[Federal Register Volume 66, Number 231 (Friday, November 30, 2001)]
[Rules and Regulations]
[Pages 59856-60125]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-29621]



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Part III





Department of Health and Human Services





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Centers for Medicare & Medicaid Services



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42 CFR Parts 413, 419, and 489



 Medicare Program; Changes to the Hospital Outpatient Prospective 
Payment System for Calendar Year 2002; Final Rule

  Federal Register / Vol. 66 , No. 231 / Friday, November 30, 2001 / 
Rules and Regulations  

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 413, 419, and 489

[CMS-1159-F2]
RIN 0938-AK54


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

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

ACTION: Final rule.

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SUMMARY: This final rule revises 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 describes changes to the amounts and factors used to determine the 
payment rates for Medicare hospital outpatient services paid under the 
prospective payment system. This final rule also announces a uniform 
reduction of 68.9 percent to be applied to each of the transitional 
pass-through payments. These changes are applicable to services 
furnished on or after January 1, 2002.

EFFECTIVE DATE: This final rule is effective January 1, 2002 and is 
applicable to services furnished on or after January 1, 2002.

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:

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 
the Superintendent of Documents, or enclose your Visa or Master Card 
number and expiration date. Credit card orders can also be placed by 
calling the order desk at (202) 512-1800 or by faxing to (202) 512-
2250. The cost for each copy is $9. As an alternative, you can view and 
photocopy the Federal Register document at most libraries designated as 
Federal Depository Libraries and at many other public and academic 
libraries throughout the country that receive the Federal Register.
    This Federal Register document is also available from the Federal 
Register online database through GPO Access, a service of the U.S. 
Government Printing Office. The Web site address is: http://www.access.gpo.gov/nara/index.html.
    Information on the outpatient prospective payment system can be 
found on our homepage. You can access these data by using the following 
directions:
    1. Go to CMS homepage (http://www.cms.hhs.gov).
    2. Click on ``Professionals.''
    3. Under the heading ``Physicians and Health Care Professionals,'' 
click on ``Medicare Coding and Payment Systems.''
    4. Select Hospital Outpatient Prospective Payment System.
    Or, you can go directly to the Hospital Outpatient Prospective 
Payment System page by typing the following: http://www.hcfa.gov/medicare/hopsmain.htm.
    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 Changes in the August 24, 2001 Proposed Rule
    1. Changes Required by BIPA 2000
    2. Additional Changes
    3. Provider-Based Changes
    D. Public Comments and Responses to the August 24, 2001 Proposed 
Rule
II. 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
    3. Coding and Payment for Mammography Services
    a. Screening Mammography
    b. Diagnostic Mammography
    c. Coding and Payment for New Technology Mammography Services
    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 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. 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
    A. Background
    B. Discussion of Pro-Rata Reduction
    C. Reducing Transitional Pass-Through Payments to Offset Costs 
Packaged into APC Groups
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. Medicare, Medicaid, and SCHIP Benefits Improvement and 
Protection Act of 2000
    1. Two-Year ``Grandfathering''
    2. Geographic Location Criteria
    3. Criteria for Temporary Treatment as Provider-Based
    D. Commitment to Re-examine EMTALA Applicability to Off-Campus 
Locations, and to Further Revise Provider-Based Regulations
    E. 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
    F. Comments on Other Issues
XI. Provisions of the Final Rule

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    A. Changes Required by BIPA
    B. Additional Changes
    C. Technical Corrections
XII. Collection of Information Requirements
XIII. 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
BBRA 1999  Balanced Budget Refinement Act of 1999
BIPA 2000  Medicare, Medicaid, and SCHIP Benefits Improvement and 
Protection Act of 2000
CAH  Critical access hospital
CAT  Computerized axial tomography
CCI  Correct Coding Initiative
CCR  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 nonphysician 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 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.
     On August 24, 2001, we published a proposed rule (66 FR 
44672) that set forth proposed changes to the Medicare hospital OPPS 
and calendar year (CY) 2002 payment rates. It also set forth proposed 
changes to the amounts and factors used to determine these payment 
rates.

C. Summary of Changes in the August 24, 2001 Proposed Rule

    On August 24, 2001, we published a proposed rule (66 FR 44672) that 
set forth proposed changes to the Medicare hospital OPPS and CY 2002 
payment rates including changes to the amounts and factors used to 
determine these payment rates.
    The following is a summary of the major changes that we proposed 
and the

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issues we addressed in the August 24, 2001 proposed rule.
1. Changes Required by BIPA 2000
    We proposed 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 payments to children's hospitals.
     Provide separate APCs for services that use contrast 
agents and those that do not.
     Payment for glaucoma screening as a covered service.
     Payment for certain new technology used in diagnostic 
mammograms.
2. Additional Changes
    We proposed 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 separate 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 relative weights.
     Calculate outlier payments on a service-by-service basis 
beginning in 2002. We also proposed a methodology for allocating 
packaged services to individual APCs in determining costs of a service 
and we proposed to use a hospital's overall outpatient cost-to-charge 
ratio to convert charges to costs.
     Set the threshold for outlier payments to require costs to 
exceed 3 times the APC payment amount and payment at 50 percent of any 
excess costs above the threshold.
     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.
     Make conforming changes to regulations text to reflect the 
exclusion from the OPPS of 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.
     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.
     A description of the Secretary's estimate of the total 
amount of pass-through payments for CY 2002 and the need for a pro rata 
reduction to those payments in that year.
3. Provider-Based Changes
    We proposed to make changes to the provider-based regulations to 
reflect the provisions of section 404 of BIPA and to codify certain 
clarifications on provider-based status that were posted on the CMS Web 
site.

D. Public Comments Received in Response to the August 24, 2001 Proposed 
Rule

    We received approximately 400 timely items of correspondence 
containing multiple comments on the proposed rule. Major issues 
addressed by the commenters included the following:
     The implementation of a uniform reduction in the 
transitional pass-through payments for CY 2002.
     Changes to APC classifications and weights for certain 
outpatient services including mammography, stereotactic radiosurgery 
and intensity modulated radiation therapy, and positive emission 
tomography (PET) scans.
     Changes to the eligibility criteria for payment as a new 
technology service.
    On November 2, 2001, we published a final rule (66 FR 55857) that 
responded to the comments on the Secretary's estimate of the total 
amount of transitional pass-through payments for CY 2002 and the need 
for a uniform reduction in the pass-through payments for that year as 
well as comments on the proposed conversion factor for CY 2002. That 
final rule announced that the conversion factor for CY 2002 is $50.904 
and that the Secretary is implementing a pro rata reduction in 2002 
(expected to be between 65 and 70 percent) to each pass-through payment 
(we stated that we would announce the exact amount of the reduction 
before the beginning of 2002).
    Summaries of the remaining public comments received and our 
responses to those comments are set forth below under the appropriate 
heading. In addition, we are announcing that the pro rata reduction is 
68.9 percent.

II. 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 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

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unusual cases, such as low volume items and services.''
    For the proposed rule and for this final rule, we analyzed the APC 
groups 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 the proposed rule, we summarized 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. In the proposed 
rule, we provided a detailed summary of the Panel discussion and 
recommendations (66 FR 44675-44686). See the proposed rule for more 
details regarding these discussions.
    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 policies 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.
    We did not receive comments on the APC changes we proposed based on 
the recommendations of the Panel except for our proposal regarding 
stereotactic radiosurgery (APCs 0300 and 0302). We discuss that 
proposal in detail below along with the comments and our responses. For 
all other APC Panel proposed changes, we briefly discuss the Panel's 
recommendation, our proposal, and the final changes we have made. We 
also received comments on APCs and the assignment of codes to APCs for 
which we made no specific proposal in the proposed rule. We address 
those comments below in section II.A.3. of this preamble.

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 
will 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 recommended the following:
     Move CPT code 56501 from APC 0016 to APC 0017.
     Move CPT code 46917 from APC 0014 to APC 0017.
    After considerable discussion 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 will group in 
APC 0017 simple destruction of lesion procedures that use laser or 
surgical techniques with extensive destruction of lesion procedures.
    We proposed to accept the Panel's recommendation regarding CPT code 
56501 and to revise the APC accordingly. We are adopting these changes 
in final; however, as shown below in Table 3, we are making 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. 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 options with and gather clinical and utilization information 
from their respective hospitals regarding these procedures.

[[Page 59860]]

    We proposed to accept the Panel's recommendations. We are adopting 
these recommendations as final; however, as discussed below in section 
II.C., we are making additional 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 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 proposed to accept the Panel's recommendations except that we 
proposed to move CPT code 29515 to APC 0059 due to the 2 times rule and 
the newer data we are using for this rule. These changes have been 
adopted as final in this document.

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 recommended the following:
     Remove CPT code 94660 from APC 0079 and create a new APC 
for this one procedure.
    We proposed to accept the Panel's recommendation by creating a new 
APC 0065, CPAP Initiation. We have adopted this change in this final 
rule.

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 recommended that the only action we take would be 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 proposed to accept the APC Panel recommendation. We are adopting 
this change as final.

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.
    The Panel recommended the following reorganization of APC 0102 to 
better reflect clinical coherence:
     Split APC 0102 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 proposed to accept the Panel's recommendations and proposed 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.

    We have made these changes final in this rule.

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.
    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 will be a duplicate payment. Therefore, 
the Panel asked that CMS address this problem when considering their 
recommendation.

[[Page 59861]]

    We proposed to accept the Panel's recommendations. We noted 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).
    We have adopted the proposed changes in final in this document.

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

    Based on previous comments we had received, we asked the Panel to 
review whether oral delivery of chemotherapy and delivery of 
chemotherapy by infusion pumps and reservoirs should be recognized for 
payment under the OPPS.
    In summary, the Panel recommended the following:
     Allow hospitals to bill for patient education on the 
administration of oral anticancer agents under the appropriate clinic 
codes.
     Assign CPT codes 96520 and 96530 to a new APC.
     Continue to use the current HCPCS Level II Q codes for 
chemotherapy administration.
     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 proposed to accept all the Panel's 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 proposed to create a new APC 0125, Refilling of Infusion 
Pump.
    We are adopting these changes as final in this rule.

