      $386.91      $162.42       $77.38
                            procedure.
   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,                 0130        27.92    $1,419.51      $659.53      $283.90
                            appendectomy.
   44979  T                Laparoscope proc,            0130        27.92    $1,419.51      $659.53      $283.90
                            app.
   45000  T                Drainage of pelvic           0149        14.49      $736.70      $293.06      $147.34
                            abscess.
   45005  T                Drainage of rectal           0148         2.58      $131.17       $43.59       $26.23
                            abscess.
   45020  T                Drainage of rectal           0149        14.49      $736.70      $293.06      $147.34
                            abscess.
   45100  T                Biopsy of rectum....         0149        14.49      $736.70      $293.06      $147.34
   45108  T                Removal of anorectal         0150        19.58      $995.49      $437.12      $199.10
                            lesion.
   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.
   45150  T                Excision of rectal           0150        19.58      $995.49      $437.12      $199.10
                            stricture.
   45160  T                Excision of rectal           0150        19.58      $995.49      $437.12      $199.10
                            lesion.

[[Page 44776]]

 
   45170  T                Excision of rectal           0150        19.58      $995.49      $437.12      $199.10
                            lesion.
   45190  T                Destruction, rectal          0150        19.58      $995.49      $437.12      $199.10
                            tumor.
   45300  T                Proctosigmoidoscopy          0146         2.95      $149.98       $65.15       $30.00
                            dx.
   45303  T                Proctosigmoidoscopy          0146         2.95      $149.98       $65.15       $30.00
                            dilate.
   45305  T                Protosigmoidoscopy w/        0146         2.95      $149.98       $65.15       $30.00
                            bx.
   45307  T                Protosigmoidoscopy           0146         2.95      $149.98       $65.15       $30.00
                            fb.
   45308  T                Protosigmoidoscopy           0147         6.15      $312.68      $146.96       $62.54
                            removal.
   45309  T                Protosigmoidoscopy           0147         6.15      $312.68      $146.96       $62.54
                            removal.
   45315  T                Protosigmoidoscopy           0147         6.15      $312.68      $146.96       $62.54
                            removal.
   45317  T                Protosigmoidoscopy           0146         2.95      $149.98       $65.15       $30.00
                            bleed.
   45320  T                Protosigmoidoscopy           0147         6.15      $312.68      $146.96       $62.54
                            ablate.
   45321  T                Protosigmoidoscopy           0147         6.15      $312.68      $146.96       $62.54
                            volvul.
   45327  T                Proctosigmoidoscopy          0147         6.15      $312.68      $146.96       $62.54
                            w/stent.
   45330  T                Diagnostic                   0146         2.95      $149.98       $65.15       $30.00
                            sigmoidoscopy.
   45331  T                Sigmoidoscopy and            0146         2.95      $149.98       $65.15       $30.00
                            biopsy.
   45332  T                Sigmoidoscopy w/fb           0146         2.95      $149.98       $65.15       $30.00
                            removal.
   45333  T                Sigmoidoscopy &              0147         6.15      $312.68      $146.96       $62.54
                            polypectomy.
   45334  T                Sigmoidoscopy for            0147         6.15      $312.68      $146.96       $62.54
                            bleeding.
   45337  T                Sigmoidoscopy &              0147         6.15      $312.68      $146.96       $62.54
                            decompress.
   45338  T                Sigmoidoscpy w/tumr          0147         6.15      $312.68      $146.96       $62.54
                            remove.
   45339  T                Sigmoidoscopy w/             0147         6.15      $312.68      $146.96       $62.54
                            ablate tumr.
   45341  T                Sigmoidoscopy w/             0147         6.15      $312.68      $146.96       $62.54
                            ultrasound.
   45342  T                Sigmoidoscopy w/us           0147         6.15      $312.68      $146.96       $62.54
                            guide bx.
   45345  T                Sigmodoscopy w/stent         0147         6.15      $312.68      $146.96       $62.54
   45355  T                Surgical colonoscopy         0143         7.87      $400.13      $198.46       $80.03
   45378  T                Diagnostic                   0143         7.87      $400.13      $198.46       $80.03
                            colonoscopy.
   45379  T                Colonoscopy w/fb             0143         7.87      $400.13      $198.46       $80.03
                            removal.
   45380  T                Colonoscopy and              0143         7.87      $400.13      $198.46       $80.03
                            biopsy.
   45382  T                Colonoscopy/control          0143         7.87      $400.13      $198.46       $80.03
                            bleeding.
   45383  T                Lesion removal               0143         7.87      $400.13      $198.46       $80.03
                            colonoscopy.
   45384  T                Lesion remove                0143         7.87      $400.13      $198.46       $80.03
                            colonoscopy.
   45385  T                Lesion removal               0143         7.87      $400.13      $198.46       $80.03
                            colonoscopy.
   45387  T                Colonoscopy w/stent.         0143         7.87      $400.13      $198.46       $80.03
   45500  T                Repair of rectum....         0150        19.58      $995.49      $437.12      $199.10
   45505  T                Repair of rectum....         0150        19.58      $995.49      $437.12      $199.10
   45520  T                Treatment of rectal          0098         1.34       $68.13       $20.88       $13.63
                            prolapse.
   45540  C                Correct rectal        ...........  ...........  ...........  ...........  ...........
                            prolapse.
   45541  C                Correct rectal        ...........  ...........  ...........  ...........  ...........
                            prolapse.
   45550  C                Repair rectum/remove  ...........  ...........  ...........  ...........  ...........
                            sigmoid.
   45560  T                Repair of rectocele.         0150        19.58      $995.49      $437.12      $199.10
   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          0148         2.58      $131.17       $43.59       $26.23
                            prolapse.
   45905  T                Dilation of anal             0149        14.49      $736.70      $293.06      $147.34
                            sphincter.
   45910  T                Dilation of rectal           0149        14.49      $736.70      $293.06      $147.34
                            narrowing.
   45915  T                Remove rectal                0148         2.58      $131.17       $43.59       $26.23
                            obstruction.
   45999  T                Rectum surgery               0148         2.58      $131.17       $43.59       $26.23
                            procedure.
   46030  T                Removal of rectal            0149        14.49      $736.70      $293.06      $147.34
                            marker.
   46040  T                Incision of rectal           0155         5.73      $291.32       $96.14       $58.26
                            abscess.
   46045  T                Incision of rectal           0150        19.58      $995.49      $437.12      $199.10
                            abscess.
   46050  T                Incision of anal             0148         2.58      $131.17       $43.59       $26.23
                            abscess.
   46060  T                Incision of rectal           0150        19.58      $995.49      $437.12      $199.10
                            abscess.
   46070  T                Incision of anal             0155         5.73      $291.32       $96.14       $58.26
                            septum.
   46080  T                Incision of anal             0149        14.49      $736.70      $293.06      $147.34
                            sphincter.
   46083  T                Incise external              0148         2.58      $131.17       $43.59       $26.23
                            hemorrhoid.
   46200  T                Removal of anal              0150        19.58      $995.49      $437.12      $199.10
                            fissure.
   46210  T                Removal of anal              0149        14.49      $736.70      $293.06      $147.34
                            crypt.
   46211  T                Removal of anal              0150        19.58      $995.49      $437.12      $199.10
                            crypts.
   46220  T                Removal of anal tab.         0149        14.49      $736.70      $293.06      $147.34
   46221  T                Ligation of                  0155         5.73      $291.32       $96.14       $58.26
                            hemorrhoid(s).
   46230  T                Removal of anal tabs         0149        14.49      $736.70      $293.06      $147.34
   46250  T                Hemorrhoidectomy....         0150        19.58      $995.49      $437.12      $199.10
   46255  T                Hemorrhoidectomy....         0150        19.58      $995.49      $437.12      $199.10
   46257  T                Remove hemorrhoids &         0150        19.58      $995.49      $437.12      $199.10
                            fissure.
   46258  T                Remove hemorrhoids &         0150        19.58      $995.49      $437.12      $199.10
                            fistula.
   46260  T                Hemorrhoidectomy....         0150        19.58      $995.49      $437.12      $199.10
   46261  T                Remove hemorrhoids &         0150        19.58      $995.49      $437.12      $199.10
                            fissure.
   46262  T                Remove hemorrhoids &         0150        19.58      $995.49      $437.12      $199.10
                            fistula.
   46270  T                Removal of anal              0150        19.58      $995.49      $437.12      $199.10
                            fistula.
   46275  T                Removal of anal              0150        19.58      $995.49      $437.12      $199.10
                            fistula.
   46280  T                Removal of anal              0150        19.58      $995.49      $437.12      $199.10
                            fistula.

[[Page 44777]]

 
   46285  T                Removal of anal              0150        19.58      $995.49      $437.12      $199.10
                            fistula.
   46288  T                Repair anal fistula.         0150        19.58      $995.49      $437.12      $199.10
   46320  T                Removal of                   0155         5.73      $291.32       $96.14       $58.26
                            hemorrhoid clot.
   46500  T                Injection into               0155         5.73      $291.32       $96.14       $58.26
                            hemorrhoids.
   46600  N                Diagnostic anoscopy.  ...........  ...........  ...........  ...........  ...........
   46604  T                Anoscopy and                 0144         1.97      $100.16       $44.07       $20.03
                            dilation.
   46606  T                Anoscopy and biopsy.         0145        12.11      $615.70      $179.39      $123.14
   46608  T                Anoscopy/ remove for         0144         1.97      $100.16       $44.07       $20.03
                            body.
   46610  T                Anoscopy/remove              0145        12.11      $615.70      $179.39      $123.14
                            lesion.
   46611  T                Anoscopy............         0145        12.11      $615.70      $179.39      $123.14
   46612  T                Anoscopy/ remove             0145        12.11      $615.70      $179.39      $123.14
                            lesions.
   46614  T                Anoscopy/control             0145        12.11      $615.70      $179.39      $123.14
                            bleeding.
   46615  T                Anoscopy............         0145        12.11      $615.70      $179.39      $123.14
   46700  T                Repair of anal               0150        19.58      $995.49      $437.12      $199.10
                            stricture.
   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               0150        19.58      $995.49      $437.12      $199.10
                            sphincter.
   46751  C                Repair of anal        ...........  ...........  ...........  ...........  ...........
                            sphincter.
   46753  T                Reconstruction of            0150        19.58      $995.49      $437.12      $199.10
                            anus.
   46754  T                Removal of suture            0149        14.49      $736.70      $293.06      $147.34
                            from anus.
   46760  T                Repair of anal               0150        19.58      $995.49      $437.12      $199.10
                            sphincter.
   46761  T                Repair of anal               0150        19.58      $995.49      $437.12      $199.10
                            sphincter.
   46762  T                Implant artificial           0150        19.58      $995.49      $437.12      $199.10
                            sphincter.
   46900  T                Destruction, anal            0016         3.31      $168.29       $70.68       $33.66
                            lesion(s).
   46910  T                Destruction, anal            0017        10.51      $534.35      $245.80      $106.87
                            lesion(s).
   46916  T                Cryosurgery, anal            0013         1.51       $76.77       $17.66       $15.35
                            lesion(s).
   46917  T                Laser surgery, anal          0695        17.06      $867.36      $398.99      $173.47
                            lesions.
   46922  T                Excision of anal             0695        17.06      $867.36      $398.99      $173.47
                            lesion(s).
   46924  T                Destruction, anal            0695        17.06      $867.36      $398.99      $173.47
                            lesion(s).
   46934  T                Destruction of               0155         5.73      $291.32       $96.14       $58.26
                            hemorrhoids.
   46935  T                Destruction of               0155         5.73      $291.32       $96.14       $58.26
                            hemorrhoids.
   46936  T                Destruction of               0149        14.49      $736.70      $293.06      $147.34
                            hemorrhoids.
   46937  T                Cryotherapy of               0149        14.49      $736.70      $293.06      $147.34
                            rectal lesion.
   46938  T                Cryotherapy of               0150        19.58      $995.49      $437.12      $199.10
                            rectal lesion.
   46940  T                Treatment of anal            0149        14.49      $736.70      $293.06      $147.34
                            fissure.
   46942  T                Treatment of anal            0149        14.49      $736.70      $293.06      $147.34
                            fissure.
   46945  T                Ligation of                  0155         5.73      $291.32       $96.14       $58.26
                            hemorrhoids.
   46946  T                Ligation of                  0155         5.73      $291.32       $96.14       $58.26
                            hemorrhoids.
   46999  T                Anus surgery                 0149        14.49      $736.70      $293.06      $147.34
                            procedure.
   47000  T                Needle biopsy of             0005         6.71      $341.15      $119.75       $68.23
                            liver.
   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..  ...........  ...........  ...........  ...........  ...........
   47379  T                Laparoscope                  0130        27.92    $1,419.51      $659.53      $283.90
                            procedure, liver.
   47399  T                Liver surgery                0005         6.71      $341.15      $119.75       $68.23
                            procedure.
   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.

[[Page 44778]]

 
   47505  N                Injection for liver   ...........  ...........  ...........  ...........  ...........
                            x-rays.
   47510  T                Insert catheter,             0152        17.44      $886.68      $207.38      $177.34
                            bile duct.
   47511  T                Insert bile duct             0152        17.44      $886.68      $207.38      $177.34
                            drain.
   47525  T                Change bile duct             0122         5.69      $289.29      $114.93       $57.86
                            catheter.
   47530  T                Revise/reinsert bile         0121         2.42      $123.04       $52.53       $24.61
                            tube.
   47550  C                Bile duct endoscopy   ...........  ...........  ...........  ...........  ...........
                            add-on.
   47552  T                Biliary endoscopy            0152        17.44      $886.68      $207.38      $177.34
                            thru skin.
   47553  T                Biliary endoscopy            0152        17.44      $886.68      $207.38      $177.34
                            thru skin.
   47554  T                Biliary endoscopy            0152        17.44      $886.68      $207.38      $177.34
                            thru skin.
   47555  T                Biliary endoscopy            0152        17.44      $886.68      $207.38      $177.34
                            thru skin.
   47556  T                Biliary endoscopy            0152        17.44      $886.68      $207.38      $177.34
                            thru skin.
   47560  T                Laparoscopy w/               0130        27.92    $1,419.51      $659.53      $283.90
                            cholangio.
   47561  T                Laparo w/cholangio/          0130        27.92    $1,419.51      $659.53      $283.90
                            biopsy.
   47562  T                Laparoscopic                 0131        39.80    $2,023.51    $1,052.23      $404.70
                            cholecystectomy.
   47563  T                Laparo                       0131        39.80    $2,023.51    $1,052.23      $404.70
                            cholecystectomy/
                            graph.
   47564  T                Laparo                       0131        39.80    $2,023.51    $1,052.23      $404.70
                            cholecystectomy/
                            explr.
   47570  C                Laparo                ...........  ...........  ...........  ...........  ...........
                            cholecystoenterosto
                            my.
   47579  T                Laparoscope proc,            0130        27.92    $1,419.51      $659.53      $283.90
                            biliary.
   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             0152        17.44      $886.68      $207.38      $177.34
                            stone.
   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           0121         2.42      $123.04       $52.53       $24.61
                            procedure.
   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,               0005         6.71      $341.15      $119.75       $68.23
                            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.  ...........  ...........  ...........  ...........  ...........
   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.
   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             0005         6.71      $341.15      $119.75       $68.23
                            procedure.
   49000  C                Exploration of        ...........  ...........  ...........  ...........  ...........
                            abdomen.
   49002  C                Reopening of abdomen  ...........  ...........  ...........  ...........  ...........

[[Page 44779]]

 
   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         0070         4.11      $208.96       $79.60       $41.79
                            cavity.
   49081  T                Removal of abdominal         0070         4.11      $208.96       $79.60       $41.79
                            fluid.
   49085  T                Remove abdomen               0153        22.44    $1,140.89      $496.31      $228.18
                            foreign body.
   49180  T                Biopsy, abdominal            0005         6.71      $341.15      $119.75       $68.23
                            mass.
   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                  0153        22.44    $1,140.89      $496.31      $228.18
                            umbilicus.
   49255  C                Removal of omentum..  ...........  ...........  ...........  ...........  ...........
   49320  T                Diag laparo separate         0130        27.92    $1,419.51      $659.53      $283.90
                            proc.
   49321  T                Laparoscopy, biopsy.         0130        27.92    $1,419.51      $659.53      $283.90
   49322  T                Laparoscopy,                 0130        27.92    $1,419.51      $659.53      $283.90
                            aspiration.
   49323  T                Laparo drain                 0130        27.92    $1,419.51      $659.53      $283.90
                            lymphocele.
   49329  T                Laparo proc, abdm/           0130        27.92    $1,419.51      $659.53      $283.90
                            per/oment.
   49400  N                Air injection into    ...........  ...........  ...........  ...........  ...........
                            abdomen.
   49420  T                Insert abdominal             0153        22.44    $1,140.89      $496.31      $228.18
                            drain.
   49421  T                Insert abdominal             0153        22.44    $1,140.89      $496.31      $228.18
                            drain.
   49422  T                Remove perm cannula/         0105        16.56      $841.94      $372.32      $168.39
                            catheter.
   49423  T                Exchange drainage            0153        22.44    $1,140.89      $496.31      $228.18
                            catheter.
   49424  N                Assess cyst,          ...........  ...........  ...........  ...........  ...........
                            contrast inject.
   49425  C                Insert abdomen-       ...........  ...........  ...........  ...........  ...........
                            venous drain.
   49426  T                Revise abdomen-              0153        22.44    $1,140.89      $496.31      $228.18
                            venous shunt.
   49427  N                Injection, abdominal  ...........  ...........  ...........  ...........  ...........
                            shunt.
   49428  C                Ligation of shunt...  ...........  ...........  ...........  ...........  ...........
   49429  T                Removal of shunt....         0105        16.56      $841.94      $372.32      $168.39
   49495  T                Repair inguinal              0154        24.09    $1,224.78      $556.98      $244.96
                            hernia, init.
   49496  T                Repair inguinal              0154        24.09    $1,224.78      $556.98      $244.96
                            hernia, init.
   49500  T                Repair inguinal              0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49501  T                Repair inguinal              0154        24.09    $1,224.78      $556.98      $244.96
                            hernia, init.
   49505  T                Repair inguinal              0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49507  T                Repair inguinal              0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49520  T                Rerepair inguinal            0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49521  T                Repair inguinal              0154        24.09    $1,224.78      $556.98      $244.96
                            hernia, rec.
   49525  T                Repair inguinal              0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49540  T                Repair lumbar hernia         0154        24.09    $1,224.78      $556.98      $244.96
   49550  T                Repair femoral               0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49553  T                Repair femoral               0154        24.09    $1,224.78      $556.98      $244.96
                            hernia, init.
   49555  T                Repair femoral               0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49557  T                Repair femoral               0154        24.09    $1,224.78      $556.98      $244.96
                            hernia, recur.
   49560  T                Repair abdominal             0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49561  T                Repair incisional            0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49565  T                Rerepair abdominal           0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49566  T                Repair incisional            0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49568  T                Hernia repair w/mesh         0154        24.09    $1,224.78      $556.98      $244.96
   49570  T                Repair epigastric            0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49572  T                Repair epigastric            0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49580  T                Repair umbilical             0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49582  T                Repair umbilical             0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49585  T                Repair umbilical             0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49587  T                Repair umbilical             0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49590  T                Repair abdominal             0154        24.09    $1,224.78      $556.98      $244.96
                            hernia.
   49600  T                Repair umbilical             0154        24.09    $1,224.78      $556.98      $244.96
                            lesion.
   49605  C                Repair umbilical      ...........  ...........  ...........  ...........  ...........
                            lesion.
   49606  C                Repair umbilical      ...........  ...........  ...........  ...........  ...........
                            lesion.
   49610  C                Repair umbilical      ...........  ...........  ...........  ...........  ...........
                            lesion.
   49611  C                Repair umbilical      ...........  ...........  ...........  ...........  ...........
                            lesion.
   49650  T                Laparo hernia repair         0131        39.80    $2,023.51    $1,052.23      $404.70
                            initial.
   49651  T                Laparo hernia repair         0131        39.80    $2,023.51    $1,052.23      $404.70
                            recur.
   49659  T                Laparo proc, hernia          0131        39.80    $2,023.51    $1,052.23      $404.70
                            repair.
   49900  C                Repair of abdominal   ...........  ...........  ...........  ...........  ...........
                            wall.
   49905  C                Omental flap........  ...........  ...........  ...........  ...........  ...........
   49906  C                Free omental flap,    ...........  ...........  ...........  ...........  ...........
                            microvasc.
   49999  T                Abdomen surgery              0121         2.42      $123.04       $52.53       $24.61
                            procedure.
   50010  C                Exploration of        ...........  ...........  ...........  ...........  ...........
                            kidney.
   50020  C                Renal abscess, open   ...........  ...........  ...........  ...........  ...........
                            drain.
   50021  C                Renal abscess,        ...........  ...........  ...........  ...........  ...........
                            percut drain.

[[Page 44780]]

 
   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            0163        30.27    $1,538.99      $792.58      $307.80
                            stone.
   50081  T                Removal of kidney            0163        30.27    $1,538.99      $792.58      $307.80
                            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.
   50200  T                Biopsy of kidney....         0005         6.71      $341.15      $119.75       $68.23
   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           0005         6.71      $341.15      $119.75       $68.23
                            lesion.
   50392  T                Insert kidney drain.         0161        16.45      $836.35      $249.36      $167.27
   50393  T                Insert ureteral tube         0160         5.98      $304.04      $110.11       $60.81
   50394  N                Injection for kidney  ...........  ...........  ...........  ...........  ...........
                            x-ray.
   50395  T                Create passage to            0160         5.98      $304.04      $110.11       $60.81
                            kidney.
   50396  T                Measure kidney               0164         0.98       $49.83       $14.95        $9.97
                            pressure.
   50398  T                Change kidney tube..         0122         5.69      $289.29      $114.93       $57.86
   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          0130        27.92    $1,419.51      $659.53      $283.90
                            cyst.
   50544  T                Laparoscopy,                 0130        27.92    $1,419.51      $659.53      $283.90
                            pyeloplasty.
   50545  C                Laparo radical        ...........  ...........  ...........  ...........  ...........
                            nephrectomy.
   50546  C                Laparoscopic          ...........  ...........  ...........  ...........  ...........
                            nephrectomy.
   50547  C                Laparo removal donor  ...........  ...........  ...........  ...........  ...........
                            kidney.
   50548  C                Laparo remove k/      ...........  ...........  ...........  ...........  ...........
                            ureter.
   50549  T                Laparoscope proc,            0130        27.92    $1,419.51      $659.53      $283.90
                            renal.
   50551  T                Kidney endoscopy....         0161        16.45      $836.35      $249.36      $167.27
   50553  T                Kidney endoscopy....         0161        16.45      $836.35      $249.36      $167.27
   50555  T                Kidney endoscopy &           0161        16.45      $836.35      $249.36      $167.27
                            biopsy.
   50557  T                Kidney endoscopy &           0161        16.45      $836.35      $249.36      $167.27
                            treatment.
   50559  T                Renal endoscopy/             0161        16.45      $836.35      $249.36      $167.27
                            radiotracer.
   50561  T                Kidney endoscopy &           0161        16.45      $836.35      $249.36      $167.27
                            treatment.
   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.
   50590  T                Fragmenting of               0169        42.65    $2,168.41    $1,192.63      $433.68
                            kidney stone.
   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               0164         0.98       $49.83       $14.95        $9.97
                            pressure.
   50688  T                Change of ureter             0121         2.42      $123.04       $52.53       $24.61
                            tube.

[[Page 44781]]

 
   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                  0131        39.80    $2,023.51    $1,052.23      $404.70
                            ureterolithotomy.
   50947  T                Laparo new ureter/           0131        39.80    $2,023.51    $1,052.23      $404.70
                            bladder.
   50948  T                Laparo new ureter/           0131        39.80    $2,023.51    $1,052.23      $404.70
                            bladder.
   50949  T                Laparoscope proc,            0130        27.92    $1,419.51      $659.53      $283.90
                            ureter.
   50951  T                Endoscopy of ureter.         0162        19.86    $1,009.72      $427.49      $201.94
   50953  T                Endoscopy of ureter.         0162        19.86    $1,009.72      $427.49      $201.94
   50955  T                Ureter endoscopy &           0162        19.86    $1,009.72      $427.49      $201.94
                            biopsy.
   50957  T                Ureter endoscopy &           0162        19.86    $1,009.72      $427.49      $201.94
                            treatment.
   50959  T                Ureter endoscopy &           0162        19.86    $1,009.72      $427.49      $201.94
                            tracer.
   50961  T                Ureter endoscopy &           0162        19.86    $1,009.72      $427.49      $201.94
                            treatment.
   50970  T                Ureter endoscopy....         0162        19.86    $1,009.72      $427.49      $201.94
   50972  T                Ureter endoscopy &           0162        19.86    $1,009.72      $427.49      $201.94
                            catheter.
   50974  T                Ureter endoscopy &           0162        19.86    $1,009.72      $427.49      $201.94
                            biopsy.
   50976  T                Ureter endoscopy &           0162        19.86    $1,009.72      $427.49      $201.94
                            treatment.
   50978  T                Ureter endoscopy &           0162        19.86    $1,009.72      $427.49      $201.94
                            tracer.
   50980  T                Ureter endoscopy &           0162        19.86    $1,009.72      $427.49      $201.94
                            treatment.
   51000  T                Drainage of bladder.         0165         5.36      $272.51       $91.76       $54.50
   51005  T                Drainage of bladder.         0156         2.62      $133.21       $39.96       $26.64
   51010  T                Drainage of bladder.         0165         5.36      $272.51       $91.76       $54.50
   51020  T                Incise & treat               0162        19.86    $1,009.72      $427.49      $201.94
                            bladder.
   51030  T                Incise & treat               0162        19.86    $1,009.72      $427.49      $201.94
                            bladder.
   51040  T                Incise & drain               0162        19.86    $1,009.72      $427.49      $201.94
                            bladder.
   51045  T                Incise bladder/drain         0162        19.86    $1,009.72      $427.49      $201.94
                            ureter.
   51050  T                Removal of bladder           0162        19.86    $1,009.72      $427.49      $201.94
                            stone.
   51060  C                Removal of ureter     ...........  ...........  ...........  ...........  ...........
                            stone.
   51065  T                Removal of ureter            0162        19.86    $1,009.72      $427.49      $201.94
                            stone.
   51080  T                Drainage of bladder          0007         7.28      $370.13       $74.03       $74.03
                            abscess.
   51500  T                Removal of bladder           0154        24.09    $1,224.78      $556.98      $244.96
                            cyst.
   51520  T                Removal of bladder           0162        19.86    $1,009.72      $427.49      $201.94
                            lesion.
   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.
   51600  N                Injection for         ...........  ...........  ...........  ...........  ...........
                            bladder x-ray.
   51605  N                Preparation for       ...........  ...........  ...........  ...........  ...........
                            bladder xray.
   51610  N                Injection for         ...........  ...........  ...........  ...........  ...........
                            bladder x-ray.
   51700  T                Irrigation of                0156         2.62      $133.21       $39.96       $26.64
                            bladder.

[[Page 44782]]

 
   51705  T                Change of bladder            0121         2.42      $123.04       $52.53       $24.61
                            tube.
   51710  T                Change of bladder            0121         2.42      $123.04       $52.53       $24.61
                            tube.
   51715  T                Endoscopic injection/        0167        24.18    $1,229.36      $555.84      $245.87
                            implant.
   51720  T                Treatment of bladder         0156         2.62      $133.21       $39.96       $26.64
                            lesion.
   51725  T                Simple                       0165         5.36      $272.51       $91.76       $54.50
                            cystometrogram.
   51726  T                Complex                      0165         5.36      $272.51       $91.76       $54.50
                            cystometrogram.
   51736  T                Urine flow                   0164         0.98       $49.83       $14.95        $9.97
                            measurement.
   51741  T                Electro-                     0164         0.98       $49.83       $14.95        $9.97
                            uroflowmetry, first.
   51772  T                Urethra pressure             0165         5.36      $272.51       $91.76       $54.50
                            profile.
   51784  T                Anal/urinary muscle          0164         0.98       $49.83       $14.95        $9.97
                            study.
   51785  T                Anal/urinary muscle          0156         2.62      $133.21       $39.96       $26.64
                            study.
   51792  T                Urinary reflex study         0156         2.62      $133.21       $39.96       $26.64
   51795  T                Urine voiding                0165         5.36      $272.51       $91.76       $54.50
                            pressure study.
   51797  T                Intraabdominal               0165         5.36      $272.51       $91.76       $54.50
                            pressure test.
   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            0162        19.86    $1,009.72      $427.49      $201.94
                            opening.
   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              0131        39.80    $2,023.51    $1,052.23      $404.70
                            suspension.
   51992  T                Laparo sling                 0132        60.31    $3,066.28    $1,239.22      $613.26
                            operation.
   52000  T                Cystoscopy..........         0160         5.98      $304.04      $110.11       $60.81
   52005  T                Cystoscopy & ureter          0161        16.45      $836.35      $249.36      $167.27
                            catheter.
   52007  T                Cystoscopy and               0161        16.45      $836.35      $249.36      $167.27
                            biopsy.
   52010  T                Cystoscopy & duct            0160         5.98      $304.04      $110.11       $60.81
                            catheter.
   52204  T                Cystoscopy..........         0161        16.45      $836.35      $249.36      $167.27
   52214  T                Cystoscopy and               0161        16.45      $836.35      $249.36      $167.27
                            treatment.
   52224  T                Cystoscopy and               0161        16.45      $836.35      $249.36      $167.27
                            treatment.
   52234  T                Cystoscopy and               0162        19.86    $1,009.72      $427.49      $201.94
                            treatment.
   52235  T                Cystoscopy and               0162        19.86    $1,009.72      $427.49      $201.94
                            treatment.
   52240  T                Cystoscopy and               0163        30.27    $1,538.99      $792.58      $307.80
                            treatment.
   52250  T                Cystoscopy and               0162        19.86    $1,009.72      $427.49      $201.94
                            radiotracer.
   52260  T                Cystoscopy and               0161        16.45      $836.35      $249.36      $167.27
                            treatment.
   52265  T                Cystoscopy and               0160         5.98      $304.04      $110.11       $60.81
                            treatment.
   52270  T                Cystoscopy & revise          0161        16.45      $836.35      $249.36      $167.27
                            urethra.
   52275  T                Cystoscopy & revise          0161        16.45      $836.35      $249.36      $167.27
                            urethra.
   52276  T                Cystoscopy and               0161        16.45      $836.35      $249.36      $167.27
                            treatment.
   52277  T                Cystoscopy and               0162        19.86    $1,009.72      $427.49      $201.94
                            treatment.
   52281  T                Cystoscopy and               0160         5.98      $304.04      $110.11       $60.81
                            treatment.
   52282  T                Cystoscopy, implant          0162        19.86    $1,009.72      $427.49      $201.94
                            stent.
   52283  T                Cystoscopy and               0161        16.45      $836.35      $249.36      $167.27
                            treatment.
   52285  T                Cystoscopy and               0161        16.45      $836.35      $249.36      $167.27
                            treatment.
   52290  T                Cystoscopy and               0161        16.45      $836.35      $249.36      $167.27
                            treatment.
   52300  T                Cystoscopy and               0161        16.45      $836.35      $249.36      $167.27
                            treatment.
   52301  T                Cystoscopy and               0161        16.45      $836.35      $249.36      $167.27
                            treatment.
   52305  T                Cystoscopy and               0161        16.45      $836.35      $249.36      $167.27
                            treatment.
   52310  T                Cystoscopy and               0160         5.98      $304.04      $110.11       $60.81
                            treatment.
   52315  T                Cystoscopy and               0161        16.45      $836.35      $249.36      $167.27
                            treatment.
   52317  T                Remove bladder stone         0162        19.86    $1,009.72      $427.49      $201.94
   52318  T                Remove bladder stone         0162        19.86    $1,009.72      $427.49      $201.94
   52320  T                Cystoscopy and               0162        19.86    $1,009.72      $427.49      $201.94
                            treatment.
   52325  T                Cystoscopy, stone            0162        19.86    $1,009.72      $427.49      $201.94
                            removal.
   52327  T                Cystoscopy, inject           0161        16.45      $836.35      $249.36      $167.27
                            material.
   52330  T                Cystoscopy and               0162        19.86    $1,009.72      $427.49      $201.94
                            treatment.
   52332  T                Cystoscopy and               0162        19.86    $1,009.72      $427.49      $201.94
                            treatment.
   52334  T                Create passage to            0162        19.86    $1,009.72      $427.49      $201.94
                            kidney.
   52341  T                Cysto w/ureter               0162        19.86    $1,009.72      $427.49      $201.94
                            stricture tx.
   52342  T                Cysto w/up stricture         0162        19.86    $1,009.72      $427.49      $201.94
                            tx.
   52343  T                Cysto w/renal                0162        19.86    $1,009.72      $427.49      $201.94
                            stricture tx.
   52344  T                Cysto/uretero, stone         0162        19.86    $1,009.72      $427.49      $201.94
                            remove.
   52345  T                Cysto/uretero w/up           0162        19.86    $1,009.72      $427.49      $201.94
                            stricture.
   52346  T                Cystouretero w/renal         0162        19.86    $1,009.72      $427.49      $201.94
                            strict.
   52351  T                Cystouretro & or             0161        16.45      $836.35      $249.36      $167.27
                            pyeloscope.
   52352  T                Cystouretro w/stone          0162        19.86    $1,009.72      $427.49      $201.94
                            remove.
   52353  T                Cystouretero w/              0163        30.27    $1,538.99      $792.58      $307.80
                            lithotripsy.
   52354  T                Cystouretero w/              0162        19.86    $1,009.72      $427.49      $201.94
                            biopsy.

[[Page 44783]]

 
   52355  T                Cystouretero w/              0162        19.86    $1,009.72      $427.49      $201.94
                            excise tumor.
   52400  T                Cystouretero w/              0162        19.86    $1,009.72      $427.49      $201.94
                            congen repr.
   52450  T                Incision of prostate         0162        19.86    $1,009.72      $427.49      $201.94
   52500  T                Revision of bladder          0162        19.86    $1,009.72      $427.49      $201.94
                            neck.
   52510  T                Dilation prostatic           0161        16.45      $836.35      $249.36      $167.27
                            urethra.
   52601  T                Prostatectomy (TURP)         0163        30.27    $1,538.99      $792.58      $307.80
   52606  T                Control postop               0162        19.86    $1,009.72      $427.49      $201.94
                            bleeding.
   52612  T                Prostatectomy, first         0163        30.27    $1,538.99      $792.58      $307.80
                            stage.
   52614  T                Prostatectomy,               0163        30.27    $1,538.99      $792.58      $307.80
                            second stage.
   52620  T                Remove residual              0163        30.27    $1,538.99      $792.58      $307.80
                            prostate.
   52630  T                Remove prostate              0163        30.27    $1,538.99      $792.58      $307.80
                            regrowth.
   52640  T                Relieve bladder              0162        19.86    $1,009.72      $427.49      $201.94
                            contracture.
   52647  T                Laser surgery of             0163        30.27    $1,538.99      $792.58      $307.80
                            prostate.
   52648  T                Laser surgery of             0163        30.27    $1,538.99      $792.58      $307.80
                            prostate.
   52700  T                Drainage of prostate         0162        19.86    $1,009.72      $427.49      $201.94
                            abscess.
   53000  T                Incision of urethra.         0166        13.02      $661.96      $218.73      $132.39
   53010  T                Incision of urethra.         0166        13.02      $661.96      $218.73      $132.39
   53020  T                Incision of urethra.         0166        13.02      $661.96      $218.73      $132.39
   53025  T                Incision of urethra.         0166        13.02      $661.96      $218.73      $132.39
   53040  T                Drainage of urethra          0166        13.02      $661.96      $218.73      $132.39
                            abscess.
   53060  T                Drainage of urethra          0166        13.02      $661.96      $218.73      $132.39
                            abscess.
   53080  T                Drainage of urinary          0166        13.02      $661.96      $218.73      $132.39
                            leakage.
   53085  C                Drainage of urinary   ...........  ...........  ...........  ...........  ...........
                            leakage.
   53200  T                Biopsy of urethra...         0166        13.02      $661.96      $218.73      $132.39
   53210  T                Removal of urethra..         0168        31.68    $1,610.67      $536.11      $322.13
   53215  T                Removal of urethra..         0168        31.68    $1,610.67      $536.11      $322.13
   53220  T                Treatment of urethra         0168        31.68    $1,610.67      $536.11      $322.13
                            lesion.
   53230  T                Removal of urethra           0168        31.68    $1,610.67      $536.11      $322.13
                            lesion.
   53235  T                Removal of urethra           0168        31.68    $1,610.67      $536.11      $322.13
                            lesion.
   53240  T                Surgery for urethra          0168        31.68    $1,610.67      $536.11      $322.13
                            pouch.
   53250  T                Removal of urethra           0166        13.02      $661.96      $218.73      $132.39
                            gland.
   53260  T                Treatment of urethra         0166        13.02      $661.96      $218.73      $132.39
                            lesion.
   53265  T                Treatment of urethra         0166        13.02      $661.96      $218.73      $132.39
                            lesion.
   53270  T                Removal of urethra           0167        24.18    $1,229.36      $555.84      $245.87
                            gland.
   53275  T                Repair of urethra            0166        13.02      $661.96      $218.73      $132.39
                            defect.
   53400  T                Revise urethra,              0168        31.68    $1,610.67      $536.11      $322.13
                            stage 1.
   53405  T                Revise urethra,              0168        31.68    $1,610.67      $536.11      $322.13
                            stage 2.
   53410  T                Reconstruction of            0168        31.68    $1,610.67      $536.11      $322.13
                            urethra.
   53415  C                Reconstruction of     ...........  ...........  ...........  ...........  ...........
                            urethra.
   53420  T                Reconstruct urethra,         0168        31.68    $1,610.67      $536.11      $322.13
                            stage 1.
   53425  T                Reconstruct urethra,         0168        31.68    $1,610.67      $536.11      $322.13
                            stage 2.
   53430  T                Reconstruction of            0168        31.68    $1,610.67      $536.11      $322.13
                            urethra.
   53440  T                Correct bladder              0182        85.94    $4,369.36    $1,492.28      $873.87
                            function.
   53442  T                Remove perineal              0166        13.02      $661.96      $218.73      $132.39
                            prosthesis.
   53443  C                Reconstruction of     ...........  ...........  ...........  ...........  ...........
                            urethra.
   53445  T                Correct urine flow           0182        85.94    $4,369.36    $1,492.28      $873.87
                            control.
   53447  T                Remove artificial            0168        31.68    $1,610.67      $536.11      $322.13
                            sphincter.
   53449  T                Correct artificial           0168        31.68    $1,610.67      $536.11      $322.13
                            sphincter.
   53450  T                Revision of urethra.         0168        31.68    $1,610.67      $536.11      $322.13
   53460  T                Revision of urethra.         0168        31.68    $1,610.67      $536.11      $322.13
   53502  T                Repair of urethra            0166        13.02      $661.96      $218.73      $132.39
                            injury.
   53505  T                Repair of urethra            0167        24.18    $1,229.36      $555.84      $245.87
                            injury.
   53510  T                Repair of urethra            0166        13.02      $661.96      $218.73      $132.39
                            injury.
   53515  T                Repair of urethra            0168        31.68    $1,610.67      $536.11      $322.13
                            injury.
   53520  T                Repair of urethra            0168        31.68    $1,610.67      $536.11      $322.13
                            defect.
   53600  T                Dilate urethra               0156         2.62      $133.21       $39.96       $26.64
                            stricture.
   53601  T                Dilate urethra               0164         0.98       $49.83       $14.95        $9.97
                            stricture.
   53605  T                Dilate urethra               0161        16.45      $836.35      $249.36      $167.27
                            stricture.
   53620  T                Dilate urethra               0165         5.36      $272.51       $91.76       $54.50
                            stricture.
   53621  T                Dilate urethra               0164         0.98       $49.83       $14.95        $9.97
                            stricture.
   53660  T                Dilation of urethra.         0164         0.98       $49.83       $14.95        $9.97
   53661  T                Dilation of urethra.         0164         0.98       $49.83       $14.95        $9.97
   53665  T                Dilation of urethra.         0166        13.02      $661.96      $218.73      $132.39
   53670  N                Insert urinary        ...........  ...........  ...........  ...........  ...........
                            catheter.
   53675  T                Insert urinary               0156         2.62      $133.21       $39.96       $26.64
                            catheter.
   53850  T                Prostatic microwave          0982        52.06    $2,646.83  ...........      $529.37
                            thermotx.
   53852  T                Prostatic rf                 0982        52.06    $2,646.83  ...........      $529.37
                            thermotx.
   53899  T                Urology surgery              0165         5.36      $272.51       $91.76       $54.50
                            procedure.
   54000  T                Slitting of prepuce.         0166        13.02      $661.96      $218.73      $132.39
   54001  T                Slitting of prepuce.         0166        13.02      $661.96      $218.73      $132.39
   54015  T                Drain penis lesion..         0008        11.36      $577.57      $115.51      $115.51
   54050  T                Destruction, penis           0013         1.51       $76.77       $17.66       $15.35
                            lesion(s).
   54055  T                Destruction, penis           0017        10.51      $534.35      $245.80      $106.87
                            lesion(s).
   54056  T                Cryosurgery, penis           0012         0.72       $36.61        $9.18        $7.32
                            lesion(s).
   54057  T                Laser surg, penis            0017        10.51      $534.35      $245.80      $106.87
                            lesion(s).

[[Page 44784]]

 
   54060  T                Excision of penis            0017        10.51      $534.35      $245.80      $106.87
                            lesion(s).
   54065  T                Destruction, penis           0695        17.06      $867.36      $398.99      $173.47
                            lesion(s).
   54100  T                Biopsy of penis.....         0020         8.56      $435.21      $130.53       $87.04
   54105  T                Biopsy of penis.....         0021        12.74      $647.73      $236.51      $129.55
   54110  T                Treatment of penis           0181        24.07    $1,223.77      $673.07      $244.75
                            lesion.
   54111  T                Treat penis lesion,          0181        24.07    $1,223.77      $673.07      $244.75
                            graft.
   54112  T                Treat penis lesion,          0181        24.07    $1,223.77      $673.07      $244.75
                            graft.
   54115  T                Treatment of penis           0008        11.36      $577.57      $115.51      $115.51
                            lesion.
   54120  T                Partial removal of           0181        24.07    $1,223.77      $673.07      $244.75
                            penis.
   54125  C                Removal of penis....  ...........  ...........  ...........  ...........  ...........
   54130  C                Remove penis & nodes  ...........  ...........  ...........  ...........  ...........
   54135  C                Remove penis & nodes  ...........  ...........  ...........  ...........  ...........
   54150  T                Circumcision........         0180        16.29      $828.22      $304.87      $165.64
   54152  T                Circumcision........         0180        16.29      $828.22      $304.87      $165.64
   54160  T                Circumcision........         0180        16.29      $828.22      $304.87      $165.64
   54161  T                Circumcision........         0180        16.29      $828.22      $304.87      $165.64
   54200  T                Treatment of penis           0156         2.62      $133.21       $39.96       $26.64
                            lesion.
   54205  T                Treatment of penis           0181        24.07    $1,223.77      $673.07      $244.75
                            lesion.
   54220  T                Treatment of penis           0156         2.62      $133.21       $39.96       $26.64
                            lesion.
   54230  N                Prepare penis study.  ...........  ...........  ...........  ...........  ...........
   54231  T                Dynamic                      0165         5.36      $272.51       $91.76       $54.50
                            cavernosometry.
   54235  T                Penile injection....         0164         0.98       $49.83       $14.95        $9.97
   54240  T                Penis study.........         0164         0.98       $49.83       $14.95        $9.97
   54250  T                Penis study.........         0165         5.36      $272.51       $91.76       $54.50
   54300  T                Revision of penis...         0181        24.07    $1,223.77      $673.07      $244.75
   54304  T                Revision of penis...         0181        24.07    $1,223.77      $673.07      $244.75
   54308  T                Reconstruction of            0181        24.07    $1,223.77      $673.07      $244.75
                            urethra.
   54312  T                Reconstruction of            0181        24.07    $1,223.77      $673.07      $244.75
                            urethra.
   54316  T                Reconstruction of            0181        24.07    $1,223.77      $673.07      $244.75
                            urethra.
   54318  T                Reconstruction of            0181        24.07    $1,223.77      $673.07      $244.75
                            urethra.
   54322  T                Reconstruction of            0181        24.07    $1,223.77      $673.07      $244.75
                            urethra.
   54324  T                Reconstruction of            0181        24.07    $1,223.77      $673.07      $244.75
                            urethra.
   54326  T                Reconstruction of            0181        24.07    $1,223.77      $673.07      $244.75
                            urethra.
   54328  T                Revise penis/urethra         0181        24.07    $1,223.77      $673.07      $244.75
   54332  C                Revise penis/urethra  ...........  ...........  ...........  ...........  ...........
   54336  C                Revise penis/urethra  ...........  ...........  ...........  ...........  ...........
   54340  T                Secondary urethral           0181        24.07    $1,223.77      $673.07      $244.75
                            surgery.
   54344  T                Secondary urethral           0181        24.07    $1,223.77      $673.07      $244.75
                            surgery.
   54348  T                Secondary urethral           0181        24.07    $1,223.77      $673.07      $244.75
                            surgery.
   54352  T                Reconstruct urethra/         0181        24.07    $1,223.77      $673.07      $244.75
                            penis.
   54360  T                Penis plastic                0181        24.07    $1,223.77      $673.07      $244.75
                            surgery.
   54380  T                Repair penis........         0181        24.07    $1,223.77      $673.07      $244.75
   54385  T                Repair penis........         0181        24.07    $1,223.77      $673.07      $244.75
   54390  C                Repair penis and      ...........  ...........  ...........  ...........  ...........
                            bladder.
   54400  T                Insert semi-rigid            0182        85.94    $4,369.36    $1,492.28      $873.87
                            prosthesis.
   54401  T                Insert self-contd            0182        85.94    $4,369.36    $1,492.28      $873.87
                            prosthesis.
   54402  T                Remove penis                 0185        57.17    $2,906.64      $906.36      $581.33
                            prosthesis.
   54405  T                Insert multi-comp            0182        85.94    $4,369.36    $1,492.28      $873.87
                            prosthesis.
   54407  T                Remove multi-comp            0185        57.17    $2,906.64      $906.36      $581.33
                            prosthesis.
   54409  T                Revise penis                 0185        57.17    $2,906.64      $906.36      $581.33
                            prosthesis.
   54420  T                Revision of penis...         0181        24.07    $1,223.77      $673.07      $244.75
   54430  C                Revision of penis...  ...........  ...........  ...........  ...........  ...........
   54435  T                Revision of penis...         0181        24.07    $1,223.77      $673.07      $244.75
   54440  T                Repair of penis.....         0181        24.07    $1,223.77      $673.07      $244.75
   54450  T                Preputial stretching         0156         2.62      $133.21       $39.96       $26.64
   54500  T                Biopsy of testis....         0005         6.71      $341.15      $119.75       $68.23
   54505  T                Biopsy of testis....         0183        20.37    $1,035.65      $448.94      $207.13
   54510  T                Removal of testis            0183        20.37    $1,035.65      $448.94      $207.13
                            lesion.
   54512  T                Excise lesion testis         0183        20.37    $1,035.65      $448.94      $207.13
   54520  T                Removal of testis...         0183        20.37    $1,035.65      $448.94      $207.13
   54522  T                Orchiectomy, partial         0183        20.37    $1,035.65      $448.94      $207.13
   54530  T                Removal of testis...         0154        24.09    $1,224.78      $556.98      $244.96
   54535  C                Extensive testis      ...........  ...........  ...........  ...........  ...........
                            surgery.
   54550  T                Exploration for              0154        24.09    $1,224.78      $556.98      $244.96
                            testis.
   54560  C                Exploration for       ...........  ...........  ...........  ...........  ...........
                            testis.
   54600  T                Reduce testis                0183        20.37    $1,035.65      $448.94      $207.13
                            torsion.
   54620  T                Suspension of testis         0183        20.37    $1,035.65      $448.94      $207.13
   54640  T                Suspension of testis         0154        24.09    $1,224.78      $556.98      $244.96
   54650  C                Orchiopexy (Fowler-   ...........  ...........  ...........  ...........  ...........
                            Stephens).
   54660  T                Revision of testis..         0183        20.37    $1,035.65      $448.94      $207.13
   54670  T                Repair testis injury         0183        20.37    $1,035.65      $448.94      $207.13
   54680  T                Relocation of                0183        20.37    $1,035.65      $448.94      $207.13
                            testis(es).
   54690  T                Laparoscopy,                 0131        39.80    $2,023.51    $1,052.23      $404.70
                            orchiectomy.
   54692  T                Laparoscopy,                 0132        60.31    $3,066.28    $1,239.22      $613.26
                            orchiopexy.
   54699  T                Laparoscope proc,            0130        27.92    $1,419.51      $659.53      $283.90
                            testis.

[[Page 44785]]

 
   54700  T                Drainage of scrotum.         0183        20.37    $1,035.65      $448.94      $207.13
   54800  T                Biopsy of epididymis         0004         3.00      $152.53       $32.57       $30.51
   54820  T                Exploration of               0183        20.37    $1,035.65      $448.94      $207.13
                            epididymis.
   54830  T                Remove epididymis            0183        20.37    $1,035.65      $448.94      $207.13
                            lesion.
   54840  T                Remove epididymis            0183        20.37    $1,035.65      $448.94      $207.13
                            lesion.
   54860  T                Removal of                   0183        20.37    $1,035.65      $448.94      $207.13
                            epididymis.
   54861  T                Removal of                   0183        20.37    $1,035.65      $448.94      $207.13
                            epididymis.
   54900  T                Fusion of spermatic          0183        20.37    $1,035.65      $448.94      $207.13
                            ducts.
   54901  T                Fusion of spermatic          0183        20.37    $1,035.65      $448.94      $207.13
                            ducts.
   55000  T                Drainage of                  0004         3.00      $152.53       $32.57       $30.51
                            hydrocele.
   55040  T                Removal of hydrocele         0154        24.09    $1,224.78      $556.98      $244.96
   55041  T                Removal of                   0154        24.09    $1,224.78      $556.98      $244.96
                            hydroceles.
   55060  T                Repair of hydrocele.         0183        20.37    $1,035.65      $448.94      $207.13
   55100  T                Drainage of scrotum          0007         7.28      $370.13       $74.03       $74.03
                            abscess.
   55110  T                Explore scrotum.....         0183        20.37    $1,035.65      $448.94      $207.13
   55120  T                Removal of scrotum           0183        20.37    $1,035.65      $448.94      $207.13
                            lesion.
   55150  T                Removal of scrotum..         0183        20.37    $1,035.65      $448.94      $207.13
   55175  T                Revision of scrotum.         0183        20.37    $1,035.65      $448.94      $207.13
   55180  T                Revision of scrotum.         0183        20.37    $1,035.65      $448.94      $207.13
   55200  T                Incision of sperm            0183        20.37    $1,035.65      $448.94      $207.13
                            duct.
   55250  T                Removal of sperm             0183        20.37    $1,035.65      $448.94      $207.13
                            duct(s).
   55300  N                Prepare, sperm duct   ...........  ...........  ...........  ...........  ...........
                            x-ray.
   55400  T                Repair of sperm duct         0183        20.37    $1,035.65      $448.94      $207.13
   55450  T                Ligation of sperm            0183        20.37    $1,035.65      $448.94      $207.13
                            duct.
   55500  T                Removal of hydrocele         0183        20.37    $1,035.65      $448.94      $207.13
   55520  T                Removal of sperm             0183        20.37    $1,035.65      $448.94      $207.13
                            cord lesion.
   55530  T                Revise spermatic             0183        20.37    $1,035.65      $448.94      $207.13
                            cord veins.
   55535  T                Revise spermatic             0154        24.09    $1,224.78      $556.98      $244.96
                            cord veins.
   55540  T                Revise hernia &              0154        24.09    $1,224.78      $556.98      $244.96
                            sperm veins.
   55550  T                Laparo ligate                0131        39.80    $2,023.51    $1,052.23      $404.70
                            spermatic vein.
   55559  T                Laparo proc,                 0130        27.92    $1,419.51      $659.53      $283.90
                            spermatic cord.
   55600  C                Incise sperm duct     ...........  ...........  ...........  ...........  ...........
                            pouch.
   55605  C                Incise sperm duct     ...........  ...........  ...........  ...........  ...........
                            pouch.
   55650  C                Remove sperm duct     ...........  ...........  ...........  ...........  ...........
                            pouch.
   55680  T                Remove sperm pouch           0183        20.37    $1,035.65      $448.94      $207.13
                            lesion.
   55700  T                Biopsy of prostate..         0184         5.23      $265.90      $122.96       $53.18
   55705  T                Biopsy of prostate..         0184         5.23      $265.90      $122.96       $53.18
   55720  T                Drainage of prostate         0162        19.86    $1,009.72      $427.49      $201.94
                            abscess.
   55725  T                Drainage of prostate         0162        19.86    $1,009.72      $427.49      $201.94
                            abscess.
   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                0163        30.27    $1,538.99      $792.58      $307.80
                            insert, pros.
   55860  T                Surgical exposure,           0165         5.36      $272.51       $91.76       $54.50
                            prostate.
   55862  C                Extensive prostate    ...........  ...........  ...........  ...........  ...........
                            surgery.
   55865  C                Extensive prostate    ...........  ...........  ...........  ...........  ...........
                            surgery.
   55870  T                Electroejaculation..         0197         2.58      $131.17       $49.55       $26.23
   55873  T                Cryoablate prostate.         0163        30.27    $1,538.99      $792.58      $307.80
   55899  T                Genital surgery              0164         0.98       $49.83       $14.95        $9.97
                            procedure.
   55970  E                Sex transformation,   ...........  ...........  ...........  ...........  ...........
                            M to F.
   55980  E                Sex transformation,   ...........  ...........  ...........  ...........  ...........
                            F to M.
   56405  T                I & D of vulva/              0192         2.73      $138.80       $35.33       $27.76
                            perineum.
   56420  T                Drainage of gland            0192         2.73      $138.80       $35.33       $27.76
                            abscess.
   56440  T                Surgery for vulva            0194        17.18      $873.47      $395.94      $174.69
                            lesion.
   56441  T                Lysis of labial              0193        12.17      $618.75      $171.13      $123.75
                            lesion(s).
   56501  T                Destruction, vulva           0017        10.51      $534.35      $245.80      $106.87
                            lesion(s).
   56515  T                Destruction, vulva           0695        17.06      $867.36      $398.99      $173.47
                            lesion(s).
   56605  T                Biopsy of vulva/             0019         4.56      $231.84       $78.91       $46.37
                            perineum.
   56606  T                Biopsy of vulva/             0019         4.56      $231.84       $78.91       $46.37
                            perineum.
   56620  T                Partial removal of           0195        22.22    $1,129.71      $483.80      $225.94
                            vulva.
   56625  T                Complete removal of          0195        22.22    $1,129.71      $483.80      $225.94
                            vulva.
   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           0194        17.18      $873.47      $395.94      $174.69
                            hymen.

[[Page 44786]]

 
   56720  T                Incision of hymen...         0193        12.17      $618.75      $171.13      $123.75
   56740  T                Remove vagina gland          0194        17.18      $873.47      $395.94      $174.69
                            lesion.
   56800  T                Repair of vagina....         0194        17.18      $873.47      $395.94      $174.69
   56805  T                Repair clitoris.....         0194        17.18      $873.47      $395.94      $174.69
   56810  T                Repair of perineum..         0194        17.18      $873.47      $395.94      $174.69
   57000  T                Exploration of               0194        17.18      $873.47      $395.94      $174.69
                            vagina.
   57010  T                Drainage of pelvic           0194        17.18      $873.47      $395.94      $174.69
                            abscess.
   57020  T                Drainage of pelvic           0193        12.17      $618.75      $171.13      $123.75
                            fluid.
   57022  T                I &d vaginal                 0007         7.28      $370.13       $74.03       $74.03
                            hematoma, ob.
   57023  T                I &d vag hematoma,           0007         7.28      $370.13       $74.03       $74.03
                            trauma.
   57061  T                Destruction vagina           0194        17.18      $873.47      $395.94      $174.69
                            lesion(s).
   57065  T                Destruction vagina           0194        17.18      $873.47      $395.94      $174.69
                            lesion(s).
   57100  T                Biopsy of vagina....         0193        12.17      $618.75      $171.13      $123.75
   57105  T                Biopsy of vagina....         0194        17.18      $873.47      $395.94      $174.69
   57106  T                Remove vagina wall,          0194        17.18      $873.47      $395.94      $174.69
                            partial.
   57107  T                Remove vagina                0195        22.22    $1,129.71      $483.80      $225.94
                            tissue, part.
   57109  T                Vaginectomy partial          0202        39.56    $2,011.31      $864.86      $402.26
                            w/nodes.
   57110  C                Remove vagina wall,   ...........  ...........  ...........  ...........  ...........
                            complete.
   57111  C                Remove vagina         ...........  ...........  ...........  ...........  ...........
                            tissue, compl.
   57112  C                Vaginectomy w/nodes,  ...........  ...........  ...........  ...........  ...........
                            compl.
   57120  T                Closure of vagina...         0194        17.18      $873.47      $395.94      $174.69
   57130  T                Remove vagina lesion         0194        17.18      $873.47      $395.94      $174.69
   57135  T                Remove vagina lesion         0194        17.18      $873.47      $395.94      $174.69
   57150  T                Treat vagina                 0191         0.27       $13.73        $3.98        $2.75
                            infection.
   57160  T                Insert pessary/other         0188         0.83       $42.20       $12.24        $8.44
                            device.
   57170  T                Fitting of diaphragm/        0191         0.27       $13.73        $3.98        $2.75
                            cap.
   57180  T                Treat vaginal                0192         2.73      $138.80       $35.33       $27.76
                            bleeding.
   57200  T                Repair of vagina....         0194        17.18      $873.47      $395.94      $174.69
   57210  T                Repair vagina/               0194        17.18      $873.47      $395.94      $174.69
                            perineum.
   57220  T                Revision of urethra.         0195        22.22    $1,129.71      $483.80      $225.94
   57230  T                Repair of urethral           0194        17.18      $873.47      $395.94      $174.69
                            lesion.
   57240  T                Repair bladder &             0195        22.22    $1,129.71      $483.80      $225.94
                            vagina.
   57250  T                Repair rectum &              0195        22.22    $1,129.71      $483.80      $225.94
                            vagina.
   57260  T                Repair of vagina....         0195        22.22    $1,129.71      $483.80      $225.94
   57265  T                Extensive repair of          0195        22.22    $1,129.71      $483.80      $225.94
                            vagina.
   57268  T                Repair of bowel              0195        22.22    $1,129.71      $483.80      $225.94
                            bulge.
   57270  C                Repair of bowel       ...........  ...........  ...........  ...........  ...........
                            pouch.
   57280  C                Suspension of vagina  ...........  ...........  ...........  ...........  ...........
   57282  C                Repair of vaginal     ...........  ...........  ...........  ...........  ...........
                            prolapse.
   57284  T                Repair paravaginal           0195        22.22    $1,129.71      $483.80      $225.94
                            defect.
   57287  T                Revise/remove sling          0202        39.56    $2,011.31      $864.86      $402.26
                            repair.
   57288  T                Repair bladder               0202        39.56    $2,011.31      $864.86      $402.26
                            defect.
   57289  T                Repair bladder &             0195        22.22    $1,129.71      $483.80      $225.94
                            vagina.
   57291  T                Construction of              0195        22.22    $1,129.71      $483.80      $225.94
                            vagina.
   57292  C                Construct vagina      ...........  ...........  ...........  ...........  ...........
                            with graft.
   57300  T                Repair rectum-vagina         0195        22.22    $1,129.71      $483.80      $225.94
                            fistula.
   57305  C                Repair rectum-vagina  ...........  ...........  ...........  ...........  ...........
                            fistula.
   57307  C                Fistula repair &      ...........  ...........  ...........  ...........  ...........
                            colostomy.
   57308  C                Fistula repair,       ...........  ...........  ...........  ...........  ...........
                            transperine.
   57310  T                Repair                       0195        22.22    $1,129.71      $483.80      $225.94
                            urethrovaginal
                            lesion.
   57311  C                Repair                ...........  ...........  ...........  ...........  ...........
                            urethrovaginal
                            lesion.
   57320  T                Repair bladder-              0195        22.22    $1,129.71      $483.80      $225.94
                            vagina lesion.
   57330  T                Repair bladder-              0195        22.22    $1,129.71      $483.80      $225.94
                            vagina lesion.
   57335  C                Repair vagina.......  ...........  ...........  ...........  ...........  ...........
   57400  T                Dilation of vagina..         0194        17.18      $873.47      $395.94      $174.69
   57410  T                Pelvic examination..         0194        17.18      $873.47      $395.94      $174.69
   57415  T                Remove vaginal               0194        17.18      $873.47      $395.94      $174.69
                            foreign body.
   57452  T                Examination of               0189         1.38       $70.16       $17.54       $14.03
                            vagina.
   57454  T                Vagina examination &         0192         2.73      $138.80       $35.33       $27.76
                            biopsy.
   57460  T                Cervix excision.....         0193        12.17      $618.75      $171.13      $123.75
   57500  T                Biopsy of cervix....         0192         2.73      $138.80       $35.33       $27.76
   57505  T                Endocervical                 0192         2.73      $138.80       $35.33       $27.76
                            curettage.
   57510  T                Cauterization of             0193        12.17      $618.75      $171.13      $123.75
                            cervix.
   57511  T                Cryocautery of               0189         1.38       $70.16       $17.54       $14.03
                            cervix.
   57513  T                Laser surgery of             0193        12.17      $618.75      $171.13      $123.75
                            cervix.
   57520  T                Conization of cervix         0194        17.18      $873.47      $395.94      $174.69
   57522  T                Conization of cervix         0195        22.22    $1,129.71      $483.80      $225.94
   57530  T                Removal of cervix...         0195        22.22    $1,129.71      $483.80      $225.94
   57531  C                Removal of cervix,    ...........  ...........  ...........  ...........  ...........
                            radical.
   57540  C                Removal of residual   ...........  ...........  ...........  ...........  ...........
                            cervix.
   57545  C                Remove cervix/repair  ...........  ...........  ...........  ...........  ...........
                            pelvis.
   57550  T                Removal of residual          0195        22.22    $1,129.71      $483.80      $225.94
                            cervix.
   57555  T                Remove cervix/repair         0195        22.22    $1,129.71      $483.80      $225.94
                            vagina.
   57556  T                Remove cervix,               0195        22.22    $1,129.71      $483.80      $225.94
                            repair bowel.
   57700  T                Revision of cervix..         0194        17.18      $873.47      $395.94      $174.69

[[Page 44787]]

 
   57720  T                Revision of cervix..         0194        17.18      $873.47      $395.94      $174.69
   57800  T                Dilation of cervical         0192         2.73      $138.80       $35.33       $27.76
                            canal.
   57820  T                D & c of residual            0196        14.62      $743.31      $357.98      $148.66
                            cervix.
   58100  T                Biopsy of uterus             0188         0.83       $42.20       $12.24        $8.44
                            lining.
   58120  T                Dilation and                 0196        14.62      $743.31      $357.98      $148.66
                            curettage.
   58140  C                Removal of uterus     ...........  ...........  ...........  ...........  ...........
                            lesion.
   58145  T                Removal of uterus            0195        22.22    $1,129.71      $483.80      $225.94
                            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.
   58300  E                Insert intrauterine   ...........  ...........  ...........  ...........  ...........
                            device.
   58301  T                Remove intrauterine          0189         1.38       $70.16       $17.54       $14.03
                            device.
   58321  T                Artificial                   0197         2.58      $131.17       $49.55       $26.23
                            insemination.
   58322  T                Artificial                   0197         2.58      $131.17       $49.55       $26.23
                            insemination.
   58323  T                Sperm washing.......         0197         2.58      $131.17       $49.55       $26.23
   58340  N                Catheter for          ...........  ...........  ...........  ...........  ...........
                            hysterography.
   58345  T                Reopen fallopian             0194        17.18      $873.47      $395.94      $174.69
                            tube.
   58350  T                Reopen fallopian             0194        17.18      $873.47      $395.94      $174.69
                            tube.
   58353  T                Endometr ablate,             0193        12.17      $618.75      $171.13      $123.75
                            thermal.
   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              0132        60.31    $3,066.28    $1,239.22      $613.26
                            hysterectomy.
   58551  T                Laparoscopy, remove          0131        39.80    $2,023.51    $1,052.23      $404.70
                            myoma.
   58555  T                Hysteroscopy, dx,            0194        17.18      $873.47      $395.94      $174.69
                            sep proc.
   58558  T                Hysteroscopy, biopsy         0190        18.27      $928.88      $443.89      $185.78
   58559  T                Hysteroscopy, lysis.         0190        18.27      $928.88      $443.89      $185.78
   58560  T                Hysteroscopy, resect         0190        18.27      $928.88      $443.89      $185.78
                            septum.
   58561  T                Hysteroscopy, remove         0190        18.27      $928.88      $443.89      $185.78
                            myoma.
   58562  T                Hysteroscopy, remove         0190        18.27      $928.88      $443.89      $185.78
                            fb.
   58563  T                Hysteroscopy,                0190        18.27      $928.88      $443.89      $185.78
                            ablation.
   58578  T                Laparo proc, uterus.         0190        18.27      $928.88      $443.89      $185.78
   58579  T                Hysteroscope                 0190        18.27      $928.88      $443.89      $185.78
                            procedure.
   58600  T                Division of                  0194        17.18      $873.47      $395.94      $174.69
                            fallopian tube.
   58605  C                Division of           ...........  ...........  ...........  ...........  ...........
                            fallopian tube.
   58611  C                Ligate oviduct(s)     ...........  ...........  ...........  ...........  ...........
                            add-on.
   58615  T                Occlude fallopian            0194        17.18      $873.47      $395.94      $174.69
                            tube(s).
   58660  T                Laparoscopy, lysis..         0131        39.80    $2,023.51    $1,052.23      $404.70
   58661  T                Laparoscopy, remove          0131        39.80    $2,023.51    $1,052.23      $404.70
                            adnexa.
   58662  T                Laparoscopy, excise          0131        39.80    $2,023.51    $1,052.23      $404.70
                            lesions.
   58670  T                Laparoscopy, tubal           0131        39.80    $2,023.51    $1,052.23      $404.70
                            cautery.
   58671  T                Laparoscopy, tubal           0131        39.80    $2,023.51    $1,052.23      $404.70
                            block.
   58672  T                Laparoscopy,                 0131        39.80    $2,023.51    $1,052.23      $404.70
                            fimbrioplasty.
   58673  T                Laparoscopy,                 0131        39.80    $2,023.51    $1,052.23      $404.70
                            salpingostomy.
   58679  T                Laparo proc, oviduct-        0130        27.92    $1,419.51      $659.53      $283.90
                            ovary.
   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.
   58800  T                Drainage of ovarian          0195        22.22    $1,129.71      $483.80      $225.94
                            cyst(s).
   58805  C                Drainage of ovarian   ...........  ...........  ...........  ...........  ...........
                            cyst(s).
   58820  T                Drain ovary abscess,         0195        22.22    $1,129.71      $483.80      $225.94
                            open.
   58822  C                Drain ovary abscess,  ...........  ...........  ...........  ...........  ...........
                            percut.
   58823  C                Drain pelvic          ...........  ...........  ...........  ...........  ...........
                            abscess, percut.
   58825  C                Transposition,        ...........  ...........  ...........  ...........  ...........
                            ovary(s).
   58900  T                Biopsy of ovary(s)..         0195        22.22    $1,129.71      $483.80      $225.94
   58920  T                Partial removal of           0202        39.56    $2,011.31      $864.86      $402.26
                            ovary(s).
   58925  T                Removal of ovarian           0202        39.56    $2,011.31      $864.86      $402.26
                            cyst(s).
   58940  C                Removal of ovary(s).  ...........  ...........  ...........  ...........  ...........
   58943  C                Removal of ovary(s).  ...........  ...........  ...........  ...........  ...........