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 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 should submit cost 
data for the Panel to use in reevaluating this issue at its 2002 
meeting.
    We noted in the proposed rule that our analysis of the more recent 
claims data we are using to reclassify and recalibrate the APCs reveals 
a significant increase in costs for this APC resulting in a payment 
rate that is double the current rate. However, very few procedures 
(fewer than 20) were billed on an outpatient basis. As we indicated in 
the proposed rule, 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.
    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 proposed to accept the Panel's recommendations.
    We have adopted these recommendations in this final rule.

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.
    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 proposed to accept the Panel's recommendations. As we stated in 
the proposed rule, we are reviewing the potential for using multiple 
claims data for determining payment rates for ERCP procedures. As a 
first step in the process, in the proposed rule, we 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 procedure in this APC. We

[[Page 59862]]

accomplished this by changing the status indicator for radiologic 
guidance and supervision codes to ``N'', which results in these codes 
being packaged. Using these additional claims resulted in significantly 
increasing the number of claims used to determine the payment rate for 
this APC and in a much higher payment rate (about $780 in this final 
rule).
    We will be presenting this issue again to the APC Panel at their 
next meeting.

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 previously 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.
    The Panel recommended that we move 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 proposed to disagree with the 
Panel's recommendation and move code 52353 to APC 0163. The 1999-2000 
cost data used for the proposed rule, which contained over 400 single 
claims for code 52353 (reported under code 52337) and over 6,000 single 
claims for code 50590, showed 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 was $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.
    Based on the updated 1999-2000 data base available for the final 
rule, we find that the cost relationship between codes 52353 and 50590 
continues to reflect a difference. There are now almost 500 single 
claims for code 52353 and almost 7,000 single claims for code 50590. 
The median cost for 50590 remains about $700 higher than the median 
cost for code 52353. Therefore, we are adopting as final our proposal 
to move code 52353 to APC 0163.

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 closely reviewed the four APCs for female reproductive 
procedures (APCs 0191, 0192, 0193, and 0194) 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, 
Hysterosocopy, 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
                                    colporrhapy.
57300............................  Closure of rectovaginal fistula;
                                    vaginal or transanal approach.

[[Page 59863]]

 
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 
lymphadenectomy and para-aortic lymph node sampling (biopsy), from APC 
0194 to the new APC, Level VI Female Reproductive Procedures.
    We proposed to accept all of these Panel recommendations. These 
APCs would be reconfigured and renumbered as APCs 0188 to 0194. We also 
proposed 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. These proposed changes have 
been adopted as final in this document.

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 a new code for 2001, CPT code 64614, 
Chemodenervation of muscles; extremities and/or trunk muscles (e.g., 
for dystonia, cerebral palsy, multiple sclerosis).
    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 currently assigned to APCs 040, Arthrocentesis and 
Ligament/Tendon Injection, 0105, Revision/Removal of Pacemakers, AICD, 
or Vascular Device, and 0971. 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):

------------------------------------------------------------------------
                                                              Reassigned
                          CPT Code                             from APC
------------------------------------------------------------------------
62280-62282................................................         0212
62290......................................................        (\1\)
62291......................................................        (\1\)
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
------------------------------------------------------------------------
\1\ Currently packaged.

     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

[[Page 59864]]

Levels I, II, III, and IV with the following exceptions:
     The Panel recommended that we not include CPT codes 62290 
and 62291 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 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 proposed to accept the Panel's recommendations for 
these services and we proposed to create new APCs 0203, 0204, 0206, and 
0207 to accommodate these changes. We are adopting these proposed 
changes as final.

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 because 
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 proposed to 
accept the Panel's recommendation with one exception. We proposed 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).
    The changes we proposed to APCs 0215, 0216, and 0217 have been 
adopted as final in this document.

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., ganciclovir implant), 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 ganciclovir, 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 proposed to make various other changes to these APCs based 
on the new data and the 2 times rule, which we are incorporating as 
final in this document.

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 recommended to the Panel that this APC be split by surgical site 
(for example, 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 
proposed to move CPT codes 30300, Remove foreign body, intranasal; 
office type procedure, 40804, Removal of embedded foreign body, 
vestibule 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. 
Based on the latest 1999-2000 data, we find that the reasons for our 
proposed revision are still valid, therefore, we have incorporated 
those changes as final in this rule.

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

[[Page 59865]]

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 stated in the proposed rule that we agreed with the Panel's 
recommendations 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, we proposed 
to 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.
    We are adopting the changes discussed in the proposed rule as 
final. However, as discussed in a comment and response below in section 
II.A.3 of this preamble, we are revising the title and status indicator 
for APC 0187.

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 proposed to leave APC 0270 intact except for the addition of two 
new codes for transesophageal echocardiography. We also proposed to 
split APC 0269 into two APCs, APC 0269, Level I Echocardiogram Except 
Transesophageal and APC 0697, Level II Echocardiogram Except 
Transesophageal. One APC (0269) would include comprehensive 
echocardiograms and the other APC (0697) would include limited/follow-
up echocardiograms and doppler add-on procedures.
    We have included these proposed changes in the APCs set forth in 
this final rule.

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 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 recommended the following:
     Make no changes to APC 0274.
     Review new cost data to determine whether payment would 
increase for APC 0274.
    We proposed to accept the Panel's recommendation. We have made no 
further changes in this APC.

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 
violates 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 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 proposed to accept the Panel's recommendations. We noted that, 
as proposed, APC 0279 violated 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 stated in the proposed rule that we believe that an 
exception to the 2 times rule is warranted.
    We are adopting the proposed changes as final. We note that APC 
0279 continues to violate the 2 times rule due to the median cost of 
CPT code 75660. However, we continue to believe an exception is 
warranted.

APC 0300: Level I Radiation Therapy

APC 0302: Level III Radiation Therapy

    As discussed in the proposed rule, we presented this APC to the 
technical advisory Panel because we had 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 for 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

[[Page 59866]]

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 submitted comments and provided testimony to the APC 
Panel on these issues. These comments 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 proposed a new coding structure to more accurately reflect the 
clinical use of these services and the resources required to perform 
them. In the proposed rule, we stated that 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. We noted that planning 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 and 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.
    We noted that treatment planning for IMRT 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.
    Our proposal stated that although there are several types of 
equipment, produced by several manufacturers, used to accomplish this 
treatment, it was 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 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. On the basis 
of this understanding we made the following proposal: Appropriate APC 
assignment and payment were to be made by creating four 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 also proposed that HCPCS codes GXXX1, G0174, and G0178 have 
status indicators of S, while GXXX2 has 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. This was based on 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.
    We based our proposal on our understanding that single-source 
photon stereotactic radiosurgery (or linear accelerator) planning and 
delivery are similar to IMRT planning and delivery in terms of clinical 
use and resource requirements. Therefore, we proposed to require coding 
for single-source photon stereotactic radiosurgery under HCPCS codes 
G0174 and G0178.
    We also noted that the AMA is establishing codes for IMRT planning 
and treatment delivery for 2002 and we proposed 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.
    Because all activities required to perform stereotactic 
radiosurgery and IMRT were to be included in the codes described above, 
we proposed 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. 
Therefore, we also proposed continuing to not recognize CPT code 61793 
for hospital billing purposes.
    We believed that our proposal would not only simplify the reporting 
process for hospitals, but also appropriately recognize the clinical 
practice and resource requirements for stereotactic radiosurgery and 
IMRT.
    We sought comments on our proposal, including the code titles, 
descriptors, and coding requirements discussed above. We also requested 
information regarding appropriate APC assignment and payment rates to 
inform our decision-making. We specifically asked for information 
regarding the costs of treatment delivery including any differences 
between the cost of a complete treatment in single versus multiple 
sessions.
    Finally, we noted that several commenters had requested placement 
of the stereotactic delivery codes in surgical APCs, therefore, we 
requested clarification and support for these comments within the 
context of our coding proposal. Specifically, we were concerned that 
appropriate payment be made for GXXX2, which has a ``per lesion'' 
descriptor.
    We received numerous comments on our proposal. These comments 
concerned our proposed coding scheme

[[Page 59867]]

and payment amounts as well as the need for separate codes recognizing 
linear accelerator-based radiosurgery. Many of the comments were part 
of a write-in campaign asking us to categorize radiosurgery as a 
surgical procedure and not a radiologic procedure. These letters also 
asserted that our payment amount for stereotactic radiosurgery should 
be $15,000. Below, we address each major issue raised by the 
commenters.
    Comment: We received several comments regarding our coding 
proposal. The commenters indicated the following:
     Our proposed codes are duplicative of currently existing 
codes.
     We should recognize CPT code 61793 in the APC system.
     Our proposed codes would not allow billing for single 
session and fractionated linear accelerator-based radiosurgery.
     We incorrectly believe that multisession radiosurgery is 
similar in resource use to IMRT.
     We should delete our proposed codes for stereotactic 
radiosurgery planning and recognize CPT code 77295 for this purpose.
     CMS should clarify the other codes that would be billable 
with our proposed codes.
     Conflicting comments on whether the proposed code for 
stereotactic radiosurgery delivery should be ``per lesion'' or ``per 
session'' or ``per course of treatment.''
    Commenters were also concerned about our ability to establish APC 
weights using claims that contained two significant procedures (e.g., 
stereotactic radiosurgery planning and stereotactic radiosurgery 
delivery).
    Response: We reviewed all these comments very carefully. After 
completing our review, we have decided to make the following 
modifications to our proposed coding scheme:
     IMRT--We are not making any changes to our proposal for 
IMRT coding. We will delete the applicable G codes (G0174 and G0178) 
and recognize the new CPT codes for IMRT planning (code 77301) and IMRT 
delivery (code 77418) as established by the AMA.
     GXXX1--Under our proposal, GXXX1 (now G0242) would have 
been used only for Cobalt-based radiosurgery. After review of the 
comments, we believe that the planning for Cobalt-based and linear 
accelerator-based radiosurgery is similar both clinically and in terms 
of resource consumption. Therefore, at the next coding update, we will 
change the descriptor for this code to include linear accelerator-based 
radiosurgery planning. We do not know whether radiosurgery planning is 
similar clinically and in terms of resource consumption to CPT code 
77295 (therapeutic radiology simulation-added field setting; three-
dimensional). Use of G0242 will allow us to collect claims data and 
cost information that will aid us in determining whether G0242 is 
similar in resource use to 77295. However, we believe that tracking the 
utilization of G0242 as well as the codes with which it is submitted is 
very important for future APC reclassification and recalibration 
purposes, therefore, at this time, we do not intend to discontinue use 
of this code.
     GXXX2--Most of the comments concerned whether this code 
(now G0243) should be ``per lesion.'' After extensive review of the 
comments, we have determined that it is more appropriate for this code 
to be used ``per session'' or ``per course of treatment.'' We have 
concluded that the resource consumption for stereotactic treatment 
delivery varies significantly depending on the size, shape, and depth 
of the lesion(s) being treated. It is quite possible for the treatment 
of two superficial, spherical lesions to be less resource intensive 
than the treatment of a single, large, irregular lesion deep within the 
brain. Furthermore, the method of treatment and the manner in which the 
resources are used make a ``per lesion'' description inappropriate. For 
example, in Cobalt-based treatment, patients are administered ``spheres 
of dose'' and moved in and out of the machine after each ``sphere of 
dose.'' The number of ``spheres of dose'' per lesion varies widely so 
therefore ``per sphere of dose'' might be an alternative description 
for this service. However, we have concluded that any descriptor other 
than ``per session'' or ``per course of treatment'' will result in, or 
create the incentive to bill for, inappropriate payments for this 
service. Furthermore, it is our understanding that hospitals usually 
have a single charge for this service and that charge is based on the 
average resource use for all patients undergoing the procedure whether 
those patients have one, two, or more lesions treated. Because of the 
variability of treatment delivery per lesion, hospitals would be 
overpaid for multi-lesion patients if their charge is based on the 
average resource use over all patients. Finally, a ``per session'' 
description is more consistent with a prospective payment system. 
Because a ``per session'' payment reflects an average that includes all 
patients, unless a hospital specializes in treatment of multi-lesion 
patients, the OPPS payment is likely to be appropriate across all 
patient types. That is, the payment will be slightly higher than costs 
for single lesion treatments, and slightly lower than costs for 
multiple lesion treatments, averaging out over all patients.
     Linear accelerator-based radiosurgery--This treatment 
poses an especially difficult problem because linear accelerator-based 
radiosurgery can be delivered in a single dose like Cobalt-based 
treatment, or it can be delivered in fractions, with a maximum of five 
fractions. We do not have any cost information concerning the resource 
use of linear accelerator-based treatment delivery, but we do 
understand that there are two types of linear accelerator-based 
delivery of radiosurgery: ``gantry-based'' and ``image-directed.'' We 
do not know if the resource use of these two subtypes of linear 
accelerator based-radiosurgery is similar. Furthermore, we do not know 
whether the total resource consumption of fractionated radiosurgery 
delivered from a linear accelerator is different from the resource 
consumption of single dose radiosurgery delivered by a linear 
accelerator.
    Therefore, in order to collect data on this procedure, we will 
designate current code G0173 for reporting single session radiosurgery 
delivered by a linear accelerator, either gantry-based or image-
directed. At the next coding update, we will revise the descriptor for 
G0173 to reflect this change. Additionally, at the next coding update, 
we will create a new G code for use by facilities for fractionated 
radiosurgery delivered by a linear accelerator (either gantry-based or 
image-directed). The number of fractions will be limited to no more 
than five. Both G0173 and the new code for fractionated linear 
accelerator-based radiosurgery will be temporary while we collect cost 
and utilization data for these services. Once we have collected these 
data, we will determine whether permanent codes are needed.
    In general, we have tried to strike a balance between recognizing 
clinically dissimilar treatments with individual codes and avoiding the 
creation of equipment-specific codes for purposes of the OPPS. We 
believe that the codes established in this final rule reflect this 
balance.
    For multiple procedure claims, we do not believe there is a problem 
recognizing claims with more than one significant procedure to assist 
us in determining appropriate APC weights. We have analyzed all the 
claims in the 1999-2000 data base for CPT code 61793 to determine the 
codes with which it was billed and in what

[[Page 59868]]

frequencies. We have developed coding edits based on this claims 
analysis and, as discussed below, the payments for stereotactic 
radiosurgery reflect the median costs for all services that will be 
included in the payment for stereotactic radiosurgery planning and 
delivery. We have discussed these coding edits in great detail with the 
American Society for Therapeutic Radiology and Oncology (ASTRO) and 
they concur with the edits.
    Comment: Many commenters asked us to place stereotactic 
radiosurgery in a ``surgical'' APC.
    Response: We do not understand these comments. We realize that a 
neurosurgeon is present during stereotactic radiosurgery but, unlike 
the hospital inpatient PPS, we have no APC designation of ``surgical.'' 
We have interpreted this comment to mean that commenters do not want 
stereotactic radiosurgery to be in the same APC as IMRT or fractionated 
stereotactic radiosurgery. As discussed below, our new assignments of 
the codes to APCs will effectively create this change.
    Comment: We received numerous comments concerning the status 
indicators we had proposed for the various radiosurgery procedures.
    Response: In view of the change in the descriptor for G0243, we 
will be changing the status indicator for G0243 to ``S.'' This is 
because there will not be multiple units of this service billed and the 
costs for providing single dose stereotactic radiosurgery is relatively 
fixed and it would be inappropriate to give this procedure, as 
finalized, a ``T'' designation (that is, the multiple procedure 
reduction is not applicable).
    Comment: Many comments addressed the payment rate for stereotactic 
radiosurgery and IMRT. Suggested amounts for payment of IMRT treatment 
planning and delivery varied from less than $300 to over $2,000 and 
suggested amounts for radiosurgery planning and treatment ranged from 
less than $1,000 to $15,000.
    Response: We have no cost data specifically associated with IMRT 
upon which to base payment for IMRT. Therefore, we used information 
that provided the basis for IMRT payment under the physician fee 
schedule and we have established APC assignments that result in payment 
rates for IMRT planning and treatment delivery similar to payment under 
the physician fee schedule. We believe this is appropriate because the 
resource use for these procedures is similar in freestanding facilities 
and in hospitals. Because we have no claims data on the costs of IMRT, 
these procedures will be assigned to new technology APCs. As cost data 
are incorporated in the OPPS claims data base, they will be used to 
recalibrate the payment for these services and determine their future 
APC assignment. We would note that payment for IMRT planning includes 
payment for the following CPT codes: 77300, 77280-77295, 77305-77321. 
The only CPT codes that may be billed in addition to G0242 (IMRT 
planning) are the CPT codes 72332-72334 for treatment devices. We plan 
to incorporate the costs of those codes into IMRT planning when we have 
collected the cost data. The APC assignment for G0242 is APC 0714, New 
Technology--IX ($1250-$1500).
    In order to determine appropriate payment amounts for both planning 
and treatment of stereotactic radiosurgery, we did an extensive 
analysis of our claims data base for code 61793 because that was the 
code used for stereotactic radiosurgery during 1999-2000. We collected 
all claims for 61793 and determined which CPT codes were billed with 
61793 and the frequency with which each of those codes was billed with 
61793. Within the subset of claims including CPT code 61793, we 
determined the median costs for 61793 and for each CPT code billed with 
61793. In analyzing these claims, it was clear that 61793 was generally 
used to bill for treatment delivery and other codes were used, in 
combination, to bill for treatment planning. For example, 61793 was 
billed with 77300 on 57 percent of the claims, with either 77295 or 
77290 on 62 percent of the claims, with either 77370 or 77336 on 77 
percent of the claims (occasionally both of these codes were on the 
same claim), and with either 77305, 77315, or 77321 on 59 percent of 
the claims.
    Based on these data, we have determined the total cost for 
stereotactic radiosurgery as follows: For stereotactic radiosurgery 
planning, we added the median costs (when billed with 61793) of 77295 
(the most typical simulation code billed with 61793), 77300, 77370 (the 
most common physics consult billed with 61793), and 77315 (the most 
common dose plan billed with 61793) and will use the sum of these 
medians as the basis for our APC assignment for 2002. The medians of 
these codes are: $134.06 for 77300; $146.97 for 77370; $955.88 for 
77295; and $206.56 for 77315. The total median cost for these codes is 
$1,443.47. Effective for services furnished on or after January 1, 
2002, we will no longer allow these codes to be billed with 
stereotactic radiosurgery. No other codes were billed frequently enough 
with 61793 to justify including their costs in our stereotactic 
radiosurgery planning code. However, treatment device codes (77332-
77334) were billed with 61793 on 42 percent of the claims, so we will 
allow one of those codes to be billed with each claim for stereotactic 
radiosurgery. We will consider incorporating their costs into the 
payment for stereotactic radiosurgery in the future. We note that the 
median cost of 77334 (the most common treatment device code billed with 
61793) was $174.27 when it was billed with 61793.
    CPT Code 20660, application of cranial tongs, caliper, or 
stereotactic frame, including removal (separate procedure), was billed 
with 61793 on only 23 percent of the claims. Because 20660 is required 
in order to perform stereotactic radiosurgery treatment, we will 
package the costs associated with 20660 into G0243, the radiosurgery 
treatment delivery code. We also note that 61793 was billed with an MRI 
of the brain on 71 percent of the claims. We will allow CTs and MRIs to 
be billed in addition to stereotactic radiosurgery planning.
    For stereotactic radiosurgery delivery, we determined that the 
median cost of 61793 (using all claims) was $5,734.22 and will use that 
amount as the basis for our APC assignment for stereotactic 
radiosurgery for 2002. No other radiotherapy treatment code was billed 
frequently enough with 61793 to justify incorporation of its cost into 
our payment (that is, the treatment code most commonly billed with 
61793 was 77470 (33 percent of the claims) and the next most common was 
77412 (6 percent of the claims)). We will not allow billing of any 
other radiation treatment delivery codes with stereotactic radiosurgery 
treatment.
    Therefore, we are assigning G0243 to APC 0721, New Technology--XVI 
($5,000 to $6,000).
    We will pay the same amount for linear accelerator-based 
stereotactic radiosurgery as for multiple source-based radiosurgery. 
For fractionated linear accelerator-based radiosurgery, we will divide 
the payment for single session radiosurgery by five and allow up to 
five payments. This will make total payment for fractionated linear 
accelerator based radiosurgery similar to linear accelerator-based 
single dose radiosurgery while allowing us to collect cost and 
utilization data for setting payments in 2003. Note that because 
application of a stereotactic frame is not required for linear 
accelerator-based radiosurgery, we will not be packaging the costs of 
code 20660 into the costs for linear accelerator-based radiosurgery.
    Linear accelerator-based radiosurgery planning will be coded with 
the same

[[Page 59869]]

code as multiple source-based radiosurgery; therefore, the APC 
assignment will be the same as well. We note that all of these codes 
associated with radiosurgery are assigned to new technology APCs as we 
have no claim data on the procedures. Once we have collected data, the 
procedures will be assigned to other APCs.
    The final APC assignments are as follows:
     77301 is assigned to APC 0712
     77418 is assigned to APC 0710
     G0173 is assigned to APC 0721
     G0242 is assigned to APC 0714
     G0243 is assigned to APC 0721.