[[Page 44788]]

 
   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        17.18      $873.47      $395.94      $174.69
   58974  T                Transfer of embryo..         0197         2.58      $131.17       $49.55       $26.23
   58976  T                Transfer of embryo..         0197         2.58      $131.17       $49.55       $26.23
   58999  T                Genital surgery              0019         4.56      $231.84       $78.91       $46.37
                            procedure.
   59000  T                Amniocentesis.......         0198         1.42       $72.20       $33.03       $14.44
   59012  T                Fetal cord                   0198         1.42       $72.20       $33.03       $14.44
                            puncture,prenatal.
   59015  T                Chorion biopsy......         0198         1.42       $72.20       $33.03       $14.44
   59020  T                Fetal contract               0198         1.42       $72.20       $33.03       $14.44
                            stress test.
   59025  T                Fetal non-stress             0198         1.42       $72.20       $33.03       $14.44
                            test.
   59030  T                Fetal scalp blood            0198         1.42       $72.20       $33.03       $14.44
                            sample.
   59050  T                Fetal monitor w/             0198         1.42       $72.20       $33.03       $14.44
                            report.
   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                0131        39.80    $2,023.51    $1,052.23      $404.70
                            pregnancy.
   59151  T                Treat ectopic                0131        39.80    $2,023.51    $1,052.23      $404.70
                            pregnancy.
   59160  T                D & c after delivery         0196        14.62      $743.31      $357.98      $148.66
   59200  T                Insert cervical              0189         1.38       $70.16       $17.54       $14.03
                            dilator.
   59300  T                Episiotomy or                0193        12.17      $618.75      $171.13      $123.75
                            vaginal repair.
   59320  T                Revision of cervix..         0194        17.18      $873.47      $395.94      $174.69
   59325  C                Revision of cervix..  ...........  ...........  ...........  ...........  ...........
   59350  C                Repair of uterus....  ...........  ...........  ...........  ...........  ...........
   59400  E                Obstetrical care....  ...........  ...........  ...........  ...........  ...........
   59409  T                Obstetrical care....         0199         4.20      $213.54       $59.79       $42.71
   59410  E                Obstetrical care....  ...........  ...........  ...........  ...........  ...........
   59412  T                Antepartum                   0199         4.20      $213.54       $59.79       $42.71
                            manipulation.
   59414  T                Deliver placenta....         0199         4.20      $213.54       $59.79       $42.71
   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         4.20      $213.54       $59.79       $42.71
   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                 0201        14.89      $757.04      $329.65      $151.41
                            miscarriage.
   59820  T                Care of miscarriage.         0201        14.89      $757.04      $329.65      $151.41
   59821  T                Treatment of                 0201        14.89      $757.04      $329.65      $151.41
                            miscarriage.
   59830  C                Treat uterus          ...........  ...........  ...........  ...........  ...........
                            infection.
   59840  T                Abortion............         0200        13.74      $698.57      $373.23      $139.71
   59841  T                Abortion............         0200        13.74      $698.57      $373.23      $139.71
   59850  C                Abortion............  ...........  ...........  ...........  ...........  ...........
   59851  C                Abortion............  ...........  ...........  ...........  ...........  ...........
   59852  C                Abortion............  ...........  ...........  ...........  ...........  ...........
   59855  C                Abortion............  ...........  ...........  ...........  ...........  ...........
   59856  C                Abortion............  ...........  ...........  ...........  ...........  ...........
   59857  C                Abortion............  ...........  ...........  ...........  ...........  ...........
   59866  T                Abortion (mpr)......         0198         1.42       $72.20       $33.03       $14.44
   59870  T                Evacuate mole of             0201        14.89      $757.04      $329.65      $151.41
                            uterus.
   59871  T                Remove cerclage              0194        17.18      $873.47      $395.94      $174.69
                            suture.
   59898  T                Laparo proc, ob care/        0130        27.92    $1,419.51      $659.53      $283.90
                            deliver.
   59899  T                Maternity care               0198         1.42       $72.20       $33.03       $14.44
                            procedure.
   60000  T                Drain thyroid/tongue         0252         6.53      $332.00      $114.24       $66.40
                            cyst.
   60001  T                Aspirate/inject              0004         3.00      $152.53       $32.57       $30.51
                            thyriod cyst.
   60100  T                Biopsy of thyroid...         0004         3.00      $152.53       $32.57       $30.51
   60200  T                Remove thyroid               0114        30.50    $1,550.68      $493.78      $310.14
                            lesion.
   60210  T                Partial thyroid              0114        30.50    $1,550.68      $493.78      $310.14
                            excision.
   60212  T                Parital thyroid              0114        30.50    $1,550.68      $493.78      $310.14
                            excision.
   60220  T                Partial removal of           0114        30.50    $1,550.68      $493.78      $310.14
                            thyroid.
   60225  T                Partial removal of           0114        30.50    $1,550.68      $493.78      $310.14
                            thyroid.
   60240  T                Removal of thyroid..         0114        30.50    $1,550.68      $493.78      $310.14

[[Page 44789]]

 
   60252  T                Removal of thyroid..         0256        28.82    $1,465.27      $623.05      $293.05
   60254  C                Extensive thyroid     ...........  ...........  ...........  ...........  ...........
                            surgery.
   60260  T                Repeat thyroid               0256        28.82    $1,465.27      $623.05      $293.05
                            surgery.
   60270  C                Removal of thyroid..  ...........  ...........  ...........  ...........  ...........
   60271  C                Removal of thyroid..  ...........  ...........  ...........  ...........  ...........
   60280  T                Remove thyroid duct          0114        30.50    $1,550.68      $493.78      $310.14
                            lesion.
   60281  T                Remove thyroid duct          0114        30.50    $1,550.68      $493.78      $310.14
                            lesion.
   60500  T                Explore parathyroid          0256        28.82    $1,465.27      $623.05      $293.05
                            glands.
   60502  C                Re-explore            ...........  ...........  ...........  ...........  ...........
                            parathyroids.
   60505  C                Explore parathyroid   ...........  ...........  ...........  ...........  ...........
                            glands.
   60512  T                Autotransplant               0021        12.74      $647.73      $236.51      $129.55
                            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,                 0130        27.92    $1,419.51      $659.53      $283.90
                            endocrine.
   60699  T                Endocrine surgery            0004         3.00      $152.53       $32.57       $30.51
                            procedure.
   61000  T                Remove cranial               0212         4.17      $212.01       $88.78       $42.40
                            cavity fluid.
   61001  T                Remove cranial               0212         4.17      $212.01       $88.78       $42.40
                            cavity fluid.
   61020  T                Remove brain cavity          0212         4.17      $212.01       $88.78       $42.40
                            fluid.
   61026  T                Injection into brain         0212         4.17      $212.01       $88.78       $42.40
                            canal.
   61050  T                Remove brain canal           0212         4.17      $212.01       $88.78       $42.40
                            fluid.
   61055  T                Injection into brain         0212         4.17      $212.01       $88.78       $42.40
                            canal.
   61070  T                Brain canal shunt            0212         4.17      $212.01       $88.78       $42.40
                            procedure.
   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           0224        29.95    $1,522.72      $453.41      $304.54
                            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.
   61330  T                Decompress eye               0256        28.82    $1,465.27      $623.05      $293.05
                            socket.
   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.

[[Page 44790]]

 
   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.
   61697  C                Brain aneurysm repr,  ...........  ...........  ...........  ...........  ...........
                            complx.
   61698  C                Brain aneurysm repr,  ...........  ...........  ...........  ...........  ...........
                            complx.
   61700  C                Brain aneurysm repr   ...........  ...........  ...........  ...........  ...........
                            , simple.
   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.

[[Page 44791]]

 
   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             0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   61791  C                Treat trigeminal      ...........  ...........  ...........  ...........  ...........
                            tract.
   61793  S                Focus radiation beam         0302        11.96      $608.07      $216.55      $121.61
   61795  S                Brain surgery using          0302        11.96      $608.07      $216.55      $121.61
                            computer.
   61850  C                Implant               ...........  ...........  ...........  ...........  ...........
                            neuroelectrodes.
   61860  C                Implant               ...........  ...........  ...........  ...........  ...........
                            neuroelectrodes.
   61862  C                Implant neurostimul,  ...........  ...........  ...........  ...........  ...........
                            subcort.
   61870  C                Implant               ...........  ...........  ...........  ...........  ...........
                            neuroelectrodes.
   61875  C                Implant               ...........  ...........  ...........  ...........  ...........
                            neuroelectrodes.
   61880  T                Revise/remove                0105        16.56      $841.94      $372.32      $168.39
                            neuroelectrode.
   61885  T                Implant neurostim            0222       112.50    $5,719.73    $2,688.27    $1,143.95
                            one array.
   61886  T                Implant neurostim            0222       112.50    $5,719.73    $2,688.27    $1,143.95
                            arrays.
   61888  T                Revise/remove                0105        16.56      $841.94      $372.32      $168.39
                            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             0121         2.42      $123.04       $52.53       $24.61
                            catheter.
   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             0121         2.42      $123.04       $52.53       $24.61
                            catheter.
   62230  T                Replace/revise brain         0224        29.95    $1,522.72      $453.41      $304.54
                            shunt.
   62252  S                Csf shunt reprogram.         0691         3.36      $170.83       $93.96       $34.17
   62256  C                Remove brain cavity   ...........  ...........  ...........  ...........  ...........
                            shunt.
   62258  C                Replace brain cavity  ...........  ...........  ...........  ...........  ...........
                            shunt.
   62263  T                Lysis epidural               0203         7.62      $387.42      $166.59       $77.48
                            adhesions.
   62268  T                Drain spinal cord            0212         4.17      $212.01       $88.78       $42.40
                            cyst.
   62269  T                Needle biopsy,               0005         6.71      $341.15      $119.75       $68.23
                            spinal cord.
   62270  T                Spinal fluid tap,            0206         3.88      $197.27       $82.85       $39.45
                            diagnostic.
   62272  T                Drain spinal fluid..         0206         3.88      $197.27       $82.85       $39.45
   62273  T                Treat epidural spine         0206         3.88      $197.27       $82.85       $39.45
                            lesion.
   62280  T                Treat spinal cord            0207         4.13      $209.98       $94.49       $42.00
                            lesion.
   62281  T                Treat spinal cord            0207         4.13      $209.98       $94.49       $42.00
                            lesion.
   62282  T                Treat spinal canal           0207         4.13      $209.98       $94.49       $42.00
                            lesion.
   62284  N                Injection for         ...........  ...........  ...........  ...........  ...........
                            myelogram.
   62287  T                Percutaneous                 0220        14.76      $750.43      $326.21      $150.09
                            diskectomy.
   62290  N                Inject for spine      ...........  ...........  ...........  ...........  ...........
                            disk x-ray.
   62291  N                Inject for spine      ...........  ...........  ...........  ...........  ...........
                            disk x-ray.
   62292  T                Injection into disk          0212         4.17      $212.01       $88.78       $42.40
                            lesion.
   62294  T                Injection into               0212         4.17      $212.01       $88.78       $42.40
                            spinal artery.
   62310  T                Inject spine c/t....         0206         3.88      $197.27       $82.85       $39.45
   62311  T                Inject spine l/s             0206         3.88      $197.27       $82.85       $39.45
                            (cd).
   62318  T                Inject spine w/cath,         0206         3.88      $197.27       $82.85       $39.45
                            c/t.
   62319  T                Inject spine w/cath          0206         3.88      $197.27       $82.85       $39.45
                            l/s (cd).
   62350  T                Implant spinal canal         0223         8.87      $450.97      $154.27       $90.19
                            cath.
   62351  C                Implant spinal canal  ...........  ...........  ...........  ...........  ...........
                            cath.
   62355  T                Remove spinal canal          0105        16.56      $841.94      $372.32      $168.39
                            catheter.
   62360  T                Insert spine                 0226         8.91      $453.00      $109.42       $90.60
                            infusion device.
   62361  T                Implant spine                0227        94.89    $4,824.40      $964.88      $964.88
                            infusion pump.
   62362  T                Implant spine                0227        94.89    $4,824.40      $964.88      $964.88
                            infusion pump.
   62365  T                Remove spine                 0105        16.56      $841.94      $372.32      $168.39
                            infusion device.
   62367  S                Analyze spine                0691         3.36      $170.83       $93.96       $34.17
                            infusion pump.
   62368  S                Analyze spine                0691         3.36      $170.83       $93.96       $34.17
                            infusion pump.

[[Page 44792]]

 
   63001  T                Removal of spinal            0208        30.93    $1,572.54      $314.51      $314.51
                            lamina.
   63003  T                Removal of spinal            0208        30.93    $1,572.54      $314.51      $314.51
                            lamina.
   63005  T                Removal of spinal            0208        30.93    $1,572.54      $314.51      $314.51
                            lamina.
   63011  T                Removal of spinal            0208        30.93    $1,572.54      $314.51      $314.51
                            lamina.
   63012  T                Removal of spinal            0208        30.93    $1,572.54      $314.51      $314.51
                            lamina.
   63015  T                Removal of spinal            0208        30.93    $1,572.54      $314.51      $314.51
                            lamina.
   63016  T                Removal of spinal            0208        30.93    $1,572.54      $314.51      $314.51
                            lamina.
   63017  T                Removal of spinal            0208        30.93    $1,572.54      $314.51      $314.51
                            lamina.
   63020  T                Neck spine disk              0208        30.93    $1,572.54      $314.51      $314.51
                            surgery.
   63030  T                Low back disk                0208        30.93    $1,572.54      $314.51      $314.51
                            surgery.
   63035  T                Spinal disk surgery          0208        30.93    $1,572.54      $314.51      $314.51
                            add-on.
   63040  T                Laminotomy, single           0208        30.93    $1,572.54      $314.51      $314.51
                            cervical.
   63042  T                Laminotomy, single           0208        30.93    $1,572.54      $314.51      $314.51
                            lumbar.
   63043  C                Laminotomy, addl      ...........  ...........  ...........  ...........  ...........
                            cervical.
   63044  C                Laminotomy, addl      ...........  ...........  ...........  ...........  ...........
                            lumbar.
   63045  T                Removal of spinal            0208        30.93    $1,572.54      $314.51      $314.51
                            lamina.
   63046  T                Removal of spinal            0208        30.93    $1,572.54      $314.51      $314.51
                            lamina.
   63047  T                Removal of spinal            0208        30.93    $1,572.54      $314.51      $314.51
                            lamina.
   63048  T                Remove spinal lamina         0208        30.93    $1,572.54      $314.51      $314.51
                            add-on.
   63055  T                Decompress spinal            0208        30.93    $1,572.54      $314.51      $314.51
                            cord.
   63056  T                Decompress spinal            0208        30.93    $1,572.54      $314.51      $314.51
                            cord.
   63057  T                Decompress spine             0208        30.93    $1,572.54      $314.51      $314.51
                            cord add-on.
   63064  T                Decompress spinal            0208        30.93    $1,572.54      $314.51      $314.51
                            cord.
   63066  T                Decompress spine             0208        30.93    $1,572.54      $314.51      $314.51
                            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.
   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.

[[Page 44793]]

 
   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           0220        14.76      $750.43      $326.21      $150.09
                            lesion.
   63610  T                Stimulation of               0220        14.76      $750.43      $326.21      $150.09
                            spinal cord.
   63615  T                Remove lesion of             0220        14.76      $750.43      $326.21      $150.09
                            spinal cord.
   63650  T                Implant                      0225        33.75    $1,715.92      $408.33      $343.18
                            neuroelectrodes.
   63655  C                Implant               ...........  ...........  ...........  ...........  ...........
                            neuroelectrodes.
   63660  T                Revise/remove                0105        16.56      $841.94      $372.32      $168.39
                            neuroelectrode.
   63685  T                Implant                      0222       112.50    $5,719.73    $2,688.27    $1,143.95
                            neuroreceiver.
   63688  T                Revise/remove                0105        16.56      $841.94      $372.32      $168.39
                            neuroreceiver.
   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  T                Install spinal shunt         0228        47.98    $2,439.40      $696.46      $487.88
   63744  T                Revision of spinal           0228        47.98    $2,439.40      $696.46      $487.88
                            shunt.
   63746  T                Removal of spinal            0109         6.57      $334.03      $133.51       $66.81
                            shunt.
   64400  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64402  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64405  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64408  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64410  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64412  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64413  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64415  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64417  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64418  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64420  T                Injection for nerve          0207         4.13      $209.98       $94.49       $42.00
                            block.
   64421  T                Injection for nerve          0207         4.13      $209.98       $94.49       $42.00
                            block.
   64425  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64430  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64435  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64445  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64450  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64470  T                Inj paravertebral c/         0207         4.13      $209.98       $94.49       $42.00
                            t.
   64472  T                Inj paravertebral c/         0207         4.13      $209.98       $94.49       $42.00
                            t add-on.
   64475  T                Inj paravertebral l/         0207         4.13      $209.98       $94.49       $42.00
                            s.
   64476  T                Inj paravertebral l/         0207         4.13      $209.98       $94.49       $42.00
                            s add-on.
   64479  T                Inj foramen epidural         0207         4.13      $209.98       $94.49       $42.00
                            c/t.
   64480  T                Inj foramen epidural         0207         4.13      $209.98       $94.49       $42.00
                            add-on.
   64483  T                Inj foramen epidural         0207         4.13      $209.98       $94.49       $42.00
                            l/s.
   64484  T                Inj foramen epidural         0207         4.13      $209.98       $94.49       $42.00
                            add-on.
   64505  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64508  T                Injection for nerve          0204         2.44      $124.05       $47.14       $24.81
                            block.
   64510  T                Injection for nerve          0207         4.13      $209.98       $94.49       $42.00
                            block.
   64520  T                Injection for nerve          0207         4.13      $209.98       $94.49       $42.00
                            block.
   64530  T                Injection for nerve          0207         4.13      $209.98       $94.49       $42.00
                            block.
   64550  A                Apply                 ...........  ...........  ...........  ...........  ...........
                            neurostimulator.
   64553  T                Implant                      0225        33.75    $1,715.92      $408.33      $343.18
                            neuroelectrodes.
   64555  T                Implant                      0225        33.75    $1,715.92      $408.33      $343.18
                            neuroelectrodes.
   64560  T                Implant                      0225        33.75    $1,715.92      $408.33      $343.18
                            neuroelectrodes.
   64565  T                Implant                      0225        33.75    $1,715.92      $408.33      $343.18
                            neuroelectrodes.
   64573  T                Implant                      0225        33.75    $1,715.92      $408.33      $343.18
                            neuroelectrodes.
   64575  T                Implant                      0225        33.75    $1,715.92      $408.33      $343.18
                            neuroelectrodes.
   64577  T                Implant                      0225        33.75    $1,715.92      $408.33      $343.18
                            neuroelectrodes.
   64580  T                Implant                      0225        33.75    $1,715.92      $408.33      $343.18
                            neuroelectrodes.
   64585  T                Revise/remove                0105        16.56      $841.94      $372.32      $168.39
                            neuroelectrode.
   64590  T                Implant                      0222       112.50    $5,719.73    $2,688.27    $1,143.95
                            neuroreceiver.
   64595  T                Revise/remove                0105        16.56      $841.94      $372.32      $168.39
                            neuroreceiver.
   64600  T                Injection treatment          0203         7.62      $387.42      $166.59       $77.48
                            of nerve.
   64605  T                Injection treatment          0203         7.62      $387.42      $166.59       $77.48
                            of nerve.
   64610  T                Injection treatment          0203         7.62      $387.42      $166.59       $77.48
                            of nerve.
   64612  T                Destroy nerve, face          0204         2.44      $124.05       $47.14       $24.81
                            muscle.
   64613  T                Destroy nerve, spine         0204         2.44      $124.05       $47.14       $24.81
                            muscle.
   64614  T                Destroy nerve,               0206         3.88      $197.27       $82.85       $39.45
                            extrem musc.

[[Page 44794]]

 
   64620  T                Injection treatment          0203         7.62      $387.42      $166.59       $77.48
                            of nerve.
   64622  T                Destr paravertebrl           0203         7.62      $387.42      $166.59       $77.48
                            nerve l/s.
   64623  T                Destr paravertebral          0203         7.62      $387.42      $166.59       $77.48
                            n add-on.
   64626  T                Destr paravertebrl           0203         7.62      $387.42      $166.59       $77.48
                            nerve c/t.
   64627  T                Destr paravertebral          0203         7.62      $387.42      $166.59       $77.48
                            n add-on.
   64630  T                Injection treatment          0207         4.13      $209.98       $94.49       $42.00
                            of nerve.
   64640  T                Injection treatment          0207         4.13      $209.98       $94.49       $42.00
                            of nerve.
   64680  T                Injection treatment          0203         7.62      $387.42      $166.59       $77.48
                            of nerve.
   64702  T                Revise finger/toe            0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   64704  T                Revise hand/foot             0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   64708  T                Revise arm/leg nerve         0220        14.76      $750.43      $326.21      $150.09
   64712  T                Revision of sciatic          0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   64713  T                Revision of arm              0220        14.76      $750.43      $326.21      $150.09
                            nerve(s).
   64714  T                Revise low back              0220        14.76      $750.43      $326.21      $150.09
                            nerve(s).
   64716  T                Revision of cranial          0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   64718  T                Revise ulnar nerve           0220        14.76      $750.43      $326.21      $150.09
                            at elbow.
   64719  T                Revise ulnar nerve           0220        14.76      $750.43      $326.21      $150.09
                            at wrist.
   64721  T                Carpal tunnel                0220        14.76      $750.43      $326.21      $150.09
                            surgery.
   64722  T                Relieve pressure on          0220        14.76      $750.43      $326.21      $150.09
                            nerve(s).
   64726  T                Release foot/toe             0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   64727  T                Internal nerve               0220        14.76      $750.43      $326.21      $150.09
                            revision.
   64732  T                Incision of brow             0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   64734  T                Incision of cheek            0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   64736  T                Incision of chin             0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   64738  T                Incision of jaw              0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   64740  T                Incision of tongue           0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   64742  T                Incision of facial           0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   64744  T                Incise nerve, back           0220        14.76      $750.43      $326.21      $150.09
                            of head.
   64746  T                Incise diaphragm             0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   64752  C                Incision of vagus     ...........  ...........  ...........  ...........  ...........
                            nerve.
   64755  C                Incision of stomach   ...........  ...........  ...........  ...........  ...........
                            nerves.
   64760  C                Incision of vagus     ...........  ...........  ...........  ...........  ...........
                            nerve.
   64761  T                Incision of pelvis           0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   64763  C                Incise hip/thigh      ...........  ...........  ...........  ...........  ...........
                            nerve.
   64766  C                Incise hip/thigh      ...........  ...........  ...........  ...........  ...........
                            nerve.
   64771  T                Sever cranial nerve.         0220        14.76      $750.43      $326.21      $150.09
   64772  T                Incision of spinal           0220        14.76      $750.43      $326.21      $150.09
                            nerve.
   64774  T                Remove skin nerve            0220        14.76      $750.43      $326.21      $150.09
                            lesion.
   64776  T                Remove digit nerve           0220        14.76      $750.43      $326.21      $150.09
                            lesion.
   64778  T                Digit nerve surgery          0220        14.76      $750.43      $326.21      $150.09
                            add-on.
   64782  T                Remove limb nerve            0220        14.76      $750.43      $326.21      $150.09
                            lesion.
   64783  T                Limb nerve surgery           0220        14.76      $750.43      $326.21      $150.09
                            add-on.
   64784  T                Remove nerve lesion.         0220        14.76      $750.43      $326.21      $150.09
   64786  T                Remove sciatic nerve         0221        22.68    $1,153.10      $463.62      $230.62
                            lesion.
   64787  T                Implant nerve end...         0220        14.76      $750.43      $326.21      $150.09
   64788  T                Remove skin nerve            0220        14.76      $750.43      $326.21      $150.09
                            lesion.
   64790  T                Removal of nerve             0220        14.76      $750.43      $326.21      $150.09
                            lesion.
   64792  T                Removal of nerve             0221        22.68    $1,153.10      $463.62      $230.62
                            lesion.
   64795  T                Biopsy of nerve.....         0220        14.76      $750.43      $326.21      $150.09
   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              0221        22.68    $1,153.10      $463.62      $230.62
                            nerve.
   64832  T                Repair nerve add-on.         0221        22.68    $1,153.10      $463.62      $230.62
   64834  T                Repair of hand or            0221        22.68    $1,153.10      $463.62      $230.62
                            foot nerve.
   64835  T                Repair of hand or            0221        22.68    $1,153.10      $463.62      $230.62
                            foot nerve.
   64836  T                Repair of hand or            0221        22.68    $1,153.10      $463.62      $230.62
                            foot nerve.
   64837  T                Repair nerve add-on.         0221        22.68    $1,153.10      $463.62      $230.62
   64840  T                Repair of leg nerve.         0221        22.68    $1,153.10      $463.62      $230.62
   64856  T                Repair/transpose             0221        22.68    $1,153.10      $463.62      $230.62
                            nerve.
   64857  T                Repair arm/leg nerve         0221        22.68    $1,153.10      $463.62      $230.62
   64858  T                Repair sciatic nerve         0221        22.68    $1,153.10      $463.62      $230.62
   64859  T                Nerve surgery.......         0221        22.68    $1,153.10      $463.62      $230.62
   64861  T                Repair of arm nerves         0221        22.68    $1,153.10      $463.62      $230.62
   64862  T                Repair of low back           0221        22.68    $1,153.10      $463.62      $230.62
                            nerves.
   64864  T                Repair of facial             0221        22.68    $1,153.10      $463.62      $230.62
                            nerve.
   64865  T                Repair of facial             0221        22.68    $1,153.10      $463.62      $230.62
                            nerve.
   64866  C                Fusion of facial/     ...........  ...........  ...........  ...........  ...........
                            other nerve.
   64868  C                Fusion of facial/     ...........  ...........  ...........  ...........  ...........
                            other nerve.
   64870  T                Fusion of facial/            0221        22.68    $1,153.10      $463.62      $230.62
                            other nerve.
   64872  T                Subsequent repair of         0221        22.68    $1,153.10      $463.62      $230.62
                            nerve.
   64874  T                Repair & revise              0221        22.68    $1,153.10      $463.62      $230.62
                            nerve add-on.
   64876  T                Repair nerve/shorten         0221        22.68    $1,153.10      $463.62      $230.62
                            bone.

[[Page 44795]]

 
   64885  T                Nerve graft, head or         0221        22.68    $1,153.10      $463.62      $230.62
                            neck.
   64886  T                Nerve graft, head or         0221        22.68    $1,153.10      $463.62      $230.62
                            neck.
   64890  T                Nerve graft, hand or         0221        22.68    $1,153.10      $463.62      $230.62
                            foot.
   64891  T                Nerve graft, hand or         0221        22.68    $1,153.10      $463.62      $230.62
                            foot.
   64892  T                Nerve graft, arm or          0221        22.68    $1,153.10      $463.62      $230.62
                            leg.
   64893  T                Nerve graft, arm or          0221        22.68    $1,153.10      $463.62      $230.62
                            leg.
   64895  T                Nerve graft, hand or         0221        22.68    $1,153.10      $463.62      $230.62
                            foot.
   64896  T                Nerve graft, hand or         0221        22.68    $1,153.10      $463.62      $230.62
                            foot.
   64897  T                Nerve graft, arm or          0221        22.68    $1,153.10      $463.62      $230.62
                            leg.
   64898  T                Nerve graft, arm or          0221        22.68    $1,153.10      $463.62      $230.62
                            leg.
   64901  T                Nerve graft add-on..         0221        22.68    $1,153.10      $463.62      $230.62
   64902  T                Nerve graft add-on..         0221        22.68    $1,153.10      $463.62      $230.62
   64905  T                Nerve pedicle                0221        22.68    $1,153.10      $463.62      $230.62
                            transfer.
   64907  T                Nerve pedicle                0221        22.68    $1,153.10      $463.62      $230.62
                            transfer.
   64999  T                Nervous system               0204         2.44      $124.05       $47.14       $24.81
                            surgery.
   65091  T                Revise eye..........         0242        25.31    $1,286.81      $597.36      $257.36
   65093  T                Revise eye with              0241        19.20      $976.17      $384.47      $195.23
                            implant.
   65101  T                Removal of eye......         0242        25.31    $1,286.81      $597.36      $257.36
   65103  T                Remove eye/insert            0242        25.31    $1,286.81      $597.36      $257.36
                            implant.
   65105  T                Remove eye/attach            0242        25.31    $1,286.81      $597.36      $257.36
                            implant.
   65110  T                Removal of eye......         0242        25.31    $1,286.81      $597.36      $257.36
   65112  T                Remove eye/revise            0242        25.31    $1,286.81      $597.36      $257.36
                            socket.
   65114  T                Remove eye/revise            0242        25.31    $1,286.81      $597.36      $257.36
                            socket.
   65125  T                Revise ocular                0240        14.86      $755.51      $315.31      $151.10
                            implant.
   65130  T                Insert ocular                0241        19.20      $976.17      $384.47      $195.23
                            implant.
   65135  T                Insert ocular                0241        19.20      $976.17      $384.47      $195.23
                            implant.
   65140  T                Attach ocular                0242        25.31    $1,286.81      $597.36      $257.36
                            implant.
   65150  T                Revise ocular                0241        19.20      $976.17      $384.47      $195.23
                            implant.
   65155  T                Reinsert ocular              0242        25.31    $1,286.81      $597.36      $257.36
                            implant.
   65175  T                Removal of ocular            0240        14.86      $755.51      $315.31      $151.10
                            implant.
   65205  S                Remove foreign body          0231         2.27      $115.41       $51.94       $23.08
                            from eye.
   65210  S                Remove foreign body          0231         2.27      $115.41       $51.94       $23.08
                            from eye.
   65220  S                Remove foreign body          0231         2.27      $115.41       $51.94       $23.08
                            from eye.
   65222  S                Remove foreign body          0231         2.27      $115.41       $51.94       $23.08
                            from eye.
   65235  T                Remove foreign body          0233        11.78      $598.92      $287.48      $119.78
                            from eye.
   65260  T                Remove foreign body          0237        33.56    $1,706.26      $852.68      $341.25
                            from eye.
   65265  T                Remove foreign body          0236        17.75      $902.45      $180.49      $180.49
                            from eye.
   65270  T                Repair of eye wound.         0240        14.86      $755.51      $315.31      $151.10
   65272  T                Repair of eye wound.         0233        11.78      $598.92      $287.48      $119.78
   65273  C                Repair of eye wound.  ...........  ...........  ...........  ...........  ...........
   65275  T                Repair of eye wound.         0233        11.78      $598.92      $287.48      $119.78
   65280  T                Repair of eye wound.         0234        20.56    $1,045.31      $502.16      $209.06
   65285  T                Repair of eye wound.         0234        20.56    $1,045.31      $502.16      $209.06
   65286  T                Repair of eye wound.         0233        11.78      $598.92      $287.48      $119.78
   65290  T                Repair of eye socket         0243        19.22      $977.18      $431.39      $195.44
                            wound.
   65400  T                Removal of eye               0233        11.78      $598.92      $287.48      $119.78
                            lesion.
   65410  T                Biopsy of cornea....         0233        11.78      $598.92      $287.48      $119.78
   65420  T                Removal of eye               0233        11.78      $598.92      $287.48      $119.78
                            lesion.
   65426  T                Removal of eye               0234        20.56    $1,045.31      $502.16      $209.06
                            lesion.
   65430  S                Corneal smear.......         0230         0.64       $32.54       $14.97        $6.51
   65435  T                Curette/treat cornea         0239         6.25      $317.76      $123.42       $63.55
   65436  T                Curette/treat cornea         0233        11.78      $598.92      $287.48      $119.78
   65450  T                Treatment of corneal         0232         3.69      $187.61       $82.55       $37.52
                            lesion.
   65600  T                Revision of cornea..         0240        14.86      $755.51      $315.31      $151.10
   65710  T                Corneal transplant..         0244        41.43    $2,106.38      $851.42      $421.28
   65730  T                Corneal transplant..         0244        41.43    $2,106.38      $851.42      $421.28
   65750  T                Corneal transplant..         0244        41.43    $2,106.38      $851.42      $421.28
   65755  T                Corneal transplant..         0244        41.43    $2,106.38      $851.42      $421.28
   65760  E                Revision of cornea..  ...........  ...........  ...........  ...........  ...........
   65765  E                Revision of cornea..  ...........  ...........  ...........  ...........  ...........
   65767  E                Corneal tissue        ...........  ...........  ...........  ...........  ...........
                            transplant.
   65770  T                Revise cornea with           0244        41.43    $2,106.38      $851.42      $421.28
                            implant.
   65771  E                Radial keratotomy...  ...........  ...........  ...........  ...........  ...........
   65772  T                Correction of                0233        11.78      $598.92      $287.48      $119.78
                            astigmatism.
   65775  T                Correction of                0233        11.78      $598.92      $287.48      $119.78
                            astigmatism.
   65800  T                Drainage of eye.....         0233        11.78      $598.92      $287.48      $119.78
   65805  T                Drainage of eye.....         0233        11.78      $598.92      $287.48      $119.78
   65810  T                Drainage of eye.....         0233        11.78      $598.92      $287.48      $119.78
   65815  T                Drainage of eye.....         0234        20.56    $1,045.31      $502.16      $209.06
   65820  T                Relieve inner eye            0232         3.69      $187.61       $82.55       $37.52
                            pressure.
   65850  T                Incision of eye.....         0234        20.56    $1,045.31      $502.16      $209.06
   65855  T                Laser surgery of eye         0247         4.73      $240.48      $110.62       $48.10
   65860  T                Incise inner eye             0247         4.73      $240.48      $110.62       $48.10
                            adhesions.
   65865  T                Incise inner eye             0233        11.78      $598.92      $287.48      $119.78
                            adhesions.
   65870  T                Incise inner eye             0234        20.56    $1,045.31      $502.16      $209.06
                            adhesions.

[[Page 44796]]

 
   65875  T                Incise inner eye             0234        20.56    $1,045.31      $502.16      $209.06
                            adhesions.
   65880  T                Incise inner eye             0233        11.78      $598.92      $287.48      $119.78
                            adhesions.
   65900  T                Remove eye lesion...         0233        11.78      $598.92      $287.48      $119.78
   65920  T                Remove implant from          0233        11.78      $598.92      $287.48      $119.78
                            eye.
   65930  T                Remove blood clot            0234        20.56    $1,045.31      $502.16      $209.06
                            from eye.
   66020  T                Injection treatment          0233        11.78      $598.92      $287.48      $119.78
                            of eye.
   66030  T                Injection treatment          0233        11.78      $598.92      $287.48      $119.78
                            of eye.
   66130  T                Remove eye lesion...         0234        20.56    $1,045.31      $502.16      $209.06
   66150  T                Glaucoma surgery....         0233        11.78      $598.92      $287.48      $119.78
   66155  T                Glaucoma surgery....         0234        20.56    $1,045.31      $502.16      $209.06
   66160  T                Glaucoma surgery....         0234        20.56    $1,045.31      $502.16      $209.06
   66165  T                Glaucoma surgery....         0234        20.56    $1,045.31      $502.16      $209.06
   66170  T                Glaucoma surgery....         0234        20.56    $1,045.31      $502.16      $209.06
   66172  T                Incision of eye.....         0234        20.56    $1,045.31      $502.16      $209.06
   66180  T                Implant eye shunt...         0234        20.56    $1,045.31      $502.16      $209.06
   66185  T                Revise eye shunt....         0234        20.56    $1,045.31      $502.16      $209.06
   66220  T                Repair eye lesion...         0236        17.75      $902.45      $180.49      $180.49
   66225  T                Repair/graft eye             0234        20.56    $1,045.31      $502.16      $209.06
                            lesion.
   66250  T                Follow-up surgery of         0233        11.78      $598.92      $287.48      $119.78
                            eye.
   66500  T                Incision of iris....         0232         3.69      $187.61       $82.55       $37.52
   66505  T                Incision of iris....         0232         3.69      $187.61       $82.55       $37.52
   66600  T                Remove iris and              0233        11.78      $598.92      $287.48      $119.78
                            lesion.
   66605  T                Removal of iris.....         0234        20.56    $1,045.31      $502.16      $209.06
   66625  T                Removal of iris.....         0233        11.78      $598.92      $287.48      $119.78
   66630  T                Removal of iris.....         0233        11.78      $598.92      $287.48      $119.78
   66635  T                Removal of iris.....         0234        20.56    $1,045.31      $502.16      $209.06
   66680  T                Repair iris &                0234        20.56    $1,045.31      $502.16      $209.06
                            ciliary body.
   66682  T                Repair iris &                0234        20.56    $1,045.31      $502.16      $209.06
                            ciliary body.
   66700  T                Destruction, ciliary         0233        11.78      $598.92      $287.48      $119.78
                            body.
   66710  T                Destruction, ciliary         0233        11.78      $598.92      $287.48      $119.78
                            body.
   66720  T                Destruction, ciliary         0233        11.78      $598.92      $287.48      $119.78
                            body.
   66740  T                Destruction, ciliary         0233        11.78      $598.92      $287.48      $119.78
                            body.
   66761  T                Revision of iris....         0247         4.73      $240.48      $110.62       $48.10
   66762  T                Revision of iris....         0247         4.73      $240.48      $110.62       $48.10
   66770  T                Removal of inner eye         0247         4.73      $240.48      $110.62       $48.10
                            lesion.
   66820  T                Incision, secondary          0232         3.69      $187.61       $82.55       $37.52
                            cataract.
   66821  T                After cataract laser         0247         4.73      $240.48      $110.62       $48.10
                            surgery.
   66825  T                Reposition                   0234        20.56    $1,045.31      $502.16      $209.06
                            intraocular lens.
   66830  T                Removal of lens              0232         3.69      $187.61       $82.55       $37.52
                            lesion.
   66840  T                Removal of lens              0245        10.75      $546.55      $256.88      $109.31
                            material.
   66850  T                Removal of lens              0249        23.51    $1,195.30      $561.79      $239.06
                            material.
   66852  T                Removal of lens              0249        23.51    $1,195.30      $561.79      $239.06
                            material.
   66920  T                Extraction of lens..         0249        23.51    $1,195.30      $561.79      $239.06
   66930  T                Extraction of lens..         0249        23.51    $1,195.30      $561.79      $239.06
   66940  T                Extraction of lens..         0245        10.75      $546.55      $256.88      $109.31
   66982  T                Cataract surgery,            0246        22.36    $1,136.83      $534.31      $227.37
                            complex.
   66983  T                Cataract surg w/iol,         0246        22.36    $1,136.83      $534.31      $227.37
                            1 stage.
   66984  T                Cataract surg w/iol,         0246        22.36    $1,136.83      $534.31      $227.37
                            i stage.
   66985  T                Insert lens                  0246        22.36    $1,136.83      $534.31      $227.37
                            prosthesis.
   66986  T                Exchange lens                0246        22.36    $1,136.83      $534.31      $227.37
                            prosthesis.
   66999  T                Eye surgery                  0247         4.73      $240.48      $110.62       $48.10
                            procedure.
   67005  T                Partial removal of           0237        33.56    $1,706.26      $852.68      $341.25
                            eye fluid.
   67010  T                Partial removal of           0237        33.56    $1,706.26      $852.68      $341.25
                            eye fluid.
   67015  T                Release of eye fluid         0237        33.56    $1,706.26      $852.68      $341.25
   67025  T                Replace eye fluid...         0236        17.75      $902.45      $180.49      $180.49
   67027  T                Implant eye drug             0237        33.56    $1,706.26      $852.68      $341.25
                            system.
   67028  T                Injection eye drug..         0235         5.39      $274.04       $78.91       $54.81
   67030  T                Incise inner eye             0236        17.75      $902.45      $180.49      $180.49
                            strands.
   67031  T                Laser surgery, eye           0247         4.73      $240.48      $110.62       $48.10
                            strands.
   67036  T                Removal of inner eye         0237        33.56    $1,706.26      $852.68      $341.25
                            fluid.
   67038  T                Strip retinal                0237        33.56    $1,706.26      $852.68      $341.25
                            membrane.
   67039  T                Laser treatment of           0237        33.56    $1,706.26      $852.68      $341.25
                            retina.
   67040  T                Laser treatment of           0237        33.56    $1,706.26      $852.68      $341.25
                            retina.
   67101  T                Repair detached              0235         5.39      $274.04       $78.91       $54.81
                            retina.
   67105  T                Repair detached              0248         4.15      $210.99       $94.05       $42.20
                            retina.
   67107  T                Repair detached              0237        33.56    $1,706.26      $852.68      $341.25
                            retina.
   67108  T                Repair detached              0237        33.56    $1,706.26      $852.68      $341.25
                            retina.
   67110  T                Repair detached              0235         5.39      $274.04       $78.91       $54.81
                            retina.
   67112  T                Rerepair detached            0237        33.56    $1,706.26      $852.68      $341.25
                            retina.
   67115  T                Release encircling           0236        17.75      $902.45      $180.49      $180.49
                            material.
   67120  T                Remove eye implant           0236        17.75      $902.45      $180.49      $180.49
                            material.
   67121  T                Remove eye implant           0237        33.56    $1,706.26      $852.68      $341.25
                            material.
   67141  T                Treatment of retina.         0235         5.39      $274.04       $78.91       $54.81
   67145  T                Treatment of retina.         0248         4.15      $210.99       $94.05       $42.20
   67208  S                Treatment of retinal         0231         2.27      $115.41       $51.94       $23.08
                            lesion.

[[Page 44797]]

 
   67210  T                Treatment of retinal         0248         4.15      $210.99       $94.05       $42.20
                            lesion.
   67218  T                Treatment of retinal         0237        33.56    $1,706.26      $852.68      $341.25
                            lesion.
   67220  T                Treatment of choroid         0235         5.39      $274.04       $78.91       $54.81
                            lesion.
   67221  T                Ocular photodynamic          0235         5.39      $274.04       $78.91       $54.81
                            ther.
   67227  T                Treatment of retinal         0235         5.39      $274.04       $78.91       $54.81
                            lesion.
   67228  T                Treatment of retinal         0248         4.15      $210.99       $94.05       $42.20
                            lesion.
   67250  T                Reinforce eye wall..         0240        14.86      $755.51      $315.31      $151.10
   67255  T                Reinforce/graft eye          0237        33.56    $1,706.26      $852.68      $341.25
                            wall.
   67299  T                Eye surgery                  0248         4.15      $210.99       $94.05       $42.20
                            procedure.
   67311  T                Revise eye muscle...         0243        19.22      $977.18      $431.39      $195.44
   67312  T                Revise two eye               0243        19.22      $977.18      $431.39      $195.44
                            muscles.
   67314  T                Revise eye muscle...         0243        19.22      $977.18      $431.39      $195.44
   67316  T                Revise two eye               0243        19.22      $977.18      $431.39      $195.44
                            muscles.
   67318  T                Revise eye muscle(s)         0243        19.22      $977.18      $431.39      $195.44
   67320  T                Revise eye muscle(s)         0243        19.22      $977.18      $431.39      $195.44
                            add-on.
   67331  T                Eye surgery follow-          0243        19.22      $977.18      $431.39      $195.44
                            up add-on.
   67332  T                Rerevise eye muscles         0243        19.22      $977.18      $431.39      $195.44
                            add-on.
   67334  T                Revise eye muscle w/         0243        19.22      $977.18      $431.39      $195.44
                            suture.
   67335  T                Eye suture during            0243        19.22      $977.18      $431.39      $195.44
                            surgery.
   67340  T                Revise eye muscle            0243        19.22      $977.18      $431.39      $195.44
                            add-on.
   67343  T                Release eye tissue..         0243        19.22      $977.18      $431.39      $195.44
   67345  T                Destroy nerve of eye         0238         2.84      $144.39       $58.96       $28.88
                            muscle.
   67350  T                Biopsy eye muscle...         0699         6.91      $351.32      $158.09       $70.26
   67399  T                Eye muscle surgery           0243        19.22      $977.18      $431.39      $195.44
                            procedure.
   67400  T                Explore/biopsy eye           0241        19.20      $976.17      $384.47      $195.23
                            socket.
   67405  T                Explore/drain eye            0241        19.20      $976.17      $384.47      $195.23
                            socket.
   67412  T                Explore/treat eye            0241        19.20      $976.17      $384.47      $195.23
                            socket.
   67413  T                Explore/treat eye            0241        19.20      $976.17      $384.47      $195.23
                            socket.
   67414  T                Explr/decompress eye         0242        25.31    $1,286.81      $597.36      $257.36
                            socket.
   67415  T                Aspiration, orbital          0239         6.25      $317.76      $123.42       $63.55
                            contents.
   67420  T                Explore/treat eye            0242        25.31    $1,286.81      $597.36      $257.36
                            socket.
   67430  T                Explore/treat eye            0242        25.31    $1,286.81      $597.36      $257.36
                            socket.
   67440  T                Explore/drain eye            0242        25.31    $1,286.81      $597.36      $257.36
                            socket.
   67445  T                Explr/decompress eye         0242        25.31    $1,286.81      $597.36      $257.36
                            socket.
   67450  T                Explore/biopsy eye           0242        25.31    $1,286.81      $597.36      $257.36
                            socket.
   67500  S                Inject/treat eye             0231         2.27      $115.41       $51.94       $23.08
                            socket.
   67505  T                Inject/treat eye             0238         2.84      $144.39       $58.96       $28.88
                            socket.
   67515  T                Inject/treat eye             0239         6.25      $317.76      $123.42       $63.55
                            socket.
   67550  T                Insert eye socket            0242        25.31    $1,286.81      $597.36      $257.36
                            implant.
   67560  T                Revise eye socket            0241        19.20      $976.17      $384.47      $195.23
                            implant.
   67570  T                Decompress optic             0242        25.31    $1,286.81      $597.36      $257.36
                            nerve.
   67599  T                Orbit surgery                0239         6.25      $317.76      $123.42       $63.55
                            procedure.
   67700  T                Drainage of eyelid           0238         2.84      $144.39       $58.96       $28.88
                            abscess.
   67710  T                Incision of eyelid..         0239         6.25      $317.76      $123.42       $63.55
   67715  T                Incision of eyelid           0240        14.86      $755.51      $315.31      $151.10
                            fold.
   67800  T                Remove eyelid lesion         0238         2.84      $144.39       $58.96       $28.88
   67801  T                Remove eyelid                0239         6.25      $317.76      $123.42       $63.55
                            lesions.
   67805  T                Remove eyelid                0238         2.84      $144.39       $58.96       $28.88
                            lesions.
   67808  T                Remove eyelid                0240        14.86      $755.51      $315.31      $151.10
                            lesion(s).
   67810  T                Biopsy of eyelid....         0238         2.84      $144.39       $58.96       $28.88
   67820  T                Revise eyelashes....         0238         2.84      $144.39       $58.96       $28.88
   67825  T                Revise eyelashes....         0238         2.84      $144.39       $58.96       $28.88
   67830  T                Revise eyelashes....         0239         6.25      $317.76      $123.42       $63.55
   67835  T                Revise eyelashes....         0240        14.86      $755.51      $315.31      $151.10
   67840  T                Remove eyelid lesion         0239         6.25      $317.76      $123.42       $63.55
   67850  T                Treat eyelid lesion.         0239         6.25      $317.76      $123.42       $63.55
   67875  T                Closure of eyelid by         0239         6.25      $317.76      $123.42       $63.55
                            suture.
   67880  T                Revision of eyelid..         0233        11.78      $598.92      $287.48      $119.78
   67882  T                Revision of eyelid..         0240        14.86      $755.51      $315.31      $151.10
   67900  T                Repair brow defect..         0240        14.86      $755.51      $315.31      $151.10
   67901  T                Repair eyelid defect         0240        14.86      $755.51      $315.31      $151.10
   67902  T                Repair eyelid defect         0240        14.86      $755.51      $315.31      $151.10
   67903  T                Repair eyelid defect         0240        14.86      $755.51      $315.31      $151.10
   67904  T                Repair eyelid defect         0240        14.86      $755.51      $315.31      $151.10
   67906  T                Repair eyelid defect         0240        14.86      $755.51      $315.31      $151.10
   67908  T                Repair eyelid defect         0240        14.86      $755.51      $315.31      $151.10
   67909  T                Revise eyelid defect         0240        14.86      $755.51      $315.31      $151.10
   67911  T                Revise eyelid defect         0240        14.86      $755.51      $315.31      $151.10
   67914  T                Repair eyelid defect         0240        14.86      $755.51      $315.31      $151.10
   67915  T                Repair eyelid defect         0239         6.25      $317.76      $123.42       $63.55
   67916  T                Repair eyelid defect         0240        14.86      $755.51      $315.31      $151.10
   67917  T                Repair eyelid defect         0240        14.86      $755.51      $315.31      $151.10
   67921  T                Repair eyelid defect         0240        14.86      $755.51      $315.31      $151.10
   67922  T                Repair eyelid defect         0239         6.25      $317.76      $123.42       $63.55
   67923  T                Repair eyelid defect         0240        14.86      $755.51      $315.31      $151.10

[[Page 44798]]

 
   67924  T                Repair eyelid defect         0240        14.86      $755.51      $315.31      $151.10
   67930  T                Repair eyelid wound.         0240        14.86      $755.51      $315.31      $151.10
   67935  T                Repair eyelid wound.         0240        14.86      $755.51      $315.31      $151.10
   67938  T                Remove eyelid                0238         2.84      $144.39       $58.96       $28.88
                            foreign body.
   67950  T                Revision of eyelid..         0240        14.86      $755.51      $315.31      $151.10
   67961  T                Revision of eyelid..         0240        14.86      $755.51      $315.31      $151.10
   67966  T                Revision of eyelid..         0240        14.86      $755.51      $315.31      $151.10
   67971  T                Reconstruction of            0241        19.20      $976.17      $384.47      $195.23
                            eyelid.
   67973  T                Reconstruction of            0241        19.20      $976.17      $384.47      $195.23
                            eyelid.
   67974  T                Reconstruction of            0241        19.20      $976.17      $384.47      $195.23
                            eyelid.
   67975  T                Reconstruction of            0240        14.86      $755.51      $315.31      $151.10
                            eyelid.
   67999  T                Revision of eyelid..         0240        14.86      $755.51      $315.31      $151.10
   68020  T                Incise/drain eyelid          0240        14.86      $755.51      $315.31      $151.10
                            lining.
   68040  T                Treatment of eyelid          0238         2.84      $144.39       $58.96       $28.88
                            lesions.
   68100  T                Biopsy of eyelid             0233        11.78      $598.92      $287.48      $119.78
                            lining.
   68110  T                Remove eyelid lining         0699         6.91      $351.32      $158.09       $70.26
                            lesion.
   68115  T                Remove eyelid lining         0239         6.25      $317.76      $123.42       $63.55
                            lesion.
   68130  T                Remove eyelid lining         0233        11.78      $598.92      $287.48      $119.78
                            lesion.
   68135  T                Remove eyelid lining         0239         6.25      $317.76      $123.42       $63.55
                            lesion.
   68200  S                Treat eyelid by              0230         0.64       $32.54       $14.97        $6.51
                            injection.
   68320  T                Revise/graft eyelid          0240        14.86      $755.51      $315.31      $151.10
                            lining.
   68325  T                Revise/graft eyelid          0242        25.31    $1,286.81      $597.36      $257.36
                            lining.
   68326  T                Revise/graft eyelid          0241        19.20      $976.17      $384.47      $195.23
                            lining.
   68328  T                Revise/graft eyelid          0241        19.20      $976.17      $384.47      $195.23
                            lining.
   68330  T                Revise eyelid lining         0233        11.78      $598.92      $287.48      $119.78
   68335  T                Revise/graft eyelid          0241        19.20      $976.17      $384.47      $195.23
                            lining.
   68340  T                Separate eyelid              0240        14.86      $755.51      $315.31      $151.10
                            adhesions.
   68360  T                Revise eyelid lining         0234        20.56    $1,045.31      $502.16      $209.06
   68362  T                Revise eyelid lining         0234        20.56    $1,045.31      $502.16      $209.06
   68399  T                Eyelid lining                0239         6.25      $317.76      $123.42       $63.55
                            surgery.
   68400  T                Incise/drain tear            0238         2.84      $144.39       $58.96       $28.88
                            gland.
   68420  T                Incise/drain tear            0240        14.86      $755.51      $315.31      $151.10
                            sac.
   68440  T                Incise tear duct             0238         2.84      $144.39       $58.96       $28.88
                            opening.
   68500  T                Removal of tear              0241        19.20      $976.17      $384.47      $195.23
                            gland.
   68505  T                Partial removal,             0241        19.20      $976.17      $384.47      $195.23
                            tear gland.
   68510  T                Biopsy of tear gland         0240        14.86      $755.51      $315.31      $151.10
   68520  T                Removal of tear sac.         0241        19.20      $976.17      $384.47      $195.23
   68525  T                Biopsy of tear sac..         0240        14.86      $755.51      $315.31      $151.10
   68530  T                Clearance of tear            0240        14.86      $755.51      $315.31      $151.10
                            duct.
   68540  T                Remove tear gland            0241        19.20      $976.17      $384.47      $195.23
                            lesion.
   68550  T                Remove tear gland            0242        25.31    $1,286.81      $597.36      $257.36
                            lesion.
   68700  T                Repair tear ducts...         0241        19.20      $976.17      $384.47      $195.23
   68705  T                Revise tear duct             0238         2.84      $144.39       $58.96       $28.88
                            opening.
   68720  T                Create tear sac              0242        25.31    $1,286.81      $597.36      $257.36
                            drain.
   68745  T                Create tear duct             0241        19.20      $976.17      $384.47      $195.23
                            drain.
   68750  T                Create tear duct             0242        25.31    $1,286.81      $597.36      $257.36
                            drain.
   68760  T                Close tear duct              0238         2.84      $144.39       $58.96       $28.88
                            opening.
   68761  S                Close tear duct              0231         2.27      $115.41       $51.94       $23.08
                            opening.
   68770  T                Close tear system            0240        14.86      $755.51      $315.31      $151.10
                            fistula.
   68801  S                Dilate tear duct             0231         2.27      $115.41       $51.94       $23.08
                            opening.
   68810  T                Probe nasolacrimal           0699         6.91      $351.32      $158.09       $70.26
                            duct.
   68811  T                Probe nasolacrimal           0240        14.86      $755.51      $315.31      $151.10
                            duct.
   68815  T                Probe nasolacrimal           0240        14.86      $755.51      $315.31      $151.10
                            duct.
   68840  T                Explore/irrigate             0699         6.91      $351.32      $158.09       $70.26
                            tear ducts.
   68850  N                Injection for tear    ...........  ...........  ...........  ...........  ...........
                            sac x-ray.
   68899  T                Tear duct system             0699         6.91      $351.32      $158.09       $70.26
                            surgery.
   69000  T                Drain external ear           0006         2.36      $119.99       $33.95       $24.00
                            lesion.
   69005  T                Drain external ear           0007         7.28      $370.13       $74.03       $74.03
                            lesion.
   69020  T                Drain outer ear              0006         2.36      $119.99       $33.95       $24.00
                            canal lesion.
   69090  E                Pierce earlobes.....  ...........  ...........  ...........  ...........  ...........
   69100  T                Biopsy of external           0019         4.56      $231.84       $78.91       $46.37
                            ear.
   69105  T                Biopsy of external           0253        13.27      $674.67      $284.00      $134.93
                            ear canal.
   69110  T                Remove external ear,         0020         8.56      $435.21      $130.53       $87.04
                            partial.
   69120  T                Removal of external          0254        19.11      $971.59      $272.41      $194.32
                            ear.
   69140  T                Remove ear canal             0254        19.11      $971.59      $272.41      $194.32
                            lesion(s).
   69145  T                Remove ear canal             0020         8.56      $435.21      $130.53       $87.04
                            lesion(s).
   69150  C                Extensive ear canal   ...........  ...........  ...........  ...........  ...........
                            surgery.
   69155  C                Extensive ear/neck    ...........  ...........  ...........  ...........  ...........
                            surgery.
   69200  X                Clear outer ear              0340         0.91       $46.27       $11.57        $9.25
                            canal.
   69205  T                Clear outer ear              0022        15.07      $766.19      $292.94      $153.24
                            canal.
   69210  X                Remove impacted ear          0340         0.91       $46.27       $11.57        $9.25
                            wax.
   69220  T                Clean out mastoid            0012         0.72       $36.61        $9.18        $7.32
                            cavity.
   69222  T                Clean out mastoid            0253        13.27      $674.67      $284.00      $134.93
                            cavity.
   69300  T                Revise external ear.         0254        19.11      $971.59      $272.41      $194.32
   69310  T                Rebuild outer ear            0256        28.82    $1,465.27      $623.05      $293.05
                            canal.