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 believed 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.
    For 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 proposed to accept the Panel's recommendation. We 
also agreed 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 
any recommendations regarding these APCs. The Panel did request to look 
at the issue of radiation oncology at its 2002 meeting.
    Therefore, we proposed 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. We are 
making no further changes to these APCs.

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 proposed 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. These proposed changes are incorporated as final in this 
rule.

Observation Services

    See the discussion on observation services in section II.C.4 of 
this preamble for the Panel's recommendations and our proposal as well 
as a discussion of the comments we received.

Inpatient Procedure List

    See the discussion of the inpatient procedures list in section 
II.C.5 of this preamble for the Panel's recommendations and our 
proposal and a discussion of the comments we received on the list.
3. Other APC Issues

APC 0285: Positron Emission Tomography (PET)

    Comment: Commenters expressed concern about the calculation of the 
payment rate for APC 0285, Positron Emission Tomography (PET), which 
includes PET for myocardial perfusion imaging. One specific concern is 
that single service claims are used to calculate relative weights 
although the applicable procedure codes for these studies are always 
linked to another diagnostic study and, therefore, they should not 
appear on single service claims. Second, the commenters are concerned 
that it is not appropriate to place both single study and multiple 
study PET procedures in the same APC.
    Response: While the PET procedures are linked with a previous 
diagnostic procedure, the latter need not have been performed on the 
same day or in the same facility. Upon review of our claims data base, 
we find that nearly 50 percent of all claims for PET myocardial 
perfusion imaging studies are single service claims. We believe this to 
be a sufficient frequency for setting payment rates consistent with the 
overall methodology for setting rates in the OPPS. With regard to the 
second concern, after further analysis of claims, we concluded that 
there is not sufficient variation in the cost among the relevant codes, 
whether single or multiple studies, to warrant a change in the APC 
structure.

PET Scans Assigned to APC 0976: New Technology--Level VII ($750-
$1000)

    In the April 7, 2000 final rule, we assigned PET scans that use 18-
flurodeoxyglucose (FDG) to APC 0980, New Technology--Level XII ($2000-
$2500) because there were no claims for these procedures in the 1996 
data used to establish the APC relative weights for 2000. However, 
based on the data from over 4,000 claims for services furnished between 
July 1, 1999 through June 30, 2000, the data base that was used to set 
the proposed APC weights, we found that the reported median costs for 
these procedures was closer to $900. Therefore, in the proposed rule, 
we

[[Page 59870]]

assigned the FDG PET scans to APC 0976, New Technology--Level VII 
($750-$1000). We received a large number of comments on this proposed 
change.
    Comment: Commenters expressed concern that the proposed APC 
assignment resulted in a much reduced payment rate for FDG PET scans. 
Many of these commenters expressed particular concern that the proposed 
rate of about $850 would not cover the cost of purchasing FDG in 
addition to the direct and indirect costs of a PET scan. The commenters 
requested that we review our data and the data they submitted and 
assign these procedures to a higher level new technology APC.
    Response: As we discussed in detail in the April 7, 2002 final rule 
(65 FR 18476-78), the purpose of assigning a service to a new 
technology APC is to pay for a new technology based on its expected 
costs (as evidenced by data collected by us from various external 
sources) while we collect claims data that would allow assignment of 
the service to a clinically appropriate APC based on the actual 
resource use of the service. Our current policy is that a service 
remains in a new technology APC for 2 to 3 years while we collect the 
necessary claims data. (See section VI.G of this preamble for a 
discussion of changes we are making to this policy effective CY 2002.) 
Because FDG PET scans were assigned to a new technology APC at the 
implementation of the OPPS in August 2000, they will continue to be 
assigned to a new technology APC through 2002. However, when we 
reviewed the claims data in our 1999-2000 data base, there were about 
5,000 single claims for these PET scans, with a median cost of about 
$900. Therefore, we proposed to move these procedures from APC 0980 to 
APC 0976.
    As requested by the commenters and consistent with our policy on 
pricing services for assignment to new technology APCs, we reviewed the 
external data provided by the commenters as well as our claims data. 
These data suggest that our claims cost data may not have accurately 
captured the entire costs of the procedure, particularly the cost of 
the FDG. Based on our analysis, we believe that the cost of an FDG PET 
scan is between $1,200 and $1,800, with a midpoint of $1,500. According 
to our methodology for pricing new technology services, these services 
will be reassigned to APC 0978, New Technology--Level IX ($1250-$1500), 
which results in a payment rate of $1,375.

Cryoablation of the Prostate

    Comment: We received several comments concerning our proposal to 
place CPT code 55873, cryosurgical ablation of the prostate, into APC 
0163, Level IV Cystourethroscopy and other Genitourinary Procedures. 
Commenters believe that we had insufficient cost data to justify moving 
this code from its current assignment, APC 0980, New Technology--XI 
($1750-$2000). They also believe that cryoablation of the prostate is 
not clinically similar to other procedures in APC 0163. One commenter 
requested moving code 55873 into either APC 0984, New Technology--XV 
($3500-$5000) or 0132, Level III Laparoscopy.
    Response: We have reviewed our 1999-2000 cost data for code 55873, 
and have 4 claims that show a median cost of just over $4,000, which 
includes the cost of the procedure as well as the associated devices. 
The devices associated with this procedure are eligible for 
transitional pass-through payments. After subtracting the estimated 
cost of the pass-through devices, we believe that the approximate 
expected cost of this procedure warrants its assignment to APC 0982 New 
Technology--XIII ($2500-$3000), with a status indicator of ``T.'' The 
devices associated with this procedure remain eligible for transitional 
pass-through payments in 2002 in addition to the APC payment amount.

Water-Induced Thermotherapy

    Comment: We received a comment from the manufacturer of the 
equipment used for water-induced thermotherapy (a treatment for benign 
prostatic hyperplasia), CPT code 53853, that our proposal to assign 
this procedure in new technology APC 0977, New Technology--VIII ($1000-
$1250) did not accurately reflect the costs and resources required to 
furnish this procedure. The commenter believes that 53853 should be 
placed in APC 0982, New Technology--XIII ($2500-$3000) with other 
minimally invasive thermotherapy treatments for benign prostatic 
hyperplasia.
    Response: We disagree with the commenter and are finalizing our 
proposal. Based on the information provided by the commenters and our 
own clinical knowledge, we understand that the resources required to 
deliver water-induced thermotherapy are less than the resources 
required for the procedures assigned to APC 0982 (CPT codes 53850, 
transurethral destruction of prostate tissue; by microwave 
thermotherapy, and 53852, transurethral destruction of prostate tissue; 
by radiofrequency thermotherapy). Less intraoperative staff time and 
less equipment resources are required for 53853 than for the other 
procedures. In addition, unlike codes 53850 and 53852, which require 
sedation or regional anesthesia, code 53853 requires only local 
anesthesia. Finally, recovery time is shorter (in part because of the 
local anesthesia) and requires fewer facility resources. Therefore, we 
believe code 53853 is appropriately assigned to APC 0977.

Ultrasound Radiologic Guidance Codes

    Comment: Several commenters inquired about a change in the proposed 
rule that resulted in the packaging of certain ultrasound and 
radiologic guidance codes. The commenters urged us to publish the data 
and rationale for these changes and recommended that the proposed 
changes not be made final, pending further review and a fuller 
discussion of the proposed changes. The commenters recommended separate 
rather than packaged payment for the guidance codes.
    Response: As we explain above in section II.A.2 of this preamble 
under the discussion for APC 0151, we accepted the APC Panel's 
recommendation to consider the use of multiple claims data to determine 
payment rates for endoscopic retrograde cholangio-pancreatography 
(ERCP). The payment rate that we proposed for ERCP was based on both 
single claims for ERCP procedures and on claims that included both an 
ERCP procedure and a radiologic supervision or guidance procedure. That 
is, rather than making separate payment for the radiologic supervision 
and guidance furnished in connection with ERCP, we packaged those costs 
into the proposed rate for APC 0151.
    Our experience using multiple procedure claims to price ERCP in 
accordance with the Panel's recommendation led us to consider other 
services that could be priced similarly. We believe that the following 
procedures assigned to APC 0268, Guidance Under Ultrasound, would never 
be performed alone, but would always be performed in connection with 
and be considered integral to the performance of another procedure: 
76930, 76932, 76934, 76938, 76941, 76942, 76945, 76946, 76948, 76950, 
76960, 76965, G0161. Therefore, if a claim listed one of the procedures 
in APC 0268 in addition to another procedure, we retained that claim in 
the pool of single-procedure bills used to calculate median costs for 
services within the various APCs. Costs

[[Page 59871]]

associated with the codes in APC 0268 were therefore packaged into the 
APCs of procedures with which they were billed between July 1, 1999 
through June 30, 2000.
    We continue to believe that the most appropriate way to pay for 
ultrasound guidance is to package its costs as part of the cost of 
performing the procedure for which the guidance is needed. Therefore, 
in the proposed rule, we assigned status indicator ``N'' to still 
active codes that had previously been in APC 0268. We applied the same 
principle to several radiologic guidance codes (76393, 19290, 19291, 
and 19295). We assigned status indicator ``N'' to these codes because 
they represent services that are always furnished in connection with 
another procedure. That is, they are integral to performing another 
procedure and would never be performed alone, as a single service. 
Therefore, costs associated with such radiologic guidance codes are 
more appropriately packaged than paid for separately.
    It is crucial that hospitals bill charges for codes with status 
indicator ``N'' to ensure that costs for packaged services are 
appropriately captured in the APCs with which they are associated. For 
the 2003 OPPS update, we will consider proposing to package additional 
guidance services with whichever procedures they are billed, including 
the following:
    76095, Stereotactic localization guidance for breast biopsy or 
needle placement.
    76355, Computerized tomography guidance for stereotactic 
localization.
    76360, Computerized tomography guidance for needle placement.
    We will report to the Panel on our progress in treating bills with 
certain packaged services as single procedure claims. We will also 
include on the agenda of the next Panel meeting a follow-up discussion 
to review the services that we have packaged thus far and to consider 
other codes that would also be more appropriately paid as packaged 
rather than separate services. To identify all the procedures with 
which the ultrasound and radiologic guidance services are packaged 
would require a review of the raw outpatient claims that make up the 
1999-2000 data that we are using to recalibrate the 2002 APC weights 
because we have previously packaged the guidance costs with whatever 
procedure they are billed in preparing the claims data base used for 
recalibration.

Breast Biopsy

    Comment: A few commenters, including the manufacturer of a 
minimally invasive breast biopsy system, expressed concern that the 
higher APC relative weight for surgical breast biopsy procedures would 
discourage Medicare beneficiary access to less invasive procedures. The 
commenters were also concerned that the proposed payment for less 
invasive breast biopsy procedures was inadequate.
    Response: As we discuss below in section II.D. of this preamble, 
the APC weights reflect hospital median costs (as determined from the 
charges reflected on claims submitted by hospitals) for a given 
procedure relative to the costs for other procedures. We expect that 
the costs for an open surgical procedure will be higher than those for 
less invasive procedures because open surgery is more resource 
intensive, especially in terms of recovery time, anesthesia, and 
nursing care. We do not agree that the higher relative weight for open 
surgical biopsy will serve as an incentive to perform this procedure 
rather than the less costly, less invasive options. The payment rate 
for the less invasive options are based on the costs of those 
procedures as reported by hospitals. We note that the payment rate for 
the breast biopsy procedure assigned to APC 0974, New Technology--Level 
V ($300-$500) (CPT code 19103, Percutaneous, automated vacuum assisted 
or rotating biopsy device, using imaging guidance) is higher in this 
final rule relative to the proposed rule (see the discussion in section 
II.D. of this preamble, below).
    Comment: Several commenters questioned why the proposed rule 
indicated that CPT code 76095, Stereotactic localization guidance for 
breast biopsy, would be moved from APC 0264, Level II Miscellaneous 
Radiology Procedures, with a status indicator of ``X'' (ancillary 
service) to APC 0187, Placement/Repositioning Miscellaneous Catheters, 
with a status indicator of ``T'' (significant procedure, multiple 
procedure reduction applies). The commenters were concerned that the 
``T'' status indicator would result in a lower payment for the 
procedure when it is billed with other procedures.
    Response: We agree with commenters that the title for APC 0187 in 
the proposed rule is misleading given the procedures that are included 
within the APC. Therefore, in the final rule, we are changing the name 
of APC 0187 to ``Miscellaneous Placement/Repositioning''. We are also 
changing the status indicator for APC 0187 from ``T'' to ``X''. We 
created APC 0187 to pay more appropriately for certain guidance codes, 
including code 76095.

Status Indicators

    Comment: A commenter asserted that some hospitals believe that 
procedure codes designated with status indicators of ``S,'' ``T,'' 
``V,'' and ``X'' mean that the procedure must be performed in the 
outpatient setting.
    Response: This is not the case. These status indicators were 
developed to assist us with our pricing policy in OPPS, not to dictate 
where the procedures could be performed. Although a status indicator of 
``C'' means that the procedure will not be paid if performed in the 
outpatient setting, the status indicators paid under the OPPS do not 
dictate where that service or procedure is covered. We pay for any 
covered service or procedure performed in the inpatient setting as an 
inpatient service as long as the patient's condition merits admission 
to the hospital as an inpatient.

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 final rule 
concerning the revisions in the physician fee schedule payment policy 
for CY 2002, published in the Federal Register on November 1, 2001 (66 
FR 55272).
    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 optometrist or ophthalmologist.
     G0118--Glaucoma screening for high risk patients furnished 
under the direct supervision of an optometrist or ophthalmologist.
    We proposed to assign the glaucoma screening codes to APC 0230, 
Level I Eye Tests. We further proposed 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

[[Page 59872]]

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 
eliminated 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. For the proposed rule, we calculated separate 
weights for the new APCs based on the data available at the time for 
recalibration. In this final rule, we are establishing separate weights 
for the new APCs based on the final data used to recalibrate 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.
----------------------------------------------------------------------------------------------------------------

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

------------------------------------------------------------------------
         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.

[[Page 59873]]

 
                              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.
                              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 d.
                              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.

[[Page 59874]]

 
                              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 of this final rule for the 
updated weights, payment rates, national unadjusted copayment, and 
minimum unadjusted copayment for all of the procedures listed above.
3. Coding and Payment for Mammography Services
    a. Screening Mammography. Screening mammography means a radiologic 
procedure provided to a woman without signs or symptoms of breast 
disease for the purpose of early detection of breast cancer. Under 
Medicare, screening mammography services can be billed in three ways: 
(1) For the physician's interpretation of the results of the screening 
mammogram (that is, the professional component of mammography 
services); (2) for all services other than the physician's 
interpretation (that is, the technical component); or (3) for both the 
professional and technical components (global billing), although global 
billing is not permitted for services furnished in the hospital 
outpatient setting.
    Section 4163 of the Omnibus Budget Reconciliation Act of 1990 (Pub. 
L. 101-508) added section 1834(c) of the Act to provide for Part B 
coverage of screening mammography performed on or after January 1, 
1991. Section 1834(c) of the Act governing those screenings did not 
include screening mammography under the physician fee schedule; it 
provided for payment under a separate statutory methodology. Payment 
for screening mammography services furnished in the hospital outpatient 
setting before January 1, 2002 is subject to the payment method set by 
the statute at section 1834(c) of the Act. When Medicare implemented 
the OPPS for services furnished beginning August 1, 2000, payment for 
screening mammography services continued to be based on the payment 
method set by the statute at section 1834(c) (the lower of hospital 
charges or the national payment limitation) of the Act and was not made 
under the OPPS.
    Section 104 of BIPA amended section 1848(j)(3) of the Act to 
include screening mammography as a physician service. As a result of 
this amendment, the payment limit that is currently the basis for 
payment is replaced beginning January 1, 2002 by payment under the 
Medicare physician fee schedule. Payments for all services under the 
physician fee schedule are resource-based and have geographic 
adjustments that reflect cost differences among areas. A discussion of 
how payment for screening mammography services is determined under the 
physician fee schedule can be found in the final rule, ``Revisions to 
Payment Policies and Five-Year Review of and Adjustments to the 
Relative Value Units Under the Physician Fee Schedule for Calendar Year 
2002,'' published in the November 1, 2001 Federal Register (66 FR 
55246). Beginning January 1, 2002, Medicare payment for screening 
mammography services furnished in a hospital outpatient setting is no 
longer the lower of hospital charges or the national payment 
limitation; however, payment will continue to be excluded from the 
OPPS. For screening mammography furnished in the outpatient setting, 
Medicare will pay hospitals the technical component amount established 
under the Medicare physician fee schedule.
    Comment: A few commenters questioned why we had not established an 
APC or a payment rate for screening mammography in the proposed rule. 
One commenter expressed grave concern that our failure to include an 
APC for screening mammography in the proposed rule meant that Medicare 
beneficiaries would not be able to receive screening mammography 
services in the hospital outpatient setting. These commenters urged 
that we establish an APC for screening mammography services and that 
the payment rate be consistent with the cost of taking a screening 
mammogram in the hospital outpatient setting rather than the payment 
rate proposed for diagnostic mammograms in APC 0271, Mammography. One 
commenter, citing a survey conducted by a professional society, 
reported the average cost of doing a screening mammogram in a hospital 
to be about $97. Several commenters supported the physician fee 
schedule payment rate for screening mammography services as a more 
reasonable recognition of associated costs than the payment rate 
proposed for diagnostic mammography under APC 0271.
    Response: The fact that we have not assigned the HCPCS codes for 
screening mammography services to an APC does not mean that Medicare 
does not pay hospitals for these services when they are furnished in 
the outpatient setting. Rather, as we explain in the April 7, 2000 
final rule, we excluded screening mammography services from payment 
under the OPPS because they were already subject to an existing fee 
schedule or other prospectively determined payment rate (65 FR 18442). 
When the OPPS was implemented on August 1, 2000, screening mammography 
services were assigned payment status indicator ``A'' to specify that 
payment would be the ``lower of charge or national rate,'' consistent 
with section 1834(c)(3) of the Act (65 FR 18445).
    As a result of section 104 of BIPA, which amended section 
1848(j)(3) of the Act to define screening mammography as a physician 
service, Medicare payment for screening mammography services furnished 
on or after January 1, 2002 is no longer subject to the payment 
methodology established under section 1834(c) of the Act. Therefore, 
payment for both the professional and technical components of screening 
mammography services furnished on or after January 1, 2002 is made 
under the physician fee schedule. This means that, effective for 
services furnished on or after January 1, 2002, the payment amount to 
hospitals for screening mammography services furnished in the 
outpatient setting will be based on the amount established for the 
technical component of screening mammography under the physician fee 
schedule.
    Hospitals are to use the following codes to bill for screening 
mammography services effective January 1, 2002:
     CPT code 76092, Screening mammography, bilateral (two view 
film study of each breast)

[[Page 59875]]