[[Page 44799]]

 
   69320  T                Rebuild outer ear            0256        28.82    $1,465.27      $623.05      $293.05
                            canal.
   69399  T                Outer ear surgery            0251         2.71      $137.78       $27.99       $27.56
                            procedure.
   69400  T                Inflate middle ear           0251         2.71      $137.78       $27.99       $27.56
                            canal.
   69401  N                Inflate middle ear    ...........  ...........  ...........  ...........  ...........
                            canal.
   69405  T                Catheterize middle           0252         6.53      $332.00      $114.24       $66.40
                            ear canal.
   69410  T                Inset middle ear             0252         6.53      $332.00      $114.24       $66.40
                            (baffle).
   69420  T                Incision of eardrum.         0251         2.71      $137.78       $27.99       $27.56
   69421  T                Incision of eardrum.         0253        13.27      $674.67      $284.00      $134.93
   69424  T                Remove ventilating           0252         6.53      $332.00      $114.24       $66.40
                            tube.
   69433  T                Create eardrum               0252         6.53      $332.00      $114.24       $66.40
                            opening.
   69436  T                Create eardrum               0253        13.27      $674.67      $284.00      $134.93
                            opening.
   69440  T                Exploration of               0254        19.11      $971.59      $272.41      $194.32
                            middle ear.
   69450  T                Eardrum revision....         0256        28.82    $1,465.27      $623.05      $293.05
   69501  T                Mastoidectomy.......         0256        28.82    $1,465.27      $623.05      $293.05
   69502  C                Mastoidectomy.......  ...........  ...........  ...........  ...........  ...........
   69505  T                Remove mastoid               0256        28.82    $1,465.27      $623.05      $293.05
                            structures.
   69511  T                Extensive mastoid            0256        28.82    $1,465.27      $623.05      $293.05
                            surgery.
   69530  T                Extensive mastoid            0256        28.82    $1,465.27      $623.05      $293.05
                            surgery.
   69535  C                Remove part of        ...........  ...........  ...........  ...........  ...........
                            temporal bone.
   69540  T                Remove ear lesion...         0253        13.27      $674.67      $284.00      $134.93
   69550  T                Remove ear lesion...         0256        28.82    $1,465.27      $623.05      $293.05
   69552  T                Remove ear lesion...         0256        28.82    $1,465.27      $623.05      $293.05
   69554  C                Remove ear lesion...  ...........  ...........  ...........  ...........  ...........
   69601  T                Mastoid surgery              0256        28.82    $1,465.27      $623.05      $293.05
                            revision.
   69602  T                Mastoid surgery              0256        28.82    $1,465.27      $623.05      $293.05
                            revision.
   69603  T                Mastoid surgery              0256        28.82    $1,465.27      $623.05      $293.05
                            revision.
   69604  T                Mastoid surgery              0256        28.82    $1,465.27      $623.05      $293.05
                            revision.
   69605  T                Mastoid surgery              0256        28.82    $1,465.27      $623.05      $293.05
                            revision.
   69610  T                Repair of eardrum...         0254        19.11      $971.59      $272.41      $194.32
   69620  T                Repair of eardrum...         0254        19.11      $971.59      $272.41      $194.32
   69631  T                Repair eardrum               0256        28.82    $1,465.27      $623.05      $293.05
                            structures.
   69632  T                Rebuild eardrum              0256        28.82    $1,465.27      $623.05      $293.05
                            structures.
   69633  T                Rebuild eardrum              0256        28.82    $1,465.27      $623.05      $293.05
                            structures.
   69635  T                Repair eardrum               0256        28.82    $1,465.27      $623.05      $293.05
                            structures.
   69636  T                Rebuild eardrum              0256        28.82    $1,465.27      $623.05      $293.05
                            structures.
   69637  T                Rebuild eardrum              0256        28.82    $1,465.27      $623.05      $293.05
                            structures.
   69641  T                Revise middle ear &          0256        28.82    $1,465.27      $623.05      $293.05
                            mastoid.
   69642  T                Revise middle ear &          0256        28.82    $1,465.27      $623.05      $293.05
                            mastoid.
   69643  T                Revise middle ear &          0256        28.82    $1,465.27      $623.05      $293.05
                            mastoid.
   69644  T                Revise middle ear &          0256        28.82    $1,465.27      $623.05      $293.05
                            mastoid.
   69645  T                Revise middle ear &          0256        28.82    $1,465.27      $623.05      $293.05
                            mastoid.
   69646  T                Revise middle ear &          0256        28.82    $1,465.27      $623.05      $293.05
                            mastoid.
   69650  T                Release middle ear           0254        19.11      $971.59      $272.41      $194.32
                            bone.
   69660  T                Revise middle ear            0256        28.82    $1,465.27      $623.05      $293.05
                            bone.
   69661  T                Revise middle ear            0256        28.82    $1,465.27      $623.05      $293.05
                            bone.
   69662  T                Revise middle ear            0256        28.82    $1,465.27      $623.05      $293.05
                            bone.
   69666  T                Repair middle ear            0256        28.82    $1,465.27      $623.05      $293.05
                            structures.
   69667  T                Repair middle ear            0256        28.82    $1,465.27      $623.05      $293.05
                            structures.
   69670  T                Remove mastoid air           0256        28.82    $1,465.27      $623.05      $293.05
                            cells.
   69676  T                Remove middle ear            0256        28.82    $1,465.27      $623.05      $293.05
                            nerve.
   69700  T                Close mastoid                0256        28.82    $1,465.27      $623.05      $293.05
                            fistula.
   69710  E                Implant/replace       ...........  ...........  ...........  ...........  ...........
                            hearing aid.
   69711  T                Remove/repair                0256        28.82    $1,465.27      $623.05      $293.05
                            hearing aid.
   69714  T                Implant temple bone          0256        28.82    $1,465.27      $623.05      $293.05
                            w/stimul.
   69715  T                Temple bne implnt w/         0256        28.82    $1,465.27      $623.05      $293.05
                            stimulat.
   69717  T                Temple bone implant          0256        28.82    $1,465.27      $623.05      $293.05
                            revision.
   69718  T                Revise temple bone           0256        28.82    $1,465.27      $623.05      $293.05
                            implant.
   69720  T                Release facial nerve         0256        28.82    $1,465.27      $623.05      $293.05
   69725  T                Release facial nerve         0256        28.82    $1,465.27      $623.05      $293.05
   69740  T                Repair facial nerve.         0256        28.82    $1,465.27      $623.05      $293.05
   69745  T                Repair facial nerve.         0256        28.82    $1,465.27      $623.05      $293.05
   69799  T                Middle ear surgery           0253        13.27      $674.67      $284.00      $134.93
                            procedure.
   69801  T                Incise inner ear....         0256        28.82    $1,465.27      $623.05      $293.05
   69802  T                Incise inner ear....         0256        28.82    $1,465.27      $623.05      $293.05
   69805  T                Explore inner ear...         0256        28.82    $1,465.27      $623.05      $293.05
   69806  T                Explore inner ear...         0256        28.82    $1,465.27      $623.05      $293.05
   69820  T                Establish inner ear          0256        28.82    $1,465.27      $623.05      $293.05
                            window.
   69840  T                Revise inner ear             0256        28.82    $1,465.27      $623.05      $293.05
                            window.
   69905  T                Remove inner ear....         0256        28.82    $1,465.27      $623.05      $293.05
   69910  T                Remove inner ear &           0256        28.82    $1,465.27      $623.05      $293.05
                            mastoid.
   69915  T                Incise inner ear             0256        28.82    $1,465.27      $623.05      $293.05
                            nerve.
   69930  T                Implant cochlear             0259       306.15   $15,565.28    $6,537.42    $3,113.06
                            device.
   69949  T                Inner ear surgery            0253        13.27      $674.67      $284.00      $134.93
                            procedure.
   69950  C                Incise inner ear      ...........  ...........  ...........  ...........  ...........
                            nerve.
   69955  T                Release facial nerve         0256        28.82    $1,465.27      $623.05      $293.05

[[Page 44800]]

 
   69960  T                Release inner ear            0256        28.82    $1,465.27      $623.05      $293.05
                            canal.
   69970  C                Remove inner ear      ...........  ...........  ...........  ...........  ...........
                            lesion.
   69979  T                Temporal bone                0251         2.71      $137.78       $27.99       $27.56
                            surgery.
   69990  N                Microsurgery add-on.  ...........  ...........  ...........  ...........  ...........
   70010  S                Contrast x-ray of            0274         5.69      $289.29      $128.12       $57.86
                            brain.
   70015  S                Contrast x-ray of            0274         5.69      $289.29      $128.12       $57.86
                            brain.
   70030  X                X-ray eye for                0260         0.76       $38.64       $21.25        $7.73
                            foreign body.
   70100  X                X-ray exam of jaw...         0260         0.76       $38.64       $21.25        $7.73
   70110  X                X-ray exam of jaw...         0260         0.76       $38.64       $21.25        $7.73
   70120  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            mastoids.
   70130  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            mastoids.
   70134  X                X-ray exam of middle         0261         1.31       $66.60       $36.63       $13.32
                            ear.
   70140  X                X-ray exam of facial         0260         0.76       $38.64       $21.25        $7.73
                            bones.
   70150  X                X-ray exam of facial         0260         0.76       $38.64       $21.25        $7.73
                            bones.
   70160  X                X-ray exam of nasal          0260         0.76       $38.64       $21.25        $7.73
                            bones.
   70170  X                X-ray exam of tear           0263         1.74       $88.47       $45.88       $17.69
                            duct.
   70190  X                X-ray exam of eye            0260         0.76       $38.64       $21.25        $7.73
                            sockets.
   70200  X                X-ray exam of eye            0260         0.76       $38.64       $21.25        $7.73
                            sockets.
   70210  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            sinuses.
   70220  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            sinuses.
   70240  X                X-ray exam,                  0260         0.76       $38.64       $21.25        $7.73
                            pituitary saddle.
   70250  X                X-ray exam of skull.         0260         0.76       $38.64       $21.25        $7.73
   70260  X                X-ray exam of skull.         0261         1.31       $66.60       $36.63       $13.32
   70300  X                X-ray exam of teeth.         0262         0.66       $33.56       $10.90        $6.71
   70310  X                X-ray exam of teeth.         0262         0.66       $33.56       $10.90        $6.71
   70320  X                Full mouth x-ray of          0262         0.66       $33.56       $10.90        $6.71
                            teeth.
   70328  X                X-ray exam of jaw            0260         0.76       $38.64       $21.25        $7.73
                            joint.
   70330  X                X-ray exam of jaw            0260         0.76       $38.64       $21.25        $7.73
                            joints.
   70332  S                X-ray exam of jaw            0275         2.82      $143.37       $72.26       $28.67
                            joint.
   70336  S                Magnetic image, jaw          0335         5.91      $300.48      $165.26       $60.10
                            joint.
   70350  X                X-ray head for               0260         0.76       $38.64       $21.25        $7.73
                            orthodontia.
   70355  X                Panoramic x-ray of           0260         0.76       $38.64       $21.25        $7.73
                            jaws.
   70360  X                X-ray exam of neck..         0260         0.76       $38.64       $21.25        $7.73
   70370  X                Throat x-ray &               0272         1.47       $74.74       $39.00       $14.95
                            fluoroscopy.
   70371  X                Speech evaluation,           0272         1.47       $74.74       $39.00       $14.95
                            complex.
   70373  X                Contrast x-ray of            0263         1.74       $88.47       $45.88       $17.69
                            larynx.
   70380  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            salivary gland.
   70390  X                X-ray exam of                0263         1.74       $88.47       $45.88       $17.69
                            salivary duct.
   70450  S                Ct head/brain w/o            0332         3.51      $178.46       $98.15       $35.69
                            dye.
   70460  S                Ct head/brain w/dye.         0283         4.89      $248.62      $136.74       $49.72
   70470  S                Ct head/brain w/o&w          0333         5.66      $287.77      $158.27       $57.55
                            dye.
   70480  S                Ct orbit/ear/fossa w/        0332         3.51      $178.46       $98.15       $35.69
                            o dye.
   70481  S                Ct orbit/ear/fossa w/        0283         4.89      $248.62      $136.74       $49.72
                            dye.
   70482  S                Ct orbit/ear/fossa w/        0333         5.66      $287.77      $158.27       $57.55
                            o&w dye.
   70486  S                Ct maxillofacial w/o         0332         3.51      $178.46       $98.15       $35.69
                            dye.
   70487  S                Ct maxillofacial w/          0283         4.89      $248.62      $136.74       $49.72
                            dye.
   70488  S                Ct maxillofacial w/          0333         5.66      $287.77      $158.27       $57.55
                            o&w dye.
   70490  S                Ct soft tissue neck          0332         3.51      $178.46       $98.15       $35.69
                            w/o dye.
   70491  S                Ct soft tissue neck          0283         4.89      $248.62      $136.74       $49.72
                            w/dye.
   70492  S                Ct sft tsue nck w/o          0333         5.66      $287.77      $158.27       $57.55
                            & w/dye.
   70496  S                Ct angiography, head         0333         5.66      $287.77      $158.27       $57.55
   70498  S                Ct angiography, neck         0333         5.66      $287.77      $158.27       $57.55
   70540  S                Mri orbit/face/neck          0336         6.85      $348.27      $191.55       $69.65
                            w/o dye.
   70542  S                Mri orbit/face/neck          0284         7.80      $396.57      $218.11       $79.31
                            w/dye.
   70543  S                Mri orbt/fac/nck w/          0337         9.26      $470.80      $258.94       $94.16
                            o&w dye.
   70544  S                Mr angiography head          0336         6.85      $348.27      $191.55       $69.65
                            w/o dye.
   70545  S                Mr angiography head          0284         7.80      $396.57      $218.11       $79.31
                            w/dye.
   70546  S                Mr angiograph head w/        0337         9.26      $470.80      $258.94       $94.16
                            o&w dye.
   70547  S                Mr angiography neck          0336         6.85      $348.27      $191.55       $69.65
                            w/o dye.
   70548  S                Mr angiography neck          0284         7.80      $396.57      $218.11       $79.31
                            w/dye.
   70549  S                Mr angiograph neck w/        0337         9.26      $470.80      $258.94       $94.16
                            o&w dye.
   70551  S                Mri brain w/o dye...         0336         6.85      $348.27      $191.55       $69.65
   70552  S                Mri brain w/dye.....         0284         7.80      $396.57      $218.11       $79.31
   70553  S                Mri brain w/o&w dye.         0337         9.26      $470.80      $258.94       $94.16
   71010  X                Chest x-ray.........         0260         0.76       $38.64       $21.25        $7.73
   71015  X                Chest x-ray.........         0260         0.76       $38.64       $21.25        $7.73
   71020  X                Chest x-ray.........         0260         0.76       $38.64       $21.25        $7.73
   71021  X                Chest x-ray.........         0260         0.76       $38.64       $21.25        $7.73
   71022  X                Chest x-ray.........         0260         0.76       $38.64       $21.25        $7.73
   71023  X                Chest x-ray and              0272         1.47       $74.74       $39.00       $14.95
                            fluoroscopy.
   71030  X                Chest x-ray.........         0260         0.76       $38.64       $21.25        $7.73
   71034  X                Chest x-ray and              0272         1.47       $74.74       $39.00       $14.95
                            fluoroscopy.
   71035  X                Chest x-ray.........         0260         0.76       $38.64       $21.25        $7.73
   71040  X                Contrast x-ray of            0263         1.74       $88.47       $45.88       $17.69
                            bronchi.
   71060  X                Contrast x-ray of            0263         1.74       $88.47       $45.88       $17.69
                            bronchi.

[[Page 44801]]

 
   71090  X                X-ray & pacemaker            0272         1.47       $74.74       $39.00       $14.95
                            insertion.
   71100  X                X-ray exam of ribs..         0260         0.76       $38.64       $21.25        $7.73
   71101  X                X-ray exam of ribs/          0260         0.76       $38.64       $21.25        $7.73
                            chest.
   71110  X                X-ray exam of ribs..         0260         0.76       $38.64       $21.25        $7.73
   71111  X                X-ray exam of ribs/          0261         1.31       $66.60       $36.63       $13.32
                            chest.
   71120  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            breastbone.
   71130  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            breastbone.
   71250  S                Ct thorax w/o dye...         0332         3.51      $178.46       $98.15       $35.69
   71260  S                Ct thorax w/dye.....         0283         4.89      $248.62      $136.74       $49.72
   71270  S                Ct thorax w/o&w dye.         0333         5.66      $287.77      $158.27       $57.55
   71275  S                Ct angiography,              0333         5.66      $287.77      $158.27       $57.55
                            chest.
   71550  S                Mri chest w/o dye...         0336         6.85      $348.27      $191.55       $69.65
   71551  S                Mri chest w/dye.....         0284         7.80      $396.57      $218.11       $79.31
   71552  S                Mri chest w/o&w dye.         0337         9.26      $470.80      $258.94       $94.16
   71555  E                Mri angio chest w or  ...........  ...........  ...........  ...........  ...........
                            w/o dye.
   72010  X                X-ray exam of spine.         0261         1.31       $66.60       $36.63       $13.32
   72020  X                X-ray exam of spine.         0260         0.76       $38.64       $21.25        $7.73
   72040  X                X-ray exam of neck           0260         0.76       $38.64       $21.25        $7.73
                            spine.
   72050  X                X-ray exam of neck           0261         1.31       $66.60       $36.63       $13.32
                            spine.
   72052  X                X-ray exam of neck           0261         1.31       $66.60       $36.63       $13.32
                            spine.
   72069  X                X-ray exam of trunk          0260         0.76       $38.64       $21.25        $7.73
                            spine.
   72070  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            thoracic spine.
   72072  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            thoracic spine.
   72074  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            thoracic spine.
   72080  X                X-ray exam of trunk          0260         0.76       $38.64       $21.25        $7.73
                            spine.
   72090  X                X-ray exam of trunk          0261         1.31       $66.60       $36.63       $13.32
                            spine.
   72100  X                X-ray exam of lower          0260         0.76       $38.64       $21.25        $7.73
                            spine.
   72110  X                X-ray exam of lower          0261         1.31       $66.60       $36.63       $13.32
                            spine.
   72114  X                X-ray exam of lower          0261         1.31       $66.60       $36.63       $13.32
                            spine.
   72120  X                X-ray exam of lower          0260         0.76       $38.64       $21.25        $7.73
                            spine.
   72125  S                Ct neck spine w/o            0332         3.51      $178.46       $98.15       $35.69
                            dye.
   72126  S                Ct neck spine w/dye.         0283         4.89      $248.62      $136.74       $49.72
   72127  S                Ct neck spine w/o&w          0333         5.66      $287.77      $158.27       $57.55
                            dye.
   72128  S                Ct chest spine w/o           0332         3.51      $178.46       $98.15       $35.69
                            dye.
   72129  S                Ct chest spine w/dye         0283         4.89      $248.62      $136.74       $49.72
   72130  S                Ct chest spine w/o&w         0333         5.66      $287.77      $158.27       $57.55
                            dye.
   72131  S                Ct lumbar spine w/o          0332         3.51      $178.46       $98.15       $35.69
                            dye.
   72132  S                Ct lumbar spine w/           0283         4.89      $248.62      $136.74       $49.72
                            dye.
   72133  S                Ct lumbar spine w/           0333         5.66      $287.77      $158.27       $57.55
                            o&w dye.
   72141  S                Mri neck spine w/o           0336         6.85      $348.27      $191.55       $69.65
                            dye.
   72142  S                Mri neck spine w/dye         0284         7.80      $396.57      $218.11       $79.31
   72146  S                Mri chest spine w/o          0336         6.85      $348.27      $191.55       $69.65
                            dye.
   72147  S                Mri chest spine w/           0284         7.80      $396.57      $218.11       $79.31
                            dye.
   72148  S                Mri lumbar spine w/o         0336         6.85      $348.27      $191.55       $69.65
                            dye.
   72149  S                Mri lumbar spine w/          0284         7.80      $396.57      $218.11       $79.31
                            dye.
   72156  S                Mri neck spine w/o&w         0337         9.26      $470.80      $258.94       $94.16
                            dye.
   72157  S                Mri chest spine w/           0337         9.26      $470.80      $258.94       $94.16
                            o&w dye.
   72158  S                Mri lumbar spine w/          0337         9.26      $470.80      $258.94       $94.16
                            o&w dye.
   72159  E                Mr angio spine w/o&w  ...........  ...........  ...........  ...........  ...........
                            dye.
   72170  X                X-ray exam of pelvis         0260         0.76       $38.64       $21.25        $7.73
   72190  X                X-ray exam of pelvis         0260         0.76       $38.64       $21.25        $7.73
   72191  S                Ct angiograph pelv w/        0333         5.66      $287.77      $158.27       $57.55
                            o&w dye.
   72192  S                Ct pelvis w/o dye...         0332         3.51      $178.46       $98.15       $35.69
   72193  S                Ct pelvis w/dye.....         0283         4.89      $248.62      $136.74       $49.72
   72194  S                Ct pelvis w/o&w dye.         0333         5.66      $287.77      $158.27       $57.55
   72195  S                Mri pelvis w/o dye..         0336         6.85      $348.27      $191.55       $69.65
   72196  S                Mri pelvis w/dye....         0284         7.80      $396.57      $218.11       $79.31
   72197  S                Mri pelvis w/o & w           0337         9.26      $470.80      $258.94       $94.16
                            dye.
   72198  E                Mr angio pelvis w/    ...........  ...........  ...........  ...........  ...........
                            o&w dye.
   72200  X                X-ray exam                   0260         0.76       $38.64       $21.25        $7.73
                            sacroiliac joints.
   72202  X                X-ray exam                   0260         0.76       $38.64       $21.25        $7.73
                            sacroiliac joints.
   72220  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            tailbone.
   72240  S                Contrast x-ray of            0274         5.69      $289.29      $128.12       $57.86
                            neck spine.
   72255  S                Contrast x-ray,              0274         5.69      $289.29      $128.12       $57.86
                            thorax spine.
   72265  S                Contrast x-ray,              0274         5.69      $289.29      $128.12       $57.86
                            lower spine.
   72270  S                Contrast x-ray of            0274         5.69      $289.29      $128.12       $57.86
                            spine.
   72275  S                Epidurography.......         0274         5.69      $289.29      $128.12       $57.86
   72285  S                X-ray c/t spine disk         0274         5.69      $289.29      $128.12       $57.86
   72295  S                X-ray of lower spine         0274         5.69      $289.29      $128.12       $57.86
                            disk.
   73000  X                X-ray exam of collar         0260         0.76       $38.64       $21.25        $7.73
                            bone.
   73010  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            shoulder blade.
   73020  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            shoulder.
   73030  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            shoulder.
   73040  S                Contrast x-ray of            0275         2.82      $143.37       $72.26       $28.67
                            shoulder.
   73050  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            shoulders.

[[Page 44802]]

 
   73060  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            humerus.
   73070  X                X-ray exam of elbow.         0260         0.76       $38.64       $21.25        $7.73
   73080  X                X-ray exam of elbow.         0260         0.76       $38.64       $21.25        $7.73
   73085  S                Contrast x-ray of            0275         2.82      $143.37       $72.26       $28.67
                            elbow.
   73090  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            forearm.
   73092  X                X-ray exam of arm,           0260         0.76       $38.64       $21.25        $7.73
                            infant.
   73100  X                X-ray exam of wrist.         0260         0.76       $38.64       $21.25        $7.73
   73110  X                X-ray exam of wrist.         0260         0.76       $38.64       $21.25        $7.73
   73115  S                Contrast x-ray of            0275         2.82      $143.37       $72.26       $28.67
                            wrist.
   73120  X                X-ray exam of hand..         0260         0.76       $38.64       $21.25        $7.73
   73130  X                X-ray exam of hand..         0260         0.76       $38.64       $21.25        $7.73
   73140  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            finger(s).
   73200  S                Ct upper extremity w/        0332         3.51      $178.46       $98.15       $35.69
                            o dye.
   73201  S                Ct upper extremity w/        0283         4.89      $248.62      $136.74       $49.72
                            dye.
   73202  S                Ct uppr extremity w/         0333         5.66      $287.77      $158.27       $57.55
                            o&w dye.
   73206  S                Ct angio upr extrm w/        0333         5.66      $287.77      $158.27       $57.55
                            o&w dye.
   73218  S                Mri upper extremity          0336         6.85      $348.27      $191.55       $69.65
                            w/o dye.
   73219  S                Mri upper extremity          0284         7.80      $396.57      $218.11       $79.31
                            w/dye.
   73220  S                Mri uppr extremity w/        0337         9.26      $470.80      $258.94       $94.16
                            o&w dye.
   73221  S                Mri joint upr extrem         0336         6.85      $348.27      $191.55       $69.65
                            w/o dye.
   73222  S                Mri joint upr extrem         0284         7.80      $396.57      $218.11       $79.31
                            w/ dye.
   73223  S                Mri joint upr extr w/        0337         9.26      $470.80      $258.94       $94.16
                            o&w dye.
   73225  E                Mr angio upr extr w/  ...........  ...........  ...........  ...........  ...........
                            o&w dye.
   73500  X                X-ray exam of hip...         0260         0.76       $38.64       $21.25        $7.73
   73510  X                X-ray exam of hip...         0260         0.76       $38.64       $21.25        $7.73
   73520  X                X-ray exam of hips..         0260         0.76       $38.64       $21.25        $7.73
   73525  S                Contrast x-ray of            0275         2.82      $143.37       $72.26       $28.67
                            hip.
   73530  X                X-ray exam of hip...         0261         1.31       $66.60       $36.63       $13.32
   73540  X                X-ray exam of pelvis         0260         0.76       $38.64       $21.25        $7.73
                            & hips.
   73542  S                X-ray exam,                  0275         2.82      $143.37       $72.26       $28.67
                            sacroiliac joint.
   73550  X                X-ray exam of thigh.         0260         0.76       $38.64       $21.25        $7.73
   73560  X                X-ray exam of knee,          0260         0.76       $38.64       $21.25        $7.73
                            1 or 2.
   73562  X                X-ray exam of knee,          0260         0.76       $38.64       $21.25        $7.73
                            3.
   73564  X                X-ray exam, knee, 4          0260         0.76       $38.64       $21.25        $7.73
                            or more.
   73565  X                X-ray exam of knees.         0260         0.76       $38.64       $21.25        $7.73
   73580  S                Contrast x-ray of            0275         2.82      $143.37       $72.26       $28.67
                            knee joint.
   73590  X                X-ray exam of lower          0260         0.76       $38.64       $21.25        $7.73
                            leg.
   73592  X                X-ray exam of leg,           0261         1.31       $66.60       $36.63       $13.32
                            infant.
   73600  X                X-ray exam of ankle.         0260         0.76       $38.64       $21.25        $7.73
   73610  X                X-ray exam of ankle.         0260         0.76       $38.64       $21.25        $7.73
   73615  S                Contrast x-ray of            0275         2.82      $143.37       $72.26       $28.67
                            ankle.
   73620  X                X-ray exam of foot..         0260         0.76       $38.64       $21.25        $7.73
   73630  X                X-ray exam of foot..         0260         0.76       $38.64       $21.25        $7.73
   73650  X                X-ray exam of heel..         0260         0.76       $38.64       $21.25        $7.73
   73660  X                X-ray exam of toe(s)         0260         0.76       $38.64       $21.25        $7.73
   73700  S                Ct lower extremity w/        0332         3.51      $178.46       $98.15       $35.69
                            o dye.
   73701  S                Ct lower extremity w/        0283         4.89      $248.62      $136.74       $49.72
                            dye.
   73702  S                Ct lwr extremity w/          0333         5.66      $287.77      $158.27       $57.55
                            o&w dye.
   73706  S                Ct angio lwr extr w/         0333         5.66      $287.77      $158.27       $57.55
                            o&w dye.
   73718  S                Mri lower extremity          0336         6.85      $348.27      $191.55       $69.65
                            w/o dye.
   73719  S                Mri lower extremity          0284         7.80      $396.57      $218.11       $79.31
                            w/dye.
   73720  S                Mri lwr extremity w/         0337         9.26      $470.80      $258.94       $94.16
                            o&w dye.
   73721  S                Mri joint of lwr             0336         6.85      $348.27      $191.55       $69.65
                            extre w/o d.
   73722  S                Mri joint of lwr             0284         7.80      $396.57      $218.11       $79.31
                            extr w/dye.
   73723  S                Mri joint lwr extr w/        0337         9.26      $470.80      $258.94       $94.16
                            o&w dye.
   73725  E                Mr ang lwr ext w or   ...........  ...........  ...........  ...........  ...........
                            w/o dye.
   74000  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            abdomen.
   74010  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            abdomen.
   74020  X                X-ray exam of                0260         0.76       $38.64       $21.25        $7.73
                            abdomen.
   74022  X                X-ray exam series,           0261         1.31       $66.60       $36.63       $13.32
                            abdomen.
   74150  S                Ct abdomen w/o dye..         0332         3.51      $178.46       $98.15       $35.69
   74160  S                Ct abdomen w/dye....         0283         4.89      $248.62      $136.74       $49.72
   74170  S                Ct abdomen w/o&w dye         0333         5.66      $287.77      $158.27       $57.55
   74175  S                Ct angio abdom w/o&w         0333         5.66      $287.77      $158.27       $57.55
                            dye.
   74181  S                Mri abdomen w/o dye.         0336         6.85      $348.27      $191.55       $69.65
   74182  S                Mri abdomen w/dye...         0284         7.80      $396.57      $218.11       $79.31
   74183  S                Mri abdomen w/o&w            0337         9.26      $470.80      $258.94       $94.16
                            dye.
   74185  E                Mri angio, abdom w    ...........  ...........  ...........  ...........  ...........
                            or w/o dy.
   74190  X                X-ray exam of                0263         1.74       $88.47       $45.88       $17.69
                            peritoneum.
   74210  S                Contrst x-ray exam           0276         1.63       $82.87       $45.58       $16.57
                            of throat.
   74220  S                Contrast x-ray,              0276         1.63       $82.87       $45.58       $16.57
                            esophagus.
   74230  S                Cinema x-ray, throat/        0276         1.63       $82.87       $45.58       $16.57
                            esoph.
   74235  S                Remove esophagus             0296         3.52      $178.96       $98.43       $35.79
                            obstruction.
   74240  S                X-ray exam, upper gi         0276         1.63       $82.87       $45.58       $16.57
                            tract.
   74241  S                X-ray exam, upper gi         0276         1.63       $82.87       $45.58       $16.57
                            tract.

[[Page 44803]]

 
   74245  S                X-ray exam, upper gi         0277         2.35      $119.48       $65.71       $23.90
                            tract.
   74246  S                Contrst x-ray uppr           0276         1.63       $82.87       $45.58       $16.57
                            gi tract.
   74247  S                Contrst x-ray uppr           0276         1.63       $82.87       $45.58       $16.57
                            gi tract.
   74249  S                Contrst x-ray uppr           0277         2.35      $119.48       $65.71       $23.90
                            gi tract.
   74250  S                X-ray exam of small          0276         1.63       $82.87       $45.58       $16.57
                            bowel.
   74251  S                X-ray exam of small          0277         2.35      $119.48       $65.71       $23.90
                            bowel.
   74260  S                X-ray exam of small          0277         2.35      $119.48       $65.71       $23.90
                            bowel.
   74270  S                Contrast x-ray exam          0276         1.63       $82.87       $45.58       $16.57
                            of colon.
   74280  S                Contrast x-ray exam          0277         2.35      $119.48       $65.71       $23.90
                            of colon.
   74283  S                Contrast x-ray exam          0276         1.63       $82.87       $45.58       $16.57
                            of colon.
   74290  S                Contrast x-ray,              0276         1.63       $82.87       $45.58       $16.57
                            gallbladder.
   74291  S                Contrast x-rays,             0276         1.63       $82.87       $45.58       $16.57
                            gallbladder.
   74300  X                X-ray bile ducts/            0263         1.74       $88.47       $45.88       $17.69
                            pancreas.
   74301  X                X-rays at surgery            0263         1.74       $88.47       $45.88       $17.69
                            add-on.
   74305  X                X-ray bile ducts/            0263         1.74       $88.47       $45.88       $17.69
                            pancreas.
   74320  X                Contrast x-ray of            0264         2.51      $127.61       $70.19       $25.52
                            bile ducts.
   74327  S                X-ray bile stone             0296         3.52      $178.96       $98.43       $35.79
                            removal.
   74328  N                Xray bile duct        ...........  ...........  ...........  ...........  ...........
                            endoscopy.
   74329  N                X-ray for pancreas    ...........  ...........  ...........  ...........  ...........
                            endoscopy.
   74330  N                X-ray bile/panc       ...........  ...........  ...........  ...........  ...........
                            endoscopy.
   74340  X                X-ray guide for GI           0272         1.47       $74.74       $39.00       $14.95
                            tube.
   74350  T                X-ray guide, stomach         0187         4.54      $230.82      $113.10       $46.16
                            tube.
   74355  T                X-ray guide,                 0187         4.54      $230.82      $113.10       $46.16
                            intestinal tube.
   74360  S                X-ray guide, GI              0296         3.52      $178.96       $98.43       $35.79
                            dilation.
   74363  S                X-ray, bile duct             0297         7.80      $396.57      $172.51       $79.31
                            dilation.
   74400  S                Contrst x-ray,               0278         2.56      $130.16       $71.59       $26.03
                            urinary tract.
   74410  S                Contrst x-ray,               0278         2.56      $130.16       $71.59       $26.03
                            urinary tract.
   74415  S                Contrst x-ray,               0278         2.56      $130.16       $71.59       $26.03
                            urinary tract.
   74420  S                Contrst x-ray,               0278         2.56      $130.16       $71.59       $26.03
                            urinary tract.
   74425  S                Contrst x-ray,               0278         2.56      $130.16       $71.59       $26.03
                            urinary tract.
   74430  S                Contrast x-ray,              0278         2.56      $130.16       $71.59       $26.03
                            bladder.
   74440  S                X-ray, male genital          0278         2.56      $130.16       $71.59       $26.03
                            tract.
   74445  S                X-ray exam of penis.         0278         2.56      $130.16       $71.59       $26.03
   74450  S                X-ray, urethra/              0278         2.56      $130.16       $71.59       $26.03
                            bladder.
   74455  S                X-ray, urethra/              0278         2.56      $130.16       $71.59       $26.03
                            bladder.
   74470  X                X-ray exam of kidney         0264         2.51      $127.61       $70.19       $25.52
                            lesion.
   74475  S                X-ray control, cath          0297         7.80      $396.57      $172.51       $79.31
                            insert.
   74480  S                X-ray control, cath          0297         7.80      $396.57      $172.51       $79.31
                            insert.
   74485  S                X-ray guide, GU              0296         3.52      $178.96       $98.43       $35.79
                            dilation.
   74710  X                X-ray measurement of         0260         0.76       $38.64       $21.25        $7.73
                            pelvis.
   74740  X                X-ray, female                0264         2.51      $127.61       $70.19       $25.52
                            genital tract.
   74742  T                X-ray, fallopian             0187         4.54      $230.82      $113.10       $46.16
                            tube.
   74775  S                X-ray exam of                0278         2.56      $130.16       $71.59       $26.03
                            perineum.
   75552  S                Heart mri for morph          0336         6.85      $348.27      $191.55       $69.65
                            w/o dye.
   75553  S                Heart mri for morph          0284         7.80      $396.57      $218.11       $79.31
                            w/dye.
   75554  S                Cardiac MRI/function         0335         5.91      $300.48      $165.26       $60.10
   75555  S                Cardiac MRI/limited          0335         5.91      $300.48      $165.26       $60.10
                            study.
   75556  E                Cardiac MRI/flow      ...........  ...........  ...........  ...........  ...........
                            mapping.
   75600  S                Contrast x-ray exam          0280        14.40      $732.12      $373.38      $146.42
                            of aorta.
   75605  S                Contrast x-ray exam          0280        14.40      $732.12      $373.38      $146.42
                            of aorta.
   75625  S                Contrast x-ray exam          0280        14.40      $732.12      $373.38      $146.42
                            of aorta.
   75630  S                X-ray aorta, leg             0280        14.40      $732.12      $373.38      $146.42
                            arteries.
   75635  S                Ct angio abdominal           0333         5.66      $287.77      $158.27       $57.55
                            arteries.
   75650  S                Artery x-rays, head          0280        14.40      $732.12      $373.38      $146.42
                            & neck.
   75658  S                Artery x-rays, arm..         0280        14.40      $732.12      $373.38      $146.42
   75660  S                Artery x-rays, head          0279         8.37      $425.55      $174.57       $85.11
                            & neck.
   75662  S                Artery x-rays, head          0279         8.37      $425.55      $174.57       $85.11
                            & neck.
   75665  S                Artery x-rays, head          0280        14.40      $732.12      $373.38      $146.42
                            & neck.
   75671  S                Artery x-rays, head          0280        14.40      $732.12      $373.38      $146.42
                            & neck.
   75676  S                Artery x-rays, neck.         0280        14.40      $732.12      $373.38      $146.42
   75680  S                Artery x-rays, neck.         0280        14.40      $732.12      $373.38      $146.42
   75685  S                Artery x-rays, spine         0279         8.37      $425.55      $174.57       $85.11
   75705  S                Artery x-rays, spine         0279         8.37      $425.55      $174.57       $85.11
   75710  S                Artery x-rays, arm/          0280        14.40      $732.12      $373.38      $146.42
                            leg.
   75716  S                Artery x-rays, arms/         0280        14.40      $732.12      $373.38      $146.42
                            legs.
   75722  S                Artery x-rays,               0280        14.40      $732.12      $373.38      $146.42
                            kidney.
   75724  S                Artery x-rays,               0280        14.40      $732.12      $373.38      $146.42
                            kidneys.
   75726  S                Artery x-rays,               0280        14.40      $732.12      $373.38      $146.42
                            abdomen.
   75731  S                Artery x-rays,               0280        14.40      $732.12      $373.38      $146.42
                            adrenal gland.
   75733  S                Artery x-rays,               0280        14.40      $732.12      $373.38      $146.42
                            adrenals.
   75736  S                Artery x-rays,               0280        14.40      $732.12      $373.38      $146.42
                            pelvis.
   75741  S                Artery x-rays, lung.         0279         8.37      $425.55      $174.57       $85.11
   75743  S                Artery x-rays, lungs         0280        14.40      $732.12      $373.38      $146.42
   75746  S                Artery x-rays, lung.         0279         8.37      $425.55      $174.57       $85.11
   75756  S                Artery x-rays, chest         0279         8.37      $425.55      $174.57       $85.11

[[Page 44804]]

 
   75774  S                Artery x-ray, each           0279         8.37      $425.55      $174.57       $85.11
                            vessel.
   75790  S                Visualize A-V shunt.         0281         4.64      $235.91      $115.16       $47.18
   75801  X                Lymph vessel x-ray,          0264         2.51      $127.61       $70.19       $25.52
                            arm/leg.
   75803  X                Lymph vessel x-              0264         2.51      $127.61       $70.19       $25.52
                            ray,arms/legs.
   75805  X                Lymph vessel x-ray,          0264         2.51      $127.61       $70.19       $25.52
                            trunk.
   75807  X                Lymph vessel x-ray,          0264         2.51      $127.61       $70.19       $25.52
                            trunk.
   75809  X                Nonvascular shunt, x-        0263         1.74       $88.47       $45.88       $17.69
                            ray.
   75810  S                Vein x-ray, spleen/          0279         8.37      $425.55      $174.57       $85.11
                            liver.
   75820  S                Vein x-ray, arm/leg.         0281         4.64      $235.91      $115.16       $47.18
   75822  S                Vein x-ray, arms/            0281         4.64      $235.91      $115.16       $47.18
                            legs.
   75825  S                Vein x-ray, trunk...         0279         8.37      $425.55      $174.57       $85.11
   75827  S                Vein x-ray, chest...         0279         8.37      $425.55      $174.57       $85.11
   75831  S                Vein x-ray, kidney..         0287         4.33      $220.15       $90.26       $44.03
   75833  S                Vein x-ray, kidneys.         0279         8.37      $425.55      $174.57       $85.11
   75840  S                Vein x-ray, adrenal          0287         4.33      $220.15       $90.26       $44.03
                            gland.
   75842  S                Vein x-ray, adrenal          0287         4.33      $220.15       $90.26       $44.03
                            glands.
   75860  S                Vein x-ray, neck....         0287         4.33      $220.15       $90.26       $44.03
   75870  S                Vein x-ray, skull...         0287         4.33      $220.15       $90.26       $44.03
   75872  S                Vein x-ray, skull...         0287         4.33      $220.15       $90.26       $44.03
   75880  S                Vein x-ray, eye              0287         4.33      $220.15       $90.26       $44.03
                            socket.
   75885  S                Vein x-ray, liver...         0279         8.37      $425.55      $174.57       $85.11
   75887  S                Vein x-ray, liver...         0280        14.40      $732.12      $373.38      $146.42
   75889  S                Vein x-ray, liver...         0279         8.37      $425.55      $174.57       $85.11
   75891  S                Vein x-ray, liver...         0279         8.37      $425.55      $174.57       $85.11
   75893  N                Venous sampling by    ...........  ...........  ...........  ...........  ...........
                            catheter.
   75894  S                X-rays, transcath            0297         7.80      $396.57      $172.51       $79.31
                            therapy.
   75896  S                X-rays, transcath            0297         7.80      $396.57      $172.51       $79.31
                            therapy.
   75898  X                Follow-up angiogram.         0264         2.51      $127.61       $70.19       $25.52
   75900  C                Arterial catheter     ...........  ...........  ...........  ...........  ...........
                            exchange.
   75940  T                X-ray placement,             0187         4.54      $230.82      $113.10       $46.16
                            vein filter.
   75945  S                Intravascular us....         0267         2.58      $131.17       $72.14       $26.23
   75946  S                Intravascular us add-        0267         2.58      $131.17       $72.14       $26.23
                            on.
   75952  C                Endovasc repair       ...........  ...........  ...........  ...........  ...........
                            abdom aorta.
   75953  C                Abdom aneurysm        ...........  ...........  ...........  ...........  ...........
                            endovas rpr.
   75960  S                Transcatheter intro,         0280        14.40      $732.12      $373.38      $146.42
                            stent.
   75961  S                Retrieval, broken            0280        14.40      $732.12      $373.38      $146.42
                            catheter.
   75962  S                Repair arterial              0280        14.40      $732.12      $373.38      $146.42
                            blockage.
   75964  S                Repair artery                0280        14.40      $732.12      $373.38      $146.42
                            blockage, each.
   75966  S                Repair arterial              0280        14.40      $732.12      $373.38      $146.42
                            blockage.
   75968  S                Repair artery                0280        14.40      $732.12      $373.38      $146.42
                            blockage, each.
   75970  S                Vascular biopsy.....         0280        14.40      $732.12      $373.38      $146.42
   75978  S                Repair venous                0280        14.40      $732.12      $373.38      $146.42
                            blockage.
   75980  S                Contrast xray exam           0297         7.80      $396.57      $172.51       $79.31
                            bile duct.
   75982  S                Contrast xray exam           0297         7.80      $396.57      $172.51       $79.31
                            bile duct.
   75984  S                Xray control                 0296         3.52      $178.96       $98.43       $35.79
                            catheter change.
   75989  N                Abscess drainage      ...........  ...........  ...........  ...........  ...........
                            under x-ray.
   75992  S                Atherectomy, x-ray           0280        14.40      $732.12      $373.38      $146.42
                            exam.
   75993  T                Atherectomy, x-ray           0081        22.04    $1,120.56      $549.07      $224.11
                            exam.
   75994  T                Atherectomy, x-ray           0081        22.04    $1,120.56      $549.07      $224.11
                            exam.
   75995  S                Atherectomy, x-ray           0280        14.40      $732.12      $373.38      $146.42
                            exam.
   75996  T                Atherectomy, x-ray           0081        22.04    $1,120.56      $549.07      $224.11
                            exam.
   76000  X                Fluoroscope                  0272         1.47       $74.74       $39.00       $14.95
                            examination.
   76001  N                Fluoroscope exam,     ...........  ...........  ...........  ...........  ...........
                            extensive.
   76003  N                Needle localization   ...........  ...........  ...........  ...........  ...........
                            by x-ray.
   76005  N                Fluoroguide for       ...........  ...........  ...........  ...........  ...........
                            spine inject.
   76006  X                X-ray stress view...         0261         1.31       $66.60       $36.63       $13.32
   76010  X                X-ray, nose to               0260         0.76       $38.64       $21.25        $7.73
                            rectum.
   76012  S                Percut                       0274         5.69      $289.29      $128.12       $57.86
                            vertebroplasty
                            fluor.
   76013  S                Percut                       0274         5.69      $289.29      $128.12       $57.86
                            vertebroplasty, ct.
   76020  X                X-rays for bone age.         0261         1.31       $66.60       $36.63       $13.32
   76040  X                X-rays, bone                 0260         0.76       $38.64       $21.25        $7.73
                            evaluation.
   76061  X                X-rays, bone survey.         0261         1.31       $66.60       $36.63       $13.32
   76062  X                X-rays, bone survey.         0261         1.31       $66.60       $36.63       $13.32
   76065  X                X-rays, bone                 0261         1.31       $66.60       $36.63       $13.32
                            evaluation.
   76066  X                Joint(s) survey,             0260         0.76       $38.64       $21.25        $7.73
                            single film.
   76070  E                CT scan, bone         ...........  ...........  ...........  ...........  ...........
                            density study.
   76075  S                Dual energy x-ray            0971         1.42       $72.20  ...........       $14.44
                            study.
   76076  S                Dual energy x-ray            0971         1.42       $72.20  ...........       $14.44
                            study.
   76078  X                Photodensitometry...         0261         1.31       $66.60       $36.63       $13.32
   76080  X                X-ray exam of                0263         1.74       $88.47       $45.88       $17.69
                            fistula.
   76086  X                X-ray of mammary             0263         1.74       $88.47       $45.88       $17.69
                            duct.
   76088  X                X-ray of mammary             0263         1.74       $88.47       $45.88       $17.69
                            ducts.
   76090  S                Mammogram, one               0271         0.64       $32.54       $17.90        $6.51
                            breast.
   76091  S                Mammogram, both              0271         0.64       $32.54       $17.90        $6.51
                            breasts.
   76092  A                Mammogram, screening  ...........  ...........  ...........  ...........  ...........

[[Page 44805]]

 
   76093  E                Magnetic image,       ...........  ...........  ...........  ...........  ...........
                            breast.
   76094  E                Magnetic image, both  ...........  ...........  ...........  ...........  ...........
                            breasts.
   76095  T                Stereotactic breast          0187         4.54      $230.82      $113.10       $46.16
                            biopsy.
   76096  X                X-ray of needle              0289         1.22       $62.03       $32.25       $12.41
                            wire, breast.
   76098  X                X-ray exam, breast           0260         0.76       $38.64       $21.25        $7.73
                            specimen.
   76100  X                X-ray exam of body           0261         1.31       $66.60       $36.63       $13.32
                            section.
   76101  X                Complex body section         0263         1.74       $88.47       $45.88       $17.69
                            x-ray.
   76102  X                Complex body section         0264         2.51      $127.61       $70.19       $25.52
                            x-rays.
   76120  X                Cinematic x-rays....         0261         1.31       $66.60       $36.63       $13.32
   76125  X                Cinematic x-rays add-        0261         1.31       $66.60       $36.63       $13.32
                            on.
   76140  E                X-ray consultation..  ...........  ...........  ...........  ...........  ...........
   76150  X                X-ray exam, dry              0260         0.76       $38.64       $21.25        $7.73
                            process.
   76350  N                Special x-ray         ...........  ...........  ...........  ...........  ...........
                            contrast study.
   76355  S                CAT scan for                 0283         4.89      $248.62      $136.74       $49.72
                            localization.
   76360  S                CAT scan for needle          0283         4.89      $248.62      $136.74       $49.72
                            biopsy.
   76370  S                CAT scan for therapy         0282         1.63       $82.87       $45.58       $16.57
                            guide.
   76375  S                3d/holograph                 0282         1.63       $82.87       $45.58       $16.57
                            reconstr add-on.
   76380  S                CAT scan follow-up           0282         1.63       $82.87       $45.58       $16.57
                            study.
   76390  S                Mr spectroscopy.....         0335         5.91      $300.48      $165.26       $60.10
   76393  N                Mr guidance for       ...........  ...........  ...........  ...........  ...........
                            needle place.
   76400  S                Magnetic image, bone         0335         5.91      $300.48      $165.26       $60.10
                            marrow.
   76499  X                Radiographic                 0260         0.76       $38.64       $21.25        $7.73
                            procedure.
   76506  S                Echo exam of head...         0266         1.67       $84.91       $46.70       $16.98
   76511  S                Echo exam of eye....         0266         1.67       $84.91       $46.70       $16.98
   76512  S                Echo exam of eye....         0266         1.67       $84.91       $46.70       $16.98
   76513  S                Echo exam of eye,            0265         1.02       $51.86       $28.52       $10.37
                            water bath.
   76516  S                Echo exam of eye....         0266         1.67       $84.91       $46.70       $16.98
   76519  S                Echo exam of eye....         0266         1.67       $84.91       $46.70       $16.98
   76529  S                Echo exam of eye....         0265         1.02       $51.86       $28.52       $10.37
   76536  S                Echo exam of head            0266         1.67       $84.91       $46.70       $16.98
                            and neck.
   76604  S                Echo exam of chest..         0266         1.67       $84.91       $46.70       $16.98
   76645  S                Echo exam of                 0265         1.02       $51.86       $28.52       $10.37
                            breast(s).
   76700  S                Echo exam of abdomen         0266         1.67       $84.91       $46.70       $16.98
   76705  S                Echo exam of abdomen         0266         1.67       $84.91       $46.70       $16.98
   76770  S                Echo exam abdomen            0266         1.67       $84.91       $46.70       $16.98
                            back wall.
   76775  S                Echo exam abdomen            0266         1.67       $84.91       $46.70       $16.98
                            back wall.
   76778  S                Echo exam kidney             0266         1.67       $84.91       $46.70       $16.98
                            transplant.
   76800  S                Echo exam spinal             0266         1.67       $84.91       $46.70       $16.98
                            canal.
   76805  S                Echo exam of                 0266         1.67       $84.91       $46.70       $16.98
                            pregnant uterus.
   76810  S                Echo exam of                 0265         1.02       $51.86       $28.52       $10.37
                            pregnant uterus.
   76815  S                Echo exam of                 0265         1.02       $51.86       $28.52       $10.37
                            pregnant uterus.
   76816  S                Echo exam follow-up/         0265         1.02       $51.86       $28.52       $10.37
                            repeat.
   76818  S                Fetl biophys profil          0266         1.67       $84.91       $46.70       $16.98
                            w/stress.
   76819  S                Fetl biophys profil          0266         1.67       $84.91       $46.70       $16.98
                            w/o strs.
   76825  S                Echo exam of fetal           0269         4.31      $219.13      $113.95       $43.83
                            heart.
   76826  S                Echo exam of fetal           0697         2.00      $101.68       $52.88       $20.34
                            heart.
   76827  S                Echo exam of fetal           0269         4.31      $219.13      $113.95       $43.83
                            heart.
   76828  S                Echo exam of fetal           0697         2.00      $101.68       $52.88       $20.34
                            heart.
   76830  S                Echo exam,                   0266         1.67       $84.91       $46.70       $16.98
                            transvaginal.
   76831  S                Echo exam, uterus...         0266         1.67       $84.91       $46.70       $16.98
   76856  S                Echo exam of pelvis.         0266         1.67       $84.91       $46.70       $16.98
   76857  S                Echo exam of pelvis.         0265         1.02       $51.86       $28.52       $10.37
   76870  S                Echo exam of scrotum         0266         1.67       $84.91       $46.70       $16.98
   76872  S                Echo exam,                   0266         1.67       $84.91       $46.70       $16.98
                            transrectal.
   76873  N                Echograp trans r,     ...........  ...........  ...........  ...........  ...........
                            pros study.
   76880  S                Echo exam of                 0266         1.67       $84.91       $46.70       $16.98
                            extremity.
   76885  S                Echo exam, infant            0266         1.67       $84.91       $46.70       $16.98
                            hips.
   76886  S                Echo exam, infant            0266         1.67       $84.91       $46.70       $16.98
                            hips.
   76930  N                Echo guide,           ...........  ...........  ...........  ...........  ...........
                            cardiocentesis.
   76932  N                Echo guide for heart  ...........  ...........  ...........  ...........  ...........
                            biopsy.
   76936  N                Echo guide for        ...........  ...........  ...........  ...........  ...........
                            artery repair.
   76941  N                Echo guide for        ...........  ...........  ...........  ...........  ...........
                            transfusion.
   76942  N                Echo guide for        ...........  ...........  ...........  ...........  ...........
                            biopsy.
   76945  N                Echo guide, villus    ...........  ...........  ...........  ...........  ...........
                            sampling.
   76946  N                Echo guide for        ...........  ...........  ...........  ...........  ...........
                            amniocentesis.
   76948  N                Echo guide, ova       ...........  ...........  ...........  ...........  ...........
                            aspiration.
   76950  N                Echo guidance         ...........  ...........  ...........  ...........  ...........
                            radiotherapy.
   76965  N                Echo guidance         ...........  ...........  ...........  ...........  ...........
                            radiotherapy.
   76970  S                Ultrasound exam              0265         1.02       $51.86       $28.52       $10.37
                            follow-up.
   76975  S                GI endoscopic                0266         1.67       $84.91       $46.70       $16.98
                            ultrasound.
   76977  S                Us bone density              0265         1.02       $51.86       $28.52       $10.37
                            measure.
   76986  S                Ultrasound guide             0266         1.67       $84.91       $46.70       $16.98
                            intraoper.
   76999  S                Echo examination             0266         1.67       $84.91       $46.70       $16.98
                            procedure.
   77261  E                Radiation therapy     ...........  ...........  ...........  ...........  ...........
                            planning.
   77262  E                Radiation therapy     ...........  ...........  ...........  ...........  ...........
                            planning.

[[Page 44806]]

 
   77263  E                Radiation therapy     ...........  ...........  ...........  ...........  ...........
                            planning.
   77280  X                Set radiation                0304         1.80       $91.52       $41.52       $18.30
                            therapy field.
   77285  X                Set radiation                0305         4.40      $223.70       $97.50       $44.74
                            therapy field.
   77290  X                Set radiation                0305         4.40      $223.70       $97.50       $44.74
                            therapy field.
   77295  X                Set radiation                0310        17.14      $871.43      $339.05      $174.29
                            therapy field.
   77299  E                Radiation therapy     ...........  ...........  ...........  ...........  ...........
                            planning.
   77300  X                Radiation therapy            0304         1.80       $91.52       $41.52       $18.30
                            dose plan.
   77305  X                Radiation therapy            0304         1.80       $91.52       $41.52       $18.30
                            dose plan.
   77310  X                Radiation therapy            0304         1.80       $91.52       $41.52       $18.30
                            dose plan.
   77315  X                Radiation therapy            0305         4.40      $223.70       $97.50       $44.74
                            dose plan.
   77321  X                Radiation therapy            0305         4.40      $223.70       $97.50       $44.74
                            port plan.
   77326  X                Radiation therapy            0305         4.40      $223.70       $97.50       $44.74
                            dose plan.
   77327  X                Radiation therapy            0305         4.40      $223.70       $97.50       $44.74
                            dose plan.
   77328  X                Radiation therapy            0305         4.40      $223.70       $97.50       $44.74
                            dose plan.
   77331  X                Special radiation            0304         1.80       $91.52       $41.52       $18.30
                            dosimetry.
   77332  X                Radiation treatment          0303         3.98      $202.35       $69.28       $40.47
                            aid(s).
   77333  X                Radiation treatment          0303         3.98      $202.35       $69.28       $40.47
                            aid(s).
   77334  X                Radiation treatment          0303         3.98      $202.35       $69.28       $40.47
                            aid(s).
   77336  X                Radiation physics            0304         1.80       $91.52       $41.52       $18.30
                            consult.
   77370  X                Radiation physics            0305         4.40      $223.70       $97.50       $44.74
                            consult.
   77399  X                External radiation           0304         1.80       $91.52       $41.52       $18.30
                            dosimetry.
   77401  S                Radiation treatment          0300         2.25      $114.39       $47.72       $22.88
                            delivery.
   77402  S                Radiation treatment          0300         2.25      $114.39       $47.72       $22.88
                            delivery.
   77403  S                Radiation treatment          0300         2.25      $114.39       $47.72       $22.88
                            delivery.
   77404  S                Radiation treatment          0300         2.25      $114.39       $47.72       $22.88
                            delivery.
   77406  S                Radiation treatment          0300         2.25      $114.39       $47.72       $22.88
                            delivery.
   77407  S                Radiation treatment          0300         2.25      $114.39       $47.72       $22.88
                            delivery.
   77408  S                Radiation treatment          0300         2.25      $114.39       $47.72       $22.88
                            delivery.
   77409  S                Radiation treatment          0300         2.25      $114.39       $47.72       $22.88
                            delivery.
   77411  S                Radiation treatment          0300         2.25      $114.39       $47.72       $22.88
                            delivery.
   77412  S                Radiation treatment          0300         2.25      $114.39       $47.72       $22.88
                            delivery.
   77413  S                Radiation treatment          0300         2.25      $114.39       $47.72       $22.88
                            delivery.
   77414  S                Radiation treatment          0300         2.25      $114.39       $47.72       $22.88
                            delivery.
   77416  S                Radiation treatment          0300         2.25      $114.39       $47.72       $22.88
                            delivery.
   77417  X                Radiology port               0260         0.76       $38.64       $21.25        $7.73
                            film(s).
   77427  E                Radiation tx          ...........  ...........  ...........  ...........  ...........
                            management, x5.
   77431  E                Radiation therapy     ...........  ...........  ...........  ...........  ...........
                            management.
   77432  E                Stereotactic          ...........  ...........  ...........  ...........  ...........
                            radiation trmt.
   77470  S                Special radiation            0302        11.96      $608.07      $216.55      $121.61
                            treatment.
   77499  E                Radiation therapy     ...........  ...........  ...........  ...........  ...........
                            management.
   77520  S                Proton trmt, simple          0974         7.57      $384.87  ...........       $76.97
                            w/o comp.
   77522  S                Proton trmt, simple          0974         7.57      $384.87  ...........       $76.97
                            w/comp.
   77523  S                Proton trmt,                 0976        16.56      $841.94  ...........      $168.39
                            intermediate.
   77525  S                Proton treatment,            0976        16.56      $841.94  ...........      $168.39
                            complex.
   77600  S                Hyperthermia                 0314         5.16      $262.34      $133.80       $52.47
                            treatment.
   77605  S                Hyperthermia                 0314         5.16      $262.34      $133.80       $52.47
                            treatment.
   77610  S                Hyperthermia                 0314         5.16      $262.34      $133.80       $52.47
                            treatment.
   77615  S                Hyperthermia                 0314         5.16      $262.34      $133.80       $52.47
                            treatment.
   77620  S                Hyperthermia                 0314         5.16      $262.34      $133.80       $52.47
                            treatment.
   77750  S                Infuse radioactive           0301         5.85      $297.43       $59.49       $59.49
                            materials.
   77761  S                Apply intrcav radiat         0312         7.77      $395.04      $109.65       $79.01
                            simple.
   77762  S                Apply intrcav radiat         0312         7.77      $395.04      $109.65       $79.01
                            interm.
   77763  S                Apply intrcav radiat         0312         7.77      $395.04      $109.65       $79.01
                            compl.
   77776  S                Apply interstit              0312         7.77      $395.04      $109.65       $79.01
                            radiat simpl.
   77777  S                Apply interstit              0312         7.77      $395.04      $109.65       $79.01
                            radiat inter.
   77778  S                Apply iterstit               0312         7.77      $395.04      $109.65       $79.01
                            radiat compl.
   77781  S                High intensity               0313        16.31      $829.23      $165.85      $165.85
                            brachytherapy.
   77782  S                High intensity               0313        16.31      $829.23      $165.85      $165.85
                            brachytherapy.
   77783  S                High intensity               0313        16.31      $829.23      $165.85      $165.85
                            brachytherapy.
   77784  S                High intensity               0313        16.31      $829.23      $165.85      $165.85
                            brachytherapy.
   77789  S                Apply surface                0300         2.25      $114.39       $47.72       $22.88
                            radiation.
   77790  N                Radiation handling..  ...........  ...........  ...........  ...........  ...........
   77799  S                Radium/radioisotope          0313        16.31      $829.23      $165.85      $165.85
                            therapy.
   78000  S                Thyroid, single              0290         1.91       $97.11       $53.41       $19.42
                            uptake.
   78001  S                Thyroid, multiple            0290         1.91       $97.11       $53.41       $19.42
                            uptakes.
   78003  S                Thyroid suppress/            0290         1.91       $97.11       $53.41       $19.42
                            stimul.
   78006  S                Thyroid imaging with         0291         3.78      $192.18       $90.20       $38.44
                            uptake.
   78007  S                Thyroid image, mult          0291         3.78      $192.18       $90.20       $38.44
                            uptakes.
   78010  S                Thyroid imaging.....         0290         1.91       $97.11       $53.41       $19.42
   78011  S                Thyroid imaging with         0290         1.91       $97.11       $53.41       $19.42
                            flow.
   78015  S                Thyroid met imaging.         0291         3.78      $192.18       $90.20       $38.44
   78016  S                Thyroid met imaging/         0291         3.78      $192.18       $90.20       $38.44
                            studies.
   78018  S                Thyroid met imaging,         0292         4.56      $231.84      $124.85       $46.37
                            body.
   78020  S                Thyroid met uptake..         0291         3.78      $192.18       $90.20       $38.44
   78070  S                Parathyroid nuclear          0291         3.78      $192.18       $90.20       $38.44
                            imaging.