     HCPCS code G0202, Screening mammography, direct digital 
image, bilateral, all views
     CPT code 76085, Computer-aided detection add-on code for 
screening mammography (can only be billed with CPT code 76092)
    We further discuss in section II.B.3.c, below, coding and payment 
for screening and diagnostic mammograms that use advanced new 
technologies.
    Payment for screening mammography services furnished in a hospital 
outpatient department beginning January 1, 2002 is equal to 80 percent 
of the lower of the hospital's actual charge or the locality specific 
technical component payment amount under the physician fee schedule. 
Coinsurance equals 20 percent of the lower of the actual charge or the 
physician fee schedule amount. The Medicare Part B deductible does not 
apply to screening mammography. The November 1 physician fee schedule 
final rule lists the relative value units for screening mammography 
services and the physician fee schedule conversion factor for CY 2002 
(66 FR 55334). In addition to the technical component payment made to 
the hospital, physicians are paid an additional amount for professional 
services furnished in connection with these procedures.
    In this final rule, we are changing the descriptor of payment 
status indicator ``A'' for the screening mammography codes to 
``Physician Fee Schedule'' to conform with the BIPA change.
    b. Diagnostic Mammography. Medicare covers a radiological mammogram 
as a diagnostic test under the following conditions:
     A patient has distinct signs and symptoms for which a 
mammogram is indicated;
     A patient has a history of breast cancer; or
     A patient is asymptomatic, but on the basis of the 
patient's history and other factors the physician considers 
significant, the physician's judgment is that a mammogram is 
appropriate.
    Payment for a diagnostic mammogram furnished in a hospital 
outpatient setting is made under the OPPS. The following codes are used 
to report diagnostic mammography: CPT code 76090, Mammography; 
unilateral, and CPT code 76091, Mammography, bilateral are used to 
report a diagnostic mammogram. These two codes are assigned to APC 
0271, Mammography, and we proposed no changes to the assignment of 
these codes in the proposed rule. (We discuss in section III.B.3.c, 
below, coding changes for the CY 2002 related to new technology 
mammography.)
    In the proposed rule, the relative weight for APC 0271 was equal to 
0.64. We recalibrated all the APC relative weights, including that for 
APC 0271, using claims data for services furnished beginning July 1, 
1999 through June 30, 2000 in accordance with the process explained in 
the proposed rule (66 FR 44695).
    Comment: We received numerous comments, many of which were the 
product of a ``write-in'' campaign, regarding the relative weight and 
payment rate proposed for APC 0271. The commenters asserted that the 
current payment rate for APC 0271 is inadequate to support the 
provision of mammography services in the hospital outpatient setting, 
and they expressed disbelief that the proposed payment rate for 2002 is 
lower than the current rate. Commenters expressed grave concern that 
the proposed payment rate for diagnostic mammography would have a 
generally negative impact on beneficiary access to mammography 
services. Many commenters cited a practice cost survey conducted by the 
American College of Radiology that indicated the average cost for 
performing a screening mammogram in a hospital outpatient setting to be 
$97. The commenters argued that diagnostic mammography is more complex 
technically and more resource intensive, requiring more than double the 
clinical labor, supply, and equipment inputs than those required for 
screening mammography. One commenter stated that the technical cost of 
providing screening mammography in the hospital setting is nearly twice 
the cost of providing the same service in a physician office setting.
    Other commenters recommended that payment for all mammography 
services furnished in the outpatient setting, both screening and 
diagnostic, be paid under the physician fee schedule to eliminate the 
significant payment disparity that will result if the proposed OPPS 
rates for diagnostic mammography are implemented in 2002. Several 
commenters complained that we provided no rationale or data to show how 
the proposed payment rate for APC 0271 was calculated nor did we 
explain why the proposed payment for these services is lower than the 
current payment. Commenters urged that we recalculate the payment rate 
for APC 0271 to represent a payment rate that is reflective of the 
resources used to perform the procedure.
    Response: We calculated the relative weight for APC 0271 in the 
April 7, 2000 final rule in accordance with the process we described in 
that rule (65 FR 18482), using, as required by the statute, claims from 
1996 and data from the most recent available hospital cost reports. 
Because we did not recalibrate the relative weights for any APC groups 
in the November 13, 2000 final rule, the relative weight (0.70) for APC 
0271 as well as the relative weights for the other APC groups have not 
changed since August 1, 2000.
    Using 1999-2000 claims data, we recalibrated all the APC weights in 
the proposed rule in accordance with the process that we explained in 
that rule (66 FR 44695). The relative weight for every APC group 
changed for two reasons: the use of more recent claims data, and the 
statutory requirements for budget neutrality. Section 1833(t)(9)(B) of 
the Act requires that estimated spending for services covered under the 
OPPS be neither greater nor less than it would have been had the 
recalibration and reclassification changes not been made. Because of 
this, the weights and, therefore, the payment rates for a specific 
service may increase or decrease depending on the change in charges 
hospitals report for that service relative to the change in charges 
hospitals report for other outpatient services. The decrease in the 
relative weight for diagnostic mammography proposed for 2002 can be 
attributed to a decrease in the relative level of charges for 
diagnostic mammography that hospitals reported for services furnished 
from July 1, 1999 through June 30, 2000 compared to the relative level 
of charges hospitals reported for all other outpatient services 
furnished during the same period. However, that weight does reflect the 
hospital resources used to perform mammograms. We note that the weight 
for APC 0271 in both the proposed and final rules is calculated from 
the median cost of almost 900,000 single-procedure claims.
    The weight for APC 0271 in this final rule is 0.60. This weight was 
recalibrated, like all of the APC weights in this final rule, in 
accordance with the methodology described in section II.D. of this 
preamble. We note that the weight for APC 0271, like the weights for 
all of the nondevice-related APCs, has decreased from the proposed 
weight. This decrease is the result of our incorporating a portion of 
the cost of pass-through devices into the base costs of the APCs with 
which the devices are associated. As we explained in the final rule 
published on November 2, 2001, the additional pass-through device costs 
that were incorporated into the base APC costs are not evenly 
distributed among the APCs, but rather are concentrated in a relatively 
small

[[Page 59876]]

number of APCs that include the procedures that use pass-through 
devices (66 FR 55862). Whereas the weights of these APCs increased as a 
result of the added device costs, in general, the weights for APCs that 
do not include device costs, such as APC 0271, decreased by 
approximately 8 percent. For a more detailed discussion of how the 
incorporation of device costs into the base APCs affects the relative 
weights, see sections II.D. and VII, below.
    Unlike screening mammography, the statute makes no specific 
designation for the technical component of diagnostic mammography 
services furnished in the hospital outpatient setting to be defined as 
a physicians' service. Therefore, we believe that the payment for 
diagnostic mammography should be included in the OPPS.
    Comment: Several commenters expressed concern that the reduced 
payment rate for diagnostic mammography would have an especially 
onerous and negative impact on small, low volume hospitals, most of 
which are located in rural areas. The commenters noted that although 
these small rural hospitals are generally the sole providers of 
mammography and radiology services to the surrounding communities, 
volume in these hospitals is nonetheless too low to offset the fixed 
costs incurred for certified staff and equipment.
    Response: In order to limit potential reductions in payment to 
hospitals under the OPPS, section 1833(t)(7) of the Act requires us to 
provide transitional payment adjustments for hospitals whose OPPS 
payments are less than our estimate of the hospital's pre-BBA payments. 
Section 1833(t)(7)(D)(i) of the Act includes a special ``hold 
harmless'' provision, which applies to hospital outpatient services 
furnished before 2004 by hospitals that are located in a rural area and 
that have no more than 100 beds. Under section 1833(t)(7)(D)(i) of the 
Act, small rural hospitals will be paid a predetermined pre-BBA amount 
for services covered under the OPPS if payment under the OPPS would be 
less than the pre-BBA amount. This hold harmless provision establishes 
a payment floor until January 1, 2004 for small rural hospitals. These 
provisions should provide some measure of protection to small hospitals 
in rural areas to the extent that the reduced payment for diagnostic 
mammography services results in overall payment reductions.
    c. Coding and Payment for New Technology Mammography Services. 
Section 104(d) of BIPA prescribes a payment methodology for both 
diagnostic and screening mammography furnished during the period April 
1, 2001 through December 31, 2001 that use a new technology, as defined 
in section 104(d)(3) of BIPA. Section 104(d)(2) of BIPA directs the 
Secretary to determine, for mammography performed after 2001, whether 
the assignment of a new HCPCS code is appropriate for mammography that 
uses a new technology. The following codes have been established to 
identify the new technology mammography services and will be used 
effective January 1, 2002:
     HCPCS code G0202, Screening mammography producing direct 
digital image, bilateral, all views.
     CPT code 76085, Digitization of film radiographic images 
with computer analysis for lesion detection and further physician 
review for interpretation, screening mammography. (This code can only 
be billed with CPT code 76092, Screening mammography, bilateral.)
     HCPCS code G0204, Diagnostic mammography, direct digital 
image, bilateral, all views.
     HCPCS code G0206, Diagnostic mammography, direct digital 
image, unilateral, all views.
     HCPCS code G0236, Digitization of film radiographic images 
with computer analysis for lesion detection and further physician 
review for interpretation, diagnostic mammography. (This code can only 
be billed with code CPT code 76090, Diagnostic mammography, unilateral, 
or CPT code 76091, Diagnostic mammography, bilateral.)
    In the proposed rule, we assigned computer-aided detection (CAD) 
and full field digital mammography (FFDM) services used for diagnostic 
mammography to APC 0271. We proposed to assign payment status indicator 
``A,'' designating that payment would be ``lower of charges or national 
rate,'' to the CAD and FFDM codes for screening mammography. Numerous 
commenters addressed our proposed payment for CAD and FFDM new 
technology mammography services. Their comments are summarized below.
    Comment: One commenter recommended that CAD used in conjunction 
with film screening mammography be assigned to a new technology APC 
under the OPPS rather than being paid under the physician fee schedule. 
The commenter argued that although section 104(a) of BIPA provided for 
payment for screening mammography under the physician fee schedule, 
payment for a new technology such as CAD is provided under a separate 
BIPA provision, section 104(d)(3), and therefore is not linked to the 
physician fee schedule.
    Response: We do not agree with the commenter's recommendation that 
CPT code 76085 for CAD used with screening mammography be assigned for 
payment to a new technology APC under the OPPS. Because CPT code 76085 
is an add-on code that can be paid only when it is billed with CPT code 
76092 for screening mammography, we believe it is more appropriate to 
pay for both CPT codes 76085 and 76092 under the physician fee schedule 
than to pay for them separately under two different payment systems.
    Comment: Most commenters recommended assignment of CAD and FFDM 
services used with diagnostic mammography to a new technology APC on 
the grounds that no existing APC would be appropriate both clinically 
and in terms of payment for these services. Commenters were unanimous 
in opposing assignment of the CAD and FFDM services used for diagnostic 
mammography to APC 0271. Several commenters were concerned that payment 
for these services under the physician fee schedule was so much higher 
than that proposed under the OPPS.
    Response: We agree that the new technology procedures associated 
with diagnostic mammography should be assigned to a new technology APC 
until we have collected cost data to make a more clinically and 
resource use appropriate APC assignment. Therefore, effective for 
services furnished on or after January 1, 2002, HCPCS codes G0204 and 
G0206 will be assigned to APC 0971 and HCPCS code G0236 will be 
assigned to APC 0970.
    The difference in payment amounts for the new technology 
mammography services between the physician fee schedule and the OPPS is 
attributable to differences in the payment methodology required under 
the statute.
    Final Action: See section II.B.3.a. for the codes used to bill for 
new technology screening mammography services. The following codes and 
APC groups are effective for new technology services used for 
diagnostic mammography beginning January 1, 2002:
    HCPCS codes G0205 and G0207 are deleted.
    Use HCPCS codes G0204 and G0206 for full field digital diagnostic 
mammography services; assigned to APC 0707.
    Use HCPCS code G0236 for computer-assisted detection with CPT code 
76090 and CPT code 76091 for diagnostic mammography; assigned to APC 
0706.

[[Page 59877]]

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). 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). We were later able to 
incorporate revenue codes 274 (prosthetic/orthotic devices), 275 
(pacemaker), and 278 (other implants) in our database, and effective 
January 1, 2001, we updated the APC payment rates to reflect inclusion 
of this information.
    As discussed in the proposed rule, we have continued to review and 
revise the list of revenue codes to be included in the database and we 
proposed 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 proposed:
     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 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.
    Comment: One commenter disagreed with our proposal to package 
revenue code 942 (education/training). The commenter stated that such a 
policy would be inappropriate because revenue code 942 is the proper 
revenue code to use when billing diabetes training with HCPCS codes 
G0108 and G0109. If CMS does package that revenue code, the commenter 
wanted to know what revenue code should be billed for diabetes 
education.
    Response: Although under OPPS we will package charges for education 
and training when billed with revenue code 942, training and education 
associated with diabetes management, identified by HCPCS codes G0108 
and G0109, is not paid under the OPPS and, therefore, is not a packaged 
service. The list of packaged revenue codes contained in the proposed 
rule represents revenue codes that are packaged when they appear on a 
bill with an OPPS service and are not billed with a HCPCS code for a 
service, like diabetes education, which is paid by Medicare but paid 
outside of the OPPS.
    Comment: One commenter questioned our proposal to package 
additional revenue centers that may be used to bill for implantable 
devices (including brachytherapy seeds) with surgical procedures. The 
commenter asked for details on how such packaging would be accomplished 
and specifically how we would account for the varying number of costly 
brachytherapy seeds used in each procedure.
    Response: In determining the median cost of a procedure or service, 
we take into account the costs associated with any packaged revenue 
center that appears on a bill as well as the cost associated with the 
specific line item that reflects the HCPCS code for the procedure or 
service. Thus, when a hospital bills a charge for brachytherapy seeds 
using one of the revenue codes that are identified as a packaged 
revenue code, we convert that charge to a cost by multiplying the 
billed charge by the hospital-specific cost-to-charge ratio for the 
related cost center. The cost of the brachytherapy seeds is then added 
to all other costs on the bill that are attributable to the procedure 
to arrive at the cost of the bill. Under this methodology, the varying 
numbers of brachytherapy seeds used and the varying costs of the seeds 
are accurately captured in the median cost data we use to calculate 
median cost for the APC. That is, we would expect that the cost 
associated with a bill would reflect the number of seeds used in a 
particular procedure and the median cost for that procedure overall 
would be an average of the varying numbers of seeds used by hospitals.
2. Special Revenue Code Packaging for Specific Types of Procedures
    We proposed 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 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

[[Page 59878]]

762  Observation room
810  Organ acquisition
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
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
569  Other medical social services
621  Supplies incident to radiology
624  Investigational device (IDE)
710  Recovery room
719  Other recovery room
762  Observation room

All Other APC Groups

250  Pharmacy
251  Generic
252  Nongeneric
257  Nonprescription drugs
258  IV Solutions
259  Other pharmacy
260  IV Therapy, general class
262  IV Therapy pharmacy services
263  IV Therapy drug/supply/delivery
264  IV Therapy supplies
269  Other IV therapy
270  M&S supplies
271  Nonsterile supplies
272  Sterile supplies
279  Other M&S supplies
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
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. However, 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 APC changes discussed above in this section of this 
preamble and our 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 
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 proposed rule set forth a list of APCs that we proposed to 
exempt from the 2 times rule based on the criteria cited above (66 FR 
44690). In cases in which compliance with the 2 times rule appeared to 
conflict with a recommendation of the APC Advisory Panel, we generally 
proposed to accept 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.
    We received no comments on our proposal. The following is the final 
list of APCs we exempted from the 2 times rule. This list reflects the 
final APCs as recalibrated based on the updated 1999-2000 data base as 
well as the incorporation of 75 percent of the estimated cost of the 
pass-through devices (See section II.D).
    List of APCs exempted from the ``two times'' requirement:

0001  Photochemotherapy
0004  Level I Needle Biopsy/Aspiration Except Bone Marrow
0043  Closed Treatment Fracture Finger/Toe/Trunk
0044  Closed Treatment Fracture/Dislocation Except Finger
0047  Arthroscopy without Prosthesis
0058  Level I Strapping and Cast Application
0060  Manipulation Therapy
0077  Level I Pulmonary Treatment
0093  Vascular Repair/Fistula Construction
0096  Non-Invasive 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
0141  Upper GI Procedures
0142  Small Intestine Endoscopy
0147  Level II Sigmoidoscopy
0164  Level I Urinary and Anal Procedures
0165  Level III Urinary and Anal Procedures
0182  Insertion of Penile Prosthesis
0187  Placement/Repositioning Misc Catheters
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, Level I

[[Page 59879]]

0215  Level I Nerve and Muscle Tests
0218  Level II Nerve and Muscle Tests
0233  Level II Anterior Segment Eye Procedures
0234  Level III Anterior Segment Eye Procedures
0237  Level III Posterior Segment Eye Procedures
0247  Laser Eye Procedures Except Retinal
0251  Level I ENT Procedures
0252  Level II ENT Procedures
0260  Level I Plain Film Except Teeth
0263  Level I Miscellaneous Radiology Procedures
0264  Level II Miscellaneous Radiology Procedures
0265  Level I Diagnostic Ultrasound Except Vascular
0279  Level I Angiography and Venography Except Extremity
0285  Positron Emission Tomography (PET)
0294  Level I Therapeutic Nuclear Medicine
0296  Level I Therapeutic Radiologic Procedures
0305  Level II Therapeutic Radiation Treatment Preparation
0322  Brief Individual Psychotherapy
0345  Level I Transfusion Laboratory Procedures
0354  Administration of Influenza/Pneumonia Vaccine
0355  Level I Immunizations
0356  Level II Immunizations
0363  Otorhyinolaryngologic Function Tests
0364  Level I Audiometry
0373  Neuropsychological Testing
0600  Low Level Clinic Visits
0601  Mid Level Clinic Visits
0602  High Level Clinic Visits
0694  Level III Excision/Biopsy
4. Observation Services
    Frequently, beneficiaries are 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. In the proposed rule, we discussed 
the clinical and payment history of observation services. We also 
discussed at length the issues we considered in determining whether to 
make separate payment for observation services. For a more detailed 
discussion of our deliberations, see 66 FR 44690-91. After careful 
consideration, we proposed the following:
     To continue to package observation services into surgical 
procedures and most clinic and emergency visits.
     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 also proposed 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 proposed to make payment for APC 0339 only if the tests 
described above are billed on the same claim as the observation 
service. (We did not propose 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.) In the proposed rule, we listed the 
following ICD-9-CM diagnosis codes that hospitals would be required to 
bill to receive payment for APC 0339:

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
    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


[[Page 59880]]