[[Page 44807]]

 
   78075  S                Adrenal nuclear              0292         4.56      $231.84      $124.85       $46.37
                            imaging.
   78099  S                Endocrine nuclear            0290         1.91       $97.11       $53.41       $19.42
                            procedure.
   78102  S                Bone marrow imaging,         0291         3.78      $192.18       $90.20       $38.44
                            ltd.
   78103  S                Bone marrow imaging,         0292         4.56      $231.84      $124.85       $46.37
                            mult.
   78104  S                Bone marrow imaging,         0291         3.78      $192.18       $90.20       $38.44
                            body.
   78110  S                Plasma volume,               0291         3.78      $192.18       $90.20       $38.44
                            single.
   78111  S                Plasma volume,               0291         3.78      $192.18       $90.20       $38.44
                            multiple.
   78120  S                Red cell mass,               0291         3.78      $192.18       $90.20       $38.44
                            single.
   78121  S                Red cell mass,               0291         3.78      $192.18       $90.20       $38.44
                            multiple.
   78122  S                Blood volume........         0292         4.56      $231.84      $124.85       $46.37
   78130  S                Red cell survival            0291         3.78      $192.18       $90.20       $38.44
                            study.
   78135  S                Red cell survival            0292         4.56      $231.84      $124.85       $46.37
                            kinetics.
   78140  S                Red cell                     0291         3.78      $192.18       $90.20       $38.44
                            sequestration.
   78160  S                Plasma iron turnover         0291         3.78      $192.18       $90.20       $38.44
   78162  S                Iron absorption exam         0291         3.78      $192.18       $90.20       $38.44
   78170  S                Red cell iron                0291         3.78      $192.18       $90.20       $38.44
                            utilization.
   78172  S                Total body iron              0291         3.78      $192.18       $90.20       $38.44
                            estimation.
   78185  S                Spleen imaging......         0291         3.78      $192.18       $90.20       $38.44
   78190  S                Platelet survival,           0291         3.78      $192.18       $90.20       $38.44
                            kinetics.
   78191  S                Platelet survival...         0291         3.78      $192.18       $90.20       $38.44
   78195  S                Lymph system imaging         0291         3.78      $192.18       $90.20       $38.44
   78199  S                Blood/lymph nuclear          0290         1.91       $97.11       $53.41       $19.42
                            exam.
   78201  S                Liver imaging.......         0291         3.78      $192.18       $90.20       $38.44
   78202  S                Liver imaging with           0291         3.78      $192.18       $90.20       $38.44
                            flow.
   78205  S                Liver imaging (3D)..         0292         4.56      $231.84      $124.85       $46.37
   78206  S                Liver image (3d) w/          0292         4.56      $231.84      $124.85       $46.37
                            flow.
   78215  S                Liver and spleen             0291         3.78      $192.18       $90.20       $38.44
                            imaging.
   78216  S                Liver & spleen image/        0291         3.78      $192.18       $90.20       $38.44
                            flow.
   78220  S                Liver function study         0291         3.78      $192.18       $90.20       $38.44
   78223  S                Hepatobiliary                0292         4.56      $231.84      $124.85       $46.37
                            imaging.
   78230  S                Salivary gland               0291         3.78      $192.18       $90.20       $38.44
                            imaging.
   78231  S                Serial salivary              0291         3.78      $192.18       $90.20       $38.44
                            imaging.
   78232  S                Salivary gland               0291         3.78      $192.18       $90.20       $38.44
                            function exam.
   78258  S                Esophageal motility          0291         3.78      $192.18       $90.20       $38.44
                            study.
   78261  S                Gastric mucosa               0291         3.78      $192.18       $90.20       $38.44
                            imaging.
   78262  S                Gastroesophageal             0291         3.78      $192.18       $90.20       $38.44
                            reflux exam.
   78264  S                Gastric emptying             0291         3.78      $192.18       $90.20       $38.44
                            study.
   78267  A                Breath tst attain/    ...........  ...........  ...........  ...........  ...........
                            anal c-14.
   78268  A                Breath test           ...........  ...........  ...........  ...........  ...........
                            analysis, c-14.
   78270  S                Vit B-12 absorption          0290         1.91       $97.11       $53.41       $19.42
                            exam.
   78271  S                Vit B-12 absorp              0290         1.91       $97.11       $53.41       $19.42
                            exam, IF.
   78272  S                Vit B-12 absorp,             0291         3.78      $192.18       $90.20       $38.44
                            combined.
   78278  S                Acute GI blood loss          0291         3.78      $192.18       $90.20       $38.44
                            imaging.
   78282  S                GI protein loss exam         0290         1.91       $97.11       $53.41       $19.42
   78290  S                Meckel's divert exam         0291         3.78      $192.18       $90.20       $38.44
   78291  S                Leveen/shunt patency         0291         3.78      $192.18       $90.20       $38.44
                            exam.
   78299  S                GI nuclear procedure         0290         1.91       $97.11       $53.41       $19.42
   78300  S                Bone imaging,                0291         3.78      $192.18       $90.20       $38.44
                            limited area.
   78305  S                Bone imaging,                0291         3.78      $192.18       $90.20       $38.44
                            multiple areas.
   78306  S                Bone imaging, whole          0291         3.78      $192.18       $90.20       $38.44
                            body.
   78315  S                Bone imaging, 3              0292         4.56      $231.84      $124.85       $46.37
                            phase.
   78320  S                Bone imaging (3D)...         0292         4.56      $231.84      $124.85       $46.37
   78350  X                Bone mineral, single         0261         1.31       $66.60       $36.63       $13.32
                            photon.
   78351  E                Bone mineral, dual    ...........  ...........  ...........  ...........  ...........
                            photon.
   78399  S                Musculoskeletal              0290         1.91       $97.11       $53.41       $19.42
                            nuclear exam.
   78414  S                Non-imaging heart            0292         4.56      $231.84      $124.85       $46.37
                            function.
   78428  S                Cardiac shunt                0292         4.56      $231.84      $124.85       $46.37
                            imaging.
   78445  S                Vascular flow                0291         3.78      $192.18       $90.20       $38.44
                            imaging.
   78455  S                Venous thrombosis            0291         3.78      $192.18       $90.20       $38.44
                            study.
   78456  S                Acute venous                 0291         3.78      $192.18       $90.20       $38.44
                            thrombus image.
   78457  S                Venous thrombosis            0291         3.78      $192.18       $90.20       $38.44
                            imaging.
   78458  S                Ven thrombosis               0291         3.78      $192.18       $90.20       $38.44
                            images, bilat.
   78459  E                Heart muscle imaging  ...........  ...........  ...........  ...........  ...........
                            (PET).
   78460  S                Heart muscle blood,          0286         5.85      $297.43      $163.58       $59.49
                            single.
   78461  S                Heart muscle blood,          0286         5.85      $297.43      $163.58       $59.49
                            multiple.
   78464  S                Heart image (3d),            0286         5.85      $297.43      $163.58       $59.49
                            single.
   78465  S                Heart image (3d),            0286         5.85      $297.43      $163.58       $59.49
                            multiple.
   78466  S                Heart infarct image.         0291         3.78      $192.18       $90.20       $38.44
   78468  S                Heart infarct image          0292         4.56      $231.84      $124.85       $46.37
                            (ef).
   78469  S                Heart infarct image          0292         4.56      $231.84      $124.85       $46.37
                            (3D).
   78472  S                Gated heart, planar,         0286         5.85      $297.43      $163.58       $59.49
                            single.
   78473  S                Gated heart,                 0286         5.85      $297.43      $163.58       $59.49
                            multiple.
   78478  S                Heart wall motion            0286         5.85      $297.43      $163.58       $59.49
                            add-on.
   78480  S                Heart function add-          0286         5.85      $297.43      $163.58       $59.49
                            on.
   78481  S                Heart first pass,            0286         5.85      $297.43      $163.58       $59.49
                            single.

[[Page 44808]]

 
   78483  S                Heart first pass,            0286         5.85      $297.43      $163.58       $59.49
                            multiple.
   78491  E                Heart image (pet),    ...........  ...........  ...........  ...........  ...........
                            single.
   78492  E                Heart image (pet),    ...........  ...........  ...........  ...........  ...........
                            multiple.
   78494  S                Heart image, spect..         0296         3.52      $178.96       $98.43       $35.79
   78496  S                Heart first pass add-        0296         3.52      $178.96       $98.43       $35.79
                            on.
   78499  S                Cardiovascular               0291         3.78      $192.18       $90.20       $38.44
                            nuclear exam.
   78580  S                Lung perfusion               0291         3.78      $192.18       $90.20       $38.44
                            imaging.
   78584  S                Lung V/Q image               0292         4.56      $231.84      $124.85       $46.37
                            single breath.
   78585  S                Lung V/Q imaging....         0292         4.56      $231.84      $124.85       $46.37
   78586  S                Aerosol lung image,          0292         4.56      $231.84      $124.85       $46.37
                            single.
   78587  S                Aerosol lung image,          0291         3.78      $192.18       $90.20       $38.44
                            multiple.
   78588  S                Perfusion lung image         0292         4.56      $231.84      $124.85       $46.37
   78591  S                Vent image, 1                0291         3.78      $192.18       $90.20       $38.44
                            breath, 1 proj.
   78593  S                Vent image, 1 proj,          0292         4.56      $231.84      $124.85       $46.37
                            gas.
   78594  S                Vent image, mult             0292         4.56      $231.84      $124.85       $46.37
                            proj, gas.
   78596  S                Lung differential            0292         4.56      $231.84      $124.85       $46.37
                            function.
   78599  S                Respiratory nuclear          0291         3.78      $192.18       $90.20       $38.44
                            exam.
   78600  S                Brain imaging, ltd           0292         4.56      $231.84      $124.85       $46.37
                            static.
   78601  S                Brain imaging, ltd w/        0291         3.78      $192.18       $90.20       $38.44
                             flow.
   78605  S                Brain imaging,               0291         3.78      $192.18       $90.20       $38.44
                            complete.
   78606  S                Brain imaging, compl         0292         4.56      $231.84      $124.85       $46.37
                            w/flow.
   78607  S                Brain imaging (3D)..         0292         4.56      $231.84      $124.85       $46.37
   78608  E                Brain imaging (PET).  ...........  ...........  ...........  ...........  ...........
   78609  E                Brain imaging (PET).  ...........  ...........  ...........  ...........  ...........
   78610  S                Brain flow imaging           0291         3.78      $192.18       $90.20       $38.44
                            only.
   78615  S                Cerebral blood flow          0291         3.78      $192.18       $90.20       $38.44
                            imaging.
   78630  S                Cerebrospinal fluid          0292         4.56      $231.84      $124.85       $46.37
                            scan.
   78635  S                CSF ventriculography         0292         4.56      $231.84      $124.85       $46.37
   78645  S                CSF shunt evaluation         0291         3.78      $192.18       $90.20       $38.44
   78647  S                Cerebrospinal fluid          0292         4.56      $231.84      $124.85       $46.37
                            scan.
   78650  S                CSF leakage imaging.         0292         4.56      $231.84      $124.85       $46.37
   78660  S                Nuclear exam of tear         0291         3.78      $192.18       $90.20       $38.44
                            flow.
   78699  S                Nervous system               0291         3.78      $192.18       $90.20       $38.44
                            nuclear exam.
   78700  S                Kidney imaging,              0291         3.78      $192.18       $90.20       $38.44
                            static.
   78701  S                Kidney imaging with          0291         3.78      $192.18       $90.20       $38.44
                            flow.
   78704  S                Imaging renogram....         0291         3.78      $192.18       $90.20       $38.44
   78707  S                Kidney flow/function         0292         4.56      $231.84      $124.85       $46.37
                            image.
   78708  S                Kidney flow/function         0292         4.56      $231.84      $124.85       $46.37
                            image.
   78709  S                Kidney flow/function         0292         4.56      $231.84      $124.85       $46.37
                            image.
   78710  S                Kidney imaging (3D).         0291         3.78      $192.18       $90.20       $38.44
   78715  S                Renal vascular flow          0291         3.78      $192.18       $90.20       $38.44
                            exam.
   78725  S                Kidney function              0291         3.78      $192.18       $90.20       $38.44
                            study.
   78730  S                Urinary bladder              0291         3.78      $192.18       $90.20       $38.44
                            retention.
   78740  S                Ureteral reflux              0291         3.78      $192.18       $90.20       $38.44
                            study.
   78760  S                Testicular imaging..         0291         3.78      $192.18       $90.20       $38.44
   78761  S                Testicular imaging/          0291         3.78      $192.18       $90.20       $38.44
                            flow.
   78799  S                Genitourinary                0292         4.56      $231.84      $124.85       $46.37
                            nuclear exam.
   78800  S                Tumor imaging,               0291         3.78      $192.18       $90.20       $38.44
                            limited area.
   78801  S                Tumor imaging, mult          0292         4.56      $231.84      $124.85       $46.37
                            areas.
   78802  S                Tumor imaging, whole         0292         4.56      $231.84      $124.85       $46.37
                            body.
   78803  S                Tumor imaging (3D)..         0292         4.56      $231.84      $124.85       $46.37
   78805  S                Abscess imaging, ltd         0292         4.56      $231.84      $124.85       $46.37
                            area.
   78806  S                Abscess imaging,             0292         4.56      $231.84      $124.85       $46.37
                            whole body.
   78807  S                Nuclear localization/        0292         4.56      $231.84      $124.85       $46.37
                            abscess.
   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           0291         3.78      $192.18       $90.20       $38.44
                            exam.
   79000  S                Init hyperthyroid            0294         5.45      $277.09      $144.06       $55.42
                            therapy.
   79001  S                Repeat hyperthyroid          0294         5.45      $277.09      $144.06       $55.42
                            therapy.
   79020  S                Thyroid ablation....         0294         5.45      $277.09      $144.06       $55.42
   79030  S                Thyroid ablation,            0294         5.45      $277.09      $144.06       $55.42
                            carcinoma.
   79035  S                Thyroid metastatic           0294         5.45      $277.09      $144.06       $55.42
                            therapy.
   79100  S                Hematopoetic nuclear         0294         5.45      $277.09      $144.06       $55.42
                            therapy.
   79200  S                Intracavitary                0295        13.97      $710.26      $390.64      $142.05
                            nuclear trmt.
   79300  S                Interstitial nuclear         0294         5.45      $277.09      $144.06       $55.42
                            therapy.
   79400  S                Nonhemato nuclear            0295        13.97      $710.26      $390.64      $142.05
                            therapy.
   79420  S                Intravascular                0295        13.97      $710.26      $390.64      $142.05
                            nuclear ther.
   79440  S                Nuclear joint                0294         5.45      $277.09      $144.06       $55.42
                            therapy.
   79900  N                Provide ther          ...........  ...........  ...........  ...........  ...........
                            radiopharm(s).
   79999  S                Nuclear medicine             0294         5.45      $277.09      $144.06       $55.42
                            therapy.
   80048  A                Basic metabolic       ...........  ...........  ...........  ...........  ...........
                            panel.
   80050  A                General health panel  ...........  ...........  ...........  ...........  ...........
   80051  A                Electrolyte panel...  ...........  ...........  ...........  ...........  ...........

[[Page 44809]]

 
   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,          ...........  ...........  ...........  ...........  ...........
                            qualitate/multi.
   80101  A                Drug screen, single.  ...........  ...........  ...........  ...........  ...........
   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,                ...........  ...........  ...........  ...........  ...........
                            carbamazepine,
                            total.
   80157  A                Assay,                ...........  ...........  ...........  ...........  ...........
                            carbamazepine, free.
   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.......  ...........  ...........  ...........  ...........  ...........
   80173  A                Assay of haloperidol  ...........  ...........  ...........  ...........  ...........
   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  X                Assay of topiramate.         0349         0.34       $17.29        $3.46        $3.46
   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....  ...........  ...........  ...........  ...........  ...........
   80438  A                TRH stimulation       ...........  ...........  ...........  ...........  ...........
                            panel.
   80439  A                TRH stimulation       ...........  ...........  ...........  ...........  ...........
                            panel.
   80440  A                TRH stimulation       ...........  ...........  ...........  ...........  ...........
                            panel.
   80500  X                Lab pathology                0343         0.42       $21.35       $11.53        $4.27
                            consultation.
   80502  X                Lab pathology                0343         0.42       $21.35       $11.53        $4.27
                            consultation.
   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..........  ...........  ...........  ...........  ...........  ...........

[[Page 44810]]

 
   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  X                Urinalysis test              0349         0.34       $17.29        $3.46        $3.46
                            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...  ...........  ...........  ...........  ...........  ...........
   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..  ...........  ...........  ...........  ...........  ...........
   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.
   82373  A                Assay, c-d transfer   ...........  ...........  ...........  ...........  ...........
                            measure.
   82374  A                Assay, blood carbon   ...........  ...........  ...........  ...........  ...........
                            dioxide.
   82375  A                Assay, blood carbon   ...........  ...........  ...........  ...........  ...........
                            monoxide.

[[Page 44811]]

 
   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, bld/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                Dehydroepiandrostero  ...........  ...........  ...........  ...........  ...........
                            ne.
   82627  A                Dehydroepiandrostero  ...........  ...........  ...........  ...........  ...........
                            ne.
   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.
   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.

[[Page 44812]]

 
   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 or 4,     ...........  ...........  ...........  ...........  ...........
                            each.
   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...  ...........  ...........  ...........  ...........  ...........
   82945  A                Glucose other fluid.  ...........  ...........  ...........  ...........  ...........
   82946  A                Glucagon tolerance    ...........  ...........  ...........  ...........  ...........
                            test.
   82947  A                Assay, glucose,       ...........  ...........  ...........  ...........  ...........
                            blood 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 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.
   83030  A                Fetal hemoglobin,     ...........  ...........  ...........  ...........  ...........
                            chemical.
   83033  A                Fetal hemoglobin      ...........  ...........  ...........  ...........  ...........
                            assay, qual.
   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..  ...........  ...........  ...........  ...........  ...........

[[Page 44813]]

 
   83090  A                Assay of homocystine  ...........  ...........  ...........  ...........  ...........
   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                L/s ratio, fetal      ...........  ...........  ...........  ...........  ...........
                            lung.
   83662  A                Foam stability,       ...........  ...........  ...........  ...........  ...........
                            fetal lung.
   83663  A                Fluoro polarize,      ...........  ...........  ...........  ...........  ...........
                            fetal lung.
   83664  A                Lamellar bdy, fetal   ...........  ...........  ...........  ...........  ...........
                            lung.
   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.
   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.

[[Page 44814]]

 
   83916  A                Oligoclonal bands...  ...........  ...........  ...........  ...........  ...........
   83918  A                Organic acids,        ...........  ...........  ...........  ...........  ...........
                            total, quant.
   83919  A                Organic acids, qual,  ...........  ...........  ...........  ...........  ...........
                            each.
   83921  A                Organic acid,         ...........  ...........  ...........  ...........  ...........
                            single, quant.
   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.
   84152  A                Assay of psa,         ...........  ...........  ...........  ...........  ...........
                            complexed.
   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.
   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.

[[Page 44815]]

 
   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  X                Assay of troponin,           0349         0.34       $17.29        $3.46        $3.46
                            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..  ...........  ...........  ...........  ...........  ...........
   84591  A                Assay of nos vitamin  ...........  ...........  ...........  ...........  ...........
   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  X                Clinical chemistry           0349         0.34       $17.29        $3.46        $3.46
                            test.
   85002  A                Bleeding time test..  ...........  ...........  ...........  ...........  ...........
   85007  A                Differential WBC      ...........  ...........  ...........  ...........  ...........
                            count.
   85008  A                Nondifferential WBC   ...........  ...........  ...........  ...........  ...........
                            count.
   85009  A                Differential WBC      ...........  ...........  ...........  ...........  ...........
                            count.
   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.

[[Page 44816]]

 
   85060  X                Blood smear                  0342         0.22       $11.19        $6.15        $2.24
                            interpretation.
   85095  T                Bone marrow                  0003         1.11       $56.43       $27.99       $11.29
                            aspiration.
   85097  X                Bone marrow                  0344         0.60       $30.51       $16.78        $6.10
                            interpretation.
   85102  T                Bone marrow biopsy..         0003         1.11       $56.43       $27.99       $11.29
   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.
   85307  A                Assay activated       ...........  ...........  ...........  ...........  ...........
                            protein c.
   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.
   85536  A                Iron stain            ...........  ...........  ...........  ...........  ...........
                            peripheral blood.
   85540  A                Wbc alkaline          ...........  ...........  ...........  ...........  ...........
                            phosphatase.
   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.

[[Page 44817]]

 
   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  X                Hematology procedure         0349         0.34       $17.29        $3.46        $3.46
   86000  A                Agglutinins, febrile  ...........  ...........  ...........  ...........  ...........
   86001  A                Allergen specific     ...........  ...........  ...........  ...........  ...........
                            igg.
   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         0343         0.42       $21.35       $11.53        $4.27
                            service.
   86078  X                Physician blood bank         0344         0.60       $30.51       $16.78        $6.10
                            service.
   86079  X                Physician blood bank         0344         0.60       $30.51       $16.78        $6.10
                            service.
   86140  A                C-reactive protein..  ...........  ...........  ...........  ...........  ...........
   86146  A                Glycoprotein          ...........  ...........  ...........  ...........  ...........
                            antibody.
   86147  A                Cardiolipin antibody  ...........  ...........  ...........  ...........  ...........
   86148  X                Phospholipid                 0349         0.34       $17.29        $3.46        $3.46
                            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                Counterimmunoelectro  ...........  ...........  ...........  ...........  ...........
                            phoresis.
   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.
   86294  A                Immunoassay, tumor    ...........  ...........  ...........  ...........  ...........
                            qual.
   86300  A                Immunoassay, tumor    ...........  ...........  ...........  ...........  ...........
                            ca 15-3.
   86301  A                Immunoassay, tumor,   ...........  ...........  ...........  ...........  ...........
                            ca 19-9.
   86304  A                Immunoassay, tumor    ...........  ...........  ...........  ...........  ...........
                            ca 125.
   86308  A                Heterophile           ...........  ...........  ...........  ...........  ...........
                            antibodies.
   86309  A                Heterophile           ...........  ...........  ...........  ...........  ...........
                            antibodies.
   86310  A                Heterophile           ...........  ...........  ...........  ...........  ...........
                            antibodies.
   86316  A                Immunoassay, tumor    ...........  ...........  ...........  ...........  ...........
                            other.
   86317  A                Immunoassay,infectio  ...........  ...........  ...........  ...........  ...........
                            us agent.
   86318  A                Immunoassay,infectio  ...........  ...........  ...........  ...........  ...........
                            us agent.
   86320  A                Serum                 ...........  ...........  ...........  ...........  ...........
                            immunoelectrophores
                            is.
   86325  A                Other                 ...........  ...........  ...........  ...........  ...........
                            immunoelectrophores
                            is.
   86327  A                Immunoelectrophoresi  ...........  ...........  ...........  ...........  ...........
                            s 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.  ...........  ...........  ...........  ...........  ...........
   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  X                T cell, absolute             0349         0.34       $17.29        $3.46        $3.46
                            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.

[[Page 44818]]

 
   86406  A                Particle              ...........  ...........  ...........  ...........  ...........
                            agglutination test.
   86430  A                Rheumatoid factor     ...........  ...........  ...........  ...........  ...........
                            test.
   86431  A                Rheumatoid factor,    ...........  ...........  ...........  ...........  ...........
                            quant.
   86485  X                Skin test, candida..         0341         0.11        $5.59        $3.08        $1.12
   86490  X                Coccidioidomycosis           0341         0.11        $5.59        $3.08        $1.12
                            skin test.
   86510  X                Histoplasmosis skin          0341         0.11        $5.59        $3.08        $1.12
                            test.
   86580  X                TB intradermal test.         0341         0.11        $5.59        $3.08        $1.12
   86585  X                TB tine test........         0341         0.11        $5.59        $3.08        $1.12
   86586  X                Skin test, unlisted.         0341         0.11        $5.59        $3.08        $1.12
   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..  ...........  ...........  ...........  ...........  ...........
   86611  A                Bartonella 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.
   86666  A                Ehrlichia antibody..  ...........  ...........  ...........  ...........  ...........
   86668  A                Francisella           ...........  ...........  ...........  ...........  ...........
                            tularensis.
   86671  A                Fungus antibody.....  ...........  ...........  ...........  ...........  ...........
   86674  A                Giardia lamblia       ...........  ...........  ...........  ...........  ...........
                            antibody.
   86677  A                Helicobacter pylori.  ...........  ...........  ...........  ...........  ...........
   86682  A                Helminth antibody...  ...........  ...........  ...........  ...........  ...........
   86683  A                Hemoglobin, fecal     ...........  ...........  ...........  ...........  ...........
                            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.  ...........  ...........  ...........  ...........  ...........
   86696  A                Herpes simplex type   ...........  ...........  ...........  ...........  ...........
                            2.
   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,  ...........  ...........  ...........  ...........  ...........
                            total.
   86705  A                Hep b core antibody,  ...........  ...........  ...........  ...........  ...........
                            igm.
   86706  A                Hep b surface         ...........  ...........  ...........  ...........  ...........
                            antibody.
   86707  A                Hep be antibody.....  ...........  ...........  ...........  ...........  ...........
   86708  A                Hep a antibody,       ...........  ...........  ...........  ...........  ...........
                            total.
   86709  A                Hep a antibody, igm.  ...........  ...........  ...........  ...........  ...........
   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......  ...........  ...........  ...........  ...........  ...........

[[Page 44819]]

 
   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.
   86757  A                Rickettsia 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  X                Immunology procedure         0349         0.34       $17.29        $3.46        $3.46
   86850  X                RBC antibody screen.         0345         0.29       $14.74        $5.37        $2.95
   86860  X                RBC antibody elution         0345         0.29       $14.74        $5.37        $2.95
   86870  X                RBC antibody                 0346         0.83       $42.20       $12.03        $8.44
                            identification.
   86880  A                Coombs test.........  ...........  ...........  ...........  ...........  ...........
   86885  A                Coombs test.........  ...........  ...........  ...........  ...........  ...........
   86886  A                Coombs test.........  ...........  ...........  ...........  ...........  ...........
   86890  X                Autologous blood             0346         0.83       $42.20       $12.03        $8.44
                            process.
   86891  X                Autologous blood, op         0345         0.29       $14.74        $5.37        $2.95
                            salvage.
   86900  A                Blood typing, ABO...  ...........  ...........  ...........  ...........  ...........
   86901  X                Blood typing, Rh (D)         0345         0.29       $14.74        $5.37        $2.95
   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  X                Bone marrow/stem             0346         0.83       $42.20       $12.03        $8.44
                            cell prep.
   86920  X                Compatibility test..         0346         0.83       $42.20       $12.03        $8.44
   86921  X                Compatibility test..         0345         0.29       $14.74        $5.37        $2.95
   86922  X                Compatibility test..         0346         0.83       $42.20       $12.03        $8.44
   86927  X                Plasma, fresh frozen         0346         0.83       $42.20       $12.03        $8.44
   86930  X                Frozen blood prep...         0347         1.73       $87.96       $20.13       $17.59
   86931  X                Frozen blood thaw...         0347         1.73       $87.96       $20.13       $17.59
   86932  X                Frozen blood freeze/         0346         0.83       $42.20       $12.03        $8.44
                            thaw.
   86940  A                Hemolysins/           ...........  ...........  ...........  ...........  ...........
                            agglutinins, auto.
   86941  A                Hemolysins/           ...........  ...........  ...........  ...........  ...........
                            agglutinins.
   86945  X                Blood product/               0345         0.29       $14.74        $5.37        $2.95
                            irradiation.
   86950  X                Leukacyte                    0347         1.73       $87.96       $20.13       $17.59
                            transfusion.
   86965  X                Pooling blood                0347         1.73       $87.96       $20.13       $17.59
                            platelets.
   86970  X                RBC pretreatment....         0345         0.29       $14.74        $5.37        $2.95
   86971  X                RBC pretreatment....         0345         0.29       $14.74        $5.37        $2.95
   86972  X                RBC pretreatment....         0345         0.29       $14.74        $5.37        $2.95
   86975  X                RBC pretreatment,            0345         0.29       $14.74        $5.37        $2.95
                            serum.
   86976  X                RBC pretreatment,            0345         0.29       $14.74        $5.37        $2.95
                            serum.
   86977  X                RBC pretreatment,            0345         0.29       $14.74        $5.37        $2.95
                            serum.
   86978  X                RBC pretreatment,            0345         0.29       $14.74        $5.37        $2.95
                            serum.
   86985  X                Split blood or               0347         1.73       $87.96       $20.13       $17.59
                            products.
   86999  X                Transfusion                  0346         0.83       $42.20       $12.03        $8.44
                            procedure.
   87001  A                Small animal          ...........  ...........  ...........  ...........  ...........
                            inoculation.
   87003  A                Small animal          ...........  ...........  ...........  ...........  ...........
                            inoculation.

[[Page 44820]]

 
   87015  A                Specimen              ...........  ...........  ...........  ...........  ...........
                            concentration.
   87040  A                Blood culture for     ...........  ...........  ...........  ...........  ...........
                            bacteria.
   87045  A                Stool culture,        ...........  ...........  ...........  ...........  ...........
                            bacteria.
   87046  A                Stool cultr,          ...........  ...........  ...........  ...........  ...........
                            bacteria, each.
   87070  A                Culture, bacteria,    ...........  ...........  ...........  ...........  ...........
                            other.
   87071  A                Culture bacteri       ...........  ...........  ...........  ...........  ...........
                            aerobic othr.
   87073  A                Culture bacteria      ...........  ...........  ...........  ...........  ...........
                            anaerobic.
   87075  A                Culture bacteria      ...........  ...........  ...........  ...........  ...........
                            anaerobic.
   87076  A                Culture anaerobe      ...........  ...........  ...........  ...........  ...........
                            ident, each.
   87077  A                Culture aerobic       ...........  ...........  ...........  ...........  ...........
                            identify.
   87081  A                Culture screen only.  ...........  ...........  ...........  ...........  ...........
   87084  A                Culture of specimen   ...........  ...........  ...........  ...........  ...........
                            by kit.
   87086  A                Urine culture/colony  ...........  ...........  ...........  ...........  ...........
                            count.
   87088  A                Urine bacteria        ...........  ...........  ...........  ...........  ...........
                            culture.
   87101  A                Skin fungi culture..  ...........  ...........  ...........  ...........  ...........
   87102  A                Fungus isolation      ...........  ...........  ...........  ...........  ...........
                            culture.
   87103  A                Blood fungus culture  ...........  ...........  ...........  ...........  ...........
   87106  A                Fungi                 ...........  ...........  ...........  ...........  ...........
                            identification,
                            yeast.
   87107  A                Fungi                 ...........  ...........  ...........  ...........  ...........
                            identification,
                            mold.
   87109  A                Mycoplasma..........  ...........  ...........  ...........  ...........  ...........
   87110  A                Chlamydia culture...  ...........  ...........  ...........  ...........  ...........
   87116  A                Mycobacteria culture  ...........  ...........  ...........  ...........  ...........
   87118  A                Mycobacteric          ...........  ...........  ...........  ...........  ...........
                            identification.
   87140  A                Cultur type           ...........  ...........  ...........  ...........  ...........
                            immunofluoresc.
   87143  A                Culture typing, glc/  ...........  ...........  ...........  ...........  ...........
                            hplc.
   87147  A                Culture type,         ...........  ...........  ...........  ...........  ...........
                            immunologic.
   87149  A                Culture type,         ...........  ...........  ...........  ...........  ...........
                            nucleic acid.
   87152  A                Culture type pulse    ...........  ...........  ...........  ...........  ...........
                            field gel.
   87158  A                Culture typing,       ...........  ...........  ...........  ...........  ...........
                            added method.
   87164  A                Dark field            ...........  ...........  ...........  ...........  ...........
                            examination.
   87166  A                Dark field            ...........  ...........  ...........  ...........  ...........
                            examination.
   87168  A                Macroscopic exam      ...........  ...........  ...........  ...........  ...........
                            arthropod.
   87169  A                Macacroscopic exam    ...........  ...........  ...........  ...........  ...........
                            parasite.
   87172  A                Pinworm exam........  ...........  ...........  ...........  ...........  ...........
   87176  A                Tissue                ...........  ...........  ...........  ...........  ...........
                            homogenization,
                            cultr.
   87177  A                Ova and parasites     ...........  ...........  ...........  ...........  ...........
                            smears.
   87181  A                Microbe susceptible,  ...........  ...........  ...........  ...........  ...........
                            diffuse.
   87184  A                Microbe susceptible,  ...........  ...........  ...........  ...........  ...........
                            disk.
   87185  A                Microbe susceptible,  ...........  ...........  ...........  ...........  ...........
                            enzyme.
   87186  A                Microbe susceptible,  ...........  ...........  ...........  ...........  ...........
                            mic.
   87187  A                Microbe susceptible,  ...........  ...........  ...........  ...........  ...........
                            mlc.
   87188  A                Microbe suscept,      ...........  ...........  ...........  ...........  ...........
                            macrobroth.
   87190  A                Microbe suscept,      ...........  ...........  ...........  ...........  ...........
                            mycobacteri.
   87197  A                Bactericidal level,   ...........  ...........  ...........  ...........  ...........
                            serum.
   87205  A                Smear, gram stain...  ...........  ...........  ...........  ...........  ...........
   87206  A                Smear, fluorescent/   ...........  ...........  ...........  ...........  ...........
                            acid stai.
   87207  A                Smear, special stain  ...........  ...........  ...........  ...........  ...........
   87210  A                Smear, wet mount,     ...........  ...........  ...........  ...........  ...........
                            saline/ink.
   87220  A                Tissue exam for       ...........  ...........  ...........  ...........  ...........
                            fungi.
   87230  A                Assay, toxin or       ...........  ...........  ...........  ...........  ...........
                            antitoxin.
   87250  A                Virus inoculate,      ...........  ...........  ...........  ...........  ...........
                            eggs/animal.
   87252  A                Virus inoculation,    ...........  ...........  ...........  ...........  ...........
                            tissue.
   87253  A                Virus inoculate       ...........  ...........  ...........  ...........  ...........
                            tissue, addl.
   87254  A                Virus inoculation,    ...........  ...........  ...........  ...........  ...........
                            shell via.
   87260  A                Adenovirus ag, if...  ...........  ...........  ...........  ...........  ...........
   87265  A                Pertussis ag, if....  ...........  ...........  ...........  ...........  ...........
   87270  A                Chlamydia             ...........  ...........  ...........  ...........  ...........
                            trachomatis ag, if.
   87272  A                Cryptosporidum/       ...........  ...........  ...........  ...........  ...........
                            gardia ag, if.
   87273  A                Herpes simplex 2,     ...........  ...........  ...........  ...........  ...........
                            ag, if.
   87274  A                Herpes simplex 1,     ...........  ...........  ...........  ...........  ...........
                            ag, if.
   87275  A                Influenza b, ag, if.  ...........  ...........  ...........  ...........  ...........
   87276  A                Influenza a, ag, if.  ...........  ...........  ...........  ...........  ...........
   87277  A                Legionella micdadei,  ...........  ...........  ...........  ...........  ...........
                            ag, if.
   87278  A                Legion pneumophilia   ...........  ...........  ...........  ...........  ...........
                            ag, if.
   87279  A                Parainfluenza, ag,    ...........  ...........  ...........  ...........  ...........
                            if.
   87280  A                Respiratory           ...........  ...........  ...........  ...........  ...........
                            syncytial ag, if.
   87281  A                Pneumocystis          ...........  ...........  ...........  ...........  ...........
                            carinii, ag, if.
   87283  A                Rubeola, ag, if.....  ...........  ...........  ...........  ...........  ...........
   87285  A                Treponema pallidum,   ...........  ...........  ...........  ...........  ...........
                            ag, if.
   87290  A                Varicella zoster,     ...........  ...........  ...........  ...........  ...........
                            ag, if.
   87299  A                Antibody detection,   ...........  ...........  ...........  ...........  ...........
                            nos, if.
   87300  A                Ag detection,         ...........  ...........  ...........  ...........  ...........
                            polyval, if.
   87301  A                Adenovirus ag, eia..  ...........  ...........  ...........  ...........  ...........
   87320  A                Chylmd trach ag, eia  ...........  ...........  ...........  ...........  ...........
   87324  A                Clostridium ag, eia.  ...........  ...........  ...........  ...........  ...........

[[Page 44821]]

 
   87327  A                Cryptococcus neoform  ...........  ...........  ...........  ...........  ...........
                            ag, eia.
   87328  A                Cryptospor ag, eia..  ...........  ...........  ...........  ...........  ...........
   87332  A                Cytomegalovirus ag,   ...........  ...........  ...........  ...........  ...........
                            eia.
   87335  A                E coli 0157 ag, eia.  ...........  ...........  ...........  ...........  ...........
   87336  A                Entamoeb hist dispr,  ...........  ...........  ...........  ...........  ...........
                            ag, eia.
   87337  A                Entamoeb hist group,  ...........  ...........  ...........  ...........  ...........
                            ag, eia.
   87338  A                Hpylori, stool, eia.  ...........  ...........  ...........  ...........  ...........
   87339  A                Hpylori ag, eia.....  ...........  ...........  ...........  ...........  ...........
   87340  A                Hepatitis b surface   ...........  ...........  ...........  ...........  ...........
                            ag, eia.
   87341  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.......  ...........  ...........  ...........  ...........  ...........
   87400  A                Influenza a/b, ag,    ...........  ...........  ...........  ...........  ...........
                            eia.
   87420  A                Resp syncytial ag,    ...........  ...........  ...........  ...........  ...........
                            eia.
   87425  A                Rotavirus ag, eia...  ...........  ...........  ...........  ...........  ...........
   87427  A                Shiga-like toxin ag,  ...........  ...........  ...........  ...........  ...........
                            eia.
   87430  A                Strep a ag, eia.....  ...........  ...........  ...........  ...........  ...........
   87449  A                Ag detect nos, eia,   ...........  ...........  ...........  ...........  ...........
                            mult.
   87450  A                Ag detect nos, eia,   ...........  ...........  ...........  ...........  ...........
                            single.
   87451  A                Ag detect polyval,    ...........  ...........  ...........  ...........  ...........
                            eia, mult.
   87470  A                Bartonella, dna, dir  ...........  ...........  ...........  ...........  ...........
                            probe.
   87471  A                Bartonella, dna, amp  ...........  ...........  ...........  ...........  ...........
                            probe.
   87472  X                Bartonella, dna,             0349         0.34       $17.29        $3.46        $3.46
                            quant.
   87475  A                Lyme dis, dna, dir    ...........  ...........  ...........  ...........  ...........
                            probe.
   87476  A                Lyme dis, dna, amp    ...........  ...........  ...........  ...........  ...........
                            probe.
   87477  X                Lyme dis, dna, quant         0349         0.34       $17.29        $3.46        $3.46
   87480  A                Candida, dna, dir     ...........  ...........  ...........  ...........  ...........
                            probe.
   87481  A                Candida, dna, amp     ...........  ...........  ...........  ...........  ...........
                            probe.
   87482  X                Candida, dna, quant.         0349         0.34       $17.29        $3.46        $3.46
   87485  A                Chylmd pneum, dna,    ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87486  A                Chylmd pneum, dna,    ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87487  X                Chylmd pneum, dna,           0349         0.34       $17.29        $3.46        $3.46
                            quant.
   87490  A                Chylmd trach, dna,    ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87491  A                Chylmd trach, dna,    ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87492  X                Chylmd trach, dna,           0349         0.34       $17.29        $3.46        $3.46
                            quant.
   87495  A                Cytomeg, dna, dir     ...........  ...........  ...........  ...........  ...........
                            probe.
   87496  A                Cytomeg, dna, amp     ...........  ...........  ...........  ...........  ...........
                            probe.
   87497  X                Cytomeg, dna, quant.         0349         0.34       $17.29        $3.46        $3.46
   87510  A                Gardner vag, dna,     ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87511  A                Gardner vag, dna,     ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87512  X                Gardner vag, dna,            0349         0.34       $17.29        $3.46        $3.46
                            quant.
   87515  A                Hepatitis b, dna,     ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87516  A                Hepatitis b , dna,    ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87517  X                Hepatitis b , dna,           0349         0.34       $17.29        $3.46        $3.46
                            quant.
   87520  A                Hepatitis c , rna,    ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87521  A                Hepatitis c , rna,    ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87522  X                Hepatitis c, rna,            0349         0.34       $17.29        $3.46        $3.46
                            quant.
   87525  A                Hepatitis g , dna,    ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87526  A                Hepatitis g, dna,     ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87527  X                Hepatitis g, dna,            0349         0.34       $17.29        $3.46        $3.46
                            quant.
   87528  A                Hsv, dna, dir probe.  ...........  ...........  ...........  ...........  ...........
   87529  A                Hsv, dna, amp probe.  ...........  ...........  ...........  ...........  ...........
   87530  X                Hsv, dna, quant.....         0349         0.34       $17.29        $3.46        $3.46
   87531  A                Hhv-6, dna, dir       ...........  ...........  ...........  ...........  ...........
                            probe.
   87532  A                Hhv-6, dna, amp       ...........  ...........  ...........  ...........  ...........
                            probe.
   87533  X                Hhv-6, dna, quant...         0349         0.34       $17.29        $3.46        $3.46
   87534  A                Hiv-1, dna, dir       ...........  ...........  ...........  ...........  ...........
                            probe.
   87535  A                Hiv-1, dna, amp       ...........  ...........  ...........  ...........  ...........
                            probe.
   87536  X                Hiv-1, dna, quant...         0349         0.34       $17.29        $3.46        $3.46
   87537  A                Hiv-2, dna, dir       ...........  ...........  ...........  ...........  ...........
                            probe.
   87538  A                Hiv-2, dna, amp       ...........  ...........  ...........  ...........  ...........
                            probe.
   87539  X                Hiv-2, dna, quant...         0349         0.34       $17.29        $3.46        $3.46
   87540  A                Legion pneumo, dna,   ...........  ...........  ...........  ...........  ...........
                            dir prob.
   87541  A                Legion pneumo, dna,   ...........  ...........  ...........  ...........  ...........
                            amp prob.
   87542  X                Legion pneumo, dna,          0349         0.34       $17.29        $3.46        $3.46
                            quant.
   87550  A                Mycobacteria, dna,    ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87551  A                Mycobacteria, dna,    ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87552  X                Mycobacteria, dna,           0349         0.34       $17.29        $3.46        $3.46
                            quant.
   87555  A                M.tuberculo, dna,     ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87556  A                M.tuberculo, dna,     ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87557  X                M.tuberculo, dna,            0349         0.34       $17.29        $3.46        $3.46
                            quant.
   87560  A                M.avium-intra, dna,   ...........  ...........  ...........  ...........  ...........
                            dir prob.

[[Page 44822]]

 
   87561  A                M.avium-intra, dna,   ...........  ...........  ...........  ...........  ...........
                            amp prob.
   87562  X                M.avium-intra, dna,          0349         0.34       $17.29        $3.46        $3.46
                            quant.
   87580  A                M.pneumon, dna, dir   ...........  ...........  ...........  ...........  ...........
                            probe.
   87581  A                M.pneumon, dna, amp   ...........  ...........  ...........  ...........  ...........
                            probe.
   87582  X                M.pneumon, dna,              0349         0.34       $17.29        $3.46        $3.46
                            quant.
   87590  A                N.gonorrhoeae, dna,   ...........  ...........  ...........  ...........  ...........
                            dir prob.
   87591  A                N.gonorrhoeae, dna,   ...........  ...........  ...........  ...........  ...........
                            amp prob.
   87592  X                N.gonorrhoeae, dna,          0349         0.34       $17.29        $3.46        $3.46
                            quant.
   87620  A                Hpv, dna, dir probe.  ...........  ...........  ...........  ...........  ...........
   87621  A                Hpv, dna, amp probe.  ...........  ...........  ...........  ...........  ...........
   87622  X                Hpv, dna, quant.....         0349         0.34       $17.29        $3.46        $3.46
   87650  A                Strep a, dna, dir     ...........  ...........  ...........  ...........  ...........
                            probe.
   87651  A                Strep a, dna, amp     ...........  ...........  ...........  ...........  ...........
                            probe.
   87652  X                Strep a, dna, quant.         0349         0.34       $17.29        $3.46        $3.46
   87797  A                Detect agent nos,     ...........  ...........  ...........  ...........  ...........
                            dna, dir.
   87798  A                Detect agent nos,     ...........  ...........  ...........  ...........  ...........
                            dna, amp.
   87799  X                Detect agent nos,            0349         0.34       $17.29        $3.46        $3.46
                            dna, quant.
   87800  A                Detect agnt mult,     ...........  ...........  ...........  ...........  ...........
                            dna, direc.
   87801  A                Detect agnt mult,     ...........  ...........  ...........  ...........  ...........
                            dna, ampli.
   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.
   87901  A                Genotype, dna, hiv    ...........  ...........  ...........  ...........  ...........
                            reverse t.
   87903  A                Phenotype, dna hiv w/ ...........  ...........  ...........  ...........  ...........
                            culture.
   87904  A                Phenotype, dna hiv w/ ...........  ...........  ...........  ...........  ...........
                            clt add.
   87999  X                Microbiology                 0349         0.34       $17.29        $3.46        $3.46
                            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,               0343         0.42       $21.35       $11.53        $4.27
                            fluids.
   88106  X                Cytopathology,               0343         0.42       $21.35       $11.53        $4.27
                            fluids.
   88107  X                Cytopathology,               0343         0.42       $21.35       $11.53        $4.27
                            fluids.
   88108  X                Cytopath,                    0343         0.42       $21.35       $11.53        $4.27
                            concentrate tech.
   88125  X                Forensic                     0343         0.42       $21.35       $11.53        $4.27
                            cytopathology.
   88130  A                Sex chromatin         ...........  ...........  ...........  ...........  ...........
                            identification.
   88140  A                Sex chromatin         ...........  ...........  ...........  ...........  ...........
                            identification.
   88141  N                Cytopath, c/v,        ...........  ...........  ...........  ...........  ...........
                            interpret.
   88142  X                Cytopath, c/v, thin          0349         0.34       $17.29        $3.46        $3.46
                            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,              0342         0.22       $11.19        $6.15        $2.24
                            other source.
   88161  X                Cytopath smear,              0343         0.42       $21.35       $11.53        $4.27
                            other source.
   88162  X                Cytopath smear,              0343         0.42       $21.35       $11.53        $4.27
                            other source.
   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                  0002         0.47       $23.90       $13.14        $4.78
                            aspiration.
   88171  T                Fine needle                  0004         3.00      $152.53       $32.57       $30.51
                            aspiration.
   88172  X                Cytopathology eval           0343         0.42       $21.35       $11.53        $4.27
                            of fna.
   88173  X                Cytopath eval, fna,          0343         0.42       $21.35       $11.53        $4.27
                            report.
   88180  X                Cell marker study...         0344         0.60       $30.51       $16.78        $6.10
   88182  X                Cell marker study...         0344         0.60       $30.51       $16.78        $6.10

[[Page 44823]]

 
   88199  X                Cytopathology                0349         0.34       $17.29        $3.46        $3.46
                            procedure.
   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  X                Cytogenetic study...         0342         0.22       $11.19        $6.15        $2.24
   88300  X                Surgical path, gross         0342         0.22       $11.19        $6.15        $2.24
   88302  X                Tissue exam by               0342         0.22       $11.19        $6.15        $2.24
                            pathologist.
   88304  X                Tissue exam by               0343         0.42       $21.35       $11.53        $4.27
                            pathologist.
   88305  X                Tissue exam by               0343         0.42       $21.35       $11.53        $4.27
                            pathologist.
   88307  X                Tissue exam by               0344         0.60       $30.51       $16.78        $6.10
                            pathologist.
   88309  X                Tissue exam by               0344         0.60       $30.51       $16.78        $6.10
                            pathologist.
   88311  X                Decalcify tissue....         0342         0.22       $11.19        $6.15        $2.24
   88312  X                Special stains......         0343         0.42       $21.35       $11.53        $4.27
   88313  X                Special stains......         0342         0.22       $11.19        $6.15        $2.24
   88314  X                Histochemical stain.         0343         0.42       $21.35       $11.53        $4.27
   88318  X                Chemical                     0343         0.42       $21.35       $11.53        $4.27
                            histochemistry.
   88319  X                Enzyme                       0342         0.22       $11.19        $6.15        $2.24
                            histochemistry.
   88321  X                Microslide                   0342         0.22       $11.19        $6.15        $2.24
                            consultation.
   88323  X                Microslide                   0343         0.42       $21.35       $11.53        $4.27
                            consultation.
   88325  X                Comprehensive review         0343         0.42       $21.35       $11.53        $4.27
                            of data.
   88329  X                Path consult introp.         0343         0.42       $21.35       $11.53        $4.27
   88331  X                Path consult                 0343         0.42       $21.35       $11.53        $4.27
                            intraop, 1 bloc.
   88332  X                Path consult                 0343         0.42       $21.35       $11.53        $4.27
                            intraop, addl.
   88342  X                Immunocytochemistry.         0344         0.60       $30.51       $16.78        $6.10
   88346  X                Immunofluorescent            0343         0.42       $21.35       $11.53        $4.27
                            study.
   88347  X                Immunofluorescent            0344         0.60       $30.51       $16.78        $6.10
                            study.
   88348  X                Electron microscopy.         0344         0.60       $30.51       $16.78        $6.10
   88349  X                Scanning electron            0344         0.60       $30.51       $16.78        $6.10
                            microscopy.
   88355  X                Analysis, skeletal           0344         0.60       $30.51       $16.78        $6.10
                            muscle.
   88356  X                Analysis, nerve.....         0344         0.60       $30.51       $16.78        $6.10
   88358  X                Analysis, tumor.....         0344         0.60       $30.51       $16.78        $6.10
   88362  X                Nerve teasing                0343         0.42       $21.35       $11.53        $4.27
                            preparations.
   88365  X                Tissue hybridization         0344         0.60       $30.51       $16.78        $6.10
   88371  A                Protein, western      ...........  ...........  ...........  ...........  ...........
                            blot tissue.
   88372  A                Protein analysis w/   ...........  ...........  ...........  ...........  ...........
                            probe.
   88399  X                Surgical pathology           0349         0.34       $17.29        $3.46        $3.46
                            procedure.
   88400  A                Bilirubin total       ...........  ...........  ...........  ...........  ...........
                            transcut.
   89050  A                Body fluid cell       ...........  ...........  ...........  ...........  ...........
                            count.
   89051  A                Body fluid cell       ...........  ...........  ...........  ...........  ...........
                            count.
   89060  A                Exam,synovial fluid   ...........  ...........  ...........  ...........  ...........
                            crystals.
   89100  X                Sample intestinal            0361         3.52      $178.96       $88.09       $35.79
                            contents.
   89105  X                Sample intestinal            0360         1.40       $71.18       $34.75       $14.24
                            contents.
   89125  A                Specimen fat stain..  ...........  ...........  ...........  ...........  ...........
   89130  X                Sample stomach               0360         1.40       $71.18       $34.75       $14.24
                            contents.
   89132  X                Sample stomach               0360         1.40       $71.18       $34.75       $14.24
                            contents.
   89135  X                Sample stomach               0360         1.40       $71.18       $34.75       $14.24
                            contents.
   89136  X                Sample stomach               0360         1.40       $71.18       $34.75       $14.24
                            contents.
   89140  X                Sample stomach               0360         1.40       $71.18       $34.75       $14.24
                            contents.
   89141  X                Sample stomach               0360         1.40       $71.18       $34.75       $14.24
                            contents.
   89160  A                Exam feces for meat   ...........  ...........  ...........  ...........  ...........
                            fibers.
   89190  A                Nasal smear for       ...........  ...........  ...........  ...........  ...........
                            eosinophils.
   89250  X                Fertilization of             0348         0.85       $43.22        $8.64        $8.64
                            oocyte.

[[Page 44824]]

 
   89251  X                Culture oocyte w/            0348         0.85       $43.22        $8.64        $8.64
                            embryos.
   89252  X                Assist oocyte                0348         0.85       $43.22        $8.64        $8.64
                            fertilization.
   89253  X                Embryo hatching.....         0348         0.85       $43.22        $8.64        $8.64
   89254  X                Oocyte                       0348         0.85       $43.22        $8.64        $8.64
                            identification.
   89255  X                Prepare embryo for           0348         0.85       $43.22        $8.64        $8.64
                            transfer.
   89256  X                Prepare                      0348         0.85       $43.22        $8.64        $8.64
                            cryopreserved
                            embryo.
   89257  X                Sperm identification         0348         0.85       $43.22        $8.64        $8.64
   89258  X                Cryopreservation,            0348         0.85       $43.22        $8.64        $8.64
                            embryo.
   89259  X                Cryopreservation,            0348         0.85       $43.22        $8.64        $8.64
                            sperm.
   89260  X                Sperm isolation,             0348         0.85       $43.22        $8.64        $8.64
                            simple.
   89261  X                Sperm isolation,             0348         0.85       $43.22        $8.64        $8.64
                            complex.
   89264  X                Identify sperm               0348         0.85       $43.22        $8.64        $8.64
                            tissue.
   89300  A                Semen analysis......  ...........  ...........  ...........  ...........  ...........
   89310  A                Semen analysis......  ...........  ...........  ...........  ...........  ...........
   89320  A                Semen analysis......  ...........  ...........  ...........  ...........  ...........
   89321  A                Semen analysis......  ...........  ...........  ...........  ...........  ...........
   89325  A                Sperm antibody test.  ...........  ...........  ...........  ...........  ...........
   89329  A                Sperm evaluation      ...........  ...........  ...........  ...........  ...........
                            test.
   89330  A                Evaluation, cervical  ...........  ...........  ...........  ...........  ...........
                            mucus.
   89350  X                Sputum specimen              0344         0.60       $30.51       $16.78        $6.10
                            collection.
   89355  A                Exam feces for        ...........  ...........  ...........  ...........  ...........
                            starch.
   89360  X                Collect sweat for            0344         0.60       $30.51       $16.78        $6.10
                            test.
   89365  A                Water load test.....  ...........  ...........  ...........  ...........  ...........
   89399  X                Pathology lab                0349         0.34       $17.29        $3.46        $3.46
                            procedure.
   90281  E                Human ig, im........  ...........  ...........  ...........  ...........  ...........
   90283  E                Human ig, iv........  ...........  ...........  ...........  ...........  ...........
   90287  E                Botulinum antitoxin.  ...........  ...........  ...........  ...........  ...........
   90288  E                Botulism ig, iv.....  ...........  ...........  ...........  ...........  ...........
   90291  E                Cmv ig, iv..........  ...........  ...........  ...........  ...........  ...........
   90296  K                Diphtheria antitoxin         0356         1.20       $61.01  ...........       $12.20
   90371  K                Hep b ig, im........         0356         1.20       $61.01  ...........       $12.20
   90375  K                Rabies ig, im/sc....         0356         1.20       $61.01  ...........       $12.20
   90376  K                Rabies ig, heat              0356         1.20       $61.01  ...........       $12.20
                            treated.
   90378  K                Rsv ig, im, 50mg....         0356         1.20       $61.01  ...........       $12.20
   90379  K                Rsv ig, iv..........         0356         1.20       $61.01  ...........       $12.20
   90384  E                Rh ig, full-dose, im  ...........  ...........  ...........  ...........  ...........
   90385  K                Rh ig, minidose, im.         0356         1.20       $61.01  ...........       $12.20
   90386  E                Rh ig, iv...........  ...........  ...........  ...........  ...........  ...........
   90389  K                Tetanus ig, im......         0356         1.20       $61.01  ...........       $12.20
   90393  K                Vaccina ig, im......         0356         1.20       $61.01  ...........       $12.20
   90396  K                Varicella-zoster ig,         0356         1.20       $61.01  ...........       $12.20
                            im.
   90399  E                Immune globulin.....  ...........  ...........  ...........  ...........  ...........
   90471  N                Immunization admin..  ...........  ...........  ...........  ...........  ...........
   90472  N                Immunization admin,   ...........  ...........  ...........  ...........  ...........
                            each add.
   90476  K                Adenovirus vaccine,          0356         1.20       $61.01  ...........       $12.20
                            type 4.
   90477  K                Adenovirus vaccine,          0356         1.20       $61.01  ...........       $12.20
                            type 7.
   90581  K                Anthrax vaccine, sc.         0356         1.20       $61.01  ...........       $12.20
   90585  K                Bcg vaccine, percut.         0356         1.20       $61.01  ...........       $12.20
   90586  K                Bcg vaccine,                 0356         1.20       $61.01  ...........       $12.20
                            intravesical.
   90632  K                Hep a vaccine, adult         0356         1.20       $61.01  ...........       $12.20
                            im.
   90633  K                Hep a vacc, ped/             0356         1.20       $61.01  ...........       $12.20
                            adol, 2 dose.
   90634  K                Hep a vacc, ped/             0356         1.20       $61.01  ...........       $12.20
                            adol, 3 dose.
   90636  K                Hep a/hep b vacc,            0355         0.20       $10.17  ...........        $2.03
                            adult im.
   90645  K                Hib vaccine, hboc,           0355         0.20       $10.17  ...........        $2.03
                            im.
   90646  K                Hib vaccine, prp-d,          0355         0.20       $10.17  ...........        $2.03
                            im.
   90647  K                Hib vaccine, prp-            0355         0.20       $10.17  ...........        $2.03
                            omp, im.
   90648  K                Hib vaccine, prp-t,          0355         0.20       $10.17  ...........        $2.03
                            im.
   90657  K                Flu vaccine, 6-35            0354         0.11        $5.59  ...........  ...........
                            mo, im.
   90658  K                Flu vaccine, 3 yrs,          0354         0.11        $5.59  ...........  ...........
                            im.
   90659  K                Flu vaccine, whole,          0354         0.11        $5.59  ...........  ...........
                            im.
   90660  E                Flu vaccine, nasal..  ...........  ...........  ...........  ...........  ...........
   90665  K                Lyme disease                 0356         1.20       $61.01  ...........       $12.20
                            vaccine, im.
   90669  E                Pneumococcal vacc,    ...........  ...........  ...........  ...........  ...........
                            ped5.
   90675  K                Rabies vaccine, im..         0356         1.20       $61.01  ...........       $12.20
   90676  K                Rabies vaccine, id..         0356         1.20       $61.01  ...........       $12.20
   90680  K                Rotovirus vaccine,           0356         1.20       $61.01  ...........       $12.20
                            oral.
   90690  K                Typhoid vaccine,             0356         1.20       $61.01  ...........       $12.20
                            oral.
   90691  K                Typhoid vaccine, im.         0356         1.20       $61.01  ...........       $12.20
   90692  K                Typhoid vaccine, h-          0355         0.20       $10.17  ...........        $2.03
                            p, sc/id.
   90693  K                Typhoid vaccine,             0356         1.20       $61.01  ...........       $12.20
                            akd, sc.
   90700  K                Dtap vaccine, im....         0355         0.20       $10.17  ...........        $2.03
   90701  K                Dtp vaccine, im.....         0355         0.20       $10.17  ...........        $2.03
   90702  K                Dt vaccine  7, im...         0355         0.20       $10.17  ...........        $2.03
   90703  K                Tetanus vaccine, im.         0355         0.20       $10.17  ...........        $2.03
   90704  K                Mumps vaccine, sc...         0355         0.20       $10.17  ...........        $2.03

[[Page 44825]]

 
   90705  K                Measles vaccine, sc.         0356         1.20       $61.01  ...........       $12.20
   90706  K                Rubella vaccine, sc.         0355         0.20       $10.17  ...........        $2.03
   90707  K                Mmr vaccine, sc.....         0356         1.20       $61.01  ...........       $12.20
   90708  K                Measles-rubella              0356         1.20       $61.01  ...........       $12.20
                            vaccine, sc.
   90709  K                Rubella & mumps              0356         1.20       $61.01  ...........       $12.20
                            vaccine, sc.
   90710  K                Mmrv vaccine, sc....         0356         1.20       $61.01  ...........       $12.20
   90712  K                Oral poliovirus              0355         0.20       $10.17  ...........        $2.03
                            vaccine.
   90713  K                Poliovirus, ipv, sc.         0355         0.20       $10.17  ...........        $2.03
   90716  K                Chicken pox vaccine,         0355         0.20       $10.17  ...........        $2.03
                            sc.
   90717  K                Yellow fever                 0356         1.20       $61.01  ...........       $12.20
                            vaccine, sc.
   90718  K                Td vaccine > 7, im..         0355         0.20       $10.17  ...........        $2.03
   90719  K                Diphtheria vaccine,          0356         1.20       $61.01  ...........       $12.20
                            im.
   90720  K                Dtp/hib vaccine, im.         0355         0.20       $10.17  ...........        $2.03
   90721  K                Dtap/hib vaccine, im         0355         0.20       $10.17  ...........        $2.03
   90723  K                Dtap-hep b-ipv               0356         1.20       $61.01  ...........       $12.20
                            vaccine, im.
   90725  K                Cholera vaccine,             0355         0.20       $10.17  ...........        $2.03
                            injectable.
   90727  K                Plague vaccine, im..         0355         0.20       $10.17  ...........        $2.03
   90732  K                Pneumococcal vacc,           0354         0.11        $5.59  ...........  ...........
                            adult/ill.
   90733  K                Meningococcal                0356         1.20       $61.01  ...........       $12.20
                            vaccine, sc.
   90735  K                Encephalitis                 0356         1.20       $61.01  ...........       $12.20
                            vaccine, sc.
   90740  K                Hepb vacc, ill pat 3         0356         1.20       $61.01  ...........       $12.20
                            dose im.
   90743  K                Hep b vacc, adol, 2          0356         1.20       $61.01  ...........       $12.20
                            dose, im.
   90744  K                Hepb vacc ped/adol 3         0356         1.20       $61.01  ...........       $12.20
                            dose im.
   90746  K                Hep b vaccine,               0356         1.20       $61.01  ...........       $12.20
                            adult, im.
   90747  K                Hepb vacc, ill pat 4         0356         1.20       $61.01  ...........       $12.20
                            dose im.
   90748  K                Hep b/hib vaccine,           0355         0.20       $10.17  ...........        $2.03
                            im.
   90749  K                Vaccine toxoid......         0355         0.20       $10.17  ...........        $2.03
   90780  E                IV infusion therapy,  ...........  ...........  ...........  ...........  ...........
                            1 hour.
   90781  E                IV infusion,          ...........  ...........  ...........  ...........  ...........
                            additional hour.
   90782  X                Injection, sc/im....         0352         0.45       $22.88        $4.58        $4.58
   90783  X                Injection, ia.......         0359         1.91       $97.11       $19.42       $19.42
   90784  X                Injection, iv.......         0359         1.91       $97.11       $19.42       $19.42
   90788  X                Injection of                 0359         1.91       $97.11       $19.42       $19.42
                            antibiotic.
   90799  X                Ther/prophylactic/dx         0352         0.45       $22.88        $4.58        $4.58
                            inject.
   90801  S                Psy dx interview....         0323         1.89       $96.09       $22.48       $19.22
   90802  S                Intac psy dx                 0323         1.89       $96.09       $22.48       $19.22
                            interview.
   90804  S                Psytx, office, 20-30         0322         1.25       $63.55       $13.35       $12.71
                            min.
   90805  S                Psytx, off, 20-30            0322         1.25       $63.55       $13.35       $12.71
                            min w/e&m.
   90806  S                Psytx, off, 45-50            0323         1.89       $96.09       $22.48       $19.22
                            min.
   90807  S                Psytx, off, 45-50            0323         1.89       $96.09       $22.48       $19.22
                            min w/e&m.
   90808  S                Psytx, office, 75-80         0323         1.89       $96.09       $22.48       $19.22
                            min.
   90809  S                Psytx, off, 75-80, w/        0323         1.89       $96.09       $22.48       $19.22
                            e&m.
   90810  S                Intac psytx, off, 20-        0322         1.25       $63.55       $13.35       $12.71
                            30 min.
   90811  S                Intac psytx, 20-30,          0322         1.25       $63.55       $13.35       $12.71
                            w/e&m.
   90812  S                Intac psytx, off, 45-        0323         1.89       $96.09       $22.48       $19.22
                            50 min.
   90813  S                Intac psytx, 45-50           0323         1.89       $96.09       $22.48       $19.22
                            min w/e&m.
   90814  S                Intac psytx, off, 75-        0323         1.89       $96.09       $22.48       $19.22
                            80 min.
   90815  S                Intac psytx, 75-80 w/        0323         1.89       $96.09       $22.48       $19.22
                            e&m.
   90816  S                Psytx, hosp, 20-30           0322         1.25       $63.55       $13.35       $12.71
                            min.
   90817  S                Psytx, hosp, 20-30           0322         1.25       $63.55       $13.35       $12.71
                            min w/e&m.
   90818  S                Psytx, hosp, 45-50           0323         1.89       $96.09       $22.48       $19.22
                            min.
   90819  S                Psytx, hosp, 45-50           0323         1.89       $96.09       $22.48       $19.22
                            min w/e&m.
   90821  S                Psytx, hosp, 75-80           0323         1.89       $96.09       $22.48       $19.22
                            min.
   90822  S                Psytx, hosp, 75-80           0323         1.89       $96.09       $22.48       $19.22
                            min w/e&m.
   90823  S                Intac psytx, hosp,           0322         1.25       $63.55       $13.35       $12.71
                            20-30 min.
   90824  S                Intac psytx, hsp 20-         0322         1.25       $63.55       $13.35       $12.71
                            30 w/e&m.
   90826  S                Intac psytx, hosp,           0323         1.89       $96.09       $22.48       $19.22
                            45-50 min.
   90827  S                Intac psytx, hsp 45-         0323         1.89       $96.09       $22.48       $19.22
                            50 w/e&m.
   90828  S                Intac psytx, hosp,           0323         1.89       $96.09       $22.48       $19.22
                            75-80 min.
   90829  S                Intac psytx, hsp 75-         0323         1.89       $96.09       $22.48       $19.22
                            80 w/e&m.
   90845  S                Psychoanalysis......         0323         1.89       $96.09       $22.48       $19.22
   90846  S                Family psytx w/o             0324         3.13      $159.14       $31.83       $31.83
                            patient.
   90847  S                Family psytx w/              0324         3.13      $159.14       $31.83       $31.83
                            patient.
   90849  S                Multiple family              0325         1.49       $75.75       $19.70       $15.15
                            group psytx.
   90853  S                Group psychotherapy.         0325         1.49       $75.75       $19.70       $15.15
   90857  S                Intac group psytx...         0325         1.49       $75.75       $19.70       $15.15
   90862  X                Medication                   0374         0.96       $48.81       $10.74        $9.76
                            management.
   90865  S                Narcosynthesis......         0323         1.89       $96.09       $22.48       $19.22
   90870  S                Electroconvulsive            0320         4.20      $213.54       $80.06       $42.71
                            therapy.
   90871  S                Electroconvulsive            0320         4.20      $213.54       $80.06       $42.71
                            therapy.
   90875  E                Psychophysiological   ...........  ...........  ...........  ...........  ...........
                            therapy.
   90876  E                Psychophysiological   ...........  ...........  ...........  ...........  ...........
                            therapy.
   90880  S                Hypnotherapy........         0323         1.89       $96.09       $22.48       $19.22
   90882  E                Environmental         ...........  ...........  ...........  ...........  ...........
                            manipulation.
   90885  N                Psy evaluation of     ...........  ...........  ...........  ...........  ...........
                            records.

[[Page 44826]]

 
   90887  N                Consultation with     ...........  ...........  ...........  ...........  ...........
                            family.
   90889  N                Preparation of        ...........  ...........  ...........  ...........  ...........
                            report.
   90899  S                Psychiatric service/         0322         1.25       $63.55       $13.35       $12.71
                            therapy.
   90901  S                Biofeedback train,           0321         1.02       $51.86       $23.86       $10.37
                            any meth.
   90911  S                Biofeedback peri/uro/        0321         1.02       $51.86       $23.86       $10.37
                            rectal.
   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            0170         1.08       $54.91       $12.08       $10.98
                            evaluation.
   90937  E                Hemodialysis,         ...........  ...........  ...........  ...........  ...........
                            repeated eval.
   90940  N                Hemodialysis access   ...........  ...........  ...........  ...........  ...........
                            study.
   90945  S                Dialysis, one                0170         1.08       $54.91       $12.08       $10.98
                            evaluation.
   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                   0361         3.52      $178.96       $88.09       $35.79
                            intubation.
   91010  X                Esophagus motility           0361         3.52      $178.96       $88.09       $35.79
                            study.
   91011  X                Esophagus motility           0361         3.52      $178.96       $88.09       $35.79
                            study.
   91012  X                Esophagus motility           0361         3.52      $178.96       $88.09       $35.79
                            study.
   91020  X                Gastric motility....         0361         3.52      $178.96       $88.09       $35.79
   91030  X                Acid perfusion of            0360         1.40       $71.18       $34.75       $14.24
                            esophagus.
   91032  X                Esophagus, acid              0361         3.52      $178.96       $88.09       $35.79
                            reflux test.
   91033  X                Prolonged acid               0361         3.52      $178.96       $88.09       $35.79
                            reflux test.
   91052  X                Gastric analysis             0361         3.52      $178.96       $88.09       $35.79
                            test.
   91055  X                Gastric intubation           0360         1.40       $71.18       $34.75       $14.24
                            for smear.
   91060  X                Gastric saline load          0360         1.40       $71.18       $34.75       $14.24
                            test.
   91065  X                Breath hydrogen test         0360         1.40       $71.18       $34.75       $14.24
   91100  X                Pass intestine               0360         1.40       $71.18       $34.75       $14.24
                            bleeding tube.
   91105  X                Gastric intubation           0361         3.52      $178.96       $88.09       $35.79
                            treatment.
   91122  T                Anal pressure record         0156         2.62      $133.21       $39.96       $26.64
   91132  X                Electrogastrography.         0360         1.40       $71.18       $34.75       $14.24
   91133  X                Electrogastrography          0360         1.40       $71.18       $34.75       $14.24
                            w/test.
   91299  X                Gastroenterology             0360         1.40       $71.18       $34.75       $14.24
                            procedure.
   92002  V                Eye exam, new                0601         1.02       $51.86       $10.37       $10.37
                            patient.
   92004  V                Eye exam, new                0602         1.49       $75.75       $15.15       $15.15
                            patient.
   92012  V                Eye exam established         0601         1.02       $51.86       $10.37       $10.37
                            pat.
   92014  V                Eye exam & treatment         0602         1.49       $75.75       $15.15       $15.15
   92015  E                Refraction..........  ...........  ...........  ...........  ...........  ...........
   92018  T                New eye exam &               0699         6.91      $351.32      $158.09       $70.26
                            treatment.
   92019  S                Eye exam & treatment         0698         1.09       $55.42       $24.94       $11.08
   92020  S                Special eye                  0230         0.64       $32.54       $14.97        $6.51
                            evaluation.
   92060  S                Special eye                  0230         0.64       $32.54       $14.97        $6.51
                            evaluation.
   92065  S                Orthoptic/pleoptic           0230         0.64       $32.54       $14.97        $6.51
                            training.
   92070  N                Fitting of contact    ...........  ...........  ...........  ...........  ...........
                            lens.
   92081  S                Visual field                 0230         0.64       $32.54       $14.97        $6.51
                            examination(s).
   92082  S                Visual field                 0698         1.09       $55.42       $24.94       $11.08
                            examination(s).
   92083  S                Visual field                 0698         1.09       $55.42       $24.94       $11.08
                            examination(s).
   92100  N                Serial tonometry      ...........  ...........  ...........  ...........  ...........
                            exam(s).
   92120  S                Tonography & eye             0230         0.64       $32.54       $14.97        $6.51
                            evaluation.
   92130  S                Water provocation            0230         0.64       $32.54       $14.97        $6.51
                            tonography.
   92135  S                Opthalmic dx imaging         0230         0.64       $32.54       $14.97        $6.51
   92140  S                Glaucoma provocative         0231         2.27      $115.41       $51.94       $23.08
                            tests.
   92225  S                Special eye exam,            0230         0.64       $32.54       $14.97        $6.51
                            initial.
   92226  S                Special eye exam,            0231         2.27      $115.41       $51.94       $23.08
                            subsequent.
   92230  T                Eye exam with photos         0699         6.91      $351.32      $158.09       $70.26
   92235  S                Eye exam with photos         0231         2.27      $115.41       $51.94       $23.08
   92240  S                Icg angiography.....         0231         2.27      $115.41       $51.94       $23.08
   92250  S                Eye exam with photos         0230         0.64       $32.54       $14.97        $6.51
   92260  S                Ophthalmoscopy/              0230         0.64       $32.54       $14.97        $6.51
                            dynamometry.
   92265  S                Eye muscle                   0231         2.27      $115.41       $51.94       $23.08
                            evaluation.
   92270  S                Electro-oculography.         0698         1.09       $55.42       $24.94       $11.08
   92275  S                Electroretinography.         0216         2.91      $147.95       $64.69       $29.59
   92283  S                Color vision                 0230         0.64       $32.54       $14.97        $6.51
                            examination.
   92284  S                Dark adaptation eye          0231         2.27      $115.41       $51.94       $23.08
                            exam.
   92285  S                Eye photography.....         0230         0.64       $32.54       $14.97        $6.51
   92286  S                Internal eye                 0230         0.64       $32.54       $14.97        $6.51
                            photography.
   92287  S                Internal eye                 0231         2.27      $115.41       $51.94       $23.08
                            photography.
   92310  E                Contact lens fitting  ...........  ...........  ...........  ...........  ...........

[[Page 44827]]

 
   92311  X                Contact lens fitting         0362         0.83       $42.20        $9.63        $8.44
   92312  X                Contact lens fitting         0362         0.83       $42.20        $9.63        $8.44
   92313  X                Contact lens fitting         0362         0.83       $42.20        $9.63        $8.44
   92314  E                Prescription of       ...........  ...........  ...........  ...........  ...........
                            contact lens.
   92315  X                Prescription of              0362         0.83       $42.20        $9.63        $8.44
                            contact lens.
   92316  X                Prescription of              0362         0.83       $42.20        $9.63        $8.44
                            contact lens.
   92317  X                Prescription of              0362         0.83       $42.20        $9.63        $8.44
                            contact lens.
   92325  X                Modification of              0362         0.83       $42.20        $9.63        $8.44
                            contact lens.
   92326  X                Replacement of               0362         0.83       $42.20        $9.63        $8.44
                            contact lens.
   92330  S                Fitting of                   0230         0.64       $32.54       $14.97        $6.51
                            artificial eye.
   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           0362         0.83       $42.20        $9.63        $8.44
                            fitting.
   92353  X                Special spectacles           0362         0.83       $42.20        $9.63        $8.44
                            fitting.
   92354  X                Special spectacles           0362         0.83       $42.20        $9.63        $8.44
                            fitting.
   92355  X                Special spectacles           0362         0.83       $42.20        $9.63        $8.44
                            fitting.
   92358  X                Eye prosthesis               0362         0.83       $42.20        $9.63        $8.44
                            service.
   92370  E                Repair & adjust       ...........  ...........  ...........  ...........  ...........
                            spectacles.
   92371  X                Repair & adjust              0362         0.83       $42.20        $9.63        $8.44
                            spectacles.
   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               0230         0.64       $32.54       $14.97        $6.51
                            procedure.
   92502  T                Ear and throat               0251         2.71      $137.78       $27.99       $27.56
                            examination.
   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         1.08       $54.91       $14.22       $10.98
   92512  X                Nasal function               0363         2.06      $104.73       $38.75       $20.95
                            studies.
   92516  X                Facial nerve                 0363         2.06      $104.73       $38.75       $20.95
                            function test.
   92520  X                Laryngeal function           0363         2.06      $104.73       $38.75       $20.95
                            studies.
   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                  0363         2.06      $104.73       $38.75       $20.95
                            nystagmus test.
   92542  X                Positional nystagmus         0363         2.06      $104.73       $38.75       $20.95
                            test.
   92543  X                Caloric vestibular           0363         2.06      $104.73       $38.75       $20.95
                            test.
   92544  X                Optokinetic                  0363         2.06      $104.73       $38.75       $20.95
                            nystagmus test.
   92545  X                Oscillating tracking         0363         2.06      $104.73       $38.75       $20.95
                            test.
   92546  X                Sinusoidal                   0363         2.06      $104.73       $38.75       $20.95
                            rotational test.
   92547  X                Supplemental                 0363         2.06      $104.73       $38.75       $20.95
                            electrical test.
   92548  X                Posturography.......         0363         2.06      $104.73       $38.75       $20.95
   92551  E                Pure tone hearing     ...........  ...........  ...........  ...........  ...........
                            test, air.
   92552  X                Pure tone                    0364         0.55       $27.96       $10.91        $5.59
                            audiometry, air.
   92553  X                Audiometry, air &            0365         1.42       $72.20       $21.66       $14.44
                            bone.
   92555  X                Speech threshold             0364         0.55       $27.96       $10.91        $5.59
                            audiometry.
   92556  X                Speech audiometry,           0364         0.55       $27.96       $10.91        $5.59
                            complete.
   92557  X                Comprehensive                0365         1.42       $72.20       $21.66       $14.44
                            hearing test.
   92559  E                Group audiometric     ...........  ...........  ...........  ...........  ...........
                            testing.
   92560  E                Bekesy audiometry,    ...........  ...........  ...........  ...........  ...........
                            screen.
   92561  X                Bekesy audiometry,           0365         1.42       $72.20       $21.66       $14.44
                            diagnosis.
   92562  X                Loudness balance             0364         0.55       $27.96       $10.91        $5.59
                            test.
   92563  X                Tone decay hearing           0364         0.55       $27.96       $10.91        $5.59
                            test.
   92564  X                Sisi hearing test...         0364         0.55       $27.96       $10.91        $5.59
   92565  X                Stenger test, pure           0364         0.55       $27.96       $10.91        $5.59
                            tone.
   92567  X                Tympanometry........         0364         0.55       $27.96       $10.91        $5.59
   92568  X                Acoustic reflex              0364         0.55       $27.96       $10.91        $5.59
                            testing.
   92569  X                Acoustic reflex              0364         0.55       $27.96       $10.91        $5.59
                            decay test.
   92571  X                Filtered speech              0364         0.55       $27.96       $10.91        $5.59
                            hearing test.
   92572  X                Staggered spondaic           0364         0.55       $27.96       $10.91        $5.59
                            word test.
   92573  X                Lombard test........         0364         0.55       $27.96       $10.91        $5.59
   92575  X                Sensorineural acuity         0365         1.42       $72.20       $21.66       $14.44
                            test.
   92576  X                Synthetic sentence           0364         0.55       $27.96       $10.91        $5.59
                            test.
   92577  X                Stenger test, speech         0365         1.42       $72.20       $21.66       $14.44
   92579  X                Visual audiometry            0365         1.42       $72.20       $21.66       $14.44
                            (vra).

[[Page 44828]]

 
   92582  X                Conditioning play            0365         1.42       $72.20       $21.66       $14.44
                            audiometry.
   92583  X                Select picture               0364         0.55       $27.96       $10.91        $5.59
                            audiometry.
   92584  X                Electrocochleography         0363         2.06      $104.73       $38.75       $20.95
   92585  S                Auditor evoke                0216         2.91      $147.95       $64.69       $29.59
                            potent, compre.
   92586  S                Auditor evoke                0971         1.42       $72.20  ...........       $14.44
                            potent, limit.
   92587  X                Evoked auditory test         0363         2.06      $104.73       $38.75       $20.95
   92588  X                Evoked auditory test         0363         2.06      $104.73       $38.75       $20.95
   92589  X                Auditory function            0364         0.55       $27.96       $10.91        $5.59
                            test(s).
   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                0365         1.42       $72.20       $21.66       $14.44
                            evaluation.
   92599  X                ENT procedure/               0364         0.55       $27.96       $10.91        $5.59
                            service.
   92950  S                Heart/lung                   0094         5.69      $289.29      $105.29       $57.86
                            resuscitation cpr.
   92953  S                Temporary external           0094         5.69      $289.29      $105.29       $57.86
                            pacing.
   92960  S                Cardioversion                0094         5.69      $289.29      $105.29       $57.86
                            electric, ext.
   92961  S                Cardioversion,               0087        14.89      $757.04      $214.72      $151.41
                            electric, int.
   92970  C                Cardioassist,         ...........  ...........  ...........  ...........  ...........
                            internal.
   92971  C                Cardioassist,         ...........  ...........  ...........  ...........  ...........
                            external.
   92975  C                Dissolve clot, heart  ...........  ...........  ...........  ...........  ...........
                            vessel.
   92977  T                Dissolve clot, heart         0120         2.35      $119.48       $42.67       $23.90
                            vessel.
   92978  S                Intravasc us, heart          0267         2.58      $131.17       $72.14       $26.23
                            add-on.
   92979  S                Intravasc us, heart          0267         2.58      $131.17       $72.14       $26.23
                            add-on.
   92980  T                Insert intracoronary         0104        71.42    $3,631.14      $726.23      $726.23
                            stent.
   92981  T                Insert intracoronary         0104        71.42    $3,631.14      $726.23      $726.23
                            stent.
   92982  T                Coronary artery              0083        50.15    $2,549.73      $794.30      $509.95
                            dilation.
   92984  T                Coronary artery              0083        50.15    $2,549.73      $794.30      $509.95
                            dilation.
   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       130.89    $6,654.71    $1,351.74    $1,330.94
   92996  T                Coronary atherectomy         0082       130.89    $6,654.71    $1,351.74    $1,330.94
                            add-on.
   92997  C                Pul art balloon       ...........  ...........  ...........  ...........  ...........
                            repr, percut.
   92998  C                Pul art balloon       ...........  ...........  ...........  ...........  ...........
                            repr, percut.
   93000  E                Electrocardiogram,    ...........  ...........  ...........  ...........  ...........
                            complete.
   93005  S                Electrocardiogram,           0099         0.38       $19.32       $10.63        $3.86
                            tracing.
   93010  S                Electrocardiogram     ...........  ...........  ...........  ...........  ...........
                            report.
   93012  N                Transmission of ecg.  ...........  ...........  ...........  ...........  ...........
   93014  E                Report on             ...........  ...........  ...........  ...........  ...........
                            transmitted ecg.
   93015  E                Cardiovascular        ...........  ...........  ...........  ...........  ...........
                            stress test.
   93016  E                Cardiovascular        ...........  ...........  ...........  ...........  ...........
                            stress test.
   93017  X                Cardiovascular               0100         1.63       $82.87       $45.58       $16.57
                            stress test.
   93018  E                Cardiovascular        ...........  ...........  ...........  ...........  ...........
                            stress test.
   93024  X                Cardiac drug stress          0100         1.63       $82.87       $45.58       $16.57
                            test.
   93040  E                Rhythm ECG with       ...........  ...........  ...........  ...........  ...........
                            report.
   93041  S                Rhythm ECG, tracing.         0099         0.38       $19.32       $10.63        $3.86
   93042  E                Rhythm ECG, report..  ...........  ...........  ...........  ...........  ...........
   93224  E                ECG monitor/report,   ...........  ...........  ...........  ...........  ...........
                            24 hrs.
   93225  X                ECG monitor/record,          0100         1.63       $82.87       $45.58       $16.57
                            24 hrs.
   93226  X                ECG monitor/report,          0100         1.63       $82.87       $45.58       $16.57
                            24 hrs.
   93227  E                ECG monitor/review,   ...........  ...........  ...........  ...........  ...........
                            24 hrs.
   93230  E                ECG monitor/report,   ...........  ...........  ...........  ...........  ...........
                            24 hrs.
   93231  X                Ecg monitor/record,          0100         1.63       $82.87       $45.58       $16.57
                            24 hrs.
   93232  X                ECG monitor/report,          0100         1.63       $82.87       $45.58       $16.57
                            24 hrs.
   93233  E                ECG monitor/review,   ...........  ...........  ...........  ...........  ...........
                            24 hrs.
   93235  E                ECG monitor/report,   ...........  ...........  ...........  ...........  ...........
                            24 hrs.
   93236  X                ECG monitor/report,          0100         1.63       $82.87       $45.58       $16.57
                            24 hrs.
   93237  E                ECG monitor/review,   ...........  ...........  ...........  ...........  ...........
                            24 hrs.
   93268  E                ECG record/review...  ...........  ...........  ...........  ...........  ...........
   93270  X                ECG recording.......         0097         0.87       $44.23       $24.33        $8.85
   93271  X                Ecg/monitoring and           0097         0.87       $44.23       $24.33        $8.85
                            analysis.
   93272  E                Ecg/review,           ...........  ...........  ...........  ...........  ...........
                            interpret only.
   93278  S                ECG/signal-averaged.         0099         0.38       $19.32       $10.63        $3.86
   93303  S                Echo transthoracic..         0269         4.31      $219.13      $113.95       $43.83
   93304  S                Echo transthoracic..         0697         2.00      $101.68       $52.88       $20.34
   93307  S                Echo exam of heart..         0269         4.31      $219.13      $113.95       $43.83
   93308  S                Echo exam of heart..         0697         2.00      $101.68       $52.88       $20.34
   93312  S                Echo transesophageal         0270         5.83      $296.41      $150.26       $59.28
   93313  S                Echo transesophageal         0270         5.83      $296.41      $150.26       $59.28
   93314  N                Echo transesophageal  ...........  ...........  ...........  ...........  ...........

[[Page 44829]]

 
   93315  S                Echo transesophageal         0270         5.83      $296.41      $150.26       $59.28
   93316  S                Echo transesophageal         0270         5.83      $296.41      $150.26       $59.28
   93317  N                Echo transesophageal  ...........  ...........  ...........  ...........  ...........
   93318  S                Echo transesophageal         0270         5.83      $296.41      $150.26       $59.28
                            intraop.
   93320  S                Doppler echo exam,           0269         4.31      $219.13      $113.95       $43.83
                            heart.
   93321  S                Doppler echo exam,           0697         2.00      $101.68       $52.88       $20.34
                            heart.
   93325  S                Doppler color flow           0697         2.00      $101.68       $52.88       $20.34
                            add-on.
   93350  S                Echo transthoracic..         0269         4.31      $219.13      $113.95       $43.83
   93501  T                Right heart                  0080        32.20    $1,637.11      $838.92      $327.42
                            catheterization.
   93503  T                Insert/place heart           0103        10.91      $554.69      $249.61      $110.94
                            catheter.
   93505  T                Biopsy of heart              0103        10.91      $554.69      $249.61      $110.94
                            lining.
   93508  N                Cath placement,       ...........  ...........  ...........  ...........  ...........
                            angiography.
   93510  T                Left heart                   0080        32.20    $1,637.11      $838.92      $327.42
                            catheterization.
   93511  T                Left heart                   0080        32.20    $1,637.11      $838.92      $327.42
                            catheterization.
   93514  T                Left heart                   0080        32.20    $1,637.11      $838.92      $327.42
                            catheterization.
   93524  T                Left heart                   0080        32.20    $1,637.11      $838.92      $327.42
                            catheterization.
   93526  T                Rt & Lt heart                0080        32.20    $1,637.11      $838.92      $327.42
                            catheters.
   93527  T                Rt & Lt heart                0080        32.20    $1,637.11      $838.92      $327.42
                            catheters.
   93528  T                Rt & Lt heart                0080        32.20    $1,637.11      $838.92      $327.42
                            catheters.
   93529  T                Rt, Lt heart                 0080        32.20    $1,637.11      $838.92      $327.42
                            catheterization.
   93530  T                Rt heart cath,               0080        32.20    $1,637.11      $838.92      $327.42
                            congenital.
   93531  T                R & l heart cath,            0080        32.20    $1,637.11      $838.92      $327.42
                            congenital.
   93532  T                R & l heart cath,            0080        32.20    $1,637.11      $838.92      $327.42
                            congenital.
   93533  T                R & l heart cath,            0080        32.20    $1,637.11      $838.92      $327.42
                            congenital.
   93536  T                Insert circulation           0103        10.91      $554.69      $249.61      $110.94
                            assi.
   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                0087        14.89      $757.04      $214.72      $151.41
                            recording.
   93602  S                Intra-atrial                 0087        14.89      $757.04      $214.72      $151.41
                            recording.
   93603  S                Right ventricular            0087        14.89      $757.04      $214.72      $151.41
                            recording.
   93607  S                Left ventricular             0087        14.89      $757.04      $214.72      $151.41
                            recording.
   93609  S                Mapping of                   0087        14.89      $757.04      $214.72      $151.41
                            tachycardia.
   93610  S                Intra-atrial pacing.         0087        14.89      $757.04      $214.72      $151.41
   93612  S                Intraventricular             0087        14.89      $757.04      $214.72      $151.41
                            pacing.
   93615  S                Esophageal recording         0087        14.89      $757.04      $214.72      $151.41
   93616  S                Esophageal recording         0087        14.89      $757.04      $214.72      $151.41
   93618  S                Heart rhythm pacing.         0087        14.89      $757.04      $214.72      $151.41
   93619  S                Electrophysiology            0085        27.39    $1,392.56      $654.48      $278.51
                            evaluation.
   93620  S                Electrophysiology            0085        27.39    $1,392.56      $654.48      $278.51
                            evaluation.
   93621  S                Electrophysiology            0085        27.39    $1,392.56      $654.48      $278.51
                            evaluation.
   93622  S                Electrophysiology            0085        27.39    $1,392.56      $654.48      $278.51
                            evaluation.
   93623  S                Stimulation, pacing          0087        14.89      $757.04      $214.72      $151.41
                            heart.
   93624  S                Electrophysiologic           0087        14.89      $757.04      $214.72      $151.41
                            study.
   93631  S                Heart pacing,                0087        14.89      $757.04      $214.72      $151.41
                            mapping.
   93640  S                Evaluation heart             0084         4.94      $251.16       $82.88       $50.23
                            device.
   93641  S                Electrophysiology            0084         4.94      $251.16       $82.88       $50.23
                            evaluation.
   93642  S                Electrophysiology            0084         4.94      $251.16       $82.88       $50.23
                            evaluation.
   93650  S                Ablate heart                 0086        47.13    $2,396.18    $1,265.37      $479.24
                            dysrhythm focus.
   93651  S                Ablate heart                 0086        47.13    $2,396.18    $1,265.37      $479.24
                            dysrhythm focus.
   93652  S                Ablate heart                 0086        47.13    $2,396.18    $1,265.37      $479.24
                            dysrhythm focus.
   93660  S                Tilt table                   0101         4.03      $204.89      $112.69       $40.98
                            evaluation.
   93662  S                Intracardiac ecg             0270         5.83      $296.41      $150.26       $59.28
                            (ice).
   93668  E                Peripheral vascular   ...........  ...........  ...........  ...........  ...........
                            rehab.
   93720  E                Total body            ...........  ...........  ...........  ...........  ...........
                            plethysmography.
   93721  S                Plethysmography              0096         1.87       $95.07       $52.29       $19.01
                            tracing.
   93722  E                Plethysmography       ...........  ...........  ...........  ...........  ...........
                            report.
   93724  S                Analyze pacemaker            0690         0.40       $20.34       $11.19        $4.07
                            system.
   93727  S                Analyze ilr system..         0690         0.40       $20.34       $11.19        $4.07
   93731  S                Analyze pacemaker            0690         0.40       $20.34       $11.19        $4.07
                            system.
   93732  S                Analyze pacemaker            0690         0.40       $20.34       $11.19        $4.07
                            system.
   93733  S                Telephone analy,             0690         0.40       $20.34       $11.19        $4.07
                            pacemaker.
   93734  S                Analyze pacemaker            0690         0.40       $20.34       $11.19        $4.07
                            system.
   93735  S                Analyze pacemaker            0690         0.40       $20.34       $11.19        $4.07
                            system.
   93736  S                Telephone analy,             0690         0.40       $20.34       $11.19        $4.07
                            pacemaker.

[[Page 44830]]

 
   93737  S                Analyze cardio/              0689         0.49       $24.91       $13.70        $4.98
                            defibrillator.
   93738  S                Analyze cardio/              0689         0.49       $24.91       $13.70        $4.98
                            defibrillator.
   93740  S                Temperature gradient         0096         1.87       $95.07       $52.29       $19.01
                            studies.
   93741  S                Analyze ht pace              0689         0.49       $24.91       $13.70        $4.98
                            device sngl.
   93742  S                Analyze ht pace              0689         0.49       $24.91       $13.70        $4.98
                            device sngl.
   93743  S                Analyze ht pace              0689         0.49       $24.91       $13.70        $4.98
                            device dual.
   93744  S                Analyze ht pace              0689         0.49       $24.91       $13.70        $4.98
                            device dual.
   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         0.66       $33.56       $16.98        $6.71
   93798  S                Cardiac rehab/               0095         0.66       $33.56       $16.98        $6.71
                            monitor.
   93799  S                Cardiovascular               0096         1.87       $95.07       $52.29       $19.01
                            procedure.
   93875  S                Extracranial study..         0096         1.87       $95.07       $52.29       $19.01
   93880  S                Extracranial study..         0267         2.58      $131.17       $72.14       $26.23
   93882  S                Extracranial study..         0267         2.58      $131.17       $72.14       $26.23
   93886  S                Intracranial study..         0267         2.58      $131.17       $72.14       $26.23
   93888  S                Intracranial study..         0267         2.58      $131.17       $72.14       $26.23
   93922  S                Extremity study.....         0096         1.87       $95.07       $52.29       $19.01
   93923  S                Extremity study.....         0096         1.87       $95.07       $52.29       $19.01
   93924  S                Extremity study.....         0096         1.87       $95.07       $52.29       $19.01
   93925  S                Lower extremity              0267         2.58      $131.17       $72.14       $26.23
                            study.
   93926  S                Lower extremity              0267         2.58      $131.17       $72.14       $26.23
                            study.
   93930  S                Upper extremity              0267         2.58      $131.17       $72.14       $26.23
                            study.
   93931  S                Upper extremity              0267         2.58      $131.17       $72.14       $26.23
                            study.
   93965  S                Extremity study.....         0096         1.87       $95.07       $52.29       $19.01
   93970  S                Extremity study.....         0267         2.58      $131.17       $72.14       $26.23
   93971  S                Extremity study.....         0267         2.58      $131.17       $72.14       $26.23
   93975  S                Vascular study......         0267         2.58      $131.17       $72.14       $26.23
   93976  S                Vascular study......         0267         2.58      $131.17       $72.14       $26.23
   93978  S                Vascular study......         0267         2.58      $131.17       $72.14       $26.23
   93979  S                Vascular study......         0267         2.58      $131.17       $72.14       $26.23
   93980  S                Penile vascular              0267         2.58      $131.17       $72.14       $26.23
                            study.
   93981  S                Penile vascular              0267         2.58      $131.17       $72.14       $26.23
                            study.
   93990  S                Doppler flow testing         0267         2.58      $131.17       $72.14       $26.23
   94010  X                Breathing capacity           0367         0.76       $38.64       $19.32        $7.73
                            test.
   94014  X                Patient recorded             0367         0.76       $38.64       $19.32        $7.73
                            spirometry.
   94015  X                Patient recorded             0367         0.76       $38.64       $19.32        $7.73
                            spirometry.
   94016  X                Review patient               0369         3.99      $202.86       $58.50       $40.57
                            spirometry.
   94060  X                Evaluation of                0368         1.53       $77.79       $39.67       $15.56
                            wheezing.
   94070  X                Evaluation of                0368         1.53       $77.79       $39.67       $15.56
                            wheezing.
   94150  N                Vital capacity test.  ...........  ...........  ...........  ...........  ...........
   94200  X                Lung function test           0367         0.76       $38.64       $19.32        $7.73
                            (MBC/MVV).
   94240  X                Residual lung                0368         1.53       $77.79       $39.67       $15.56
                            capacity.
   94250  X                Expired gas                  0367         0.76       $38.64       $19.32        $7.73
                            collection.
   94260  X                Thoracic gas volume.         0368         1.53       $77.79       $39.67       $15.56
   94350  X                Lung nitrogen                0368         1.53       $77.79       $39.67       $15.56
                            washout curve.
   94360  X                Measure airflow              0368         1.53       $77.79       $39.67       $15.56
                            resistance.
   94370  X                Breath airway                0368         1.53       $77.79       $39.67       $15.56
                            closing volume.
   94375  X                Respiratory flow             0367         0.76       $38.64       $19.32        $7.73
                            volume loop.
   94400  X                CO2 breathing                0368         1.53       $77.79       $39.67       $15.56
                            response curve.
   94450  X                Hypoxia response             0367         0.76       $38.64       $19.32        $7.73
                            curve.
   94620  X                Pulmonary stress             0368         1.53       $77.79       $39.67       $15.56
                            test/simple.
   94621  X                Pulm stress test/            0369         3.99      $202.86       $58.50       $40.57
                            complex.
   94640  S                Airway inhalation            0077         0.42       $21.35       $11.74        $4.27
                            treatment.
   94642  S                Aerosol inhalation           0078         0.93       $47.28       $20.33        $9.46
                            treatment.
   94650  S                Pressure breathing           0077         0.42       $21.35       $11.74        $4.27
                            (IPPB).
   94651  S                Pressure breathing           0077         0.42       $21.35       $11.74        $4.27
                            (IPPB).
   94652  C                Pressure breathing    ...........  ...........  ...........  ...........  ...........
                            (IPPB).
   94656  S                Initial ventilator           0079         0.62       $31.52       $17.34        $6.30
                            mgmt.
   94657  S                Continued ventilator         0079         0.62       $31.52       $17.34        $6.30
                            mgmt.
   94660  S                Pos airway pressure,         0068         3.33      $169.30       $93.12       $33.86
                            CPAP.
   94662  S                Neg press                    0079         0.62       $31.52       $17.34        $6.30
                            ventilation, cnp.
   94664  S                Aerosol or vapor             0077         0.42       $21.35       $11.74        $4.27
                            inhalations.
   94665  S                Aerosol or vapor             0077         0.42       $21.35       $11.74        $4.27
                            inhalations.
   94667  S                Chest wall                   0077         0.42       $21.35       $11.74        $4.27
                            manipulation.
   94668  S                Chest wall                   0077         0.42       $21.35       $11.74        $4.27
                            manipulation.
   94680  X                Exhaled air                  0368         1.53       $77.79       $39.67       $15.56
                            analysis, o2.
   94681  X                Exhaled air                  0368         1.53       $77.79       $39.67       $15.56
                            analysis, o2/co2.
   94690  X                Exhaled air analysis         0367         0.76       $38.64       $19.32        $7.73
   94720  X                Monoxide diffusing           0367         0.76       $38.64       $19.32        $7.73
                            capacity.

[[Page 44831]]

 
   94725  X                Membrane diffusion           0368         1.53       $77.79       $39.67       $15.56
                            capacity.
   94750  X                Pulmonary compliance         0368         1.53       $77.79       $39.67       $15.56
                            study.
   94760  N                Measure blood oxygen  ...........  ...........  ...........  ...........  ...........
                            level.
   94761  N                Measure blood oxygen  ...........  ...........  ...........  ...........  ...........
                            level.
   94762  N                Measure blood oxygen  ...........  ...........  ...........  ...........  ...........
                            level.
   94770  X                Exhaled carbon               0367         0.76       $38.64       $19.32        $7.73
                            dioxide test.
   94772  X                Breath recording,            0369         3.99      $202.86       $58.50       $40.57
                            infant.
   94799  X                Pulmonary service/           0367         0.76       $38.64       $19.32        $7.73
                            procedure.
   95004  X                Allergy skin tests..         0370         0.87       $44.23       $11.81        $8.85
   95010  X                Sensitivity skin             0370         0.87       $44.23       $11.81        $8.85
                            tests.
   95015  X                Sensitivity skin             0370         0.87       $44.23       $11.81        $8.85
                            tests.
   95024  X                Allergy skin tests..         0370         0.87       $44.23       $11.81        $8.85
   95027  X                Skin end point               0370         0.87       $44.23       $11.81        $8.85
                            titration.
   95028  X                Allergy skin tests..         0370         0.87       $44.23       $11.81        $8.85
   95044  X                Allergy patch tests.         0370         0.87       $44.23       $11.81        $8.85
   95052  X                Photo patch test....         0370         0.87       $44.23       $11.81        $8.85
   95056  X                Photosensitivity             0370         0.87       $44.23       $11.81        $8.85
                            tests.
   95060  X                Eye allergy tests...         0370         0.87       $44.23       $11.81        $8.85
   95065  X                Nose allergy test...         0370         0.87       $44.23       $11.81        $8.85
   95070  X                Bronchial allergy            0369         3.99      $202.86       $58.50       $40.57
                            tests.
   95071  X                Bronchial allergy            0369         3.99      $202.86       $58.50       $40.57
                            tests.
   95075  X                Ingestion challenge          0361         3.52      $178.96       $88.09       $35.79
                            test.
   95078  X                Provocative testing.         0370         0.87       $44.23       $11.81        $8.85
   95115  X                Immunotherapy, one           0353         0.27       $13.73        $2.75        $2.75
                            injection.
   95117  X                Immunotherapy                0353         0.27       $13.73        $2.75        $2.75
                            injections.
   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              0371         0.76       $38.64        $7.73        $7.73
                            services.
   95145  X                Antigen therapy              0371         0.76       $38.64        $7.73        $7.73
                            services.
   95146  X                Antigen therapy              0371         0.76       $38.64        $7.73        $7.73
                            services.
   95147  X                Antigen therapy              0371         0.76       $38.64        $7.73        $7.73
                            services.
   95148  X                Antigen therapy              0371         0.76       $38.64        $7.73        $7.73
                            services.
   95149  X                Antigen therapy              0371         0.76       $38.64        $7.73        $7.73
                            services.
   95165  X                Antigen therapy              0371         0.76       $38.64        $7.73        $7.73
                            services.
   95170  X                Antigen therapy              0371         0.76       $38.64        $7.73        $7.73
                            services.
   95180  X                Rapid                        0370         0.87       $44.23       $11.81        $8.85
                            desensitization.
   95199  X                Allergy immunology           0370         0.87       $44.23       $11.81        $8.85
                            services.
   95805  S                Multiple sleep               0209        11.73      $596.38      $310.12      $119.28
                            latency test.
   95806  S                Sleep study,                 0213         2.95      $149.98       $77.99       $30.00
                            unattended.
   95807  S                Sleep study,                 0209        11.73      $596.38      $310.12      $119.28
                            attended.
   95808  S                Polysomnography, 1-3         0209        11.73      $596.38      $310.12      $119.28
   95810  S                Polysomnography, 4           0209        11.73      $596.38      $310.12      $119.28
                            or more.
   95811  S                Polysomnography w/           0209        11.73      $596.38      $310.12      $119.28
                            cpap.
   95812  S                Electroencephalogram         0213         2.95      $149.98       $77.99       $30.00
                            (EEG).
   95813  S                Electroencephalogram         0213         2.95      $149.98       $77.99       $30.00
                            (EEG).
   95816  S                Electroencephalogram         0214         2.27      $115.41       $57.71       $23.08
                            (EEG).
   95819  S                Electroencephalogram         0214         2.27      $115.41       $57.71       $23.08
                            (EEG).
   95822  S                Sleep                        0214         2.27      $115.41       $57.71       $23.08
                            electroencephalogra
                            m.
   95824  S                Electroencephalograp         0214         2.27      $115.41       $57.71       $23.08
                            hy.
   95827  S                Night                        0209        11.73      $596.38      $310.12      $119.28
                            electroencephalogra
                            m.
   95829  S                Surgery                      0214         2.27      $115.41       $57.71       $23.08
                            electrocorticogram.
   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.......         0218         1.09       $55.42       $23.83       $11.08
   95858  S                Tensilon test &              0215         0.66       $33.56       $17.45        $6.71
                            myogram.
   95860  S                Muscle test, one             0218         1.09       $55.42       $23.83       $11.08
                            limb.
   95861  S                Muscle test, two             0218         1.09       $55.42       $23.83       $11.08
                            limbs.
   95863  S                Muscle test, 3 limbs         0218         1.09       $55.42       $23.83       $11.08
   95864  S                Muscle test, 4 limbs         0218         1.09       $55.42       $23.83       $11.08
   95867  S                Muscle test, head or         0218         1.09       $55.42       $23.83       $11.08
                            neck.
   95868  S                Muscle test, head or         0218         1.09       $55.42       $23.83       $11.08
                            neck.
   95869  S                Muscle test, thor            0215         0.66       $33.56       $17.45        $6.71
                            paraspinal.
   95870  S                Muscle test,                 0218         1.09       $55.42       $23.83       $11.08
                            nonparaspinal.
   95872  S                Muscle test, one             0215         0.66       $33.56       $17.45        $6.71
                            fiber.
   95875  S                Limb exercise test..         0215         0.66       $33.56       $17.45        $6.71

[[Page 44832]]

 
   95900  S                Motor nerve                  0218         1.09       $55.42       $23.83       $11.08
                            conduction test.
   95903  S                Motor nerve                  0218         1.09       $55.42       $23.83       $11.08
                            conduction test.
   95904  S                Sense/mixed n                0215         0.66       $33.56       $17.45        $6.71
                            conduction tst.
   95920  S                Intraop nerve test           0218         1.09       $55.42       $23.83       $11.08
                            add-on.
   95921  S                Autonomic nerv               0215         0.66       $33.56       $17.45        $6.71
                            function test.
   95922  S                Autonomic nerv               0215         0.66       $33.56       $17.45        $6.71
                            function test.
   95923  S                Autonomic nerv               0215         0.66       $33.56       $17.45        $6.71
                            function test.
   95925  S                Somatosensory                0216         2.91      $147.95       $64.69       $29.59
                            testing.
   95926  S                Somatosensory                0216         2.91      $147.95       $64.69       $29.59
                            testing.
   95927  S                Somatosensory                0216         2.91      $147.95       $64.69       $29.59
                            testing.
   95930  S                Visual evoked                0216         2.91      $147.95       $64.69       $29.59
                            potential test.
   95933  S                Blink reflex test...         0215         0.66       $33.56       $17.45        $6.71
   95934  S                H-reflex test.......         0215         0.66       $33.56       $17.45        $6.71
   95936  S                H-reflex test.......         0215         0.66       $33.56       $17.45        $6.71
   95937  S                Neuromuscular                0218         1.09       $55.42       $23.83       $11.08
                            junction test.
   95950  S                Ambulatory eeg               0213         2.95      $149.98       $77.99       $30.00
                            monitoring.
   95951  S                EEG monitoring/              0209        11.73      $596.38      $310.12      $119.28
                            videorecord.
   95953  S                EEG monitoring/              0209        11.73      $596.38      $310.12      $119.28
                            computer.
   95954  S                EEG monitoring/              0213         2.95      $149.98       $77.99       $30.00
                            giving drugs.
   95955  S                EEG during surgery..         0214         2.27      $115.41       $57.71       $23.08
   95956  N                Eeg monitoring,       ...........  ...........  ...........  ...........  ...........
                            cable/radio.
   95957  N                EEG digital analysis  ...........  ...........  ...........  ...........  ...........
   95958  S                EEG monitoring/              0213         2.95      $149.98       $77.99       $30.00
                            function test.
   95961  S                Electrode                    0216         2.91      $147.95       $64.69       $29.59
                            stimulation, brain.
   95962  S                Electrode stim,              0216         2.91      $147.95       $64.69       $29.59
                            brain add-on.
   95970  S                Analyze neurostim,           0692         1.73       $87.96       $48.38       $17.59
                            no prog.
   95971  S                Analyze neurostim,           0692         1.73       $87.96       $48.38       $17.59
                            simple.
   95972  S                Analyze neurostim,           0692         1.73       $87.96       $48.38       $17.59
                            complex.
   95973  S                Analyze neurostim,           0692         1.73       $87.96       $48.38       $17.59
                            complex.
   95974  S                Cranial neurostim,           0692         1.73       $87.96       $48.38       $17.59
                            complex.
   95975  S                Cranial neurostim,           0692         1.73       $87.96       $48.38       $17.59
                            complex.
   95999  N                Neurological          ...........  ...........  ...........  ...........  ...........
                            procedure.
   96100  X                Psychological                0373         1.11       $56.43       $15.80       $11.29
                            testing.
   96105  X                Assessment of                0373         1.11       $56.43       $15.80       $11.29
                            aphasia.
   96110  X                Developmental test,          0373         1.11       $56.43       $15.80       $11.29
                            lim.
   96111  X                Developmental test,          0373         1.11       $56.43       $15.80       $11.29
                            extend.
   96115  X                Neurobehavior status         0373         1.11       $56.43       $15.80       $11.29
                            exam.
   96117  X                Neuropsych test              0373         1.11       $56.43       $15.80       $11.29
                            battery.
   96400  E                Chemotherapy, sc/im.  ...........  ...........  ...........  ...........  ...........
   96405  E                Intralesional chemo   ...........  ...........  ...........  ...........  ...........
                            admin.
   96406  E                Intralesional chemo   ...........  ...........  ...........  ...........  ...........
                            admin.
   96408  E                Chemotherapy, push    ...........  ...........  ...........  ...........  ...........
                            technique.
   96410  E                Chemotherapy,infusio  ...........  ...........  ...........  ...........  ...........
                            n method.
   96412  E                Chemo, infuse method  ...........  ...........  ...........  ...........  ...........
                            add-on.
   96414  E                Chemo, infuse method  ...........  ...........  ...........  ...........  ...........
                            add-on.
   96420  E                Chemotherapy, push    ...........  ...........  ...........  ...........  ...........
                            technique.
   96422  E                Chemotherapy,infusio  ...........  ...........  ...........  ...........  ...........
                            n method.
   96423  E                Chemo, infuse method  ...........  ...........  ...........  ...........  ...........
                            add-on.
   96425  E                Chemotherapy,infusio  ...........  ...........  ...........  ...........  ...........
                            n method.
   96440  E                Chemotherapy,         ...........  ...........  ...........  ...........  ...........
                            intracavitary.
   96445  E                Chemotherapy,         ...........  ...........  ...........  ...........  ...........
                            intracavitary.
   96450  E                Chemotherapy, into    ...........  ...........  ...........  ...........  ...........
                            CNS.
   96520  T                Pump refilling,              0125         3.20      $162.69  ...........       $32.54
                            maintenance.
   96530  T                Pump refilling,              0125         3.20      $162.69  ...........       $32.54
                            maintenance.
   96542  E                Chemotherapy          ...........  ...........  ...........  ...........  ...........
                            injection.
   96545  E                Provide chemotherapy  ...........  ...........  ...........  ...........  ...........
                            agent.
   96549  E                Chemotherapy,         ...........  ...........  ...........  ...........  ...........
                            unspecified.
   96570  T                Photodynamic tx, 30          0973         4.73      $240.48  ...........       $48.10
                            min.
   96571  T                Photodynamic tx,             0973         4.73      $240.48  ...........       $48.10
                            addl 15 min.
   96900  S                Ultraviolet light            0001         0.45       $22.88        $8.24        $4.58
                            therapy.
   96902  N                Trichogram..........  ...........  ...........  ...........  ...........  ...........
   96910  S                Photochemotherapy            0001         0.45       $22.88        $8.24        $4.58
                            with UV-B.
   96912  S                Photochemotherapy            0001         0.45       $22.88        $8.24        $4.58
                            with UV-A.
   96913  S                Photochemotherapy,           0001         0.45       $22.88        $8.24        $4.58
                            UV-A or B.
   96999  S                Dermatological               0001         0.45       $22.88        $8.24        $4.58
                            procedure.
   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...  ...........  ...........  ...........  ...........  ...........

[[Page 44833]]

 
   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.
   97532  A                Cognitive skills      ...........  ...........  ...........  ...........  ...........
                            development.
   97533  A                Sensory integration.  ...........  ...........  ...........  ...........  ...........
   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.
   97601  A                Wound care selective  ...........  ...........  ...........  ...........  ...........
   97602  N                Wound care non-       ...........  ...........  ...........  ...........  ...........
                            selective.
   97703  A                Prosthetic checkout.  ...........  ...........  ...........  ...........  ...........
   97750  A                Physical performance  ...........  ...........  ...........  ...........  ...........
                            test.
   97780  E                Acupuncture w/o       ...........  ...........  ...........  ...........  ...........
                            stimul.
   97781  E                Acupuncture w/stimul  ...........  ...........  ...........  ...........  ...........
   97799  A                Physical medicine     ...........  ...........  ...........  ...........  ...........
                            procedure.
   97802  E                Medical nutrition,    ...........  ...........  ...........  ...........  ...........
                            indiv, in.
   97803  E                Med nutrition,        ...........  ...........  ...........  ...........  ...........
                            indiv, subseq.
   97804  E                Medical nutrition,    ...........  ...........  ...........  ...........  ...........
                            group.
   98925  S                Osteopathic                  0060         0.25       $12.71        $2.54        $2.54
                            manipulation.
   98926  S                Osteopathic                  0060         0.25       $12.71        $2.54        $2.54
                            manipulation.
   98927  S                Osteopathic                  0060         0.25       $12.71        $2.54        $2.54
                            manipulation.
   98928  S                Osteopathic                  0060         0.25       $12.71        $2.54        $2.54
                            manipulation.
   98929  S                Osteopathic                  0060         0.25       $12.71        $2.54        $2.54
                            manipulation.
   98940  S                Chiropractic                 0060         0.25       $12.71        $2.54        $2.54
                            manipulation.
   98941  S                Chiropractic                 0060         0.25       $12.71        $2.54        $2.54
                            manipulation.
   98942  S                Chiropractic                 0060         0.25       $12.71        $2.54        $2.54
                            manipulation.
   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.
   99142  N                Sedation, oral/       ...........  ...........  ...........  ...........  ...........
                            rectal/nasal.
   99170  T                Anogenital exam,             0191         0.27       $13.73        $3.98        $2.75
                            child.
   99172  E                Ocular function       ...........  ...........  ...........  ...........  ...........
                            screen.
   99173  E                Visual acuity screen  ...........  ...........  ...........  ...........  ...........
   99175  N                Induction of          ...........  ...........  ...........  ...........  ...........
                            vomiting.
   99183  E                Hyperbaric oxygen     ...........  ...........  ...........  ...........  ...........
                            therapy.

[[Page 44834]]

 
   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         0.57       $28.98       $10.09        $5.80
   99199  E                Special service/proc/ ...........  ...........  ...........  ...........  ...........
                            report.
   99201  V                Office/outpatient            0600         0.93       $47.28        $9.46        $9.46
                            visit, new.
   99202  V                Office/outpatient            0600         0.93       $47.28        $9.46        $9.46
                            visit, new.
   99203  V                Office/outpatient            0601         1.02       $51.86       $10.37       $10.37
                            visit, new.
   99204  V                Office/outpatient            0602         1.49       $75.75       $15.15       $15.15
                            visit, new.
   99205  V                Office/outpatient            0602         1.49       $75.75       $15.15       $15.15
                            visit, new.
   99211  V                Office/outpatient            0600         0.93       $47.28        $9.46        $9.46
                            visit, est.
   99212  V                Office/outpatient            0600         0.93       $47.28        $9.46        $9.46
                            visit, est.
   99213  V                Office/outpatient            0601         1.02       $51.86       $10.37       $10.37
                            visit, est.
   99214  V                Office/outpatient            0602         1.49       $75.75       $15.15       $15.15
                            visit, est.
   99215  V                Office/outpatient            0602         1.49       $75.75       $15.15       $15.15
                            visit, est.
   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  N                Observ/hosp same      ...........  ...........  ...........  ...........  ...........
                            date.
   99235  N                Observ/hosp same      ...........  ...........  ...........  ...........  ...........
                            date.
   99236  N                Observ/hosp same      ...........  ...........  ...........  ...........  ...........
                            date.
   99238  E                Hospital discharge    ...........  ...........  ...........  ...........  ...........
                            day.
   99239  E                Hospital discharge    ...........  ...........  ...........  ...........  ...........
                            day.
   99241  V                Office consultation.         0600         0.93       $47.28        $9.46        $9.46
   99242  V                Office consultation.         0600         0.93       $47.28        $9.46        $9.46
   99243  V                Office consultation.         0601         1.02       $51.86       $10.37       $10.37
   99244  V                Office consultation.         0602         1.49       $75.75       $15.15       $15.15
   99245  V                Office consultation.         0602         1.49       $75.75       $15.15       $15.15
   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                 0600         0.93       $47.28        $9.46        $9.46
                            consultation.
   99272  V                Confirmatory                 0600         0.93       $47.28        $9.46        $9.46
                            consultation.
   99273  V                Confirmatory                 0601         1.02       $51.86       $10.37       $10.37
                            consultation.
   99274  V                Confirmatory                 0602         1.49       $75.75       $15.15       $15.15
                            consultation.
   99275  V                Confirmatory                 0602         1.49       $75.75       $15.15       $15.15
                            consultation.
   99281  V                Emergency dept visit         0610         1.34       $68.13       $20.65       $13.63
   99282  V                Emergency dept visit         0610         1.34       $68.13       $20.65       $13.63
   99283  V                Emergency dept visit         0611         2.33      $118.46       $36.47       $23.69
   99284  V                Emergency dept visit         0612         3.75      $190.66       $54.14       $38.13
   99285  V                Emergency dept visit         0612         3.75      $190.66       $54.14       $38.13
   99288  E                Direct advanced life  ...........  ...........  ...........  ...........  ...........
                            support.
   99291  S                Critical care, first         0620         9.13      $464.19      $152.78       $92.84
                            hour.
   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.
   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.

[[Page 44835]]

 
   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.
   99377  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                      0094         5.69      $289.29      $105.29       $57.86
                            resuscitation.
   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.
   A0080  E                Noninterest escort    ...........  ...........  ...........  ...........  ...........
                            in non er.
   A0090  E                Interest escort in    ...........  ...........  ...........  ...........  ...........
                            non er.
   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.
   A0382  A                Basic support         ...........  ...........  ...........  ...........  ...........
                            routine suppls.
   A0384  A                Bls defibrillation    ...........  ...........  ...........  ...........  ...........
                            supplies.

[[Page 44836]]

 
   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.
   A0425  A                Ground mileage......  ...........  ...........  ...........  ...........  ...........
   A0426  A                Als 1...............  ...........  ...........  ...........  ...........  ...........
   A0427  A                ALS1-emergency......  ...........  ...........  ...........  ...........  ...........
   A0428  A                bls.................  ...........  ...........  ...........  ...........  ...........
   A0429  A                BLS-emergency.......  ...........  ...........  ...........  ...........  ...........
   A0430  A                Fixed wing air        ...........  ...........  ...........  ...........  ...........
                            transport.
   A0431  A                Rotary wing air       ...........  ...........  ...........  ...........  ...........
                            transport.
   A0432  A                PI volunteer          ...........  ...........  ...........  ...........  ...........
                            ambulance co.
   A0433  A                als 2...............  ...........  ...........  ...........  ...........  ...........
   A0434  A                Specialty care        ...........  ...........  ...........  ...........  ...........
                            transport.
   A0435  A                Fixed wing air        ...........  ...........  ...........  ...........  ...........
                            mileage.
   A0436  A                Rotary wing air       ...........  ...........  ...........  ...........  ...........
                            mileage.
   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  E                5+ CC sterile         ...........  ...........  ...........  ...........  ...........
                            syringe&needle.
   A4210  E                Nonneedle injection   ...........  ...........  ...........  ...........  ...........
                            device.
   A4211  E                Supp for self-adm     ...........  ...........  ...........  ...........  ...........
                            injections.
   A4212  E                Non coring needle or  ...........  ...........  ...........  ...........  ...........
                            stylet.
   A4213  E                20+ CC syringe only.  ...........  ...........  ...........  ...........  ...........
   A4214  A                30 CC sterile water/  ...........  ...........  ...........  ...........  ...........
                            saline.
   A4215  E                Sterile needle......  ...........  ...........  ...........  ...........  ...........
   A4220  A                Infusion pump refill  ...........  ...........  ...........  ...........  ...........
                            kit.
   A4221  A                Maint drug infus      ...........  ...........  ...........  ...........  ...........
                            cath per wk.
   A4222  A                Drug infusion pump    ...........  ...........  ...........  ...........  ...........
                            supplies.
   A4230  A                Infus insulin pump    ...........  ...........  ...........  ...........  ...........
                            non needl.
   A4231  A                Infusion insulin      ...........  ...........  ...........  ...........  ...........
                            pump needle.
   A4232  A                Syringe w/needle      ...........  ...........  ...........  ...........  ...........
                            insulin 3cc.
   A4244  E                Alcohol or peroxide   ...........  ...........  ...........  ...........  ...........
                            per pint.
   A4245  E                Alcohol wipes per     ...........  ...........  ...........  ...........  ...........
                            box.
   A4246  E                Betadine/phisohex     ...........  ...........  ...........  ...........  ...........
                            solution.
   A4247  E                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.
   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  N                Permanent tear duct   ...........  ...........  ...........  ...........  ...........
                            plug.
   A4265  A                Paraffin............  ...........  ...........  ...........  ...........  ...........
   A4270  A                Disposable endoscope  ...........  ...........  ...........  ...........  ...........
                            sheath.
   A4280  A                Brst prsths adhsv     ...........  ...........  ...........  ...........  ...........
                            attchmnt.
   A4290  N                Sacral nerve stim     ...........  ...........  ...........  ...........  ...........
                            test lead.
   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.
   A4319  A                Sterile H2O           ...........  ...........  ...........  ...........  ...........
                            irrigation solut.
   A4320  A                Irrigation tray.....  ...........  ...........  ...........  ...........  ...........
   A4321  A                Cath therapeutic      ...........  ...........  ...........  ...........  ...........
                            irrig agent.
   A4322  A                Irrigation syringe..  ...........  ...........  ...........  ...........  ...........
   A4323  A                Saline irrigation     ...........  ...........  ...........  ...........  ...........
                            solution.
   A4324  A                Male ext cath w/adh   ...........  ...........  ...........  ...........  ...........
                            coating.
   A4325  A                Male ext cath w/adh   ...........  ...........  ...........  ...........  ...........
                            strip.
   A4326  A                Male external         ...........  ...........  ...........  ...........  ...........
                            catheter.

[[Page 44837]]

 
   A4327  A                Fem urinary collect   ...........  ...........  ...........  ...........  ...........
                            dev cup.
   A4328  A                Fem urinary collect   ...........  ...........  ...........  ...........  ...........
                            pouch.
   A4329  A                External catheter     ...........  ...........  ...........  ...........  ...........
                            start set.
   A4330  A                Stool collection      ...........  ...........  ...........  ...........  ...........
                            pouch.
   A4331  A                Extension drainage    ...........  ...........  ...........  ...........  ...........
                            tubing.
   A4332  A                Lubricant for cath    ...........  ...........  ...........  ...........  ...........
                            insertion.
   A4333  A                Urinary cath anchor   ...........  ...........  ...........  ...........  ...........
                            device.
   A4334  A                Urinary cath leg      ...........  ...........  ...........  ...........  ...........
                            strap.
   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.
   A4348  A                Male ext cath         ...........  ...........  ...........  ...........  ...........
                            extended wear.
   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                Adhesive, liquid or   ...........  ...........  ...........  ...........  ...........
                            equal.
   A4365  A                Adhesive remover      ...........  ...........  ...........  ...........  ...........
                            wipes.
   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.
   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.
   A4396  A                Peristomal hernia     ...........  ...........  ...........  ...........  ...........
                            supprt blt.
   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.
   A4464  A                Joint support device/ ...........  ...........  ...........  ...........  ...........
                            garment.
   A4465  A                Non-elastic           ...........  ...........  ...........  ...........  ...........
                            extremity binder.
   A4470  A                Gravlee jet washer..  ...........  ...........  ...........  ...........  ...........
   A4480  A                Vabra aspirator.....  ...........  ...........  ...........  ...........  ...........
   A4481  A                Tracheostoma filter.  ...........  ...........  ...........  ...........  ...........
   A4483  A                Moisture exchanger..  ...........  ...........  ...........  ...........  ...........

[[Page 44838]]

 
   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.
   A4561  N                Pessary rubber, any   ...........  ...........  ...........  ...........  ...........
                            type.
   A4562  N                Pessary, non          ...........  ...........  ...........  ...........  ...........
                            rubber,any type.
   A4565  A                Slings..............  ...........  ...........  ...........  ...........  ...........
   A4570  N                Splint..............  ...........  ...........  ...........  ...........  ...........
   A4572  A                Rib belt............  ...........  ...........  ...........  ...........  ...........
   A4575  E                Hyperbaric o2         ...........  ...........  ...........  ...........  ...........
                            chamber disps.
   A4580  N                Cast supplies         ...........  ...........  ...........  ...........  ...........
                            (plaster).
   A4590  N                Special casting       ...........  ...........  ...........  ...........  ...........
                            material.
   A4595  A                TENS suppl 2 lead     ...........  ...........  ...........  ...........  ...........
                            per month.
   A4608  A                Transtracheal oxygen  ...........  ...........  ...........  ...........  ...........
                            cath.
   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.
   A4642  G                Satumomab pendetide          0704  ...........      $831.25  ...........      $119.00
                            per dose.
   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.  ...........  ...........  ...........  ...........  ...........
   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..  ...........  ...........  ...........  ...........  ...........

[[Page 44839]]

 
   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.
   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...  ...........  ...........  ...........  ...........  ...........
   A5200  A                Percutaneous          ...........  ...........  ...........  ...........  ...........
                            catheter anchor.
   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  ...........  ...........  ...........  ...........  ...........
   A6021  A                Collagen dressing     ...........  ...........  ...........  ...........  ...........
                            =16 sq in.
   A6022  A                Collagen drsg>6=48    ...........  ...........  ...........  ...........  ...........
                            sq in.
   A6023  A                Collagen dressing     ...........  ...........  ...........  ...........  ...........
                            >48 sq in.
   A6024  A                Collagen dsg wound    ...........  ...........  ...........  ...........  ...........
                            filler.
   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.

[[Page 44840]]

 
   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.
   A6231  A                Hydrogel dsg=16 sq    ...........  ...........  ...........  ...........  ...........
                            in.
   A6232  A                Hydrogel dsg>16=48    ...........  ...........  ...........  ...........  ...........
                            sq in.
   A6233  A                Hydrogel dressing     ...........  ...........  ...........  ...........  ...........
                            >48 sq in.
   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.
   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.

[[Page 44841]]

 
   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.
   A7018  A                Water distilled w/    ...........  ...........  ...........  ...........  ...........
                            nebulizer.
   A7019  A                Saline solution       ...........  ...........  ...........  ...........  ...........
                            dispenser.
   A7020  A                Sterile H2O or NSS w  ...........  ...........  ...........  ...........  ...........
                            lgv neb.
   A7501  A                Tracheostoma valve w  ...........  ...........  ...........  ...........  ...........
                            diaphra.
   A7502  A                Replacement           ...........  ...........  ...........  ...........  ...........
                            diaphragm/fplate.
   A7503  A                HMES filter holder    ...........  ...........  ...........  ...........  ...........
                            or cap.
   A7504  A                Tracheostoma HMES     ...........  ...........  ...........  ...........  ...........
                            filter.
   A7505  A                HMES or trach valve   ...........  ...........  ...........  ...........  ...........
                            housing.
   A7506  A                HMES/trachvalve       ...........  ...........  ...........  ...........  ...........
                            adhesivedisk.
   A7507  A                Integrated filter &   ...........  ...........  ...........  ...........  ...........
                            holder.
   A7508  A                Housing & Integrated  ...........  ...........  ...........  ...........  ...........
                            Adhesiv.
   A7509  A                Heat & moisture       ...........  ...........  ...........  ...........  ...........
                            exchange sys.
   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  G                Technetium TC 99m            1600  ...........      $115.90  ...........       $16.59
                            sestamibi.
   A9502  G                Technetium TC99M             0705  ...........      $129.96  ...........       $18.60
                            tetrofosmin.
   A9503  G                Technetium TC 99m            1601  ...........       $36.46  ...........        $3.30
                            medronate.
   A9504  G                Technetium tc 99m            1602  ...........       $45.13  ...........        $6.46
                            apcitide.
   A9505  G                Thallous chloride TL         1603  ...........       $29.45  ...........        $3.78
                            201/mci.
   A9507  G                Indium/111 capromab          1604  ...........    $1,128.13  ...........      $161.50
                            pendetid.
   A9508  G                Iobenguane sulfate I-        1045  ...........      $495.65  ...........       $44.87
                            131.
   A9510  G                Technetium TC99m             1205  ...........       $85.50  ...........        $7.74
                            Disofenin.
   A9600  G                Strontium-89                 0701  ...........      $963.42  ...........      $137.92
                            chloride.
   A9605  G                Samarium sm153               0702  ...........    $1,020.00  ...........      $146.02
                            lexidronamm.
   A9700  G                Echocardiography             9016  ...........       $39.58  ...........        $5.67
                            Contrast.
   A9900  A                Supply/accessory/     ...........  ...........  ...........  ...........  ...........
                            service.
   A9901  A                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      ...........  ...........  ...........  ...........  ...........
                            cat1natural.
   B4152  A                Enteral formulae      ...........  ...........  ...........  ...........  ...........
                            category ii.
   B4153  A                Enteral formulae      ...........  ...........  ...........  ...........  ...........
                            categoryIII.
   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.
   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.

[[Page 44842]]

 
   B9999  A                Parenteral supp not   ...........  ...........  ...........  ...........  ...........
                            othrws c.
   C1010  K                Blood, L/R, CMV-NEG.         1010         2.94      $149.48  ...........       $29.90
   C1011  K                Platelets, HLA-m, L/         1011        12.12      $616.21  ...........      $123.24
                            R, unit.
   C1012  K                PLATELET CONC, L/R,          1012         1.96       $99.65  ...........       $19.93
                            Irrad.
   C1013  K                PLATELET CONC, L/R,          1013         1.20       $61.01  ...........       $12.20
                            Unit.
   C1014  K                Platelet,Aph/Pher, L/        1014         9.13      $464.19  ...........       $92.84
                            R, unit.
   C1016  K                BLOOD,L/R,FROZ/DEGLY/        1016         7.31      $371.66  ...........       $74.33
                            Washed.
   C1017  K                Plt, APH/PHER,L/             1017         9.53      $484.52  ...........       $96.90
                            R,CMV-NEG.
   C1018  K                Blood, L/R,                  1018         3.20      $162.69  ...........       $32.54
                            IRRADIATED.
   C1019  K                Plt, APH/PHER, L/R,          1019         9.85      $500.79  ...........      $100.16
                            IRRAD.
   C1050  S                PROSORBA Column.....         0976        16.56      $841.94  ...........      $168.39
   C1079  G                CO 57/58 0.5 Mci....         1079  ...........      $253.84  ...........       $36.34
   C1087  G                I-123 per uci, dx            1087  ...........         $.65  ...........         $.09
                            use.
   C1088  T                LASER OPTIC TR Sys..         0980        35.49    $1,804.38  ...........      $360.88
   C1090  G                IN 111 chloride, per         1090  ...........      $152.00  ...........       $21.76
                            mCi.
   C1091  G                IN 111                       1091  ...........      $482.84  ...........       $69.12
                            oxyquinoline,per
                            5mCi.
   C1092  G                IN 111 PENETATE, PER         1092  ...........      $769.50  ...........      $110.16
                            1.5 mci.
   C1094  G                TC 99M albumin aggr,         1094  ...........       $33.09  ...........        $4.74
                            per via.
   C1095  G                TC 99M DEPREOTIDE,           1095  ...........      $760.00  ...........      $108.80
                            PER Vial.
   C1096  G                TC 99M EXAMETAZIME,          1096  ...........      $423.04  ...........       $60.56
                            PER Dose.
   C1097  G                TC 99M MEBROFENIN,           1097  ...........       $51.43  ...........        $7.36
                            PER Vial.
   C1098  G                TC 99M PENTETATE,            1098  ...........       $22.64  ...........        $2.76
                            PER Vial.
   C1099  G                TC 99M                       1099  ...........       $42.75  ...........        $6.12
                            PYROPHOSPHATE,PER
                            Via.
   C1122  G                Tc 99M ARCITUMOMAB           1122  ...........    $1,235.00  ...........      $176.80
                            PER VIAL.
   C1166  G                CYTARABINE                   1166  ...........      $371.45  ...........       $53.18
                            LIPOSOMAL, 10 mg.
   C1167  G                EPIRUBICIN HCL, 2 mg         1167  ...........       $24.94  ...........        $3.57
   C1178  G                BUSULFAN IV, 6 Mg...         1178  ...........       $26.49  ...........        $3.79
   C1188  G                I-131 per uci, dx            1188  ...........         $.78  ...........         $.10
                            use.
   C1200  G                TC 99M Sodium                1200  ...........      $107.40  ...........       $15.37
                            Glucoheptonat.
   C1201  G                TC 99M SUCCIMER, PER         1201  ...........      $135.66  ...........       $19.42
                            Vial.
   C1202  G                TC 99M SULFUR                1202  ...........       $36.10  ...........        $3.27
                            COLLOID, Vial.
   C1207  G                OCTREOTIDE ACETATE           1207  ...........      $140.37  ...........       $20.10
                            DEPOT 1mg.
   C1300  S                HYPERBARIC Oxygen...         0971         1.42       $72.20  ...........       $14.44
   C1305  G                Apligraf............         1305  ...........    $1,157.81  ...........      $165.75
   C1348  G                I-131 per mci sol,           1348  ...........      $146.57  ...........       $20.98
                            rx use.
   C1713  H                Anchor/screw bn/             1713  ...........  ...........  ...........  ...........
                            bn,tis/bn.
   C1714  H                Cath, trans                  1714  ...........  ...........  ...........  ...........
                            atherectomy, dir.
   C1715  H                Brachytherapy needle         1715  ...........  ...........  ...........  ...........
   C1716  H                Brachytx seed, Gold          1716  ...........  ...........  ...........  ...........
                            198.
   C1717  H                Brachytx seed, HDR           1717  ...........  ...........  ...........  ...........
                            Ir-192.
   C1718  H                Brachytx seed,               1718  ...........  ...........  ...........  ...........
                            Iodine 125.
   C1719  H                Brachytx seed,Non-           1719  ...........  ...........  ...........  ...........
                            HDR Ir-192.
   C1720  H                Brachytx seed,               1720  ...........  ...........  ...........  ...........
                            Palladium 103.
   C1721  H                AICD, dual chamber..         1721  ...........  ...........  ...........  ...........
   C1722  H                AICD, single chamber         1722  ...........  ...........  ...........  ...........
   C1723  H                Cath, ablation, non-         1723  ...........  ...........  ...........  ...........
                            cardiac.
   C1724  H                Cath, trans                  1724  ...........  ...........  ...........  ...........
                            atherec,rotation.
   C1725  H                Cath, translumin non-        1725  ...........  ...........  ...........  ...........
                            laser.
   C1726  H                Cath, bal dil, non-          1726  ...........  ...........  ...........  ...........
                            vascular.
   C1727  H                Cath, bal tis dis,           1727  ...........  ...........  ...........  ...........
                            non-vas.
   C1728  H                Cath, brachytx seed          1728  ...........  ...........  ...........  ...........
                            adm.
   C1729  H                Cath, drainage......         1729  ...........  ...........  ...........  ...........
   C1730  H                Cath, EP, 19 or few          1730  ...........  ...........  ...........  ...........
                            elect.
   C1731  H                Cath, EP, 20 or more         1731  ...........  ...........  ...........  ...........
                            elec.
   C1732  H                Cath, EP, diag/abl,          1732  ...........  ...........  ...........  ...........
                            3D/vect.
   C1733  H                Cath, EP, othr than          1733  ...........  ...........  ...........  ...........
                            cool-tip.
   C1750  H                Cath,                        1750  ...........  ...........  ...........  ...........
                            hemodialysis,long-
                            term.
   C1751  H                Cath, inf, per/cent/         1751  ...........  ...........  ...........  ...........
                            midline.
   C1752  H                Cath,hemodialysis,sh         1752  ...........  ...........  ...........  ...........
                            ort-term.
   C1753  H                Cath, intravas               1753  ...........  ...........  ...........  ...........
                            ultrasound.
   C1754  H                Catheter,                    1754  ...........  ...........  ...........  ...........
                            intradiscal.
   C1755  H                Catheter,                    1755  ...........  ...........  ...........  ...........
                            intraspinal.
   C1756  H                Cath, pacing,                1756  ...........  ...........  ...........  ...........
                            transesoph.
   C1757  H                Cath, thrombectomy/          1757  ...........  ...........  ...........  ...........
                            embolect.
   C1758  H                Catheter, ureteral..         1758  ...........  ...........  ...........  ...........
   C1759  H                Cath, intra                  1759  ...........  ...........  ...........  ...........
                            echocardiography.
   C1760  H                Closure dev, vasc...         1760  ...........  ...........  ...........  ...........
   C1762  H                Conn tiss, human(inc         1762  ...........  ...........  ...........  ...........
                            fascia).
   C1763  H                Conn tiss, non-human         1763  ...........  ...........  ...........  ...........
   C1764  H                Event recorder,              1764  ...........  ...........  ...........  ...........
                            cardiac.
   C1765  H                Adhesion barrier....         1765  ...........  ...........  ...........  ...........
   C1766  H                Intro/                       1766  ...........  ...........  ...........  ...........
                            sheath,strble,non-
                            peel.
   C1767  H                Generator,                   1767  ...........  ...........  ...........  ...........
                            neurostim, imp.
   C1768  H                Graft, vascular.....         1768  ...........  ...........  ...........  ...........
   C1769  H                Guide wire..........         1769  ...........  ...........  ...........  ...........

[[Page 44843]]

 
   C1770  H                Imaging coil, MR,            1770  ...........  ...........  ...........  ...........
                            insertable.
   C1771  H                Rep dev, urinary, w/         1771  ...........  ...........  ...........  ...........
                            sling.
   C1772  H                Infusion pump,               1772  ...........  ...........  ...........  ...........
                            programmable.
   C1773  H                Ret dev, insertable.         1773  ...........  ...........  ...........  ...........
   C1776  H                Joint device                 1776  ...........  ...........  ...........  ...........
                            (implantable).
   C1777  H                Lead, AICD, endo             1777  ...........  ...........  ...........  ...........
                            single coil.
   C1778  H                Lead,                        1778  ...........  ...........  ...........  ...........
                            neurostimulator.
   C1779  H                Lead, pmkr,                  1779  ...........  ...........  ...........  ...........
                            transvenous VDD.
   C1780  H                Lens, intraocular            1780  ...........  ...........  ...........  ...........
                            (new tech).
   C1781  H                Mesh (implantable)..         1781  ...........  ...........  ...........  ...........
   C1782  H                Morcellator.........         1782  ...........  ...........  ...........  ...........
   C1784  H                Ocular dev, intraop,         1784  ...........  ...........  ...........  ...........
                            det ret.
   C1785  H                Pmkr, dual, rate-            1785  ...........  ...........  ...........  ...........
                            resp.
   C1786  H                Pmkr, single, rate-          1786  ...........  ...........  ...........  ...........
                            resp.
   C1787  H                Patient progr,               1787  ...........  ...........  ...........  ...........
                            neurostim.
   C1788  H                Port, indwelling,            1788  ...........  ...........  ...........  ...........
                            imp.
   C1789  H                Prosthesis, breast,          1789  ...........  ...........  ...........  ...........
                            imp.
   C1813  H                Prosthesis, penile,          1813  ...........  ...........  ...........  ...........
                            inflatab.
   C1815  H                Pros, urinary sph,           1815  ...........  ...........  ...........  ...........
                            imp.
   C1816  H                Receiver/                    1816  ...........  ...........  ...........  ...........
                            transmitter, neuro.
   C1817  H                Septal defect imp            1817  ...........  ...........  ...........  ...........
                            sys.
   C1874  H                Stent, coated/cov w/         1874  ...........  ...........  ...........  ...........
                            del sys.
   C1875  H                Stent, coated/cov w/         1875  ...........  ...........  ...........  ...........
                            o del sy.
   C1876  H                Stent, non-coa/non-          1876  ...........  ...........  ...........  ...........
                            cov w/del.
   C1877  H                Stent, non-coat/cov          1877  ...........  ...........  ...........  ...........
                            w/o del.
   C1878  H                Matrl for vocal cord         1878  ...........  ...........  ...........  ...........
   C1879  H                Tissue marker,               1879  ...........  ...........  ...........  ...........
                            implantable.
   C1880  H                Vena cava filter....         1880  ...........  ...........  ...........  ...........
   C1881  H                Dialysis access              1881  ...........  ...........  ...........  ...........
                            system.
   C1882  H                AICD, other than             1882  ...........  ...........  ...........  ...........
                            sing/dual.
   C1883  H                Adapt/ext, pacing/           1883  ...........  ...........  ...........  ...........
                            neuro lead.
   C1885  H                Cath, translumin             1885  ...........  ...........  ...........  ...........
                            angio laser.
   C1887  H                Catheter, guiding...         1887  ...........  ...........  ...........  ...........
   C1891  H                Infusion pump,non-           1891  ...........  ...........  ...........  ...........
                            prog, perm.
   C1892  H                Intro/                       1892  ...........  ...........  ...........  ...........
                            sheath,fixed,peel-
                            away.
   C1893  H                Intro/sheath,                1893  ...........  ...........  ...........  ...........
                            fixed,non-peel.
   C1894  H                Intro/sheath, non-           1894  ...........  ...........  ...........  ...........
                            laser.
   C1895  H                Lead, AICD, endo             1895  ...........  ...........  ...........  ...........
                            dual coil.
   C1896  H                Lead, AICD, non sing/        1896  ...........  ...........  ...........  ...........
                            dual.
   C1897  H                Lead, neurostim test         1897  ...........  ...........  ...........  ...........
                            kit.
   C1898  H                Lead, pmkr, other            1898  ...........  ...........  ...........  ...........
                            than trans.
   C1899  H                Lead, pmkr/AICD              1899  ...........  ...........  ...........  ...........
                            combination.
   C2615  H                Sealant, pulmonary,          2615  ...........  ...........  ...........  ...........
                            liquid.
   C2616  H                Brachytx seed,               2616  ...........  ...........  ...........  ...........
                            Yttrium-90.
   C2617  H                Stent, non-cor, tem          2617  ...........  ...........  ...........  ...........
                            w/o del.
   C2618  H                Probe, cryoablation.         2618  ...........  ...........  ...........  ...........
   C2619  H                Pmkr, dual, non rate-        2619  ...........  ...........  ...........  ...........
                            resp.
   C2620  H                Pmkr, single, non            2620  ...........  ...........  ...........  ...........
                            rate-resp.
   C2621  H                Pmkr, other than             2621  ...........  ...........  ...........  ...........
                            sing/dual.
   C2622  H                Prosthesis, penile,          2622  ...........  ...........  ...........  ...........
                            non-inf.
   C2625  H                Stent, non-cor, tem          2625  ...........  ...........  ...........  ...........
                            w/del sy.
   C2626  H                Infusion pump, non-          2626  ...........  ...........  ...........  ...........
                            prog,temp.
   C2627  H                Cath, suprapubic/            2627  ...........  ...........  ...........  ...........
                            cystoscopic.
   C2628  H                Catheter, occlusion.         2628  ...........  ...........  ...........  ...........
   C2629  H                Intro/sheath, laser.         2629  ...........  ...........  ...........  ...........
   C2630  H                Cath, EP, cool-tip..         2630  ...........  ...........  ...........  ...........
   C2631  H                Rep dev, urinary, w/         2631  ...........  ...........  ...........  ...........
                            o sling.
   C8900  S                MRA w/cont, abd.....         0284         7.80      $396.57      $218.11       $79.31
   C8901  S                MRA w/o cont, abd...         0336         6.85      $348.27      $191.55       $69.65
   C8902  S                MRA w/o fol w/cont,          0337         9.26      $470.80      $258.94       $94.16
                            abd.
   C8903  S                MRI w/cont, breast,          0284         7.80      $396.57      $218.11       $79.31
                            uni.
   C8904  S                MRI w/o cont,                0336         6.85      $348.27      $191.55       $69.65
                            breast, uni.
   C8905  S                MRI w/o fol w/cont,          0337         9.26      $470.80      $258.94       $94.16
                            brst, un.
   C8906  S                MRI w/cont, breast,          0284         7.80      $396.57      $218.11       $79.31
                            bi.
   C8907  S                MRI w/o cont,                0336         6.85      $348.27      $191.55       $69.65
                            breast, bi.
   C8908  S                MRI w/o fol w/cont,          0337         9.26      $470.80      $258.94       $94.16
                            breast,.
   C8909  S                MRA w/cont, chest...         0284         7.80      $396.57      $218.11       $79.31
   C8910  S                MRA w/o cont, chest.         0336         6.85      $348.27      $191.55       $69.65
   C8911  S                MRA w/o fol w/cont,          0337         9.26      $470.80      $258.94       $94.16
                            chest.
   C8912  S                MRA w/cont, lwr ext.         0284         7.80      $396.57      $218.11       $79.31
   C8913  S                MRA w/o cont, lwr            0336         6.85      $348.27      $191.55       $69.65
                            ext.
   C8914  S                MRA w/o fol w/cont,          0337         9.26      $470.80      $258.94       $94.16
                            lwr ext.
   C9000  G                Na chromateCr51, per         9000  ...........         $.32  ...........         $.05
                            0.25mCi.
   C9001  G                Linezolid inj, 200mg         9001  ...........       $34.14  ...........        $4.89
   C9002  G                Tenecteplase, 50mg/          9002  ...........    $2,612.50  ...........      $374.00
                            vial.

[[Page 44844]]

 
   C9003  G                Palivizumab, per 50          9003  ...........      $664.49  ...........       $95.13
                            mg.
   C9004  G                Gemtuzumab                   9004  ...........    $1,929.69  ...........      $276.25
                            ozogamicin inj,5m.
   C9006  G                Tacrolimus inj, per          9006  ...........      $113.15  ...........       $16.20
                            5 mg.
   C9007  G                Baclofen Intrathecal         9007  ...........       $79.80  ...........       $11.42
                            kit-1am.
   C9008  G                Baclofen Refill Kit-         9008  ...........      $233.70  ...........       $33.46
                            500mcg.
   C9009  G                Baclofen Refill Kit-         9009  ...........      $491.15  ...........       $70.31
                            2000mcg.
   C9010  G                Baclofen Refill Kit--        9010  ...........      $861.65  ...........      $123.35
                            4000mcg.
   C9011  G                Caffeine Citrate,            9011  ...........       $12.22  ...........        $1.75
                            inj, 1ml.
   C9012  G                Injection, arsenic           9012  ...........      $237.50  ...........       $34.00
                            trioxide.
   C9013  G                Co 57 cobaltous              9013  ...........       $10.02  ...........        $1.43
                            chloride.
   C9017  E                Lomustine, 10 mg....  ...........  ...........  ...........  ...........  ...........
   C9018  G                Botulinum tox B, per         9018  ...........        $8.79  ...........        $1.26
                            100 u.
   C9019  G                Caspofungin acetate,         9019  ...........       $34.20  ...........        $4.90
                            5 mg.
   C9020  G                Sirolimus tablet, 1          9020  ...........        $6.51  ...........         $.89
                            mg.
   C9100  G                Iodinated I-131              9100  ...........        $9.84  ...........        $1.41
                            Albumin.
   C9102  G                51 Na Chromate,              9102  ...........         $.65  ...........         $.09
                            50mCi.
   C9103  G                Na Iothalamate I-            9103  ...........       $11.66  ...........        $1.67
                            125, 10 uCi.
   C9104  G                Anti-thymocyte               9104  ...........      $251.75  ...........       $36.04
                            globulin,25mg.
   C9105  G                Hep B imm glob, per          9105  ...........      $135.43  ...........       $12.26
                            1 ml.
   C9108  G                Thyrotropin alfa,            9108  ...........      $531.05  ...........       $76.02
                            1.1 mg.
   C9109  G                Tirofliban hcl, 6.25         9109  ...........      $217.64  ...........       $31.16
                            mg.
   C9503  K                Fresh frozen plasma,         9503         1.69       $85.92  ...........       $17.18
                            ea unit.
   C9700  T                Water Induced Thermo         0977        21.30    $1,082.93  ...........      $216.59
   C9701  S                Stretta System......         0976        16.56      $841.94  ...........      $168.39
   C9702  S                Chkmate/Novost/              0981        42.59    $2,165.36  ...........      $433.07
                            Galileo Brach.
   C9708  T                Preview Tx Planning          0975        11.83      $601.46  ...........      $120.29
                            Software.
   D0120  E                Periodic oral         ...........  ...........  ...........  ...........  ...........
                            evaluation.
   D0140  E                Limit oral eval       ...........  ...........  ...........  ...........  ...........
                            problm focus.
   D0150  S                Comprehensve oral            0330         7.68      $390.47       $78.09       $78.09
                            evaluation.
   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           0330         7.68      $390.47       $78.09       $78.09
                            film.
   D0250  S                Extraoral first film         0330         7.68      $390.47       $78.09       $78.09
   D0260  S                Extraoral ea                 0330         7.68      $390.47       $78.09       $78.09
                            additional film.
   D0270  S                Dental bitewing              0330         7.68      $390.47       $78.09       $78.09
                            single film.
   D0272  S                Dental bitewings two         0330         7.68      $390.47       $78.09       $78.09
                            films.
   D0274  S                Dental bitewings             0330         7.68      $390.47       $78.09       $78.09
                            four films.
   D0277  S                Vert bitewings-sev           0330         7.68      $390.47       $78.09       $78.09
                            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         7.68      $390.47       $78.09       $78.09
   D0470  E                Diagnostic casts....  ...........  ...........  ...........  ...........  ...........
   D0472  S                Gross exam, prep &           0330         7.68      $390.47       $78.09       $78.09
                            report.
   D0473  S                Micro exam, prep &           0330         7.68      $390.47       $78.09       $78.09
                            report.
   D0474  S                Micro w exam of surg         0330         7.68      $390.47       $78.09       $78.09
                            margins.
   D0480  S                Cytopath smear prep          0330         7.68      $390.47       $78.09       $78.09
                            & report.
   D0501  S                Histopathologic              0330         7.68      $390.47       $78.09       $78.09
                            examinations.
   D0502  S                Other oral pathology         0330         7.68      $390.47       $78.09       $78.09
                            procedu.
   D0999  S                Unspecified                  0330         7.68      $390.47       $78.09       $78.09
                            diagnostic proce.
   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         0330         7.68      $390.47       $78.09       $78.09
                            unilat.
   D1515  S                Fixed bilat space            0330         7.68      $390.47       $78.09       $78.09
                            maintainer.
   D1520  S                Remove unilat space          0330         7.68      $390.47       $78.09       $78.09
                            maintain.
   D1525  S                Remove bilat space           0330         7.68      $390.47       $78.09       $78.09
                            maintain.
   D1550  S                Recement space               0330         7.68      $390.47       $78.09       $78.09
                            maintainer.

[[Page 44845]]

 
   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.
   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.

[[Page 44846]]

 
   D2970  S                Temporary- fractured         0330         7.68      $390.47       $78.09       $78.09
                            tooth.
   D2980  E                Crown repair........  ...........  ...........  ...........  ...........  ...........
   D2999  S                Dental unspec                0330         7.68      $390.47       $78.09       $78.09
                            restorative pr.
   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.
   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                   0330         7.68      $390.47       $78.09       $78.09
                            endosseous implan.
   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         7.68      $390.47       $78.09       $78.09
   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          0330         7.68      $390.47       $78.09       $78.09
                            quadrant.
   D4263  S                Bone replce graft            0330         7.68      $390.47       $78.09       $78.09
                            first site.
   D4264  S                Bone replce graft            0330         7.68      $390.47       $78.09       $78.09
                            each add.
   D4266  E                Guided tiss regen     ...........  ...........  ...........  ...........  ...........
                            resorble.
   D4267  E                Guided tiss regen     ...........  ...........  ...........  ...........  ...........
                            nonresorb.
   D4268  S                Surgical revision            0330         7.68      $390.47       $78.09       $78.09
                            procedure.
   D4270  S                Pedicle soft tissue          0330         7.68      $390.47       $78.09       $78.09
                            graft pr.
   D4271  S                Free soft tissue             0330         7.68      $390.47       $78.09       $78.09
                            graft proc.
   D4273  S                Subepithelial tissue         0330         7.68      $390.47       $78.09       $78.09
                            graft.
   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                   0330         7.68      $390.47       $78.09       $78.09
                            debridement.
   D4381  S                Localized chemo              0330         7.68      $390.47       $78.09       $78.09
                            delivery.
   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.

[[Page 44847]]

 
   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.
   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               0330         7.68      $390.47       $78.09       $78.09
                            sectional.
   D5912  S                Facial moulage               0330         7.68      $390.47       $78.09       $78.09
                            complete.
   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         7.68      $390.47       $78.09       $78.09
   D5984  S                Radiation shield....         0330         7.68      $390.47       $78.09       $78.09
   D5985  S                Radiation cone               0330         7.68      $390.47       $78.09       $78.09
                            locator.
   D5986  E                Fluoride applicator.  ...........  ...........  ...........  ...........  ...........
   D5987  S                Commissure splint...         0330         7.68      $390.47       $78.09       $78.09
   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.

[[Page 44848]]

 
   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.
   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         7.68      $390.47       $78.09       $78.09
   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          0330         7.68      $390.47       $78.09       $78.09
                            tooth.
   D7120  S                Each add tooth               0330         7.68      $390.47       $78.09       $78.09
                            extraction.
   D7130  S                Tooth root removal..         0330         7.68      $390.47       $78.09       $78.09
   D7210  S                Rem imp tooth w              0330         7.68      $390.47       $78.09       $78.09
                            mucoper flp.
   D7220  S                Impact tooth remov           0330         7.68      $390.47       $78.09       $78.09
                            soft tiss.
   D7230  S                Impact tooth remov           0330         7.68      $390.47       $78.09       $78.09
                            part bony.
   D7240  S                Impact tooth remov           0330         7.68      $390.47       $78.09       $78.09
                            comp bony.

[[Page 44849]]

 
   D7241  S                Impact tooth rem             0330         7.68      $390.47       $78.09       $78.09
                            bony w/comp.
   D7250  S                Tooth root removal..         0330         7.68      $390.47       $78.09       $78.09
   D7260  S                Oral antral fistula          0330         7.68      $390.47       $78.09       $78.09
                            closure.
   D7270  E                Tooth reimplantation  ...........  ...........  ...........  ...........  ...........
   D7272  E                Tooth                 ...........  ...........  ...........  ...........  ...........
                            transplantation.
   D7280  E                Exposure impact       ...........  ...........  ...........  ...........  ...........
                            tooth orthod.
   D7281  E                Exposure tooth aid    ...........  ...........  ...........  ...........  ...........
                            eruption.
   D7285  E                Biopsy of oral        ...........  ...........  ...........  ...........  ...........
                            tissue hard.
   D7286  E                Biopsy of oral        ...........  ...........  ...........  ...........  ...........
                            tissue soft.
   D7290  E                Repositioning of      ...........  ...........  ...........  ...........  ...........
                            teeth.
   D7291  S                Transseptal                  0330         7.68      $390.47       $78.09       $78.09
                            fiberotomy.
   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.

[[Page 44850]]

 
   D7920  E                Dental skin graft...  ...........  ...........  ...........  ...........  ...........
   D7940  S                Reshaping bone               0330         7.68      $390.47       $78.09       $78.09
                            orthognathic.
   D7941  E                Bone cutting ramus    ...........  ...........  ...........  ...........  ...........
                            closed.
   D7943  E                Cutting ramus open w/ ...........  ...........  ...........  ...........  ...........
                            graft.
   D7944  E                Bone cutting          ...........  ...........  ...........  ...........  ...........
                            segmented.
   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  N                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/                 0330         7.68      $390.47       $78.09       $78.09
                            medicaments.
   D9910  E                Dent appl             ...........  ...........  ...........  ...........  ...........
                            desensitizing med.
   D9911  E                Appl desensitizing    ...........  ...........  ...........  ...........  ...........
                            resin.
   D9920  E                Behavior management.  ...........  ...........  ...........  ...........  ...........
   D9930  S                Treatment of                 0330         7.68      $390.47       $78.09       $78.09
                            complications.
   D9940  S                Dental occlusal              0330         7.68      $390.47       $78.09       $78.09
                            guard.
   D9941  E                Fabrication athletic  ...........  ...........  ...........  ...........  ...........
                            guard.
   D9950  S                Occlusion analysis..         0330         7.68      $390.47       $78.09       $78.09
   D9951  S                Limited occlusal             0330         7.68      $390.47       $78.09       $78.09
                            adjustment.
   D9952  S                Complete occlusal            0330         7.68      $390.47       $78.09       $78.09
                            adjustment.
   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.

[[Page 44851]]

 
   D9999  E                Adjunctive procedure  ...........  ...........  ...........  ...........  ...........
   E0100  A                Cane adjust/fixed     ...........  ...........  ...........  ...........  ...........
                            with tip.
   E0105  A                Cane adjust/fixed     ...........  ...........  ...........  ...........  ...........
                            quad/3 pro.
   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.
   E0148  A                Heavyduty walker no   ...........  ...........  ...........  ...........  ...........
                            wheels.
   E0149  A                Heavy duty wheeled    ...........  ...........  ...........  ...........  ...........
                            walker.
   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.
   E0168  A                Heavyduty/wide        ...........  ...........  ...........  ...........  ...........
                            commode chair.
   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  E                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.........  ...........  ...........  ...........  ...........  ...........

[[Page 44852]]

 
   E0244  E                Toilet seat raised..  ...........  ...........  ...........  ...........  ...........
   E0245  E                Tub stool or bench..  ...........  ...........  ...........  ...........  ...........
   E0246  E                Transfer tub rail     ...........  ...........  ...........  ...........  ...........
                            attachment.
   E0249  A                Pad water             ...........  ...........  ...........  ...........  ...........
                            circulating heat u.
   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  E                Hospital bed          ...........  ...........  ...........  ...........  ...........
                            institutional t.
   E0271  A                Mattress innerspring  ...........  ...........  ...........  ...........  ...........
   E0272  A                Mattress foam rubber  ...........  ...........  ...........  ...........  ...........
   E0273  E                Bed board...........  ...........  ...........  ...........  ...........  ...........
   E0274  E                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.
   E0298  E                Heavyduty/xtra wide   ...........  ...........  ...........  ...........  ...........
                            hosp bed.
   E0305  A                Rails bed side half   ...........  ...........  ...........  ...........  ...........
                            length.
   E0310  A                Rails bed side full   ...........  ...........  ...........  ...........  ...........
                            length.
   E0315  E                Bed accessory brd/    ...........  ...........  ...........  ...........  ...........
                            tbl/supprt.
   E0325  A                Urinal male jug-type  ...........  ...........  ...........  ...........  ...........
   E0326  A                Urinal female jug-    ...........  ...........  ...........  ...........  ...........
                            type.
   E0350  E                Control unit bowel    ...........  ...........  ...........  ...........  ...........
                            system.
   E0352  E                Disposable pack w/    ...........  ...........  ...........  ...........  ...........
                            bowel syst.
   E0370  E                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  E                Gas system            ...........  ...........  ...........  ...........  ...........
                            stationary compre.
   E0430  E                Oxygen system gas     ...........  ...........  ...........  ...........  ...........
                            portable.
   E0431  A                Portable gaseous 02.  ...........  ...........  ...........  ...........  ...........
   E0434  A                Portable liquid 02..  ...........  ...........  ...........  ...........  ...........
   E0435  E                Oxygen system liquid  ...........  ...........  ...........  ...........  ...........
                            portabl.
   E0439  A                Stationary liquid 02  ...........  ...........  ...........  ...........  ...........
   E0440  E                Oxygen system liquid  ...........  ...........  ...........  ...........  ...........
                            station.
   E0441  A                Oxygen contents,      ...........  ...........  ...........  ...........  ...........
                            gaseous.
   E0442  A                Oxygen contents,      ...........  ...........  ...........  ...........  ...........
                            liquid.
   E0443  A                Portable 02           ...........  ...........  ...........  ...........  ...........
                            contents, gas.
   E0444  A                Portable 02           ...........  ...........  ...........  ...........  ...........
                            contents, liquid.
   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.
   E0571  A                Aerosol compressor    ...........  ...........  ...........  ...........  ...........
                            for svneb.
   E0572  A                Aerosol compressor    ...........  ...........  ...........  ...........  ...........
                            adjust pr.
   E0574  A                Ultrasonic generator  ...........  ...........  ...........  ...........  ...........
                            w svneb.
   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.

[[Page 44853]]

 
   E0602  E                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.
   E0610  A                Pacemaker monitr      ...........  ...........  ...........  ...........  ...........
                            audible/vis.
   E0615  A                Pacemaker monitr      ...........  ...........  ...........  ...........  ...........
                            digital/vis.
   E0616  N                Cardiac event         ...........  ...........  ...........  ...........  ...........
                            recorder.
   E0617  A                Automatic ext         ...........  ...........  ...........  ...........  ...........
                            defibrillator.
   E0621  A                Patient lift sling    ...........  ...........  ...........  ...........  ...........
                            or seat.
   E0625  E                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  E                Safety equipment....  ...........  ...........  ...........  ...........  ...........
   E0710  E                Restraints any type.  ...........  ...........  ...........  ...........  ...........
   E0720  A                Tens two lead.......  ...........  ...........  ...........  ...........  ...........
   E0730  A                Tens four lead......  ...........  ...........  ...........  ...........  ...........
   E0731  A                Conductive garment    ...........  ...........  ...........  ...........  ...........
                            for tens/.
   E0740  E                Incontinence          ...........  ...........  ...........  ...........  ...........
                            treatment systm.
   E0744  A                Neuromuscular stim    ...........  ...........  ...........  ...........  ...........
                            for scoli.
   E0745  A                Neuromuscular stim    ...........  ...........  ...........  ...........  ...........
                            for shock.
   E0746  E                Electromyograph       ...........  ...........  ...........  ...........  ...........
                            biofeedback.
   E0747  A                Elec osteogen stim    ...........  ...........  ...........  ...........  ...........
                            not spine.
   E0748  A                Elec osteogen stim    ...........  ...........  ...........  ...........  ...........
                            spinal.
   E0749  N                Elec osteogen stim    ...........  ...........  ...........  ...........  ...........
                            implanted.
   E0753  N                Neurostimulator       ...........  ...........  ...........  ...........  ...........
                            electrodes.
   E0755  E                Electronic salivary   ...........  ...........  ...........  ...........  ...........
                            reflex s.
   E0756  A                Implantable pulse     ...........  ...........  ...........  ...........  ...........
                            generator.
   E0757  A                Implantable RF        ...........  ...........  ...........  ...........  ...........
                            receiver.
   E0758  A                External RF           ...........  ...........  ...........  ...........  ...........
                            transmitter.
   E0760  E                Osteogen ultrasound   ...........  ...........  ...........  ...........  ...........
                            stimltor.
   E0765  E                Nerve stimulator for  ...........  ...........  ...........  ...........  ...........
                            tx n&v.
   E0776  A                Iv pole.............  ...........  ...........  ...........  ...........  ...........
   E0779  A                Amb infusion pump     ...........  ...........  ...........  ...........  ...........
                            mechanical.
   E0780  A                Mech amb infusion     ...........  ...........  ...........  ...........  ...........
                            pump 8hrs.
   E0781  A                External ambulatory   ...........  ...........  ...........  ...........  ...........
                            infus pu.
   E0782  N                Non-programble        ...........  ...........  ...........  ...........  ...........
                            infusion pump.
   E0783  N                Programmable          ...........  ...........  ...........  ...........  ...........
                            infusion pump.
   E0784  A                Ext amb infusn pump   ...........  ...........  ...........  ...........  ...........
                            insulin.
   E0785  N                Replacement impl      ...........  ...........  ...........  ...........  ...........
                            pump cathet.
   E0786  A                Implantable pump      ...........  ...........  ...........  ...........  ...........
                            replacement.
   E0791  A                Parenteral infusion   ...........  ...........  ...........  ...........  ...........
                            pump sta.
   E0830  N                Ambulatory traction   ...........  ...........  ...........  ...........  ...........
                            device.
   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.

[[Page 44854]]

 
   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  E                Tray................  ...........  ...........  ...........  ...........  ...........
   E0951  E                Loop heel...........  ...........  ...........  ...........  ...........  ...........
   E0952  E                Loop tie............  ...........  ...........  ...........  ...........  ...........
   E0953  E                Pneumatic tire......  ...........  ...........  ...........  ...........  ...........
   E0954  E                Wheelchair semi-      ...........  ...........  ...........  ...........  ...........
                            pneumatic ca.
   E0958  E                Whlchr att- conv 1    ...........  ...........  ...........  ...........  ...........
                            arm drive.
   E0959  E                Amputee adapter.....  ...........  ...........  ...........  ...........  ...........
   E0961  E                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  E                Wheelchair head rest  ...........  ...........  ...........  ...........  ...........
                            extensi.
   E0967  E                Wheelchair hand rims  ...........  ...........  ...........  ...........  ...........
   E0968  E                Wheelchair commode    ...........  ...........  ...........  ...........  ...........
                            seat.
   E0969  E                Wheelchair narrowing  ...........  ...........  ...........  ...........  ...........
                            device.
   E0970  E                Wheelchair no. 2      ...........  ...........  ...........  ...........  ...........
                            footplates.
   E0971  E                Wheelchair anti-      ...........  ...........  ...........  ...........  ...........
                            tipping devi.
   E0972  A                Transfer board or     ...........  ...........  ...........  ...........  ...........
                            device.
   E0973  E                Wheelchair adjustabl  ...........  ...........  ...........  ...........  ...........
                            height.
   E0974  E                Wheelchair grade-aid  ...........  ...........  ...........  ...........  ...........
   E0975  E                Wheelchair            ...........  ...........  ...........  ...........  ...........
                            reinforced seat u.
   E0976  E                Wheelchair            ...........  ...........  ...........  ...........  ...........
                            reinforced back u.
   E0977  E                Wheelchair wedge      ...........  ...........  ...........  ...........  ...........
                            cushion.
   E0978  E                Wheelchair belt w/    ...........  ...........  ...........  ...........  ...........
                            airplane b.
   E0979  E                Wheelchair belt with  ...........  ...........  ...........  ...........  ...........
                            velcro.
   E0980  E                Wheelchair safety     ...........  ...........  ...........  ...........  ...........
                            vest.
   E0990  E                Whellchair elevating  ...........  ...........  ...........  ...........  ...........
                            leg res.
   E0991  E                Wheelchair upholstry  ...........  ...........  ...........  ...........  ...........
                            seat.
   E0992  E                Wheelchair solid      ...........  ...........  ...........  ...........  ...........
                            seat insert.
   E0993  E                Wheelchair back       ...........  ...........  ...........  ...........  ...........
                            upholstery.
   E0994  E                Wheelchair arm rest.  ...........  ...........  ...........  ...........  ...........
   E0995  E                Wheelchair calf rest  ...........  ...........  ...........  ...........  ...........
   E0996  E                Wheelchair tire       ...........  ...........  ...........  ...........  ...........
                            solid.
   E0997  E                Wheelchair caster w/  ...........  ...........  ...........  ...........  ...........
                            a fork.
   E0998  E                Wheelchair caster w/  ...........  ...........  ...........  ...........  ...........
                            o a fork.
   E0999  E                Wheelchr pneumatic    ...........  ...........  ...........  ...........  ...........
                            tire w/wh.
   E1000  E                Wheelchair tire       ...........  ...........  ...........  ...........  ...........
                            pneumatic ca.
   E1001  E                Wheelchair wheel....  ...........  ...........  ...........  ...........  ...........
   E1031  A                Rollabout chair with  ...........  ...........  ...........  ...........  ...........
                            casters.
   E1035  E                Patient transfer      ...........  ...........  ...........  ...........  ...........
                            system.
   E1050  E                Whelchr fxd full      ...........  ...........  ...........  ...........  ...........
                            length arms.
   E1060  E                Wheelchair            ...........  ...........  ...........  ...........  ...........
                            detachable arms.
   E1065  E                Wheelchair power      ...........  ...........  ...........  ...........  ...........
                            attachment.
   E1066  E                Wheelchair battery    ...........  ...........  ...........  ...........  ...........
                            charger.
   E1069  E                Wheelchair deep       ...........  ...........  ...........  ...........  ...........
                            cycle batter.
   E1070  E                Wheelchair            ...........  ...........  ...........  ...........  ...........
                            detachable foot r.
   E1083  E                Hemi-wheelchair       ...........  ...........  ...........  ...........  ...........
                            fixed arms.
   E1084  E                Hemi-wheelchair       ...........  ...........  ...........  ...........  ...........
                            detachable a.
   E1085  E                Hemi-wheelchair       ...........  ...........  ...........  ...........  ...........
                            fixed arms.
   E1086  E                Hemi-wheelchair       ...........  ...........  ...........  ...........  ...........
                            detachable a.
   E1087  E                Wheelchair lightwt    ...........  ...........  ...........  ...........  ...........
                            fixed arm.
   E1088  E                Wheelchair            ...........  ...........  ...........  ...........  ...........
                            lightweight det a.
   E1089  E                Wheelchair lightwt    ...........  ...........  ...........  ...........  ...........
                            fixed arm.
   E1090  E                Wheelchair            ...........  ...........  ...........  ...........  ...........
                            lightweight det a.
   E1091  E                Wheelchair youth....  ...........  ...........  ...........  ...........  ...........
   E1092  E                Wheelchair wide w/    ...........  ...........  ...........  ...........  ...........
                            leg rests.
   E1093  E                Wheelchair wide w/    ...........  ...........  ...........  ...........  ...........
                            foot rest.
   E1100  E                Whchr s-recl fxd arm  ...........  ...........  ...........  ...........  ...........
                            leg res.
   E1110  E                Wheelchair semi-recl  ...........  ...........  ...........  ...........  ...........
                            detach.
   E1130  E                Whlchr stand fxd arm  ...........  ...........  ...........  ...........  ...........
                            ft rest.
   E1140  E                Wheelchair standard   ...........  ...........  ...........  ...........  ...........
                            detach a.
   E1150  E                Wheelchair standard   ...........  ...........  ...........  ...........  ...........
                            w/ leg r.
   E1160  E                Wheelchair fixed      ...........  ...........  ...........  ...........  ...........
                            arms.
   E1170  E                Whlchr ampu fxd arm   ...........  ...........  ...........  ...........  ...........
                            leg rest.
   E1171  E                Wheelchair amputee w/ ...........  ...........  ...........  ...........  ...........
                            o leg r.
   E1172  E                Wheelchair amputee    ...........  ...........  ...........  ...........  ...........
                            detach ar.
   E1180  E                Wheelchair amputee w/ ...........  ...........  ...........  ...........  ...........
                             foot r.

[[Page 44855]]

 
   E1190  E                Wheelchair amputee w/ ...........  ...........  ...........  ...........  ...........
                             leg re.
   E1195  E                Wheelchair amputee    ...........  ...........  ...........  ...........  ...........
                            heavy dut.
   E1200  E                Wheelchair amputee    ...........  ...........  ...........  ...........  ...........
                            fixed arm.
   E1210  E                Whlchr moto ful arm   ...........  ...........  ...........  ...........  ...........
                            leg rest.
   E1211  E                Wheelchair motorized  ...........  ...........  ...........  ...........  ...........
                            w/ det.
   E1212  E                Wheelchair motorized  ...........  ...........  ...........  ...........  ...........
                            w full.
   E1213  E                Wheelchair motorized  ...........  ...........  ...........  ...........  ...........
                            w/ det.
   E1220  E                Whlchr special size/  ...........  ...........  ...........  ...........  ...........
                            constrc.
   E1221  E                Wheelchair spec size  ...........  ...........  ...........  ...........  ...........
                            w foot.
   E1222  E                Wheelchair spec size  ...........  ...........  ...........  ...........  ...........
                            w/ leg.
   E1223  E                Wheelchair spec size  ...........  ...........  ...........  ...........  ...........
                            w foot.
   E1224  E                Wheelchair spec size  ...........  ...........  ...........  ...........  ...........
                            w/ leg.
   E1225  E                Wheelchair spec sz    ...........  ...........  ...........  ...........  ...........
                            semi-recl.
   E1226  E                Wheelchair spec sz    ...........  ...........  ...........  ...........  ...........
                            full-recl.
   E1227  E                Wheelchair spec sz    ...........  ...........  ...........  ...........  ...........
                            spec ht a.
   E1228  E                Wheelchair spec sz    ...........  ...........  ...........  ...........  ...........
                            spec ht b.
   E1230  A                Power operated        ...........  ...........  ...........  ...........  ...........
                            vehicle.
   E1240  E                Whchr litwt det arm   ...........  ...........  ...........  ...........  ...........
                            leg rest.
   E1250  E                Wheelchair lightwt    ...........  ...........  ...........  ...........  ...........
                            fixed arm.
   E1260  E                Wheelchair lightwt    ...........  ...........  ...........  ...........  ...........
                            foot rest.
   E1270  E                Wheelchair            ...........  ...........  ...........  ...........  ...........
                            lightweight leg r.
   E1280  E                Whchr h-duty det arm  ...........  ...........  ...........  ...........  ...........
                            leg res.
   E1285  E                Wheelchair heavy      ...........  ...........  ...........  ...........  ...........
                            duty fixed.
   E1290  E                Wheelchair hvy duty   ...........  ...........  ...........  ...........  ...........
                            detach a.
   E1295  E                Wheelchair heavy      ...........  ...........  ...........  ...........  ...........
                            duty fixed.
   E1296  E                Wheelchair special    ...........  ...........  ...........  ...........  ...........
                            seat heig.
   E1297  E                Wheelchair special    ...........  ...........  ...........  ...........  ...........
                            seat dept.
   E1298  E                Wheelchair spec seat  ...........  ...........  ...........  ...........  ...........
                            depth/w.
   E1300  E                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.
   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.
   G0001  A                Drawing blood for     ...........  ...........  ...........  ...........  ...........
                            specimen.
   G0002  N                Temporary urinary     ...........  ...........  ...........  ...........  ...........
                            catheter.
   G0004  E                ECG transm phys       ...........  ...........  ...........  ...........  ...........
                            review & int.

[[Page 44856]]

 
   G0005  X                ECG 24 hour                  0097         0.87       $44.23       $24.33        $8.85
                            recording.
   G0006  X                ECG transmission &           0097         0.87       $44.23       $24.33        $8.85
                            analysis.
   G0007  N                ECG phy review &      ...........  ...........  ...........  ...........  ...........
                            interpret.
   G0008  K                Admin influenza              0354         0.11        $5.59  ...........  ...........
                            virus vac.
   G0009  K                Admin pneumococcal           0354         0.11        $5.59  ...........  ...........
                            vaccine.
   G0010  N                Admin hepatitis b     ...........  ...........  ...........  ...........  ...........
                            vaccine.
   G0015  X                Post symptom ECG             0097         0.87       $44.23       $24.33        $8.85
                            tracing.
   G0016  E                Post symptom ECG md   ...........  ...........  ...........  ...........  ...........
                            review.
   G0117  S                Glaucoma screen, md          0230         0.64       $32.54       $14.97        $6.51
                            perform.
   G0118  S                Glaucoma screen, md          0230         0.64       $32.54       $14.97        $6.51
                            supr.
   G0025  X                Collagen skin test           0343         0.42       $21.35       $11.53        $4.27
                            kit.
   G0026  A                Fecal leukocyte       ...........  ...........  ...........  ...........  ...........
                            examination.
   G0027  A                Semen analysis......  ...........  ...........  ...........  ...........  ...........
   G0030  S                PET imaging prev PET         0285        20.07    $1,020.40      $415.21      $204.08
                            single.
   G0031  S                PET imaging prev PET         0285        20.07    $1,020.40      $415.21      $204.08
                            multple.
   G0032  S                PET follow SPECT             0285        20.07    $1,020.40      $415.21      $204.08
                            78464 singl.
   G0033  S                PET follow SPECT             0285        20.07    $1,020.40      $415.21      $204.08
                            78464 mult.
   G0034  S                PET follow SPECT             0285        20.07    $1,020.40      $415.21      $204.08
                            76865 singl.
   G0035  S                PET follow SPECT             0285        20.07    $1,020.40      $415.21      $204.08
                            78465 mult.
   G0036  S                PET follow cornry            0285        20.07    $1,020.40      $415.21      $204.08
                            angio sing.
   G0037  S                PET follow cornry            0285        20.07    $1,020.40      $415.21      $204.08
                            angio mult.
   G0038  S                PET follow myocard           0285        20.07    $1,020.40      $415.21      $204.08
                            perf sing.
   G0039  S                PET follow myocard           0285        20.07    $1,020.40      $415.21      $204.08
                            perf mult.
   G0040  S                PET follow stress            0285        20.07    $1,020.40      $415.21      $204.08
                            echo singl.
   G0041  S                PET follow stress            0285        20.07    $1,020.40      $415.21      $204.08
                            echo mult.
   G0042  S                PET follow                   0285        20.07    $1,020.40      $415.21      $204.08
                            ventriculogm sing.
   G0043  S                PET follow                   0285        20.07    $1,020.40      $415.21      $204.08
                            ventriculogm mult.
   G0044  S                PET following rest           0285        20.07    $1,020.40      $415.21      $204.08
                            ECG singl.
   G0045  S                PET following rest           0285        20.07    $1,020.40      $415.21      $204.08
                            ECG mult.
   G0046  S                PET follow stress            0285        20.07    $1,020.40      $415.21      $204.08
                            ECG singl.
   G0047  S                PET follow stress            0285        20.07    $1,020.40      $415.21      $204.08
                            ECG mult.
   G0050  S                Residual urine by            0265         1.02       $51.86       $28.52       $10.37
                            ultrasound.
   G0101  V                CA screen;pelvic/            0601         1.02       $51.86       $10.37       $10.37
                            breast exam.
   G0102  N                Prostate ca           ...........  ...........  ...........  ...........  ...........
                            screening; dre.
   G0103  A                Psa, total screening  ...........  ...........  ...........  ...........  ...........
   G0104  S                CA screen;flexi              0159         2.51      $127.61  ...........       $31.90
                            sigmoidscope.
   G0105  S                Colorectal scrn; hi          0158         7.00      $355.89  ...........       $88.97
                            risk ind.
   G0106  S                Colon CA                     0157         2.14      $108.80  ...........       $27.20
                            screen;barium enema.
   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.
   G0120  S                Colon ca scrn;               0157         2.14      $108.80  ...........       $27.20
                            barium enema.
   G0121  E                Colon ca scrn not hi  ...........  ...........  ...........  ...........  ...........
                            rsk ind.
   G0122  S                Colon ca scrn;               0157         2.14      $108.80  ...........       $27.20
                            barium enema.
   G0123  A                Screen cerv/vag thin  ...........  ...........  ...........  ...........  ...........
                            layer.
   G0124  A                Screen c/v thin       ...........  ...........  ...........  ...........  ...........
                            layer by MD.
   G0125  S                PET image pulmonary          0976        16.56      $841.94  ...........      $168.39
                            nodule.
   G0126  S                Lung image (PET)             0976        16.56      $841.94  ...........      $168.39
                            staging.
   G0127  T                Trim nail(s)........         0009         0.68       $34.57        $8.99        $6.91
   G0128  E                CORF skilled nursing  ...........  ...........  ...........  ...........  ...........
                            service.
   G0129  P                Partial hosp prog            0033         4.17      $212.01  ...........       $42.40
                            service.
   G0130  X                Single energy x-ray          0261         1.31       $66.60       $36.63       $13.32
                            study.
   G0131  S                CT scan, bone                0288         1.27       $64.57       $35.51       $12.91
                            density study.
   G0132  S                CT scan, bone                0288         1.27       $64.57       $35.51       $12.91
                            density study.
   G0141  E                Scr c/v cyto,autosys  ...........  ...........  ...........  ...........  ...........
                            and md.
   G0143  A                Scr c/v               ...........  ...........  ...........  ...........  ...........
                            cyto,thinlayer,resc
                            r.
   G0144  A                Scr c/v               ...........  ...........  ...........  ...........  ...........
                            cyto,thinlayer,resc
                            r.
   G0145  A                Scr c/v               ...........  ...........  ...........  ...........  ...........
                            cyto,thinlayer,resc
                            r.
   G0147  A                Scr c/v cyto,         ...........  ...........  ...........  ...........  ...........
                            automated sys.
   G0148  A                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.
   G0156  E                HHCP-svs of aide,ea   ...........  ...........  ...........  ...........  ...........
                            15 min.
   G0163  S                Pet for rec of               0976        16.56      $841.94  ...........      $168.39
                            colorectal ca.
   G0164  S                Pet for lymphoma             0976        16.56      $841.94  ...........      $168.39
                            staging.

[[Page 44857]]

 
   G0165  S                Pet,rec of melanoma/         0976        16.56      $841.94  ...........      $168.39
                            met ca.
   G0166  T                Extrnl counterpulse,         0972         2.84      $144.39  ...........       $28.88
                            per tx.
   G0167  E                Hyperbaric oz tx;no   ...........  ...........  ...........  ...........  ...........
                            md reqrd.
   G0168  T                Wound closure by             0970         0.47       $23.90  ...........        $4.78
                            adhesive.
   G0173  S                Stereo                       0302        11.96      $608.07      $216.55      $121.61
                            radoisurgery,comple
                            te.
   G0174  S                Intensitymodulatedra         0302        11.96      $608.07      $216.55      $121.61
                            diation.
   G0175  V                OPPS Service,sched           0602         1.49       $75.75       $15.15       $15.15
                            team conf.
   G0176  P                OPPS/PHP;activity            0033         4.17      $212.01  ...........       $42.40
                            therapy.
   G0177  P                OPPS/PHP; train &            0033         4.17      $212.01  ...........       $42.40
                            educ serv.
   G0178  S                Intensitymodulatedra         0302        11.96      $608.07      $216.55      $121.61
                            diation.
   G0179  E                MD recertification    ...........  ...........  ...........  ...........  ...........
                            HHA PT.
   G0180  E                MD certification HHA  ...........  ...........  ...........  ...........  ...........
                            patient.
   G0181  E                Home health care      ...........  ...........  ...........  ...........  ...........
                            supervision.
   G0182  E                Hospice care          ...........  ...........  ...........  ...........  ...........
                            supervision.
   G0183  T                Ocular photodynamic          0235         5.39      $274.04       $78.91       $54.81
                            therapy.
   G0184  T                Ocular photdynamicTx         0235         5.39      $274.04       $78.91       $54.81
                            2nd eye.
   G0185  T                Transpuppillary              0235         5.39      $274.04       $78.91       $54.81
                            thermotx.
   G0186  T                Dstry eye lesn,fdr           0235         5.39      $274.04       $78.91       $54.81
                            vssl tech.
   G0187  T                Dstry mclr                   0235         5.39      $274.04       $78.91       $54.81
                            drusen,photocoag.
   G0188  X                Xray lwr extrmty-            0261         1.31       $66.60       $36.63       $13.32
                            full lngth.
   G0190  N                Immunization          ...........  ...........  ...........  ...........  ...........
                            administration.
   G0191  N                Immunization          ...........  ...........  ...........  ...........  ...........
                            admin,each add.
   G0192  N                Immunization oral/    ...........  ...........  ...........  ...........  ...........
                            intranasal.
   G0193  A                Endoscopicstudyswall  ...........  ...........  ...........  ...........  ...........
                            owfunctn.
   G0194  A                Sensorytestingendosc  ...........  ...........  ...........  ...........  ...........
                            opicstud.
   G0195  A                Clinicalevalswallowi  ...........  ...........  ...........  ...........  ...........
                            ngfunct.
   G0196  A                Evalofswallowingwith  ...........  ...........  ...........  ...........  ...........
                            radioopa.
   G0197  A                Evalofptforprescipsp  ...........  ...........  ...........  ...........  ...........
                            eechdevi.
   G0198  A                Patientadapation&tra  ...........  ...........  ...........  ...........  ...........
                            inforspe.
   G0199  A                Reevaluationofpatien  ...........  ...........  ...........  ...........  ...........
                            tusespec.
   G0200  A                Evalofpatientprescip  ...........  ...........  ...........  ...........  ...........
                            ofvoicep.
   G0201  A                Modifortraininginuse  ...........  ...........  ...........  ...........  ...........
                            voicepro.
   G0202  A                Screeningmammography  ...........  ...........  ...........  ...........  ...........
                            digital.
   G0203  A                Screenmammographyfil  ...........  ...........  ...........  ...........  ...........
                            mdigital.
   G0204  S                Diagnosticmammograph         0271         0.64       $32.54       $17.90        $6.51
                            ydigital.
   G0205  S                Diagnosticmammograph         0271         0.64       $32.54       $17.90        $6.51
                            yfilmpro.
   G0206  S                Diagnosticmammograph         0271         0.64       $32.54       $17.90        $6.51
                            ydigital.
   G0207  S                Diagnostic                   0271         0.64       $32.54       $17.90        $6.51
                            mammography film.
   G0210  S                PET img wholebody            0976        16.56      $841.94  ...........      $168.39
                            dxlung ca.
   G0211  S                PET img wholebody            0976        16.56      $841.94  ...........      $168.39
                            init lung.
   G0212  S                PET img wholebod             0976        16.56      $841.94  ...........      $168.39
                            restag lung.
   G0213  S                PET img wholebody dx         0976        16.56      $841.94  ...........      $168.39
                            colorec.
   G0214  S                PET img wholebod             0976        16.56      $841.94  ...........      $168.39
                            init colore.
   G0215  S                PETimg wholebod              0976        16.56      $841.94  ...........      $168.39
                            restag colre.
   G0216  S                PET img wholebod dx          0976        16.56      $841.94  ...........      $168.39
                            melanoma.
   G0217  S                PET img wholebod             0976        16.56      $841.94  ...........      $168.39
                            init melano.
   G0218  S                PET img wholebod             0976        16.56      $841.94  ...........      $168.39
                            restag mela.
   G0219  S                PET img wholbod              0976        16.56      $841.94  ...........      $168.39
                            melano nonco.
   G0220  S                PET img wholebod dx          0976        16.56      $841.94  ...........      $168.39
                            lymphoma.
   G0221  S                PET imag wholbod             0976        16.56      $841.94  ...........      $168.39
                            init lympho.
   G0222  S                PET imag wholbod             0976        16.56      $841.94  ...........      $168.39
                            resta lymph.
   G0223  S                PET imag wholbod reg         0976        16.56      $841.94  ...........      $168.39
                            dx head.
   G0224  S                PET imag wholbod reg         0976        16.56      $841.94  ...........      $168.39
                            ini hea.
   G0225  S                PET whol restag              0976        16.56      $841.94  ...........      $168.39
                            headneck onl.
   G0226  S                PET img wholbody dx          0976        16.56      $841.94  ...........      $168.39
                            esophagl.
   G0227  S                PET img wholbod ini          0976        16.56      $841.94  ...........      $168.39
                            esophage.
   G0228  S                PET img wholbod              0976        16.56      $841.94  ...........      $168.39
                            restg esopha.
   G0229  S                PET img metabolic            0976        16.56      $841.94  ...........      $168.39
                            brain pres.
   G0230  S                PET myocard                  0976        16.56      $841.94  ...........      $168.39
                            viability post s.
   G9001  E                MCCD, initial rate..  ...........  ...........  ...........  ...........  ...........
   G9002  E                MCCD,maintenance      ...........  ...........  ...........  ...........  ...........
                            rate.
   G9003  E                MCCD, risk adj hi,    ...........  ...........  ...........  ...........  ...........
                            initial.
   G9004  E                MCCD, risk adj lo,    ...........  ...........  ...........  ...........  ...........
                            initial.
   G9005  E                MCCD, risk adj,       ...........  ...........  ...........  ...........  ...........
                            maintenance.
   G9006  E                MCCD, Home            ...........  ...........  ...........  ...........  ...........
                            monitoring.
   G9007  E                MCCD, sch team conf.  ...........  ...........  ...........  ...........  ...........
   G9008  E                Mccd,phys coor-care   ...........  ...........  ...........  ...........  ...........
                            ovrsght.
   G9016  A                Demo-smoking          ...........  ...........  ...........  ...........  ...........
                            cessation coun.
   H0001  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            assess.
   H0002  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            screenin.
   H0003  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            screenin.
   H0004  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0005  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0006  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0007  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.

[[Page 44858]]

 
   H0008  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0009  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0010  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0011  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0012  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0013  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0014  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0015  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0016  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0017  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0018  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0019  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0020  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            services.
   H0021  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            training.
   H0022  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            interven.
   H0023  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            outreach.
   H0024  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            preventi.
   H0025  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            preventi.
   H0026  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            preventi.
   H0027  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            preventi.
   H0028  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            preventi.
   H0029  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            preventi.
   H0030  E                Alcohol and/or drug   ...........  ...........  ...........  ...........  ...........
                            hotline.
   J0120  N                Tetracyclin           ...........  ...........  ...........  ...........  ...........
                            injection.
   J0130  G                Abciximab injection.         1605  ...........      $513.02  ...........       $73.44
   J0150  K                Injection adenosine          0917         0.37       $18.81  ...........        $3.62
                            6 MG.
   J0151  E                Adenosine injection.  ...........  ...........  ...........  ...........  ...........
   J0170  N                Adrenalin epinephrin  ...........  ...........  ...........  ...........  ...........
                            inject.
   J0190  N                Inj biperiden         ...........  ...........  ...........  ...........  ...........
                            lactate/5 mg.
   J0200  N                Alatrofloxacin        ...........  ...........  ...........  ...........  ...........
                            mesylate.
   J0205  G                Alglucerase                  0900  ...........       $37.53  ...........        $5.37
                            injection.
   J0207  G                Amifostine..........         7000  ...........      $392.06  ...........       $56.13
   J0210  N                Methyldopate hcl      ...........  ...........  ...........  ...........  ...........
                            injection.
   J0256  G                Alpha 1 proteinase           0901  ...........        $2.09  ...........         $.30
                            inhibitor.
   J0270  E                Alprostadil for       ...........  ...........  ...........  ...........  ...........
                            injection.
   J0275  E                Alprostadil urethral  ...........  ...........  ...........  ...........  ...........
                            suppos.
   J0280  N                Aminophyllin 250 MG   ...........  ...........  ...........  ...........  ...........
                            inj.
   J0282  N                Amiodarone HCl......  ...........  ...........  ...........  ...........  ...........
   J0285  N                Amphotericin B......  ...........  ...........  ...........  ...........  ...........
   J0286  G                Amphotericin B lipid         7001  ...........      $109.25  ...........       $15.64
                            complex.
   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  G                Injection                    1606  ...........    $2,559.11  ...........      $366.36
                            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.
   J0476  E                Baclofen intrathecal  ...........  ...........  ...........  ...........  ...........
                            trial.
   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.
   J0585  G                Botulinum toxin a            0902  ...........        $4.39  ...........         $.56
                            per unit.
   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  ...........  ...........  ...........  ...........  ...........
   J0640  G                Leucovorin calcium           0725  ...........        $4.98  ...........         $.45
                            injection.
   J0670  N                Inj mepivacaine HCL/  ...........  ...........  ...........  ...........  ...........
                            10 ml.

[[Page 44859]]

 
   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.
   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.
   J0735  N                Clonidine             ...........  ...........  ...........  ...........  ...........
                            hydrochloride.
   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.
   J0850  G                Cytomegalovirus imm          0903  ...........      $656.27  ...........       $84.28
                            IV /vial.
   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  ...........  ...........  ...........  ...........  ...........
   J1190  G                Dexrazoxane HCl              0726  ...........      $194.53  ...........       $27.85
                            injection.
   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.
   J1245  K                Dipyridamole                 0917         0.37       $18.81  ...........        $3.62
                            injection.
   J1250  N                Inj dobutamine HCL/   ...........  ...........  ...........  ...........  ...........
                            250 mg.
   J1260  G                Dolasetron mesylate.         0750  ...........       $16.45  ...........        $2.11
   J1320  N                Amitriptyline         ...........  ...........  ...........  ...........  ...........
                            injection.
   J1325  G                Epoprostenol                 7003  ...........       $17.37  ...........        $2.49
                            injection.
   J1327  G                Eptifibatide                 1607  ...........       $13.58  ...........        $1.94
                            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  G                Etidronate disodium          0727  ...........       $63.65  ...........        $9.11
                            inj.
   J1438  G                Etanercept injection         1608  ...........      $140.98  ...........       $20.18
   J1440  G                Filgrastim 300 mcg           0728  ...........      $179.08  ...........       $25.64
                            injeciton.
   J1441  G                Filgrastim 480 mcg           7049  ...........      $285.38  ...........       $40.85
                            injection.
   J1450  N                Fluconazole.........  ...........  ...........  ...........  ...........  ...........
   J1452  N                Intraocular           ...........  ...........  ...........  ...........  ...........
                            Fomivirsen na.
   J1455  N                Foscarnet sodium      ...........  ...........  ...........  ...........  ...........
                            injection.
   J1460  N                Gamma globulin 1 CC   ...........  ...........  ...........  ...........  ...........
                            inj.
   J1470  E                Gamma globulin 2 CC   ...........  ...........  ...........  ...........  ...........
                            inj.

[[Page 44860]]

 
   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.
   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.
   J1561  G                Immune globulin 500          0905  ...........       $25.92  ...........        $3.33
                            mg.
   J1563  N                IV immune globulin..  ...........  ...........  ...........  ...........  ...........
   J1565  G                RSV-ivig............         0906  ...........      $406.34  ...........       $58.17
   J1570  K                Ganciclovir sodium           0907         0.46       $23.39  ...........        $4.51
                            injection.
   J1580  N                Garamycin gentamicin  ...........  ...........  ...........  ...........  ...........
                            inj.
   J1600  N                Gold sodium           ...........  ...........  ...........  ...........  ...........
                            thiomaleate inj.
   J1610  N                Glucagon              ...........  ...........  ...........  ...........  ...........
                            hydrochloride/1 MG.
   J1620  G                Gonadorelin hydroch/         7005  ...........       $38.47  ...........        $5.51
                            100 mcg.
   J1626  G                Granisetron HCl              0764  ...........       $18.54  ...........        $2.38
                            injection.
   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.
   J1670  G                Tetanus immune               0908  ...........      $102.60  ...........       $14.69
                            globulin inj.
   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.
   J1745  G                Infliximab injection         7043  ...........       $63.23  ...........        $9.05
   J1750  N                Iron dextran........  ...........  ...........  ...........  ...........  ...........
   J1785  G                Injection                    0916  ...........        $3.75  ...........         $.54
                            imiglucerase /unit.
   J1790  N                Droperidol injection  ...........  ...........  ...........  ...........  ...........
   J1800  N                Propranolol           ...........  ...........  ...........  ...........  ...........
                            injection.
   J1810  G                Droperidol/fentanyl          7047  ...........        $6.67  ...........         $.95
                            inj.
   J1820  N                Insulin injection...  ...........  ...........  ...........  ...........  ...........
   J1825  G                Interferon beta-1a..         0909  ...........      $225.23  ...........       $32.24
   J1830  G                Interferon beta-1b /         0910  ...........       $54.15  ...........        $7.75
                            .25 MG.
   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  ...........  ...........  ...........  ...........  ...........
   J1950  G                Leuprolide acetate /         0800  ...........       $81.60  ...........        $7.39
                            3.75 MG.
   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.
   J2260  K                Inj milrinone                7007         0.48       $24.40  ...........        $4.88
                            lactate / 5 ML.
   J2270  N                Morphine sulfate      ...........  ...........  ...........  ...........  ...........
                            injection.
   J2271  N                Morphine so4          ...........  ...........  ...........  ...........  ...........
                            injection 100mg.
   J2275  G                Morphine sulfate             7010  ...........        $7.41  ...........         $.95
                            injection.
   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.

[[Page 44861]]

 
   J2350  N                Niacinamide/niacin    ...........  ...........  ...........  ...........  ...........
                            injection.
   J2352  G                Octreotide acetate           7031  ...........      $125.65  ...........       $17.99
                            injection.
   J2355  G                Oprelvekin injection         7011  ...........      $236.31  ...........       $33.83
   J2360  N                Orphenadrine          ...........  ...........  ...........  ...........  ...........
                            injection.
   J2370  N                Phenylephrine hcl     ...........  ...........  ...........  ...........  ...........
                            injection.
   J2400  N                Chloroprocaine hcl    ...........  ...........  ...........  ...........  ...........
                            injection.
   J2405  G                Ondansetron hcl              0768  ...........        $3.92  ...........         $.50
                            injection.
   J2410  N                Oxymorphone hcl       ...........  ...........  ...........  ...........  ...........
                            injection.
   J2430  G                Pamidronate disodium         0730  ...........      $253.68  ...........       $32.58
                            /30 MG.
   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.
   J2545  A                Pentamidine           ...........  ...........  ...........  ...........  ...........
                            isethionte/300mg.
   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.
   J2765  G                Metoclopramide hcl           0754  ...........        $1.55  ...........         $.20
                            injection.
   J2770  G                Quinupristin/                1024  ...........      $102.05  ...........       $14.61
                            dalfopristin.
   J2780  N                Ranitidine            ...........  ...........  ...........  ...........  ...........
                            hydrochloride inj.
   J2790  G                Rho d immune                 0884  ...........       $34.11  ...........        $4.38
                            globulin inj.
   J2792  G                Rho(D) immune                1609  ...........       $20.64  ...........        $2.65
                            globulin h, sd.
   J2795  N                Ropivacaine HCl       ...........  ...........  ...........  ...........  ...........
                            injection.
   J2800  N                Methocarbamol         ...........  ...........  ...........  ...........  ...........
                            injection.
   J2810  N                Inj theophylline per  ...........  ...........  ...........  ...........  ...........
                            40 MG.
   J2820  G                Sargramostim                 0731  ...........       $29.06  ...........        $4.16
                            injection.
   J2860  N                Secobarbital sodium   ...........  ...........  ...........  ...........  ...........
                            inj.
   J2910  N                Aurothioglucose       ...........  ...........  ...........  ...........  ...........
                            injeciton.
   J2912  N                Sodium chloride       ...........  ...........  ...........  ...........  ...........
                            injection.
   J2915  N                NA Ferric Gluconate   ...........  ...........  ...........  ...........  ...........
                            Complex.
   J2920  N                Methylprednisolone    ...........  ...........  ...........  ...........  ...........
                            injection.
   J2930  N                Methylprednisolone    ...........  ...........  ...........  ...........  ...........
                            injection.
   J2950  N                Promazine hcl         ...........  ...........  ...........  ...........  ...........
                            injeciton.
   J2970  N                Methicillin sodium    ...........  ...........  ...........  ...........  ...........
                            injection.
   J2993  G                Reteplase injection.         9005  ...........    $1,306.25  ...........      $187.00
   J2995  K                Inj streptokinase /          0911         1.80       $91.52  ...........       $17.68
                            250000 IU.
   J2997  K                Alteplase                    7048         0.39       $19.83  ...........        $3.97
                            recombinant.
   J3000  N                Streptomycin          ...........  ...........  ...........  ...........  ...........
                            injection.
   J3010  G                Fentanyl citrate             7014  ...........        $1.40  ...........         $.18
                            injeciton.
   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  E                Thyrotropin           ...........  ...........  ...........  ...........  ...........
                            injection.
   J3245  G                Tirofiban                    7041  ...........      $435.27  ...........       $62.31
                            hydrochloride.
   J3250  N                Trimethobenzamide     ...........  ...........  ...........  ...........  ...........
                            hcl inj.
   J3260  N                Tobramycin sulfate    ...........  ...........  ...........  ...........  ...........
                            injection.
   J3265  N                Injection torsemide   ...........  ...........  ...........  ...........  ...........
                            10 mg/ml.
   J3270  N                Imipramine hcl        ...........  ...........  ...........  ...........  ...........
                            injection.
   J3280  G                Thiethylperazine             0755  ...........        $5.43  ...........         $.70
                            maleate inj.
   J3301  N                Triamcinolone         ...........  ...........  ...........  ...........  ...........
                            acetonide inj.
   J3302  N                Triamcinolone         ...........  ...........  ...........  ...........  ...........
                            diacetate inj.

[[Page 44862]]

 
   J3303  N                Triamcinolone         ...........  ...........  ...........  ...........  ...........
                            hexacetonl inj.
   J3305  G                Inj trimetrexate             7045  ...........       $86.09  ...........       $12.32
                            glucoronate.
   J3310  N                Perphenazine          ...........  ...........  ...........  ...........  ...........
                            injeciton.
   J3320  N                Spectinomycn di-hcl   ...........  ...........  ...........  ...........  ...........
                            inj.
   J3350  N                Urea injection......  ...........  ...........  ...........  ...........  ...........
   J3360  N                Diazepam injection..  ...........  ...........  ...........  ...........  ...........
   J3364  N                Urokinase 5000 IU     ...........  ...........  ...........  ...........  ...........
                            injection.
   J3365  K                Urokinase 250,000 IU         7036         6.93      $352.34  ...........       $70.47
                            inj.
   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.
   J3485  N                Zidovudine..........  ...........  ...........  ...........  ...........  ...........
   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.
   J7190  G                Factor viii.........         0925  ...........         $.87  ...........         $.11
   J7191  G                Factor VIII                  0926  ...........        $2.09  ...........         $.30
                            (porcine).
   J7192  G                Factor viii                  0927  ...........        $1.19  ...........         $.15
                            recombinant.
   J7194  G                Factor ix complex...         0928  ...........         $.68  ...........         $.09
   J7197  G                Antithrombin iii             0930  ...........        $1.05  ...........         $.15
                            injection.
   J7198  G                Anti-inhibitor......         0929  ...........        $1.43  ...........         $.18
   J7199  E                Hemophilia clot       ...........  ...........  ...........  ...........  ...........
                            factor noc.
   J7300  E                Intraut copper        ...........  ...........  ...........  ...........  ...........
                            contraceptive.
   J7310  G                Ganciclovir long act         0913  ...........    $4,750.00  ...........      $680.00
                            implant.
   J7315  G                Sodium hyaluronate           7315  ...........      $136.80  ...........       $19.58
                            injection.
   J7320  G                Hylan G-F 20                 1611  ...........      $213.86  ...........       $30.62
                            injection.
   J7330  G                Cultured                     1059  ...........   $14,250.00  ...........    $2,040.00
                            chondrocytes implnt.
   J7500  G                Azathioprine oral            0886  ...........        $1.24  ...........         $.16
                            50mg.
   J7501  G                Azathioprine                 0887  ...........         $.75  ...........         $.10
                            parenteral.
   J7502  G                Cyclosporine oral            0888  ...........        $5.23  ...........         $.47
                            100 mg.
   J7504  G                Lymphocyte immune            0890  ...........      $249.47  ...........       $32.04
                            globulin.
   J7505  G                Monoclonal                   7038  ...........      $777.31  ...........      $111.28
                            antibodies.
   J7506  G                Prednisone oral.....         7050  ...........         $.07  ...........         $.01
   J7507  G                Tacrolimus oral per          0891  ...........        $2.91  ...........         $.42
                            1 MG.
   J7508  E                Tacrolimus oral per   ...........  ...........  ...........  ...........  ...........
                            5 MG.
   J7509  N                Methylprednisolone    ...........  ...........  ...........  ...........  ...........
                            oral.
   J7510  N                Prednisolone oral     ...........  ...........  ...........  ...........  ...........
                            per 5 mg.
   J7513  G                Daclizumab,                  1612  ...........      $397.29  ...........       $56.88
                            parenteral.
   J7515  N                Cyclosporine oral 25  ...........  ...........  ...........  ...........  ...........
                            mg.
   J7516  G                Cyclosporin                  0889  ...........       $25.08  ...........        $2.27
                            parenteral 250mg.
   J7517  G                Mycophenolate                9015  ...........        $2.40  ...........         $.34
                            mofetil oral.
   J7520  G                Sirolimus, oral.....         9106  ...........        $6.51  ...........         $.93
   J7525  E                Tacrolimus injection  ...........  ...........  ...........  ...........  ...........
   J7599  E                Immunosuppressive     ...........  ...........  ...........  ...........  ...........
                            drug noc.
   J7608  A                Acetylcysteine inh    ...........  ...........  ...........  ...........  ...........
                            sol u d.
   J7618  A                Albuterol inh sol     ...........  ...........  ...........  ...........  ...........
                            con.
   J7619  A                Albuterol inh sol u   ...........  ...........  ...........  ...........  ...........
                            d.
   J7628  A                Bitolterol mes inhal  ...........  ...........  ...........  ...........  ...........
                            sol con.
   J7629  A                Bitolterol mes inh    ...........  ...........  ...........  ...........  ...........
                            sol u d.
   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.
   J7639  A                Dornase alpha inhal   ...........  ...........  ...........  ...........  ...........
                            sol u d.

[[Page 44863]]

 
   J7642  A                Glycopyrrolate inhal  ...........  ...........  ...........  ...........  ...........
                            sol con.
   J7643  A                Glycopyrrolate inhal  ...........  ...........  ...........  ...........  ...........
                            sol u d.
   J7644  A                Ipratropium brom inh  ...........  ...........  ...........  ...........  ...........
                            sol u d.
   J7648  A                Isoetharine hcl inh   ...........  ...........  ...........  ...........  ...........
                            sol con.
   J7649  A                Isoetharine hcl inh   ...........  ...........  ...........  ...........  ...........
                            sol u d.
   J7658  A                Isoproterenolhcl inh  ...........  ...........  ...........  ...........  ...........
                            sol con.
   J7659  A                Isoproterenol hcl     ...........  ...........  ...........  ...........  ...........
                            inh sol ud.
   J7668  A                Metaproterenol inh    ...........  ...........  ...........  ...........  ...........
                            sol con.
   J7669  A                Metaproterenol inh    ...........  ...........  ...........  ...........  ...........
                            sol u d.
   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.
   J8499  E                Oral prescrip drug    ...........  ...........  ...........  ...........  ...........
                            non chemo.
   J8510  G                Oral busulfan.......         7015  ...........        $1.81  ...........         $.23
   J8520  G                Capecitabine, oral,          7042  ...........        $2.43  ...........         $.35
                            150 mg.
   J8521  N                Capecitabine, oral,   ...........  ...........  ...........  ...........  ...........
                            500 mg.
   J8530  G                Cyclophosphamide             0801  ...........        $2.23  ...........         $.32
                            oral 25 MG.
   J8560  G                Etoposide oral 50 MG         0802  ...........       $50.89  ...........        $7.29
   J8600  G                Melphalan oral 2 MG.         0803  ...........        $2.18  ...........         $.31
   J8610  G                Methotrexate oral            0826  ...........        $2.73  ...........         $.25
                            2.5 MG.
   J8700  G                Temozolmide.........         1086  ...........        $5.93  ...........         $.85
   J8999  E                Oral prescription     ...........  ...........  ...........  ...........  ...........
                            drug chemo.
   J9000  G                Doxorubic hcl 10 MG          0847  ...........        $9.00  ...........        $1.29
                            vl chemo.
   J9001  G                Doxorubicin hcl              7046  ...........      $358.95  ...........       $51.39
                            liposome inj.
   J9015  G                Aldesleukin/single           0807  ...........      $641.25  ...........       $91.80
                            use vial.
   J9020  G                Asparaginase                 0814  ...........       $59.70  ...........        $8.55
                            injection.
   J9031  G                Bcg live                     0809  ...........      $166.44  ...........       $21.37
                            intravesical vac.
   J9040  G                Bleomycin sulfate            0857  ...........      $289.37  ...........       $41.43
                            injection.
   J9045  G                Carboplatin                  0811  ...........      $111.11  ...........       $15.91
                            injection.
   J9050  G                Carmus bischl nitro          0812  ...........      $114.41  ...........       $16.38
                            inj.
   J9060  G                Cisplatin 10 MG              0813  ...........       $47.12  ...........        $6.75
                            injeciton.
   J9062  E                Cisplatin 50 MG       ...........  ...........  ...........  ...........  ...........
                            injeciton.
   J9065  G                Inj cladribine per 1         0858  ...........       $56.08  ...........        $8.03
                            MG.
   J9070  G                Cyclophosphamide 100         0815  ...........        $5.98  ...........         $.77
                            MG inj.
   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.
   J9093  G                Cyclophosphamide             0816  ...........        $6.13  ...........         $.79
                            lyophilized.
   J9094  E                Cyclophosphamide      ...........  ...........  ...........  ...........  ...........
                            lyophilized.
   J9095  E                Cyclophosphamide      ...........  ...........  ...........  ...........  ...........
                            lyophilized.
   J9096  E                Cyclophosphamide      ...........  ...........  ...........  ...........  ...........
                            lyophilized.
   J9097  E                Cyclophosphamide      ...........  ...........  ...........  ...........  ...........
                            lyophilized.
   J9100  G                Cytarabine hcl 100           0817  ...........        $4.75  ...........         $.43
                            MG inj.
   J9110  E                Cytarabine hcl 500    ...........  ...........  ...........  ...........  ...........
                            MG inj.
   J9120  G                Dactinomycin                 0818  ...........       $13.23  ...........        $1.89
                            actinomycin d.
   J9130  G                Dacarbazine 10 MG            0819  ...........       $11.28  ...........        $1.02
                            inj.
   J9140  E                Dacarbazine 200 MG    ...........  ...........  ...........  ...........  ...........
                            inj.
   J9150  G                Daunorubicin........         0820  ...........       $76.62  ...........        $6.94
   J9151  G                Daunorubicin citrate         0821  ...........       $64.60  ...........        $9.25
                            liposom.
   J9160  G                Denileukin diftitox,         1084  ...........      $999.88  ...........      $143.14
                            300 mcg.
   J9165  G                Diethylstilbestrol           0822  ...........        $3.99  ...........         $.57
                            injection.
   J9170  G                Docetaxel...........         0823  ...........      $297.83  ...........       $42.64
   J9180  E                Epirubicin HCl        ...........  ...........  ...........  ...........  ...........
                            injection.
   J9181  G                Etoposide 10 MG inj.         0824  ...........        $3.86  ...........         $.35
   J9182  E                Etoposide 100 MG inj  ...........  ...........  ...........  ...........  ...........
   J9185  G                Fludarabine                  0842  ...........      $258.88  ...........       $37.06
                            phosphate inj.
   J9190  G                Fluorouracil                 0859  ...........        $1.48  ...........         $.13
                            injection.
   J9200  G                Floxuridine                  0827  ...........      $129.56  ...........       $11.73
                            injection.
   J9201  G                Gemcitabine HCl.....         0828  ...........      $102.13  ...........       $14.62
   J9202  G                Goserelin acetate            0810  ...........      $446.49  ...........       $63.92
                            implant.
   J9206  G                Irinotecan injection         0830  ...........      $125.47  ...........       $17.96
   J9208  G                Ifosfomide injection         0831  ...........      $156.65  ...........       $22.43
   J9209  G                Mesna injection.....         0732  ...........       $40.44  ...........        $5.79
   J9211  G                Idarubicin hcl               0832  ...........      $412.21  ...........       $59.01
                            injeciton.
   J9212  G                Interferon alfacon-1         0833  ...........        $4.10  ...........         $.59
   J9213  G                Interferon alfa-2a           0834  ...........       $34.87  ...........        $4.99
                            inj.
   J9214  G                Interferon alfa-2b           0836  ...........       $12.98  ...........        $1.67
                            inj.
   J9215  G                Interferon alfa-n3           0865  ...........        $7.86  ...........        $1.12
                            inj.
   J9216  G                Interferon gamma 1-b         0838  ...........      $285.64  ...........       $40.89
                            inj.
   J9217  G                Leuprolide acetate           9217  ...........      $564.92  ...........       $51.14
                            suspnsion.

[[Page 44864]]

 
   J9218  G                Leuprolide acetate           0861  ...........       $26.15  ...........        $2.37
                            injeciton.
   J9219  N                Leuprolide acetate    ...........  ...........  ...........  ...........  ...........
                            implant.
   J9230  G                Mechlorethamine hcl          0839  ...........       $11.88  ...........        $1.70
                            inj.
   J9245  G                Inj melphalan                0840  ...........      $381.65  ...........       $54.64
                            hydrochl 50 MG.
   J9250  G                Methotrexate sodium          0841  ...........         $.41  ...........         $.04
                            inj.
   J9260  E                Methotrexate sodium   ...........  ...........  ...........  ...........  ...........
                            inj.
   J9265  G                Paclitaxel injection         0863  ...........      $164.08  ...........       $21.07
   J9266  G                Pegaspargase/singl           0843  ...........    $1,255.57  ...........      $179.74
                            dose vial.
   J9268  G                Pentostatin                  0844  ...........    $1,654.14  ...........      $236.80
                            injection.
   J9270  G                Plicamycin                   0860  ...........       $93.80  ...........       $13.43
                            (mithramycin) inj.
   J9280  G                Mitomycin 5 MG inj..         0862  ...........      $121.65  ...........       $11.01
   J9290  E                Mitomycin 20 MG inj.  ...........  ...........  ...........  ...........  ...........
   J9291  E                Mitomycin 40 MG inj.  ...........  ...........  ...........  ...........  ...........
   J9293  G                Mitoxantrone                 0864  ...........      $244.20  ...........       $34.96
                            hydrochl / 5 MG.
   J9310  G                Rituximab cancer             0849  ...........      $454.55  ...........       $65.07
                            treatment.
   J9320  G                Streptozocin                 0850  ...........      $117.64  ...........       $16.84
                            injection.
   J9340  G                Thiotepa injection..         0851  ...........      $116.97  ...........       $16.75
   J9350  G                Topotecan...........         0852  ...........      $632.56  ...........       $90.56
   J9355  G                Trastuzumab.........         1613  ...........       $52.83  ...........        $7.56
   J9357  G                Valrubicin, 200 mg..         1614  ...........      $423.23  ...........       $60.59
   J9360  G                Vinblastine sulfate          0853  ...........        $4.11  ...........         $.37
                            inj.
   J9370  G                Vincristine sulfate          0854  ...........       $30.16  ...........        $2.73
                            1 MG inj.
   J9375  E                Vincristine sulfate   ...........  ...........  ...........  ...........  ...........
                            2 MG inj.
   J9380  E                Vincristine sulfate   ...........  ...........  ...........  ...........  ...........
                            5 MG inj.
   J9390  G                Vinorelbine tartrate/        0855  ...........       $79.28  ...........       $11.35
                            10 mg.
   J9600  G                Porfimer sodium.....         0856  ...........    $2,603.67  ...........      $372.74
   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.
   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.

[[Page 44865]]

 
   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.....  ...........  ...........  ...........  ...........  ...........
   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.
   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.
   K0415  E                RX antiemetic drg,    ...........  ...........  ...........  ...........  ...........
                            oral NOS.

[[Page 44866]]

 
   K0416  E                Rx antiemetic         ...........  ...........  ...........  ...........  ...........
                            drg,rectal NOS.
   K0452  A                Wheelchair bearings.  ...........  ...........  ...........  ...........  ...........
   K0455  A                Pump uninterrupted    ...........  ...........  ...........  ...........  ...........
                            infusion.
   K0460  A                WC power add-on       ...........  ...........  ...........  ...........  ...........
                            joystick.
   K0461  A                WC power add-on       ...........  ...........  ...........  ...........  ...........
                            tiller cntrl.
   K0462  A                Temporary             ...........  ...........  ...........  ...........  ...........
                            replacement eqpmnt.
   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.
   K0538  A                Neg pressure wnd      ...........  ...........  ...........  ...........  ...........
                            thrpy pump.
   K0539  A                Neg pres wnd thrpy    ...........  ...........  ...........  ...........  ...........
                            dsg set.
   K0540  A                Neg pres wnd thrp     ...........  ...........  ...........  ...........  ...........
                            canister.
   K0541  A                Speech generating     ...........  ...........  ...........  ...........  ...........
                            device.
   K0542  A                Speech generating     ...........  ...........  ...........  ...........  ...........
                            device.
   K0543  A                Speech generating     ...........  ...........  ...........  ...........  ...........
                            device.
   K0544  A                Speech generating     ...........  ...........  ...........  ...........  ...........
                            device.
   K0545  A                Speech generating     ...........  ...........  ...........  ...........  ...........
                            software.
   K0546  A                Accessory for         ...........  ...........  ...........  ...........  ...........
                            sgd,mntng syst.
   K0547  A                Accessory for         ...........  ...........  ...........  ...........  ...........
                            sgd,not clasfd.
   K0548  A                Insulin lispro......  ...........  ...........  ...........  ...........  ...........
   K0549  A                Hosp bed hvy dty      ...........  ...........  ...........  ...........  ...........
                            xtra wide.
   K0550  A                Hosp bed xtra hvy     ...........  ...........  ...........  ...........  ...........
                            dty x wide.
   K0551  A                Residual limb         ...........  ...........  ...........  ...........  ...........
                            support system.
   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.
   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  ...........  ...........  ...........  ...........  ...........

[[Page 44867]]

 
   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.
   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.

[[Page 44868]]

 
   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.
   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.  ...........  ...........  ...........  ...........  ...........

[[Page 44869]]

 
   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.
   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  E                Ft insert ucb         ...........  ...........  ...........  ...........  ...........
                            berkeley shell.
   L3001  E                Foot insert remov     ...........  ...........  ...........  ...........  ...........
                            molded spe.
   L3002  E                Foot insert           ...........  ...........  ...........  ...........  ...........
                            plastazote or eq.
   L3003  E                Foot insert silicone  ...........  ...........  ...........  ...........  ...........
                            gel eac.
   L3010  E                Foot longitudinal     ...........  ...........  ...........  ...........  ...........
                            arch suppo.
   L3020  E                Foot longitud/        ...........  ...........  ...........  ...........  ...........
                            metatarsal sup.
   L3030  E                Foot arch support     ...........  ...........  ...........  ...........  ...........
                            remov prem.
   L3040  E                Ft arch suprt         ...........  ...........  ...........  ...........  ...........
                            premold longit.
   L3050  E                Foot arch supp        ...........  ...........  ...........  ...........  ...........
                            premold metat.
   L3060  E                Foot arch supp        ...........  ...........  ...........  ...........  ...........
                            longitud/meta.
   L3070  E                Arch suprt att to     ...........  ...........  ...........  ...........  ...........
                            sho longit.
   L3080  E                Arch supp att to      ...........  ...........  ...........  ...........  ...........
                            shoe metata.
   L3090  E                Arch supp att to      ...........  ...........  ...........  ...........  ...........
                            shoe long/m.
   L3100  E                Hallus-valgus nght    ...........  ...........  ...........  ...........  ...........
                            dynamic s.
   L3140  E                Abduction rotation    ...........  ...........  ...........  ...........  ...........
                            bar shoe.
   L3150  E                Abduct rotation bar   ...........  ...........  ...........  ...........  ...........
                            w/o shoe.
   L3160  E                Shoe styled           ...........  ...........  ...........  ...........  ...........
                            positioning dev.
   L3170  E                Foot plastic heel     ...........  ...........  ...........  ...........  ...........
                            stabilizer.
   L3201  E                Oxford w supinat/     ...........  ...........  ...........  ...........  ...........
                            pronat inf.
   L3202  E                Oxford w/ supinat/    ...........  ...........  ...........  ...........  ...........
                            pronator c.
   L3203  E                Oxford w/ supinator/  ...........  ...........  ...........  ...........  ...........
                            pronator.

[[Page 44870]]

 
   L3204  E                Hightop w/ supp/      ...........  ...........  ...........  ...........  ...........
                            pronator inf.
   L3206  E                Hightop w/ supp/      ...........  ...........  ...........  ...........  ...........
                            pronator chi.
   L3207  E                Hightop w/ supp/      ...........  ...........  ...........  ...........  ...........
                            pronator jun.
   L3208  E                Surgical boot each    ...........  ...........  ...........  ...........  ...........
                            infant.
   L3209  E                Surgical boot each    ...........  ...........  ...........  ...........  ...........
                            child.
   L3211  E                Surgical boot each    ...........  ...........  ...........  ...........  ...........
                            junior.
   L3212  E                Benesch boot pair     ...........  ...........  ...........  ...........  ...........
                            infant.
   L3213  E                Benesch boot pair     ...........  ...........  ...........  ...........  ...........
                            child.
   L3214  E                Benesch boot pair     ...........  ...........  ...........  ...........  ...........
                            junior.
   L3215  E                Orthopedic ftwear     ...........  ...........  ...........  ...........  ...........
                            ladies oxf.
   L3216  E                Orthoped ladies       ...........  ...........  ...........  ...........  ...........
                            shoes dpth i.
   L3217  E                Ladies shoes hightop  ...........  ...........  ...........  ...........  ...........
                            depth i.
   L3218  E                Ladies surgical boot  ...........  ...........  ...........  ...........  ...........
                            each.
   L3219  E                Orthopedic mens       ...........  ...........  ...........  ...........  ...........
                            shoes oxford.
   L3221  E                Orthopedic mens       ...........  ...........  ...........  ...........  ...........
                            shoes dpth i.
   L3222  E                Mens shoes hightop    ...........  ...........  ...........  ...........  ...........
                            depth inl.
   L3223  E                Mens surgical boot    ...........  ...........  ...........  ...........  ...........
                            each.
   L3224  A                Woman's shoe oxford   ...........  ...........  ...........  ...........  ...........
                            brace.
   L3225  A                Man's shoe oxford     ...........  ...........  ...........  ...........  ...........
                            brace.
   L3230  E                Custom shoes depth    ...........  ...........  ...........  ...........  ...........
                            inlay.
   L3250  E                Custom mold shoe      ...........  ...........  ...........  ...........  ...........
                            remov prost.
   L3251  E                Shoe molded to pt     ...........  ...........  ...........  ...........  ...........
                            silicone s.
   L3252  E                Shoe molded           ...........  ...........  ...........  ...........  ...........
                            plastazote cust.
   L3253  E                Shoe molded           ...........  ...........  ...........  ...........  ...........
                            plastazote cust.
   L3254  E                Orth foot non-        ...........  ...........  ...........  ...........  ...........
                            stndard size/w.
   L3255  E                Orth foot non-        ...........  ...........  ...........  ...........  ...........
                            standard size/.
   L3257  E                Orth foot add charge  ...........  ...........  ...........  ...........  ...........
                            split s.
   L3260  E                Ambulatory surgical   ...........  ...........  ...........  ...........  ...........
                            boot eac.
   L3265  E                Plastazote sandal     ...........  ...........  ...........  ...........  ...........
                            each.
   L3300  E                Sho lift taper to     ...........  ...........  ...........  ...........  ...........
                            metatarsal.
   L3310  E                Shoe lift elev heel/  ...........  ...........  ...........  ...........  ...........
                            sole neo.
   L3320  E                Shoe lift elev heel/  ...........  ...........  ...........  ...........  ...........
                            sole cor.
   L3330  E                Lifts elevation       ...........  ...........  ...........  ...........  ...........
                            metal extens.
   L3332  E                Shoe lifts tapered    ...........  ...........  ...........  ...........  ...........
                            to one-ha.
   L3334  E                Shoe lifts elevation  ...........  ...........  ...........  ...........  ...........
                            heel /i.
   L3340  E                Shoe wedge sach.....  ...........  ...........  ...........  ...........  ...........
   L3350  E                Shoe heel wedge.....  ...........  ...........  ...........  ...........  ...........
   L3360  E                Shoe sole wedge       ...........  ...........  ...........  ...........  ...........
                            outside sole.
   L3370  E                Shoe sole wedge       ...........  ...........  ...........  ...........  ...........
                            between sole.
   L3380  E                Shoe clubfoot wedge.  ...........  ...........  ...........  ...........  ...........
   L3390  E                Shoe outflare wedge.  ...........  ...........  ...........  ...........  ...........
   L3400  E                Shoe metatarsal bar   ...........  ...........  ...........  ...........  ...........
                            wedge ro.
   L3410  E                Shoe metatarsal bar   ...........  ...........  ...........  ...........  ...........
                            between.
   L3420  E                Full sole/heel wedge  ...........  ...........  ...........  ...........  ...........
                            btween.
   L3430  E                Sho heel count plast  ...........  ...........  ...........  ...........  ...........
                            reinfor.
   L3440  E                Heel leather          ...........  ...........  ...........  ...........  ...........
                            reinforced.
   L3450  E                Shoe heel sach        ...........  ...........  ...........  ...........  ...........
                            cushion type.
   L3455  E                Shoe heel new         ...........  ...........  ...........  ...........  ...........
                            leather standa.
   L3460  E                Shoe heel new rubber  ...........  ...........  ...........  ...........  ...........
                            standar.
   L3465  E                Shoe heel thomas      ...........  ...........  ...........  ...........  ...........
                            with wedge.
   L3470  E                Shoe heel thomas      ...........  ...........  ...........  ...........  ...........
                            extend to b.
   L3480  E                Shoe heel pad &       ...........  ...........  ...........  ...........  ...........
                            depress for.
   L3485  E                Shoe heel pad         ...........  ...........  ...........  ...........  ...........
                            removable for.
   L3500  E                Ortho shoe add        ...........  ...........  ...........  ...........  ...........
                            leather insol.
   L3510  E                Orthopedic shoe add   ...........  ...........  ...........  ...........  ...........
                            rub insl.
   L3520  E                O shoe add felt w     ...........  ...........  ...........  ...........  ...........
                            leath insl.
   L3530  E                Ortho shoe add half   ...........  ...........  ...........  ...........  ...........
                            sole.
   L3540  E                Ortho shoe add full   ...........  ...........  ...........  ...........  ...........
                            sole.
   L3550  E                O shoe add standard   ...........  ...........  ...........  ...........  ...........
                            toe tap.
   L3560  E                O shoe add horseshoe  ...........  ...........  ...........  ...........  ...........
                            toe tap.
   L3570  E                O shoe add instep     ...........  ...........  ...........  ...........  ...........
                            extension.
   L3580  E                O shoe add instep     ...........  ...........  ...........  ...........  ...........
                            velcro clo.
   L3590  E                O shoe convert to     ...........  ...........  ...........  ...........  ...........
                            sof counte.
   L3595  E                Ortho shoe add march  ...........  ...........  ...........  ...........  ...........
                            bar.
   L3600  E                Trans shoe calip      ...........  ...........  ...........  ...........  ...........
                            plate exist.
   L3610  E                Trans shoe caliper    ...........  ...........  ...........  ...........  ...........
                            plate new.
   L3620  E                Trans shoe solid      ...........  ...........  ...........  ...........  ...........
                            stirrup exi.
   L3630  E                Trans shoe solid      ...........  ...........  ...........  ...........  ...........
                            stirrup new.
   L3640  E                Shoe dennis browne    ...........  ...........  ...........  ...........  ...........
                            splint bo.
   L3649  E                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.

[[Page 44871]]

 
   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.
   L3760  E                EO withjoint,         ...........  ...........  ...........  ...........  ...........
                            Prefabricated.
   L3800  A                Whfo short opponen    ...........  ...........  ...........  ...........  ...........
                            no attach.
   L3805  A                Whfo long opponens    ...........  ...........  ...........  ...........  ...........
                            no attach.
   L3807  A                WHFO,no joint,        ...........  ...........  ...........  ...........  ...........
                            prefabricated.
   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  E                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..  ...........  ...........  ...........  ...........  ...........
   L3920  A                Knuckle bender with   ...........  ...........  ...........  ...........  ...........
                            outrigge.
   L3922  A                Knuckle bend 2 seg    ...........  ...........  ...........  ...........  ...........
                            to flex j.
   L3923  A                HFO, no joint,        ...........  ...........  ...........  ...........  ...........
                            prefabricated.
   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.

[[Page 44872]]

 
   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.
   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.

[[Page 44873]]

 
   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                Bk flex inner socket  ...........  ...........  ...........  ...........  ...........
                            ext fra.
   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.
   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 suspension sleeve  ...........  ...........  ...........  ...........  ...........
   L5675  A                Bk heavy duty susp    ...........  ...........  ...........  ...........  ...........
                            sleeve.
   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.

[[Page 44874]]

 
   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.
   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.

[[Page 44875]]

 
   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.
   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       ...........  ...........  ...........  ...........  ...........
                            model555.
   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 grip1/2   ...........  ...........  ...........  ...........  ...........
                            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.

[[Page 44876]]

 
   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.
   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.
   L8040  A                Nasal prosthesis....  ...........  ...........  ...........  ...........  ...........
   L8041  A                Midfacial prosthesis  ...........  ...........  ...........  ...........  ...........
   L8042  A                Orbital prosthesis..  ...........  ...........  ...........  ...........  ...........
   L8043  A                Upper facial          ...........  ...........  ...........  ...........  ...........
                            prosthesis.
   L8044  A                Hemi-facial           ...........  ...........  ...........  ...........  ...........
                            prosthesis.
   L8045  A                Auricular prosthesis  ...........  ...........  ...........  ...........  ...........
   L8046  A                Partial facial        ...........  ...........  ...........  ...........  ...........
                            prosthesis.
   L8047  A                Nasal septal          ...........  ...........  ...........  ...........  ...........
                            prosthesis.
   L8048  A                Unspec maxillofacial  ...........  ...........  ...........  ...........  ...........
                            prosth.
   L8049  A                Repair maxillofacial  ...........  ...........  ...........  ...........  ...........
                            prosth.
   L8100  E                Compression stocking  ...........  ...........  ...........  ...........  ...........
                            BK18-30.
   L8110  E                Compression stocking  ...........  ...........  ...........  ...........  ...........
                            BK30-40.
   L8120  E                Compression stocking  ...........  ...........  ...........  ...........  ...........
                            BK40-50.
   L8130  E                Gc stocking           ...........  ...........  ...........  ...........  ...........
                            thighlngth 18-30.
   L8140  E                Gc stocking           ...........  ...........  ...........  ...........  ...........
                            thighlngth 30-40.
   L8150  E                Gc stocking           ...........  ...........  ...........  ...........  ...........
                            thighlngth 40-50.
   L8160  E                Gc stocking full      ...........  ...........  ...........  ...........  ...........
                            lngth 18-30.

[[Page 44877]]

 
   L8170  E                Gc stocking full      ...........  ...........  ...........  ...........  ...........
                            lngth 30-40.
   L8180  E                Gc stocking full      ...........  ...........  ...........  ...........  ...........
                            lngth 40-50.
   L8190  E                Gc stocking           ...........  ...........  ...........  ...........  ...........
                            waistlngth 18-30.
   L8195  E                Gc stocking           ...........  ...........  ...........  ...........  ...........
                            waistlngth 30-40.
   L8200  E                Gc stocking           ...........  ...........  ...........  ...........  ...........
                            waistlngth 40-50.
   L8210  E                Gc stocking custom    ...........  ...........  ...........  ...........  ...........
                            made.
   L8220  E                Gc stocking           ...........  ...........  ...........  ...........  ...........
                            lymphedema.
   L8230  E                Gc stocking garter    ...........  ...........  ...........  ...........  ...........
                            belt.
   L8239  E                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  N                Implant breast        ...........  ...........  ...........  ...........  ...........
                            silicone/eq.
   L8603  N                Collagen imp urinary  ...........  ...........  ...........  ...........  ...........
                            2.5 ml.
   L8606  A                Synthetic implnt      ...........  ...........  ...........  ...........  ...........
                            urinary 1ml.
   L8610  N                Ocular implant......  ...........  ...........  ...........  ...........  ...........
   L8612  N                Aqueous shunt         ...........  ...........  ...........  ...........  ...........
                            prosthesis.
   L8613  N                Ossicular implant...  ...........  ...........  ...........  ...........  ...........
   L8614  H                Cochlear device/             1002  ...........  ...........  ...........  ...........
                            system.
   L8619  A                Replace cochlear      ...........  ...........  ...........  ...........  ...........
                            processor.
   L8630  N                Metacarpophalangeal   ...........  ...........  ...........  ...........  ...........
                            implant.
   L8641  N                Metatarsal joint      ...........  ...........  ...........  ...........  ...........
                            implant.
   L8642  N                Hallux implant......  ...........  ...........  ...........  ...........  ...........
   L8658  N                Interphalangeal       ...........  ...........  ...........  ...........  ...........
                            joint implnt.
   L8670  N                Vascular graft,       ...........  ...........  ...........  ...........  ...........
                            synthetic.
   L8699  N                Prosthetic implant    ...........  ...........  ...........  ...........  ...........
                            NOS.
   L9900  A                O&P supply/accessory/ ...........  ...........  ...........  ...........  ...........
                            service.
   M0064  X                Visit for drug               0374         0.96       $48.81       $10.74        $9.76
                            monitoring.
   M0075  E                Cellular therapy....  ...........  ...........  ...........  ...........  ...........
   M0076  E                Prolotherapy........  ...........  ...........  ...........  ...........  ...........
   M0100  E                Intragastric          ...........  ...........  ...........  ...........  ...........
                            hypothermia.
   M0300  E                IV chelationtherapy.  ...........  ...........  ...........  ...........  ...........
   M0301  E                Fabric wrapping of    ...........  ...........  ...........  ...........  ...........
                            aneurysm.
   M0302  T                Assessment of                0970         0.47       $23.90  ...........        $4.78
                            cardiac output.
   P2028  X                Cephalin floculation         0349         0.34       $17.29        $3.46        $3.46
                            test.
   P2029  X                Congo red blood test         0349         0.34       $17.29        $3.46        $3.46
   P2031  E                Hair analysis.......  ...........  ...........  ...........  ...........  ...........
   P2033  X                Blood thymol                 0349         0.34       $17.29        $3.46        $3.46
                            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.
   P9010  K                Whole blood for              0950         2.13      $108.29  ...........       $21.66
                            transfusion.
   P9011  E                Blood split unit....  ...........  ...........  ...........  ...........  ...........
   P9012  K                Cryoprecipitate each         0952         0.72       $36.61  ...........        $7.32
                            unit.
   P9016  K                RBC leukocytes               0954         2.89      $146.93  ...........       $29.39
                            reduced.
   P9017  K                One donor fresh              0955         2.31      $117.45  ...........       $23.49
                            frozn plasma.
   P9019  K                Platelets, each unit         0957         1.00       $50.84  ...........       $10.17
   P9020  K                Plaelet rich plasma          0958         1.19       $60.50  ...........       $12.10
                            unit.
   P9021  K                Red blood cells unit         0959         2.09      $106.26  ...........       $21.25
   P9022  K                Washed red blood             0960         3.89      $197.78  ...........       $39.56
                            cells unit.
   P9023  K                Frozen plasma,               0949         3.00      $152.53  ...........       $30.51
                            pooled, sd.
   P9031  K                Platelets leukocytes         0954         2.89      $146.93  ...........       $29.39
                            reduced.
   P9032  K                Platelets,                   9500         1.81       $92.02  ...........       $18.40
                            irradiated.
   P9033  K                Platelets                    0954         2.89      $146.93  ...........       $29.39
                            leukoreduced irrad.
   P9034  K                Platelets, pheresis.         9501         9.91      $503.84  ...........      $100.77
   P9035  K                Platelet pheres              9501         9.91      $503.84  ...........      $100.77
                            leukoreduced.

[[Page 44878]]

 
   P9036  K                Platelet pheresis            9502        10.75      $546.55  ...........      $109.31
                            irradiated.
   P9037  K                Plate pheres                 9501         9.91      $503.84  ...........      $100.77
                            leukoredu irrad.
   P9038  K                RBC irradiated......         9505         2.64      $134.22  ...........       $26.84
   P9039  K                RBC deglycerolized..         9504         4.45      $226.25  ...........       $45.25
   P9040  K                RBC leukoreduced             9504         4.45      $226.25  ...........       $45.25
                            irradiated.
   P9041  K                Albumin(human), 5%..         0961         2.24      $113.89  ...........       $22.78
   P9042  K                Albumin (human), 25%         0962         1.12       $56.94  ...........       $11.39
   P9043  K                Plasma protein               0956         1.29       $65.59  ...........       $13.12
                            fraction.
   P9044  K                Cryoprecipitatereduc         1009         0.88       $44.74  ...........        $8.95
                            edplasma.
   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.
   Q0035  X                Cardiokymography....         0100         1.63       $82.87       $45.58       $16.57
   Q0081  T                Infusion ther other          0120         2.35      $119.48       $42.67       $23.90
                            than che.
   Q0083  S                Chemo by other than          0116         0.98       $49.83        $9.97        $9.97
                            infusion.
   Q0084  S                Chemotherapy by              0117         3.48      $176.93       $52.69       $35.39
                            infusion.
   Q0085  S                Chemo by both                0118         3.52      $178.96       $72.03       $35.79
                            infusion and o.
   Q0086  A                Physical therapy      ...........  ...........  ...........  ...........  ...........
                            evaluation/.
   Q0091  T                Obtaining screen pap         0191         0.27       $13.73        $3.98        $2.75
                            smear.
   Q0092  N                Set up port xray      ...........  ...........  ...........  ...........  ...........
                            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.
   Q0136  G                Non esrd epoetin             0733  ...........       $11.85  ...........        $1.52
                            alpha inj.
   Q0144  E                Azithromycin          ...........  ...........  ...........  ...........  ...........
                            dihydrate, oral.
   Q0160  G                Factor IX non-               0931  ...........         $.76  ...........         $.10
                            recombinant.
   Q0161  G                Factor IX                    0932  ...........        $1.12  ...........         $.16
                            recombinant.
   Q0163  G                Diphenhydramine HCl          1400  ...........         $.12  ...........         $.01
                            50mg.
   Q0164  G                Prochlorperazine             1401  ...........         $.57  ...........         $.05
                            maleate 5mg.
   Q0165  E                Prochlorperazine      ...........  ...........  ...........  ...........  ...........
                            maleate10mg.
   Q0166  G                Granisetron HCl 1 mg         0765  ...........       $44.70  ...........        $5.74
                            oral.
   Q0167  G                Dronabinol 2.5mg             0762  ...........        $3.28  ...........         $.42
                            oral.
   Q0168  E                Dronabinol 5mg oral.  ...........  ...........  ...........  ...........  ...........
   Q0169  G                Promethazine HCl             1402  ...........         $.03  ...........         $.00
                            12.5mg oral.
   Q0170  E                Promethazine HCl 25   ...........  ...........  ...........  ...........  ...........
                            mg oral.
   Q0171  G                Chlorpromazine HCl           1403  ...........         $.07  ...........         $.01
                            10mg oral.
   Q0172  E                Chlorpromazine HCl    ...........  ...........  ...........  ...........  ...........
                            25mg oral.
   Q0173  G                Trimethobenzamide            1404  ...........         $.36  ...........         $.03
                            HCl 250mg.
   Q0174  G                Thiethylperazine             1405  ...........         $.56  ...........         $.08
                            maleate10mg.
   Q0175  G                Perphenazine 4mg             1406  ...........         $.62  ...........         $.06
                            oral.
   Q0176  E                Perphenazine 8mg      ...........  ...........  ...........  ...........  ...........
                            oral.
   Q0177  G                Hydroxyzine pamoate          1407  ...........         $.20  ...........         $.02
                            25mg.
   Q0178  E                Hydroxyzine pamoate   ...........  ...........  ...........  ...........  ...........
                            50mg.
   Q0179  G                Ondansetron HCl 8mg          0769  ...........       $25.15  ...........        $3.23
                            oral.
   Q0180  G                Dolasetron mesylate          0763  ...........       $69.64  ...........        $8.94
                            oral.
   Q0181  E                Unspecified oral      ...........  ...........  ...........  ...........  ...........
                            anti-emetic.
   Q0183  N                Nonmetabolic active   ...........  ...........  ...........  ...........  ...........
                            tissue.
   Q0184  N                Metabolically active  ...........  ...........  ...........  ...........  ...........
                            tissue.
   Q0185  N                Metabolic active D/E  ...........  ...........  ...........  ...........  ...........
                            tissue.
   Q0187  G                Factor viia                  1409  ...........    $1,596.00  ...........      $228.48
                            recombinant.
   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  N                Oral cabergoline 0.5  ...........  ...........  ...........  ...........  ...........
                            mg.
   Q2002  G                Elliotts b solution          7022  ...........       $14.25  ...........        $2.04
                            per ml.
   Q2003  G                Aprotinin, 10,000            7019  ...........        $2.06  ...........         $.30
                            kiu.
   Q2004  G                Bladder calculi              7023  ...........       $24.70  ...........        $3.54
                            irrig sol.
   Q2005  G                Corticorelin ovine           7024  ...........      $368.03  ...........       $52.69
                            triflutat.
   Q2006  G                Digoxin immune fab           7025  ...........      $551.66  ...........       $78.97
                            (ovine).
   Q2007  G                Ethanolamine oleate          7026  ...........       $39.73  ...........        $5.69
                            100 mg.
   Q2008  G                Fomepizole, 15 mg...         7027  ...........        $1.09  ...........         $.16
   Q2009  G                Fosphenytoin, 50 mg.         7028  ...........        $9.55  ...........        $1.37
   Q2010  G                Glatiramer acetate,          7029  ...........       $30.07  ...........        $4.30
                            per dose.
   Q2011  G                Hemin, per 1 mg.....         7030  ...........         $.99  ...........         $.14
   Q2012  G                Pegademase bovine,           7039  ...........      $139.33  ...........       $19.95
                            25 iu.
   Q2013  G                Pentastarch 10%              7040  ...........       $15.11  ...........        $2.16
                            solution.
   Q2014  G                Sermorelin acetate,          7032  ...........       $15.78  ...........        $2.26
                            0.5 mg.
   Q2015  G                Somatrem, 5 mg......         7033  ...........      $209.48  ...........       $29.99
   Q2016  G                Somatropin, 1 mg....         7034  ...........       $39.90  ...........        $5.12
   Q2017  G                Teniposide, 50 mg...         7035  ...........      $216.32  ...........       $30.97

[[Page 44879]]

 
   Q2018  G                Urofollitropin, 75           7037  ...........       $73.29  ...........        $9.41
                            iu.
   Q2019  G                Basiliximab.........         1615  ...........    $1,348.76  ...........      $193.09
   Q2020  G                Histrelin acetate...         1616  ...........       $14.16  ...........        $2.03
   Q2021  G                Lepirudin...........         1617  ...........      $131.96  ...........       $18.89
   Q2022  G                VonWillebrandFactrCm         1618  ...........         $.95  ...........         $.14
                            plxperIU.
   Q3001  E                Brachytherapy                0918  ...........  ...........  ...........  ...........
                            Radioelements.
   Q3002  G                Gallium ga 67.......         1619  ...........       $24.38  ...........        $3.13
   Q3003  G                Technetium tc99m             1620  ...........      $384.75  ...........       $55.08
                            bicisate.
   Q3004  G                Xenon xe 133........         1621  ...........       $29.93  ...........        $3.84
   Q3005  G                Technetium tc99m             1622  ...........      $176.53  ...........       $25.27
                            mertiatide.
   Q3006  G                Technetium tc99m             1623  ...........       $22.61  ...........        $3.24
                            glucepatate.
   Q3007  G                Sodium phosphate p32         1624  ...........       $81.10  ...........       $11.61
   Q3008  G                Indium 111-in                1625  ...........      $935.75  ...........      $133.96
                            pentetreotide.
   Q3009  G                Technetium tc99m             1626  ...........       $36.74  ...........        $5.26
                            oxidronate.
   Q3010  G                Technetium                   1627  ...........       $40.90  ...........        $5.85
                            tc99mlabeledrbcs.
   Q3011  G                Chromic phosphate            1628  ...........      $150.86  ...........       $21.60
                            p32.
   Q3012  G                Cyanocobalamin               1089  ...........       $97.85  ...........       $14.01
                            cobalt co57.
   Q3013  G                Verteporfin for              1203  ...........    $1,458.25  ...........      $208.76
                            injection.
   Q4001  A                Cast sup body cast    ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4002  A                Cast sup body cast    ...........  ...........  ...........  ...........  ...........
                            fiberglas.
   Q4003  A                Cast sup shoulder     ...........  ...........  ...........  ...........  ...........
                            cast plstr.
   Q4004  A                Cast sup shoulder     ...........  ...........  ...........  ...........  ...........
                            cast fbrgl.
   Q4005  A                Cast sup long arm     ...........  ...........  ...........  ...........  ...........
                            adult plst.
   Q4006  A                Cast sup long arm     ...........  ...........  ...........  ...........  ...........
                            adult fbrg.
   Q4007  A                Cast sup long arm     ...........  ...........  ...........  ...........  ...........
                            ped plster.
   Q4008  A                Cast sup long arm     ...........  ...........  ...........  ...........  ...........
                            ped fbrgls.
   Q4009  A                Cast sup sht arm      ...........  ...........  ...........  ...........  ...........
                            adult plstr.
   Q4010  A                Cast sup sht arm      ...........  ...........  ...........  ...........  ...........
                            adult fbrgl.
   Q4011  A                Cast sup sht arm ped  ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4012  A                Cast sup sht arm ped  ...........  ...........  ...........  ...........  ...........
                            fbrglas.
   Q4013  A                Cast sup gauntlet     ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4014  A                Cast sup gauntlet     ...........  ...........  ...........  ...........  ...........
                            fiberglass.
   Q4015  A                Cast sup gauntlet     ...........  ...........  ...........  ...........  ...........
                            ped plster.
   Q4016  A                Cast sup gauntlet     ...........  ...........  ...........  ...........  ...........
                            ped fbrgls.
   Q4017  A                Cast sup lng arm      ...........  ...........  ...........  ...........  ...........
                            splint plst.
   Q4018  A                Cast sup lng arm      ...........  ...........  ...........  ...........  ...........
                            splint fbrg.
   Q4019  A                Cast sup lng arm      ...........  ...........  ...........  ...........  ...........
                            splnt ped p.
   Q4020  A                Cast sup lng arm      ...........  ...........  ...........  ...........  ...........
                            splnt ped f.
   Q4021  A                Cast sup sht arm      ...........  ...........  ...........  ...........  ...........
                            splint plst.
   Q4022  A                Cast sup sht arm      ...........  ...........  ...........  ...........  ...........
                            splint fbrg.
   Q4023  A                Cast sup sht arm      ...........  ...........  ...........  ...........  ...........
                            splnt ped p.
   Q4024  A                Cast sup sht arm      ...........  ...........  ...........  ...........  ...........
                            splnt ped f.
   Q4025  A                Cast sup hip spica    ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4026  A                Cast sup hip spica    ...........  ...........  ...........  ...........  ...........
                            fiberglas.
   Q4027  A                Cast sup hip spica    ...........  ...........  ...........  ...........  ...........
                            ped plstr.
   Q4028  A                Cast sup hip spica    ...........  ...........  ...........  ...........  ...........
                            ped fbrgl.
   Q4029  A                Cast sup long leg     ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4030  A                Cast sup long leg     ...........  ...........  ...........  ...........  ...........
                            fiberglass.
   Q4031  A                Cast sup lng leg ped  ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4032  A                Cast sup lng leg ped  ...........  ...........  ...........  ...........  ...........
                            fbrgls.
   Q4033  A                Cast sup lng leg      ...........  ...........  ...........  ...........  ...........
                            cylinder pl.
   Q4034  A                Cast sup lng leg      ...........  ...........  ...........  ...........  ...........
                            cylinder fb.
   Q4035  A                Cast sup lngleg       ...........  ...........  ...........  ...........  ...........
                            cylndr ped p.
   Q4036  A                Cast sup lngleg       ...........  ...........  ...........  ...........  ...........
                            cylndr ped f.
   Q4037  A                Cast sup shrt leg     ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4038  A                Cast sup shrt leg     ...........  ...........  ...........  ...........  ...........
                            fiberglass.
   Q4039  A                Cast sup shrt leg     ...........  ...........  ...........  ...........  ...........
                            ped plster.
   Q4040  A                Cast sup shrt leg     ...........  ...........  ...........  ...........  ...........
                            ped fbrgls.
   Q4041  A                Cast sup lng leg      ...........  ...........  ...........  ...........  ...........
                            splnt plstr.
   Q4042  A                Cast sup lng leg      ...........  ...........  ...........  ...........  ...........
                            splnt fbrgl.
   Q4043  A                Cast sup lng leg      ...........  ...........  ...........  ...........  ...........
                            splnt ped p.
   Q4044  A                Cast sup lng leg      ...........  ...........  ...........  ...........  ...........
                            splnt ped f.
   Q4045  A                Cast sup sht leg      ...........  ...........  ...........  ...........  ...........
                            splnt plstr.
   Q4046  A                Cast sup sht leg      ...........  ...........  ...........  ...........  ...........
                            splnt fbrgl.
   Q4047  A                Cast sup sht leg      ...........  ...........  ...........  ...........  ...........
                            splnt ped p.
   Q4048  A                Cast sup sht leg      ...........  ...........  ...........  ...........  ...........
                            splnt ped f.
   Q4049  A                Finger splint,        ...........  ...........  ...........  ...........  ...........
                            static.
   Q4050  A                Cast supplies         ...........  ...........  ...........  ...........  ...........
                            unlisted.
   Q4051  A                Splint supplies misc  ...........  ...........  ...........  ...........  ...........
   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.

[[Page 44880]]

 
   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.
   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.

[[Page 44881]]

 
   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.
   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  E                Progressive lens per  ...........  ...........  ...........  ...........  ...........
                            lens.
   V2785  F                Corneal tissue        ...........  ...........  ...........  ...........  ...........
                            processing.
   V2790  N                Amniotic membrane...  ...........  ...........  ...........  ...........  ...........
   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                Hearing aid monaural  ...........  ...........  ...........  ...........  ...........
                            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.

[[Page 44882]]

 
   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  E                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.

      
  

  

  Federal Register / Vol. 66, No. 165 / Friday, August 24, 2001 / 
Proposed Rules  

[[Page 44882]]


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

Copyright American Dental Association. All rights reserved.

[[Page 44882]]



 Addendum E.--CPT Codes Which Would Be Paid Only As Inpatient Procedures
------------------------------------------------------------------------
  CPT/      HOPD Status
  HCPCS      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 repair/fract
   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, sitting procedure
   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, hemorr/excise liver
   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

[[Page 44883]]

 
   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
   16035  C                Incision of burn scab, initi
   16036  C                Incise burn scab, addl incis
   19200  C                Removal of breast
   19220  C                Removal of breast
   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
   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

[[Page 44884]]

 
   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                Reconst lwr jaw w/o graft
   21194  C                Reconst lwr jaw w/graft
   21195  C                Reconst lwr jaw w/o fixation
   21196  C                Reconst lwr jaw w/fixation
   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

[[Page 44885]]

 
   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
   25420  C                Repair/graft radius & ulna
   25900  C                Amputation of forearm
   25905  C                Amputation of forearm

[[Page 44886]]

 
   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
   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

[[Page 44887]]

 
   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
   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
   27535  C                Treat knee fracture
   27536  C                Treat knee fracture
   27540  C                Treat knee fracture
   27556  C                Treat knee dislocation
   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
   31375  C                Partial removal of larynx
   31380  C                Partial removal of larynx
   31382  C                Partial removal of larynx

[[Page 44888]]

 
   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

[[Page 44889]]

 
   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)
   33141  C                Heart tmr w/other procedure
   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
   33261  C                Ablate heart dysrhythm focus
   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

[[Page 44890]]

 
   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, modified fontan
   33617  C                Repair single ventricle
   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

[[Page 44891]]

 
   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
   34451  C                Removal of vein clot
   34502  C                Reconstruct vena cava
   34800  C                Endovasc abdo repair w/tube
   34802  C                Endovasc abdo repr w/device
   34804  C                Endovasc abdo repr w/device
   34808  C                Endovasc abdo occlud device
   34812  C                Xpose for endoprosth, aortic
   34813  C                Xpose for endoprosth, femorl
   34820  C                Xpose for endoprosth, iliac
   34825  C                Endovasc extend prosth, init
   34826  C                Endovasc exten prosth, addl
   34830  C                Open aortic tube prosth repr
   34831  C                Open aortoiliac prosth repr
   34832  C                Open aortofemor prosth repr
   35001  C                Repair defect of artery
   35002  C                Repair artery rupture, neck
   35005  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

[[Page 44892]]

 
   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
   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
   35480  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
   35600  C                Harvest artery for cabg
   35601  C                Artery bypass graft
   35606  C                Artery bypass graft
   35612  C                Artery bypass graft
   35616  C                Artery bypass graft

[[Page 44893]]

 
   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
   35800  C                Explore neck vessels
   35820  C                Explore chest vessels
   35840  C                Explore abdominal vessels
   35870  C                Repair vessel graft defect
   35901  C                Excision, graft, neck
   35905  C                Excision, graft, thorax
   35907  C                Excision, graft, abdomen
   36510  C                Insertion of catheter, vein
   36660  C                Insertion catheter, artery
   36822  C                Insertion of cannula(s)
   36823  C                Insertion of cannula(s)
   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
   37616  C                Ligation of chest artery
   37617  C                Ligation of abdomen artery
   37618  C                Ligation of extremity artery
   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

[[Page 44894]]

 
   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
   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

[[Page 44895]]

 
   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
   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
   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

[[Page 44896]]

 
   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
   47570  C                Laparo cholecystoenterostomy
   47600  C                Removal of gallbladder
   47605  C                Removal of gallbladder
   47610  C                Removal of gallbladder
   47612  C                Removal of gallbladder

[[Page 44897]]

 
   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
   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

[[Page 44898]]

 
   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
   50545  C                Laparo radical nephrectomy
   50546  C                Laparoscopic nephrectomy
   50547  C                Laparo removal donor kidney
   50548  C                Laparo remove k/ureter
   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

[[Page 44899]]

 
   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
   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
   57110  C                Remove vagina wall, complete
   57111  C                Remove vagina tissue, compl
   57112  C                Vaginectomy w/nodes, compl
   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
   57311  C                Repair urethrovaginal lesion
   57335  C                Repair vagina
   57531  C                Removal of cervix, radical

[[Page 44900]]

 
   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
   58605  C                Division of fallopian tube
   58611  C                Ligate oviduct(s) add-on
   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
   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
   60254  C                Extensive thyroid surgery
   60270  C                Removal of thyroid
   60271  C                Removal of thyroid
   60502  C                Re-explore parathyroids
   60505  C                Explore parathyroid glands
   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

[[Page 44901]]

 
   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

[[Page 44902]]

 
   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
   61697  C                Brain aneurysm repr, complx
   61698  C                Brain aneurysm repr, complx
   61700  C                Brain aneurysm repr , simple
   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
   61850  C                Implant neuroelectrodes
   61860  C                Implant neuroelectrodes
   61862  C                Implant neurostimul, subcort
   61870  C                Implant neuroelectrodes
   61875  C                Implant neuroelectrodes
   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

[[Page 44903]]

 
   62223  C                Establish brain cavity shunt
   62256  C                Remove brain cavity shunt
   62258  C                Replace brain cavity shunt
   62351  C                Implant spinal canal cath
   63043  C                Laminotomy, addl cervical
   63044  C                Laminotomy, addl lumbar
   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
   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
   64752  C                Incision of vagus nerve

[[Page 44904]]

 
   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
   75900  C                Arterial catheter exchange
   75952  C                Endovasc repair abdom aorta
   75953  C                Abdom aneurysm endovas rpr
   92970  C                Cardioassist, internal
   92971  C                Cardioassist, external
   92975  C                Dissolve clot, heart vessel
   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)
   99190  C                Special pump services
   99191  C                Special pump services
   99192  C                Special pump services
   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
------------------------------------------------------------------------
CPT codes and descriptions only are copyright American Medical
  Association. All Rights Reserved. Applicable FARS/DFARS Apply.
Copyright American Dental Association. All rights reserved.

      
  

  

  Federal Register / Vol. 66, No. 165 / Friday, August 24, 2001 / 
Proposed Rules  

[[Page 44904]]


      

                 Addendum H.--Wage Index for Urban Areas
------------------------------------------------------------------------
                                                                  Wage
              Urban area  (constituent counties)                  index
------------------------------------------------------------------------
0040  Abilene, TX.............................................    0.8118
  Taylor, TX
0060  Aguadilla, PR...........................................    0.4738
  Aguada, PR
  Aguadilla, PR
  Moca, PR
0080  Akron, OH...............................................    0.9924
  Portage, OH
  Summit, OH
0120  Albany, GA..............................................    1.0675
  Dougherty, GA
  Lee, GA
0160  Albany-Schenectady-Troy, NY.............................    0.8597
  Albany, NY
  Montgomery, NY
  Rensselaer, NY
  Saratoga, NY
  Schenectady, NY
  Schoharie, NY
0200  Albuquerque, NM.........................................    0.9855
  Bernalillo, NM
  Sandoval, NM
  Valencia, NM
0220  Alexandria, LA..........................................    0.8137
  Rapides, LA
0240  Allentown-Bethlehem-Easton, PA..........................    0.9443
  Carbon, PA
  Lehigh, PA
  Northampton, PA
0280  Altoona, PA.............................................    0.9225
  Blair, PA
0320  Amarillo, TX............................................    0.8706
  Potter, TX
  Randall, TX
0380  Anchorage, AK...........................................    1.2605
  Anchorage, AK
0440  Ann Arbor, MI...........................................    1.1220
  Lenawee, MI
  Livingston, MI

[[Page 44905]]

 
  Washtenaw, MI
0450  Anniston, AL............................................    0.8360
  Calhoun, AL
0460  Appleton-Oshkosh-Neenah, WI.............................    0.9203
  Calumet, WI
  Outagamie, WI
  Winnebago, WI
0470  Arecibo, PR.............................................    0.4683
  Arecibo, PR
  Camuy, PR
  Hatillo, PR
0480  Asheville, NC...........................................    0.9307
  Buncombe, NC
  Madison, NC
0500  Athens, GA..............................................    0.9956
  Clarke, GA
  Madison, GA
  Oconee, GA
0520  \1\ Atlanta, GA.........................................    1.0176
  Barrow, GA
  Bartow, GA
  Carroll, GA
  Cherokee, GA
  Clayton, GA
  Cobb, GA
  Coweta, GA
  DeKalb, GA
  Douglas, GA
  Fayette, GA
  Forsyth, GA
  Fulton, GA
  Gwinnett, GA
  Henry, GA
  Newton, GA
  Paulding, GA
  Pickens, GA
  Rockdale, GA
  Spalding, GA
  Walton, GA
0560  Atlantic-Cape May, NJ...................................    1.1349
  Atlantic, NJ
  Cape May, NJ
0580  Auburn-Opelika, AL......................................    0.8325
  Lee, AL
0600  Augusta-Aiken, GA-SC....................................    1.0090
  Columbia, GA
  McDuffie, GA
  Richmond, GA
  Aiken, SC
  Edgefield, SC
0640  \1\ Austin-San Marcos, TX...............................    0.9327
  Bastrop, TX
  Caldwell, TX
  Hays, TX
  Travis, TX
  Williamson, TX
0680  \2\ Bakersfield, CA.....................................    0.9870
  Kern, CA
0720  \1\ Baltimore, MD.......................................    0.9723
  Anne Arundel, MD
  Baltimore, MD
  Baltimore City, MD
  Carroll, MD
  Harford, MD
  Howard, MD
  Queen Anne's, MD
0733  Bangor, ME..............................................    0.9559
  Penobscot, ME
0743  Barnstable-Yarmouth, MA.................................    1.3539
  Barnstable, MA
0760  Baton Rouge, LA.........................................    0.8258
  Ascension, LA
  East Baton Rouge, LA
  Livingston, LA
  West Baton Rouge, LA
0840  Beaumont-Port Arthur, TX................................    0.8508
  Hardin, TX
  Jefferson, TX
  Orange, TX
0860  Bellingham, WA..........................................    1.1963
  Whatcom, WA
0870  \2\ Benton Harbor, MI...................................    0.9115
  Berrien, MI
0875  \1\ Bergen-Passaic, NJ..................................    1.1669
  Bergen, NJ
  Passaic, NJ
0880  Billings, MT............................................    0.9623
  Yellowstone, MT
0920  Biloxi-Gulfport-Pascagoula, MS..........................    0.8538
  Hancock, MS
  Harrison, MS
  Jackson, MS
0960  Binghamton, NY..........................................    0.8595
  Broome, NY
  Tioga, NY
1000  Birmingham, AL..........................................    0.8648
  Blount, AL
  Jefferson, AL
  St. Clair, AL
  Shelby, AL
1010  \2\ Bismarck, ND........................................    0.7965
  Burleigh, ND
  Morton, ND
1020  \2\ Bloomington, IN.....................................    0.8757
  Monroe, IN
1040  Bloomington-Normal, IL..................................    0.8545
  McLean, IL
1080  Boise City, ID..........................................    0.9190
  Ada, ID
  Canyon, ID
1123  \1,2\ Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH      1.1586
 (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-Brockton, MA-NH (NH    1.1483
 Hospitals)...................................................
  Bristol, MA
  Essex, MA
  Middlesex, MA
  Norfolk, MA
  Plymouth, MA
  Suffolk, MA
  Worcester, MA
  Hillsborough, NH
  Merrimack, NH
  Rockingham, NH
  Strafford, NH
1125  Boulder-Longmont, CO....................................    0.9836
  Boulder, CO
1145  Brazoria, TX............................................    0.8299
  Brazoria, TX
1150  Bremerton, WA...........................................    1.0882
  Kitsap, WA
1240  Brownsville-Harlingen-San Benito, TX....................    0.8783
  Cameron, TX
1260  Bryan-College Station, TX...............................    0.9296
  Brazos, TX
1280  \1\ Buffalo-Niagara Falls, NY...........................    0.9405
  Erie, NY
  Niagara, NY
1303  Burlington, VT..........................................    0.9826
  Chittenden, VT
  Franklin, VT
  Grand Isle, VT
1310  Caguas, PR..............................................    0.5158
  Caguas, PR
  Cayey, PR
  Cidra, PR
  Gurabo, PR
  San Lorenzo, PR
1320  Canton-Massillon, OH....................................    0.9059
  Carroll, OH
  Stark, OH
1350  Casper, WY..............................................    0.9606
  Natrona, WY
1360  Cedar Rapids, IA........................................    0.8711
  Linn, IA
1400  Champaign-Urbana, IL....................................    0.9264
  Champaign, IL
1440  Charleston-North Charleston, SC.........................    0.9293
  Berkeley, SC
  Charleston, SC
  Dorchester, SC
1480  Charleston, WV..........................................    0.9369
  Kanawha, WV
  Putnam, WV
1520  \1\ Charlotte-Gastonia-Rock Hill, NC-SC.................    0.9469
  Cabarrus, NC
  Gaston, NC
  Lincoln, NC
  Mecklenburg, NC
  Rowan, NC
  Stanly, NC
  Union, NC
  York, SC
1540  Charlottesville, VA.....................................    1.0688
  Albemarle, VA
  Charlottesville City, VA
  Fluvanna, VA
  Greene, VA
1560  Chattanooga, TN-GA......................................    0.9446
  Catoosa, GA
  Dade, GA
  Walker, GA
  Hamilton, TN
  Marion, TN
1580  \2\ Cheyenne, WY........................................    0.8855
  Laramie, WY
1600  \1\ Chicago, IL.........................................    1.1011
  Cook, IL
  DeKalb, IL
  DuPage, IL
  Grundy, IL
  Kane, IL

[[Page 44906]]

 
  Kendall, IL
  Lake, IL
  McHenry, IL
  Will, IL
1620  Chico-Paradise, CA......................................    0.9909
  Butte, CA
1640  \1\ Cincinnati, OH-KY-IN................................    0.9574
  Dearborn, IN
  Ohio, IN
  Boone, KY
  Campbell, KY
  Gallatin, KY
  Grant, KY
  Kenton, KY
  Pendleton, KY
  Brown, OH
  Clermont, OH
  Hamilton, OH
  Warren, OH
1660  Clarksville-Hopkinsville, TN-KY.........................    0.8481
  Christian, KY
  Montgomery, TN
1680  \1\ Cleveland-Lorain-Elyria, OH.........................    0.9496
  Ashtabula, OH
  Cuyahoga, OH
  Geauga, OH
  Lake, OH
  Lorain, OH
  Medina, OH
1720  Colorado Springs, CO....................................    0.9754
  El Paso, CO
1740  Columbia, MO............................................    0.8787
  Boone, MO
1760  Columbia, SC............................................    0.9589
  Lexington, SC
  Richland, SC
1800  Columbus, GA-AL Russell, AL.............................    0.8471
  Chattahoochee, GA
  Harris, GA
  Muscogee, GA
1840  \1\ Columbus, OH........................................    0.9724
  Delaware, OH
  Fairfield, OH
  Franklin, OH
  Licking, OH
  Madison, OH
  Pickaway, OH
1880  Corpus Christi, TX......................................    0.8203
  Nueces, TX
  San Patricio, TX
1890  Corvallis, OR...........................................    1.1781
  Benton, OR
1900  \2\ Cumberland, MD-WV (MD Hospitals)....................    0.8962
  Allegany, MD
  Mineral, WV
1900  Cumberland, MD-WV (WV Hospital).........................    0.8402
  Allegany, MD
  Mineral, WV
1920  \1\ Dallas, TX..........................................    0.9506
  Collin, TX
  Dallas, TX
  Denton, TX
  Ellis, TX
  Henderson, TX
  Hunt, TX
  Kaufman, TX
  Rockwall, TX
1950  Danville, VA............................................    0.8641
  Danville City, VA
  Pittsylvania, VA
1960  Davenport-Moline-Rock Island, IA-IL.....................    0.8790
  Scott, IA
  Henry, IL
  Rock Island, IL
2000  Dayton-Springfield, OH..................................    0.9323
  Clark, OH
  Greene, OH
  Miami, OH
  Montgomery, OH
2020  Daytona Beach, FL.......................................    0.9069
  Flagler, FL
  Volusia, FL
2030  Decatur, AL.............................................    0.8817
  Lawrence, AL
  Morgan, AL
2040  \2\ Decatur, IL.........................................    0.8140
  Macon, IL
2080  \1\ Denver, CO..........................................    1.0289
  Adams, CO
  Arapahoe, CO
  Denver, CO
  Douglas, CO
  Jefferson, CO
2120  Des Moines, IA..........................................    0.8881
  Dallas, IA
  Polk, IA
  Warren, IA
2160  \1\ Detroit, MI.........................................    1.0478
  Lapeer, MI
  Macomb, MI
  Monroe, MI
  Oakland, MI
  St. Clair, MI
  Wayne, MI
2180  Dothan, AL..............................................    0.8005
  Dale, AL
  Houston, AL
2190  Dover, DE...............................................    1.0453
  Kent, DE
2200  Dubuque, IA.............................................    0.8617
  Dubuque, IA
2240  Duluth-Superior, MN-WI..................................    1.0401
  St. Louis, MN
  Douglas, WI
2281  Dutchess County, NY.....................................    1.0639
  Dutchess, NY
2290  \2\ Eau Claire, WI......................................    0.9121
  Chippewa, WI
  Eau Claire, WI
2320  El Paso, TX.............................................    0.9162
  El Paso, TX
2330  Elkhart-Goshen, IN......................................    0.9646
  Elkhart, IN
2335  Elmira, NY..............................................    0.8530
  Chemung, NY
2340  Enid, OK................................................    0.8454
  Garfield, OK
2360  Erie, PA................................................    0.8911
  Erie, PA
2400  Eugene-Springfield, OR..................................    1.1485
  Lane, OR
2440  \2\ Evansville-Henderson, IN-KY (IN Hospitals)..........    0.8757
  Posey, IN
  Vanderburgh, IN
  Warrick, IN
  Henderson, KY
2440  \2\ Evansville-Henderson, IN-KY (KY Hospitals)..........    0.8019
  Posey, IN
  Vanderburgh, IN
  Warrick, IN
  Henderson, KY
2520  Fargo-Moorhead, ND-MN...................................    0.9374
  Clay, MN
  Cass, ND
2560  Fayetteville, NC........................................    0.9132
  Cumberland, NC
2580  Fayetteville-Springdale-Rogers, AR......................    0.7587
  Benton, AR
  Washington, AR
2620  Flagstaff, AZ-UT........................................    1.0678
  Coconino, AZ
  Kane, UT
2640  Flint, MI...............................................    1.0920
  Genesee, MI
2650  Florence, AL............................................    0.7927
  Colbert, AL
  Lauderdale, AL
2655  Florence, SC............................................    0.8843
  Florence, SC
2670  Fort Collins-Loveland, CO...............................    1.0161
  Larimer, CO
2680  \1\ Ft. Lauderdale, FL..................................    1.0906
  Broward, FL
2700  Fort Myers-Cape Coral, FL...............................    0.9380
  Lee, FL
2710  Fort Pierce-Port St. Lucie, FL..........................    1.0067
  Martin, FL
  St. Lucie, FL
2720  Fort Smith, AR-OK.......................................    0.8076
  Crawford, AR
  Sebastian, AR
  Sequoyah, OK
2750  \2\ Fort Walton Beach, FL...............................    0.8733
  Okaloosa, FL
2760  Fort Wayne, IN..........................................    0.9186
  Adams, IN
  Allen, IN
  De Kalb, IN
  Huntington, IN
  Wells, IN
  Whitley, IN
2800  \1\ Fort Worth-Arlington, TX............................    0.9452
  Hood, TX
  Johnson, TX
  Parker, TX
  Tarrant, TX
2840  Fresno, CA..............................................    0.9972
  Fresno, CA
  Madera, CA
2880  Gadsden, AL.............................................    0.8845
  Etowah, AL
2900  Gainesville, FL.........................................    1.2133
  Alachua, FL
2920  Galveston-Texas City, TX................................    1.0271
  Galveston, TX
2960  Gary, IN................................................    0.9571
  Lake, IN
  Porter, IN
2975  \2\ Glens Falls, NY.....................................    0.8530
  Warren, NY

[[Page 44907]]

 
  Washington, NY
2980  Goldsboro, NC...........................................    0.8810
  Wayne, NC
2985  Grand Forks, ND-MN......................................    0.9173
  Polk, MN
  Grand Forks, ND
2995  Grand Junction, CO......................................    0.9816
  Mesa, CO
3000  \1\ Grand Rapids-Muskegon-Holland, MI...................    1.0161
  Allegan, MI
  Kent, MI
  Muskegon, MI
  Ottawa, MI
3040  Great Falls, MT.........................................    0.9301
  Cascade, MT
3060  Greeley, CO.............................................    0.9604
  Weld, CO
3080  Green Bay, WI...........................................    0.9440
  Brown, WI
3120  \1\ Greensboro-Winston-Salem-High Point, NC.............    0.9616
  Alamance, NC
  Davidson, NC
  Davie, NC
  Forsyth, NC
  Guilford, NC
  Randolph, NC
  Stokes, NC
  Yadkin, NC
3150  Greenville, NC..........................................    0.9963
  Pitt, NC
3160  Greenville-Spartanburg-Anderson, SC.....................    0.9110
  Anderson, SC
  Cherokee, SC
  Greenville, SC
  Pickens, SC
  Spartanburg, SC
3180  \2\ Hagerstown, MD......................................    0.8962
  Washington, MD
3200  Hamilton-Middletown, OH.................................    0.9269
  Butler, OH
3240  Harrisburg-Lebanon-Carlisle, PA.........................    0.9311
  Cumberland, PA
  Dauphin, PA
  Lebanon, PA
  Perry, PA
3283  \1,\ \2\ Hartford, CT...................................    1.2357
  Hartford, CT
  Litchfield, CT
  Middlesex, CT
  Tolland, CT
3285  \2\ Hattiesburg, MS.....................................    0.7612
  Forrest, MS
  Lamar, MS
3290  Hickory-Morganton-Lenoir, NC............................    0.9517
  Alexander, NC
  Burke, NC
  Caldwell, NC
  Catawba, NC
3320  Honolulu, HI............................................    1.1658
  Honolulu, HI
3350  Houma, LA...............................................    0.8043
  Lafourche, LA
  Terrebonne, LA
3360  \1\ Houston, TX.........................................    0.9604
  Chambers, TX
  Fort Bend, TX
  Harris, TX
  Liberty, TX
  Montgomery, TX
  Waller, TX
3400  Huntington-Ashland, WV-KY-OH............................    0.9700
  Boyd, KY
  Carter, KY
  Greenup, KY
  Lawrence, OH
  Cabell, WV
  Wayne, WV
3440  Huntsville, AL..........................................    0.8854
  Limestone, AL
  Madison, AL
3480  \1\ Indianapolis, IN....................................    0.9771
  Boone, IN
  Hamilton, IN
  Hancock, IN
  Hendricks, IN
  Johnson, IN
  Madison, IN
  Marion, IN
  Morgan, IN
  Shelby, IN
3500  Iowa City, IA...........................................    0.9973
  Johnson, IA
3520  Jackson, MI.............................................    0.9387
  Jackson, MI
3560  Jackson, MS.............................................    0.8589
  Hinds, MS
  Madison, MS
  Rankin, MS
3580  Jackson, TN.............................................    0.9117
  Madison, TN
  Chester, TN
3600  \1\ Jacksonville, FL....................................    0.9040
  Clay, FL
  Duval, FL
  Nassau, FL
  St. Johns, FL
3605  \2\ Jacksonville, NC....................................    0.8632
  Onslow, NC
3610  \2\ Jamestown, NY.......................................    0.8530
  Chautauqua, NY
3620  Janesville-Beloit, WI...................................    0.9840
  Rock, WI
3640  Jersey City, NJ.........................................    1.1216
  Hudson, NJ
3660  Johnson City-Kingsport-Bristol, TN-VA...................    0.8540
  Carter, TN
  Hawkins, TN
  Sullivan, TN
  Unicoi, TN
  Washington, TN
  Bristol City, VA
  Scott, VA
  Washington, VA
3680  Johnstown, PA...........................................    0.8959
  Cambria, PA
  Somerset, PA
3700  Jonesboro, AR...........................................    0.8523
  Craighead, AR
3710  Joplin, MO..............................................    0.8736
  Jasper, MO
  Newton, MO
3720  Kalamazoo-Battlecreek, MI...............................    1.0696
  Calhoun, MI
  Kalamazoo, MI
  Van Buren, MI
3740  Kankakee, IL............................................    0.9268
  Kankakee, IL
3760  \1\ Kansas City, KS-MO..................................    0.9430
  Johnson, KS
  Leavenworth, KS
  Miami, KS
  Wyandotte, KS
  Cass, MO
  Clay, MO
  Clinton, MO
  Jackson, MO
  Lafayette, MO
  Platte, MO
  Ray, MO
3800  Kenosha, WI.............................................    0.9678
  Kenosha, WI
3810  \2\ Killeen-Temple, TX..................................    0.7673
  Bell, TX
  Coryell, TX
3840  Knoxville, TN...........................................    0.8904
  Anderson, TN
  Blount, TN
  Knox, TN
  Loudon, TN
  Sevier, TN
  Union, TN
3850  Kokomo, IN..............................................    0.9290
  Howard, IN
  Tipton, IN
3870  La Crosse, WI-MN........................................    0.9328
  Houston, MN
  La Crosse, WI
3880  Lafayette, LA...........................................    0.8600
  Acadia, LA
  Lafayette, LA
  St. Landry, LA
  St. Martin, LA
3920  Lafayette, IN...........................................    0.9165
  Clinton, IN
  Tippecanoe, IN
3960  Lake Charles, LA........................................    0.7810
  Calcasieu, LA
3980  Lakeland-Winter Haven, FL...............................    0.9167
  Polk, FL
4000  Lancaster, PA...........................................    0.9413
  Lancaster, PA
4040  Lansing-East Lansing, MI................................    0.9653
  Clinton, MI
  Eaton, MI
  Ingham, MI
4080  Laredo, TX..............................................    0.7877
  Webb, TX
4100  \2\ Las Cruces, NM......................................    0.8835
  Dona Ana, NM
4120  \1\ Las Vegas, NV-AZ....................................    1.1238
  Mohave, AZ
  Clark, NV
  Nye, NV
4150  Lawrence, KS............................................    0.8756
  Douglas, KS
4200  Lawton, OK..............................................    0.8783
  Comanche, OK
4243  Lewiston-Auburn, ME.....................................    0.9451
  Androscoggin, ME
4280  Lexington, KY...........................................    0.8850
  Bourbon, KY
  Clark, KY
  Fayette, KY

[[Page 44908]]

 
  Jessamine, KY
  Madison, KY
  Scott, KY
  Woodford, KY
4320  Lima, OH................................................    0.9558
  Allen, OH
  Auglaize, OH
4360  Lincoln, NE.............................................    1.0272
  Lancaster, NE
4400  Little Rock-North Little Rock, AR.......................    0.9053
  Faulkner, AR
  Lonoke, AR
  Pulaski, AR
  Saline, AR
4420  Longview-Marshall, TX...................................    0.8439
  Gregg, TX
  Harrison, TX
  Upshur, TX
4480  \1\ Los Angeles-Long Beach, CA..........................    1.2071
  Los Angeles, CA
4520  \1\ Louisville, KY-IN...................................    0.9596
  Clark, IN
  Floyd, IN
  Harrison, IN
  Scott, IN
  Bullitt, KY
  Jefferson, KY
  Oldham, KY
4600  Lubbock, TX.............................................    0.8547
  Lubbock, TX
4640  Lynchburg, VA...........................................    0.9208
  Amherst, VA
  Bedford, VA
  Bedford City, VA
  Campbell, VA
  Lynchburg City, VA
4680  Macon, GA...............................................    0.9077
  Bibb, GA
  Houston, GA
  Jones, GA
  Peach, GA
  Twiggs, GA
4720  Madison, WI.............................................    1.0462
  Dane, WI
4800  Mansfield, OH...........................................    0.8827
  Crawford, OH
  Richland, OH
4840  Mayaguez, PR............................................    0.4917
  Anasco, PR
  Cabo Rojo, PR
  Hormigueros, PR
  Mayaguez, PR
  Sabana Grande, PR
  San German, PR
4880  McAllen-Edinburg-Mission, TX............................    0.8433
  Hidalgo, TX
4890  Medford-Ashland, OR.....................................    1.0433
  Jackson, OR
4900  Melbourne-Titusville-Palm Bay, FL.......................    0.9883
  Brevard, FL
4920  \1\ Memphis, TN-AR-MS...................................    0.9435
  Crittenden, AR
  DeSoto, MS
  Fayette, TN
  Shelby, TN
  Tipton, TN
4940  Merced, CA..............................................    0.9870
  Merced, CA
5000  \1\ Miami, FL...........................................    0.9934
  Dade, FL
5015  \1\ Middlesex-Somerset-Hunterdon, NJ....................    1.1952
  Hunterdon, NJ
  Middlesex, NJ
  Somerset, NJ
5080  \1\ Milwaukee-Waukesha, WI..............................    0.9898
  Milwaukee, WI
  Ozaukee, WI
  Washington, WI
  Waukesha, WI
5120  \1\ Minneapolis-St. Paul, MN-WI.........................    1.1000
  Anoka, MN
  Carver, MN
  Chisago, MN
  Dakota, MN
  Hennepin, MN
  Isanti, MN
  Ramsey, MN
  Scott, MN
  Sherburne, MN
  Washington, MN
  Wright, MN
  Pierce, WI
  St. Croix, WI
5140  Missoula, MT............................................    0.9453
  Missoula, MT
5160  Mobile, AL..............................................    0.7766
  Baldwin, AL
  Mobile, AL
5170  Modesto, CA.............................................    1.0945
  Stanislaus, CA
5190  \1\ Monmouth-Ocean, NJ..................................    1.1514
  Monmouth, NJ
  Ocean, NJ
5200  Monroe, LA..............................................    0.8296
  Ouachita, LA
5240  Montgomery, AL..........................................    0.7502
  Autauga, AL
  Elmore, AL
  Montgomery, AL
5280  Muncie, IN..............................................    0.9689
  Delaware, IN
5330  Myrtle Beach, SC........................................    0.8855
  Horry, SC
5345  Naples, FL..............................................    0.9566
  Collier, FL
5360  1 Nashville, TN.........................................    0.9602
  Cheatham, TN
  Davidson, TN
  Dickson, TN
  Robertson, TN
  Rutherford, TN
  Sumner, TN
  Williamson, TN
  Wilson, TN
5380  1 Nassau-Suffolk, NY....................................    1.3841
  Nassau, NY
  Suffolk, NY
5483  1,2 New Haven-Bridgeport-Stamford-Waterbury.............    1.2357
  Danbury, CT
  Fairfield, CT
  New Haven, CT
5523  2 New London-Norwich, CT................................    1.2357
  New London, CT
5560  1 New Orleans, LA.......................................    0.9054
  Jefferson, LA
  Orleans, LA
  Plaquemines, LA
  St. Bernard, LA
  St. Charles, LA
  St. James, LA
  St. John The Baptist, LA
  St. Tammany, LA
5600  1 New York, NY..........................................    1.3923
  Bronx, NY
  Kings, NY
  New York, NY
  Putnam, NY
  Queens, NY
  Richmond, NY
  Rockland, NY
  Westchester, NY
5640  1 Newark, NJ............................................    1.2004
  Essex, NJ
  Morris, NJ
  Sussex, NJ
  Union, NJ
  Warren, NJ
5660  Newburgh, NY-PA.........................................    1.1235
  Orange, NY
  Pike, PA
5720  1 Norfolk-Virginia Beach-Newport News, VA-NC............    0.8630
  Currituck, NC
  Chesapeake City, VA
  Gloucester, VA
  Hampton City, VA
  Isle of Wight, VA
  James City, VA
  Mathews, VA
  Newport News City, VA
  Norfolk City, VA
  Poquoson City, VA
  Portsmouth City, VA
  Suffolk City, VA
  Virginia Beach City, VA
  Williamsburg City, VA
  York, VA
5775  1 Oakland, CA...........................................    1.5416
  Alameda, CA
  Contra Costa, CA
5790  Ocala, FL...............................................    0.9579
  Marion, FL
5800  Odessa-Midland, TX......................................    0.9017
  Ector, TX
  Midland, TX
5880  1 Oklahoma City, OK.....................................    0.8728
  Canadian, OK
  Cleveland, OK
  Logan, OK
  McClain, OK
  Oklahoma, OK
  Pottawatomie, OK
5910  Olympia, WA.............................................    1.1481
  Thurston, WA
5920  Omaha, NE-IA............................................    0.9696
  Pottawattamie, IA
  Cass, NE
  Douglas, NE
  Sarpy, NE
  Washington, NE
5945  1 Orange County, CA.....................................    1.1354
  Orange, CA
5960  1 Orlando, FL...........................................    0.9464

[[Page 44909]]

 
  Lake, FL
  Orange, FL
  Osceola, FL
  Seminole, FL
5990  Owensboro, KY...........................................    0.8346
  Daviess, KY
6015  Panama City, FL.........................................    0.9166
  Bay, FL
6020  Parkersburg-Marietta, WV-OH (WV Hospitals)..............    0.8192
  Washington, OH
  Wood, WV
6020  2 Parkersburg-Marietta, WV-OH (OH Hospitals)............    0.8761
  Washington, OH
  Wood, WV
6080  2 Pensacola, FL.........................................    0.8733
  Escambia, FL
  Santa Rosa, FL
6120  Peoria-Pekin, IL........................................    0.8883
  Peoria, IL
  Tazewell, IL
  Woodford, IL
6160  1 Philadelphia, PA-NJ...................................    1.0626
  Burlington, NJ
  Camden, NJ
  Gloucester, NJ
  Salem, NJ
  Bucks, PA
  Chester, PA
  Delaware, PA
  Montgomery, PA
  Philadelphia, PA
6200  1 Phoenix-Mesa, AZ......................................    0.9654
  Maricopa, AZ
  Pinal, AZ
6240  Pine Bluff, AR..........................................    0.7837
  Jefferson, AR
6280  1 Pittsburgh, PA........................................    0.9714
  Allegheny, PA
  Beaver, PA
  Butler, PA
  Fayette, PA
  Washington, PA
  Westmoreland, PA
6323  2 Pittsfield, MA........................................    1.1586
  Berkshire, MA
6340  Pocatello, ID...........................................    0.9557
  Bannock, ID
6360  Ponce, PR...............................................    0.5278
  Guayanilla, PR
  Juana Diaz, PR
  Penuelas, PR
  Ponce, PR
  Villalba, PR
  Yauco, PR
6403  Portland, ME............................................    0.9501
  Cumberland, ME
  Sagadahoc, ME
  York, ME
6440  1 Portland-Vancouver, OR-WA.............................    1.1291
  Clackamas, OR
  Columbia, OR
  Multnomah, OR
  Washington, OR
  Yamhill, OR
  Clark, WA
6483  1 Providence-Warwick-Pawtucket, RI......................    1.0781
  Bristol, RI
  Kent, RI
  Newport, RI
  Providence, RI
  Washington, RI
6520  Provo-Orem, UT..........................................    0.9967
  Utah, UT
6560  2 Pueblo, CO............................................    0.8909
  Pueblo, CO
6580  Punta Gorda, FL.........................................    0.8818
  Charlotte, FL
6600  Racine, WI..............................................    0.9441
  Racine, WI
6640  1 Raleigh-Durham-Chapel Hill, NC........................    0.9901
  Chatham, NC
  Durham, NC
  Franklin, NC
  Johnston, NC
  Orange, NC
  Wake, NC
6660  Rapid City, SD..........................................    0.8971
  Pennington, SD
6680  2 Reading, PA...........................................    0.8473
  Berks, PA
6690  Redding, CA.............................................    1.1222
  Shasta, CA
6720  Reno, NV................................................    1.0456
  Washoe, NV
6740  Richland-Kennewick-Pasco, WA............................    1.1086
  Benton, WA
  Franklin, WA
6760  Richmond-Petersburg, VA.................................    0.9712
  Charles City County, VA
  Chesterfield, VA
  Colonial Heights City, VA
  Dinwiddie, VA
  Goochland, VA
  Hanover, VA
  Henrico, VA
  Hopewell City, VA
  New Kent, VA
  Petersburg City, VA
  Powhatan, VA
  Prince George, VA
  Richmond City, VA
6780  \1\ Riverside-San Bernardino, CA........................    1.1012
  Riverside, CA
  San Bernardino, CA
6800  \2\ Roanoke, VA.........................................    0.8473
  Botetourt, VA
  Roanoke, VA
  Roanoke City, VA
  Salem City, VA
6820  Rochester, MN...........................................    1.1595
  Olmsted, MN
6840  \1\ Rochester, NY.......................................    0.9238
  Genesee, NY
  Livingston, NY
  Monroe, NY
  Ontario, NY
  Orleans, NY
  Wayne, NY
6880  Rockford, IL............................................    0.9194
  Boone, IL
  Ogle, IL
  Winnebago, IL
6895  Rocky Mount, NC.........................................    0.9197
  Edgecombe, NC
  Nash, NC
6920  1 Sacramento, CA........................................    1.1809
  El Dorado, CA
  Placer, CA
  Sacramento, CA
6960  Saginaw-Bay City-Midland, MI............................    0.9662
  Bay, MI                                                       ........
  Midland, MI                                                   ........
  Saginaw, MI                                                   ........
6980  St. Cloud, MN...........................................    1.0040
  Benton, MN                                                    ........
  Stearns, MN                                                   ........
7000  St. Joseph, MO..........................................    0.9113
  Andrew, MO                                                    ........
  Buchanan, MO                                                  ........
7040  \1\ St. Louis, MO-IL....................................    0.9024
  Clinton, IL                                                   ........
  Jersey, IL                                                    ........
  Madison, IL                                                   ........
  Monroe, IL                                                    ........
  St. Clair, IL                                                 ........
  Franklin, MO                                                  ........
  Jefferson, MO                                                 ........
  Lincoln, MO                                                   ........
  St. Charles, MO                                               ........
  St. Louis, MO                                                 ........
  St. Louis City, MO                                            ........
  Warren, MO                                                    ........
7080  \2\ Salem, OR...........................................    1.0156
  Marion, OR                                                    ........
  Polk, OR                                                      ........
7120  Salinas, CA.............................................    1.4854
  Monterey, CA                                                  ........
7160  \1\ Salt Lake City-Ogden, UT............................    0.9976
  Davis, UT                                                     ........
  Salt Lake, UT                                                 ........
  Weber, UT                                                     ........
7200  San Angelo, TX..........................................    0.8288
  Tom Green, TX                                                 ........
7240  \1\ San Antonio, TX.....................................    0.8333
  Bexar, TX                                                     ........
  Comal, TX                                                     ........
  Guadalupe, TX                                                 ........
  Wilson, TX                                                    ........
7320  \1\ San Diego, CA.......................................    1.1480
  San Diego, CA                                                 ........
7360  \1\ San Francisco, CA...................................    1.4319
  Marin, CA                                                     ........
  San Francisco, CA                                             ........
  San Mateo, CA                                                 ........
7400  \1\ San Jose, CA........................................    1.4249
  Santa Clara, CA                                               ........
7440  \1\ San Juan-Bayamon, PR................................    0.4812
  Aguas Buenas, PR                                              ........
  Barceloneta, PR                                               ........
  Bayamon, PR                                                   ........
  Canovanas, PR                                                 ........
  Carolina, PR                                                  ........
  Catano, PR                                                    ........
  Ceiba, PR                                                     ........
  Comerio, PR                                                   ........
  Corozal, PR                                                   ........
  Dorado, PR                                                    ........
  Fajardo, PR                                                   ........
  Florida, PR                                                   ........
  Guaynabo, PR                                                  ........
  Humacao, PR                                                   ........
  Juncos, PR                                                    ........

[[Page 44910]]

 
  Los Piedras, PR                                               ........
  Loiza, PR                                                     ........
  Luguillo, PR                                                  ........
  Manati, PR                                                    ........
  Morovis, PR                                                   ........
  Naguabo, PR                                                   ........
  Naranjito, PR                                                 ........
  Rio Grande, PR                                                ........
  San Juan, PR                                                  ........
  Toa Alta, PR                                                  ........
  Toa Baja, PR                                                  ........
  Trujillo Alto, PR                                             ........
  Vega Alta, PR                                                 ........
  Vega Baja, PR                                                 ........
  Yabucoa, PR                                                   ........
7460  San Luis Obispo-Atascadero-Paso Robles, CA..............    1.1117
  San Luis Obispo, CA                                           ........
7480  Santa Barbara-Santa Maria-Lompoc, CA....................    1.0927
  Santa Barbara, CA                                             ........
7485  Santa Cruz-Watsonville, CA..............................    1.4049
  Santa Cruz, CA                                                ........
7490  Santa Fe, NM............................................    1.0312
  Los Alamos, NM                                                ........
  Santa Fe, NM                                                  ........
7500  Santa Rosa, CA..........................................    1.2727
  Sonoma, CA                                                    ........
7510  Sarasota-Bradenton, FL..................................    1.0118
  Manatee, FL                                                   ........
  Sarasota, FL                                                  ........
7520  Savannah, GA............................................    0.9349
  Bryan, GA                                                     ........
  Chatham, GA                                                   ........
  Effingham, GA                                                 ........
7560  \2\ Scranton-Wilkes-Barre-Hazleton, PA..................    0.8473
  Columbia, PA                                                  ........
  Lackawanna, PA                                                ........
  Luzerne, PA                                                   ........
  Wyoming, PA                                                   ........
7600  \1\ Seattle-Bellevue-Everett, WA........................    1.1056
  Island, WA                                                    ........
  King, WA                                                      ........
  Snohomish, WA                                                 ........
7610  \2\ Sharon, PA..........................................    0.8473
  Mercer, PA                                                    ........
7620  \2\ Sheboygan, WI.......................................    0.9121
  Sheboygan, WI                                                 ........
7640  Sherman-Denison, TX.....................................    0.9163
  Grayson, TX                                                   ........
7680  Shreveport-Bossier City, LA.............................    0.9165
  Bossier, LA                                                   ........
  Caddo, LA                                                     ........
  Webster, LA                                                   ........
7720  Sioux City, IA-NE.......................................    0.8868
  Woodbury, IA                                                  ........
  Dakota, NE                                                    ........
7760  Sioux Falls, SD.........................................    0.9245
  Lincoln, SD                                                   ........
  Minnehaha, SD                                                 ........
7800  South Bend, IN..........................................    1.0303
  St. Joseph, IN                                                ........
7840  Spokane, WA.............................................    1.0791
  Spokane, WA                                                   ........
7880  Springfield, IL.........................................    0.8502
  Menard, IL                                                    ........
  Sangamon, IL
7920  Springfield, MO.........................................    0.8666
  Christian, MO                                                 ........
  Greene, MO                                                    ........
  Webster, MO                                                   ........
8003  \2\ Springfield, MA.....................................    1.1586
  Hampden, MA                                                   ........
  Hampshire, MA                                                 ........
8050  State College, PA.......................................    0.9239
  Centre, PA                                                    ........
8080  \2\ Steubenville-Weirton, OH-WV (OH Hospitals)..........    0.8761
  Jefferson, OH                                                 ........
  Brooke, WV                                                    ........
  Hancock, WV                                                   ........
8080  Steubenville-Weirton, OH-WV (WV Hospitals)..............    0.8737
  Jefferson, OH                                                 ........
  Brooke, WV                                                    ........
  Hancock, WV                                                   ........
8120  Stockton-Lodi, CA.......................................    1.1114
  San Joaquin, CA                                               ........
8140  \2\ Sumter, SC..........................................    0.8606
  Sumter, SC                                                    ........
8160  Syracuse, NY............................................    0.9247
  Cayuga, NY                                                    ........
  Madison, NY                                                   ........
  Onondaga, NY                                                  ........
  Oswego, NY                                                    ........
8200  Tacoma, WA..............................................    1.1751
  Pierce, WA                                                    ........
8240  \2\ Tallahassee, FL.....................................    0.8733
  Gadsden, FL                                                   ........
  Leon, FL                                                      ........
8280  \1\ Tampa-St. Petersburg-Clearwater, FL.................    0.9095
  Hernando, FL                                                  ........
  Hillsborough, FL                                              ........
  Pasco, FL                                                     ........
  Pinellas, FL                                                  ........
8320  \2\ Terre Haute, IN.....................................    0.8757
  Clay, IN                                                      ........
  Vermillion, IN                                                ........
  Vigo, IN                                                      ........
8360  Texarkana, AR--Texarkana, TX............................    0.8414
  Miller, AR                                                    ........
  Bowie, TX                                                     ........
8400  Toledo, OH..............................................    0.9815
  Fulton, OH                                                    ........
  Lucas, OH                                                     ........
  Wood, OH                                                      ........
8440  Topeka, KS..............................................    0.9015
  Shawnee, KS                                                   ........
8480  Trenton, NJ.............................................    1.0172
  Mercer, NJ                                                    ........
8520  Tucson, AZ..............................................    0.9002
  Pima, AZ                                                      ........
8560  Tulsa, OK...............................................    0.8949
  Creek, OK                                                     ........
  Osage, OK                                                     ........
  Rogers, OK                                                    ........
  Tulsa, OK                                                     ........
  Wagoner, OK                                                   ........
8600  Tuscaloosa, AL..........................................    0.8265
  Tuscaloosa, AL                                                ........
8640  Tyler, TX...............................................    0.9109
  Smith, TX                                                     ........
8680  \2\ Utica-Rome, NY......................................    0.8530
  Herkimer, NY                                                  ........
  Oneida, NY                                                    ........
8720  Vallejo-Fairfield-Napa, CA..............................    1.3535
  Napa, CA                                                      ........
  Solano, CA                                                    ........
8735  Ventura, CA.............................................    1.1088
  Ventura, CA                                                   ........
8750  Victoria, TX............................................    0.8354
  Victoria, TX                                                  ........
8760  Vineland-Millville-Bridgeton, NJ........................    1.0473
  Cumberland, NJ                                                ........
8780  \2\ Visalia-Tulare-Porterville, CA......................    0.9870
  Tulare, CA                                                    ........
8800  Waco, TX................................................    0.8268
  McLennan, TX                                                  ........
8840  \1\ Washington, DC-MD-VA-WV.............................    1.1176
  District of Columbia, DC                                      ........
  Calvert, MD                                                   ........
  Charles, MD                                                   ........
  Frederick, MD                                                 ........
  Montgomery, MD                                                ........
  Prince Georges, MD                                            ........
  Alexandria City, VA                                           ........
  Arlington, VA                                                 ........
  Clarke, VA                                                    ........
  Culpeper, VA                                                  ........
  Fairfax, VA                                                   ........
  Fairfax City, VA                                              ........
  Falls Church City, VA                                         ........
  Fauquier, VA                                                  ........
  Fredericksburg City, VA                                       ........
  King George, VA                                               ........
  Loudoun, VA                                                   ........
  Manassas City, VA                                             ........
  Manassas Park City, VA                                        ........
  Prince William, VA                                            ........
  Spotsylvania, VA                                              ........
  Stafford, VA                                                  ........
  Warren, VA                                                    ........
  Berkeley, WV                                                  ........
  Jefferson, WV                                                 ........
8920  Waterloo-Cedar Falls, IA................................    0.8608
  Black Hawk, IA                                                ........
8940  Wausau, WI..............................................    0.9516
  Marathon, WI                                                  ........
8960  \1\ West Palm Beach-Boca Raton, FL......................    0.9785
  Palm Beach, FL                                                ........
9000  \2\ Wheeling, WV-OH (WV Hospitals)......................    0.8145
  Belmont, OH                                                   ........
  Marshall, WV                                                  ........
  Ohio, WV                                                      ........
9000  \2\ Wheeling, WV-OH (OH Hospitals)......................    0.8761
  Belmont, OH                                                   ........
  Marshall, WV                                                  ........
  Ohio, WV                                                      ........
9040  Wichita, KS.............................................    0.9541
  Butler, KS                                                    ........
  Harvey, KS                                                    ........
  Sedgwick, KS                                                  ........
9080  Wichita Falls, TX.......................................    0.8015
  Archer, TX                                                    ........
  Wichita, TX                                                   ........
9140  Williamsport, PA........................................    0.8503
  Lycoming, PA                                                  ........
9160  Wilmington-Newark, DE-MD................................    1.0757
  New Castle, DE                                                ........

[[Page 44911]]

 
  Cecil, MD                                                     ........
9200  Wilmington, NC..........................................    0.9971
  New Hanover, NC                                               ........
  Brunswick, NC                                                 ........
9260  Yakima, WA..............................................    1.0690
  Yakima, WA                                                    ........
9270  \2\ Yolo, CA............................................    0.9870
  Yolo, CA                                                      ........
9280  \2\ York, PA............................................    0.8473
  York, PA                                                      ........
9320  Youngstown-Warren, OH...................................    0.9480
  Columbiana, OH                                                ........
  Mahoning, OH                                                  ........
  Trumbull, OH                                                  ........
9340  Yuba City, CA...........................................    1.0479
  Sutter, CA                                                    ........
  Yuba, CA                                                      ........
9360  Yuma, AZ................................................    0.8904
  Yuma, AZ
------------------------------------------------------------------------
\1\ Large Urban Area.
\2\ Hospitals geographically located in the area are assigned the
  statewide rural wage index for FY 2002.


                 Addendum I.--Wage Index for Rural Areas
------------------------------------------------------------------------
                                                                  Wage
                         Nonurban area                            index
------------------------------------------------------------------------
Alabama.......................................................    0.7483
Alaska........................................................    1.2006
Arizona.......................................................    0.8747
Arkansas......................................................    0.7561
California....................................................    0.9870
Colorado......................................................    0.8909
Connecticut...................................................    1.2357
Delaware......................................................    0.9487
Florida.......................................................    0.8733
Georgia.......................................................    0.8341
Hawaii........................................................    1.1235
Idaho.........................................................    0.8820
Illinois......................................................    0.8140
Indiana.......................................................    0.8757
Iowa..........................................................    0.8194
Kansas........................................................    0.7850
Kentucky......................................................    0.8019
Louisiana.....................................................    0.7755
Maine.........................................................    0.8714
Maryland......................................................    0.8962
Massachusetts.................................................    1.1586
Michigan......................................................    0.9115
Minnesota.....................................................    0.9109
Mississippi...................................................    0.7612
Missouri......................................................    0.7838
Montana.......................................................    0.8642
Nebraska......................................................    0.8233
Nevada........................................................    0.9785
New Hampshire.................................................    0.9914
New Jersey \1\................................................
New Mexico....................................................    0.8835
New York......................................................    0.8530
North Carolina................................................    0.8632
North Dakota..................................................    0.7965
Ohio..........................................................    0.8761
Oklahoma......................................................    0.7646
Oregon........................................................    1.0156
Pennsylvania..................................................    0.8473
Puerto Rico...................................................    0.4654
Rhode Island \1\..............................................
South Carolina................................................    0.8606
South Dakota..................................................    0.7934
Tennessee.....................................................    0.7901
Texas.........................................................    0.7673
Utah..........................................................    0.9156
Vermont.......................................................    0.9576
Virginia......................................................    0.8473
Washington....................................................    1.0301
West Virginia.................................................    0.8145
Wisconsin.....................................................    0.9121
Wyoming.......................................................   0.8855
------------------------------------------------------------------------
\1\ All counties within the State are classified as urban.


       Addendum J.--Wage Index for Hospitals That Are Reclassified
------------------------------------------------------------------------
                                                                  Wage
                             Area                                 index
------------------------------------------------------------------------
Abilene, TX...................................................    0.8118
Akron, OH.....................................................    0.9924
Albany, GA....................................................    1.0675
Albuquerque, NM...............................................    0.9748
Alexandria, LA................................................    0.8137
Allentown-Bethlehem-Easton, PA................................    0.9443
Altoona, PA...................................................    0.9225
Amarillo, TX..................................................    0.8485
Anchorage, AK.................................................    1.2605
Ann Arbor, MI.................................................    1.1220
Anniston, AL..................................................    0.7922
Asheville, NC.................................................    0.9307
Athens, GA....................................................    0.9818
Atlanta, GA...................................................    1.0066
Augusta-Aiken, GA-SC..........................................    1.0090
Austin-San Marcos, TX.........................................    0.9327
Barnstable-Yarmouth, MA.......................................    1.3415
Baton Rouge, LA...............................................    0.8258
Bellingham, WA................................................    1.1427
Benton Harbor, MI.............................................    0.9115
Bergen-Passaic, NJ............................................    1.1669
Billings, MT..................................................    0.9623
Biloxi-Gulfport-Pascagoula, MS................................    0.8198
Binghamton, NY................................................    0.8595
Birmingham, AL................................................    0.8648
Bismarck, ND..................................................    0.7965
Bloomington-Normal, IL........................................    0.8545
Boise City, ID................................................    0.9190
Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH..............    1.1483
Burlington, VT................................................    0.9606
Caguas, PR....................................................    0.4993
Casper, WY....................................................    0.9454
Champaign-Urbana, IL..........................................    0.9264
Charleston-North Charleston, SC...............................    0.9293
Charleston, WV................................................    0.8991
Charlotte-Gastonia-Rock Hill, NC-SC...........................    0.9469
Chattanooga, TN-GA............................................    0.9207
Chicago, IL...................................................    1.0887
Cincinnati, OH-KY-IN..........................................    0.9574
Clarksville-Hopkinsville, TN-KY...............................    0.8481
Cleveland-Lorain-Elyria, OH...................................    0.9496
Columbia, MO..................................................    0.8787
Columbia, SC..................................................    0.9264
Columbus, GA-AL...............................................    0.8471
Columbus, OH..................................................    0.9724
Corpus Christi, TX............................................    0.8203
Dallas, TX....................................................    0.9506
Davenport-Moline-Rock Island, IA-IL...........................    0.8790
Dayton-Springfield, OH........................................    0.9323
Denver, CO....................................................    1.0289
Des Moines, IA................................................    0.8881
Dothan, AL....................................................    0.8005
Dover, DE.....................................................    0.9957
Duluth-Superior, MN-WI........................................    1.0299
Eau Claire, WI................................................    0.9121
Elkhart-Goshen, IN............................................    0.9516
Erie, PA......................................................    0.8780
Eugene-Springfield, OR........................................    1.1073
Fargo-Moorhead, ND-MN.........................................    0.9247
Fayetteville, NC..............................................    0.8970
Flagstaff, AZ-UT..............................................    1.0222
Flint, MI.....................................................    1.0920
Florence, AL..................................................    0.7927
Florence, SC..................................................    0.8843
Fort Collins-Loveland, CO.....................................    1.0161
Ft. Lauderdale, FL............................................    1.0906
Fort Pierce-Port St. Lucie, FL................................    1.0067
Fort Smith, AR-OK.............................................    0.7889
Fort Walton Beach, FL.........................................    0.8547
Fort Wayne, IN................................................    0.9059
Forth Worth-Arlington, TX.....................................    0.9452
Gadsden, AL...................................................    0.8446
Gainesville, FL...............................................    1.1855
Grand Forks, ND-MN (ND Hospitals).............................    0.9022
Grand Forks, ND-MN (MN Hospital)..............................    0.9109
Grand Junction, CO............................................    0.9816
Grand Rapids-Muskegon-Holland, MI.............................    1.0052
Great Falls, MT...............................................    0.9301
Greeley, CO...................................................    0.9604
Green Bay, WI.................................................    0.9440
Greensboro-Winston-Salem-High Point, NC.......................    0.9474
Greenville, NC................................................    0.9751
Greenville-Spartanburg-Anderson, SC...........................    0.9110
Harrisburg-Lebanon-Carlisle, PA...............................    0.9068
Hartford, CT..................................................    1.1586
Hattiesburg, MS...............................................    0.7612
Hickory-Morganton-Lenoir, NC..................................    0.9517
Honolulu, HI..................................................    1.1658
Houston, TX...................................................    0.9604
Huntington-Ashland, WV-KY-OH..................................    0.9286
Huntsville, AL................................................    0.8657
Indianapolis, IN..............................................    0.9666
Iowa City, IA.................................................    0.9820
Jackson, MS...................................................    0.8589
Jackson, TN...................................................    0.8945
Jacksonville, FL..............................................    0.9040
Johnson City-Kingsport-Bristol, TN-VA.........................    0.8540
Jonesboro, AR.................................................    0.8093
Joplin, MO....................................................    0.8560
Kalamazoo-Battlecreek, MI.....................................    1.0537
Kansas City, KS-MO............................................    0.9430
Knoxville, TN.................................................    0.8904
Kokomo, IN....................................................    0.9290
Lafayette, LA.................................................    0.8430
Lansing-East Lansing, MI......................................    0.9653
Las Vegas, NV-AZ..............................................    1.1238
Lawton, OK....................................................    0.8372
Lexington, KY.................................................    0.8675

[[Page 44912]]

 
Lima, OH......................................................    0.9558
Lincoln, NE...................................................    0.9945
Little Rock-North Little Rock, AR.............................    0.8938
Longview-Marshall, TX.........................................    0.8439
Los Angeles-Long Beach, CA....................................    1.2071
Louisville, KY-IN.............................................    0.9481
Lubbock, TX...................................................    0.8547
Lynchburg, VA.................................................    0.8897
Macon, GA.....................................................    0.9077
Madison, WI...................................................    1.0462
Mansfield, OH.................................................    0.8827
Medford-Ashland, OR...........................................    1.0156
Melbourne-Titusville-Palm Bay, FL.............................    0.9883
Memphis, TN-AR-MS.............................................    0.9152
Miami, FL.....................................................    0.9934
Milwaukee-Waukesha, WI........................................    0.9898
Minneapolis-St. Paul, MN-WI...................................    1.1000
Missoula, MT..................................................    0.9273
Mobile, AL....................................................    0.7766
Modesto, CA...................................................    1.0945
Monmouth-Ocean, NJ............................................    1.1514
Monroe, LA....................................................    0.8191
Montgomery, AL................................................    0.7502
Myrtle Beach, SC..............................................    0.8663
Nashville, TN.................................................    0.9433
New Haven-Bridgeport-Stamford-Waterbury-Danbury, CT...........    1.2357
New London-Norwich, CT........................................    1.1578
New Orleans, LA...............................................    0.9054
New York, NY..................................................    1.3923
Newark, NJ....................................................    1.2004
Newburgh, NY-PA...............................................    1.0838
Norfolk-Virginia Beach-Newport News, VA-NC....................    0.8632
Oakland, CA...................................................    1.5313
Odessa-Midland, TX (TX Hospitals).............................    0.8769
Odessa-Midland, TX (NM Hospitals).............................    0.8835
Oklahoma City, OK.............................................    0.8728
Omaha, NE-IA..................................................    0.9696
Orange County, CA.............................................    1.1354
Orlando, FL...................................................    0.9464
Peoria-Pekin, IL..............................................    0.8883
Philadelphia, PA-NJ...........................................    1.0626
Pine Bluff, AR................................................    0.7837
Pittsburgh, PA................................................    0.9550
Pittsfield, MA................................................    1.0018
Pocatello, ID.................................................    0.9264
Portland, ME..................................................    0.9501
Portland-Vancouver, OR-WA.....................................    1.1291
Provo-Orem, UT................................................    0.9840
Raleigh-Durham-Chapel Hill, NC................................    0.9901
Rapid City, SD................................................    0.8849
Reading, PA...................................................    0.8473
Redding, CA...................................................    1.1222
Reno, NV......................................................    1.0456
Richland-Kennewick-Pasco, WA..................................    1.0478
Richmond-Petersburg, VA.......................................    0.9712
Roanoke, VA...................................................    0.8468
Rochester, MN.................................................    1.1595
Rockford, IL..................................................    0.9080
Sacramento, CA................................................    1.1809
Saginaw-Bay City-Midland, MI..................................    0.9662
St. Cloud, MN.................................................    1.0040
St. Joseph, MO................................................    0.8953
St. Louis, MO-IL..............................................    0.8911
Salinas, CA...................................................    1.4738
Salt Lake City-Ogden, UT......................................    0.9976
San Diego, CA.................................................    1.1480
Santa Fe, NM..................................................    1.0013
Santa Rosa, CA................................................    1.2408
Sarasota-Bradenton, FL........................................    1.0118
Savannah, GA..................................................    0.9349
Seattle-Bellevue-Everett, WA..................................    1.1056
Sherman-Denison, TX...........................................    0.8899
Shreveport-Bossier City, LA...................................    0.9165
Sioux City, IA-NE.............................................    0.8868
Sioux Falls, SD...............................................    0.9037
South Bend, IN................................................    1.0176
Spokane, WA...................................................    1.0663
Springfield, IL...............................................    0.8502
Springfield, MO...............................................    0.8454
Stockton-Lodi, CA.............................................    1.1114
Syracuse, NY..................................................    0.9247
Tampa-St. Petersburg-Clearwater, FL...........................    0.9095
Texarkana, AR--Texarkana, TX..................................    0.8414
Toledo, OH....................................................    0.9815
Topeka, KS....................................................    0.8850
Tucson, AZ....................................................    0.9002
Tulsa, OK.....................................................    0.8815
Tuscaloosa, AL................................................    0.8265
Tyler, TX.....................................................    0.8905
Victoria, TX..................................................    0.8212
Waco, TX......................................................    0.8268
Washington, DC-MD-VA-WV.......................................    1.1024
Waterloo-Cedar Falls, IA......................................    0.8608
Wausau, WI....................................................    0.9516
West Palm Beach-Boca Raton, FL................................    0.9785
Wichita, KS...................................................    0.9218
Wichita Falls, TX.............................................    0.8015
Wilmington-Newark, DE-MD......................................    1.0757
Rural Alabama.................................................    0.7483
Rural Florida.................................................    0.8733
Rural Illinois (IA Hospital)..................................    0.8194
Rural Illinois (MO Hospital)..................................    0.8140
Rural Kentucky................................................    0.8019
Rural Louisiana...............................................    0.7755
Rural Michigan................................................    0.9115
Rural Minnesota...............................................    0.9109
Rural Missouri (AK Hospital)..................................    0.7838
Rural Missouri (KS Hospital)..................................    0.7850
Rural Montana.................................................    0.8642
Rural Nebraska................................................    0.8233
Rural Nevada..................................................    0.9219
Rural Oregon..................................................    1.0156
Rural Texas...................................................    0.7673
Rural Washington..............................................    1.0301
Rural Wisconsin...............................................    0.9121
Rural Wyoming.................................................    0.8855
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[FR Doc. 01-21213 Filed 8-20-01; 10:08 am]
BILLING CODE 4120-01-P