    In the proposed rule, we specified the following process to 
identify the appropriate median cost for APC 0339 (66 FR 44692). 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.
    Finally, we stated that we would consider medical research 
submitted to support the benefits of observation services for 
conditions other than those we had proposed. This information will 
assist us in determining whether these other conditions meet the 
criteria we used to select the three conditions we proposed to include 
in APC 0339.
    We received a large number of comments on this proposal. Many 
commenters commended our proposal to pay separately for observation 
services. However, other commenters either had questions about or 
suggestions on revising our proposal. Those comments and our responses 
appear below.
    Comment: We received comments requesting that we expand the list of 
conditions for which we would make a separate payment for observation 
services. Some commenters listed specific conditions that should be 
added to the list (for example, abdominal pain, atrial fibrillation, or 
pyelonephritis) while others asserted that any condition a physician 
thought required observation should qualify for separate payment. One 
commenter submitted medical literature as supportive evidence that we 
should expand our list of conditions. One commenter argued that 
developing a restrictive list of conditions for which separate payment 
would be made is inconsistent with the medical literature and with 
InterQual, which publishes the criteria used by Peer Review 
Organizations to assess whether admission to the hospital as an 
inpatient is necessary.
    Response: We wish to clarify that our proposal merely specified a 
list of conditions for which we would make separate payment for 
observation services. For all other conditions, payment for observation 
services would be packaged into the APC in which those services were 
provided. For example, if a patient with syncope goes to the emergency 
room and receives emergency services and observation services, the 
payment to the hospital for the emergency visit includes payment for 
the observation service. The payment rate calculated for clinic and 
emergency visits includes the packaged costs of observation services to 
the extent that those costs were included on the visit bills.
    We have reviewed the commenters' suggestions for additional 
conditions and the medical literature that they submitted in support of 
their requests. At this time, we are finalizing our proposal without 
expanding the list of conditions for which separate observation payment 
will be made. As noted in the proposed rule, we believe that chest 
pain, asthma, and congestive heart failure are the only conditions that 
require a well-defined set of hospital services that are distinctly 
different from the services provided in a clinic or emergency service. 
Thus, they are the services for which a separately payable observation 
period is clinically appropriate. Given the clinically improper use of 
observation care by hospitals in the recent past, we want to minimize 
the risk of future improper use while ensuring a valid medical benefit 
to the patient for appropriate medical care. Therefore, we believe it 
is premature to expand the conditions for which we will separately pay 
for observation services. We want to observe the effect of separate 
payment for this limited set of conditions to determine what clinical 
and payment issues arise before expanding the list of conditions. 
Furthermore, an essential issue for Medicare is that separate payment 
for observation be made only when those services are clearly distinct 
and separate from prolonged clinic or emergency department care and 
when observation provides a distinct clinical benefit that cannot be 
obtained by sending the patient home or admitting the patient to the 
hospital. We believe that the medical literature demonstrates such a 
benefit exists for patients with chest pain, congestive heart failure, 
and asthma.
    We will continue to review this issue and any information that is 
provided to us. If we believe an expansion of the list of conditions is 
appropriate, we will include such a proposal in a future proposed rule.
    Comment: An association of hospitals provided an explanation of 
their concept of ``rapid treatment,'' which they distinguished from 
observation. They defined observation as a service required by managed 
care contracts that involves only physiologic monitoring, frequent 
nursing assessment, and the patient's routine daily medication.
    Response: This level of care would not qualify as an observation 
service, either packaged or separately paid, under Medicare. We require 
that during observation, patients be actively assessed and, if 
necessary, treated in order to determine if they should be admitted or 
may be safely discharged.
    Comment: Several commenters pointed out that correct coding 
guidelines allow hospitals to code the reason for a patient's visit in 
any one of several fields on the claim including the principal 
diagnosis field, the secondary diagnosis field, and the admitting 
diagnosis field. These commenters suggested that facilities be allowed 
to report the appropriate diagnosis code supporting the provision of 
observation services in the admitting, principal, or secondary 
diagnosis field.
    Response: We agree with the commenters and will ensure that our 
software is designed to allow this.
    Comment: Commenters argued that additional ICD-9-CM diagnosis codes 
for chest pain, congestive heart failure, and asthma be added to the 
proposed list of diagnoses qualifying observation care for separate 
payment. These included: for asthma: 493.00, 493.10, 493.20, 493.90; 
for congestive heart failure: 391.8, 398.91, 402.01, 402.11, 402.91, 
404.01, 404.03, 404.11, 404.13, 404.91, 404.93; for chest pain: codes 
for weakness, shortness of breath, palpitations, rapid heart beat, and 
syncope. One commenter asked that we include codes for chronic 
obstructive pulmonary disease (COPD) on the list of qualifying 
diagnoses. One commenter believes that 428.1 and 428.9 are not to be 
used for congestive heart failure and should be deleted from the list.
    Response: With regard to the comments to add diagnosis codes for 
asthma, our proposal included codes for status asthmaticus and acute 
exacerbations of asthma. The codes suggested by the commenters are used 
for chronic, stable asthma, or unspecified asthma. Our clinical 
judgment is that these patients do not require active observation care 
that meets our definition and, thus, a separate payment is not 
warranted. Therefore, we have not revised our list of qualifying 
diagnoses for asthma.
    With regard to the suggested codes to be added for congestive heart 
failure, we agree with the commenters and are adding the codes to the 
list.

[[Page 59881]]

    With regard to the suggested codes for chest pain, we note that 
786.05, Shortness of breath, was included on our proposed list of 
qualifying codes. If a patient has one of the other suggested symptoms 
(weakness, palpitations, rapid heartbeat, and syncope), it would be 
appropriate to use one of the proposed codes as the diagnosis (for 
example, 413.9, other and unspecified angina). Therefore, we believe 
the list we proposed covers the additions suggested by the commenter.
    With regard to the requested deletions of codes 428.1 and 428.9, we 
disagree. Code 428.1 is specified for use in patients with acute 
pulmonary edema and 428.9 is used for patients with congestive heart 
failure without a specific diagnosis and both codes are therefore 
appropriately included on the list.
    Comment: Several commenters believe that dedicated observation 
units would not be financially viable if only three conditions 
qualified for payment.
    Response: We want to emphasize that we are making payment for all 
observation services provided in the outpatient setting. Payment for 
observation services not meeting the requirements for separate payment 
in APC 0339 is included in the payment for the clinic or emergency 
department visit. That is, the payment for each clinic or emergency 
department visit contains a payment for packaged observation services. 
This means that hospitals are being paid for observation every time a 
clinic or emergency visit is billed.
    Our policy of separate payment for certain observation services is 
not intended to increase the total amount of money paid for observation 
services. Instead, our policy redistributes payments into a separate 
APC; the relative weight of the new APC for observation services 
reflects costs that would otherwise be reflected in the relative 
weights for other relevant APCs. Thus, the payments for clinic and 
emergency visits are slightly lower than would have been the case had 
we not created a separate payment for observation. The only hospitals 
that could be disadvantaged are those that provided observation care 
for packaged conditions to an unusually large number of patients. 
Hospitals with large numbers of observation cases for chest pain, 
asthma, and congestive heart failure will benefit from our new policy. 
Hospitals with an average number of observation cases will be neither 
advantaged nor disadvantaged by our new policy.
    Comment: Some commenters believe it is inappropriate ``not to pay 
for observation'' for other conditions. Others argued that because 
pulse oximetry, one of the diagnostic tests we identified as a 
condition of separate payment for congestive heart failure, is a 
packaged service, it is not paid for and therefore cannot be reported 
on the bill. This would place hospitals in a ``Catch-22'' situation 
because they would be required to report pulse oximetry to be paid 
separately for observation but could not report pulse oximetry because 
it is packaged.
    Response: These comments reflect a misunderstanding of what it 
means for a service to be ``packaged.'' The concept is perhaps most 
clearly understood in terms of the anesthesia used during surgery. The 
costs of the anesthesia drugs and administration are associated with 
the surgery with which they were billed, and become part of the payment 
for the surgery. It is understood that anesthesia is paid for, but not 
paid for separately from the surgical procedure. Similarly, we packaged 
the cost of observation whenever it was billed. It is packaged into 
surgical procedures as well as clinic and emergency visits. Each time a 
hospital bills for a procedure or visit, any associated observation 
cost is recognized. Because, according to the literature, observation 
is billed in fewer than 6 percent of emergency room visits, the cost is 
not always readily identifiable. However, we wish to emphasize that it 
is important for hospital bills to show that observation was provided 
and the charges associated with it. This is because the charges for 
packaged services might affect outlier and transitional corridor 
payments, and are used to update the APC weights. Thus, hospitals 
should report pulse oximetry on the bill even though it is not 
separately payable.
    Comment: Surgeons reported that hospitals, believing that 
observation is not payable, would not allow postoperative observation 
for patients such as those who have undergone mastectomy or 
thyroidectomy.
    Response: Surgery performed in the outpatient setting should not, 
as a rule, require a period of postoperative observation. As provided 
in section 230.6E of the Medicare Hospital Manual, standing orders for 
observation following outpatient surgery is not a covered service. In 
addition, that section states that the availability of an outpatient 
observation unit at a hospital is not a reason to perform, on an 
outpatient basis, surgeries for which an overnight stay is anticipated.
    Although an occasional surgical case may require a longer recovery 
period, as a rule, surgical outpatients should not require observation. 
We note, however, that to the extent that observation care is provided 
to surgical patients, the cost of that care is packaged into the 
payment for the surgical APC.
    Comment: There were many comments on the list of diagnostic tests 
required for separate payment for observation services. Several 
commenters pointed out that nebulizer treatments, by definition, are 
not diagnostic. These commenters also noted that observation of asthma 
patients need not involve nebulizer treatments (that is, some patients 
are treated with intravenous steroids or inhalers). Others indicated 
that pulse oximetry is a routine test and is not usually coded. Other 
commenters were concerned that the required tests would not all be 
performed within the period of observation; that is, some tests might 
be performed in the emergency department before admission to 
observation status.
    Response: The requirement that certain diagnostic tests be 
performed in order to receive separate payment for observation services 
reflects our concern that observation not be considered a way to keep a 
patient in a ``holding pattern.'' We are aware that some patients are 
considered to be in observation overnight when they are placed in a bed 
on a nursing unit, with vital signs taken every 4 hours. This is not 
the service we recognize as observation, which we define as an active 
treatment to determine if a patient's condition is going to require 
that he or she be admitted as an inpatient, or if it resolves itself so 
that the patient may be discharged. The services we included on the 
list of required treatment were designed to indicate that an active 
assessment of the patient was being undertaken. We believe this is 
consistent with the clinical practice of observation.
    We agree that nebulizer treatments are not diagnostic, and, 
although, based on the experience of our clinical staff, are frequently 
used in acute asthma, they need not be used for every asthma patient 
receiving observation services. We agree that occasionally patients may 
use their own inhaler or be given intravenous medications without 
nebulizer treatments. Thus, we are not including this treatment on the 
final list of services required for separate payment of observation. As 
discussed above, pulse oximetry, although packaged, should be reported 
on the bill when furnished.
    We agree that some of the required diagnostic testing (for example, 
cardiac enzymes) may be performed as part of the emergency or clinic 
visit before the

[[Page 59882]]

beneficiary is admitted to observation status. We will ensure that our 
software identifies when the required diagnostic tests were performed 
in the clinic or emergency department as well as diagnostic tests 
performed during the period of observation.
    Comment: Several commenters claimed that requiring specific 
clinical interventions for observation care was an intrusion into the 
practice of medicine.
    Response: We disagree with the commenters. We are setting 
conditions only for separate payment for observation. All observation 
care that does not meet the criteria for classification into APC 0339 
will continue to be paid as part of the service into which it is 
packaged. In order to ensure that we are making separate payment only 
when it is warranted, we are providing as a condition for separate 
payment that a minimal number of appropriate diagnostic tests must be 
performed. The hospital will continue to receive packaged payment for 
observation care for beneficiaries who require such care but for whom 
the required tests were not performed.
    As stated above, we are withdrawing the proposed condition of 
administering nebulizer treatments. We will allow either pulse oximetry 
or peak expiratory flow rate to be performed as a requirement to 
receive separate payment for observation of asthma patients. We are 
finalizing our requirements for chest pain and congestive heart 
failure. We note that none of the commenters had any clinical 
disagreement with the designation of these specific tests. Their only 
concern stemmed from the misconception that these tests would be 
required to be performed in order to receive payment for observation 
care. We will closely follow the impact of these requirements and, if 
we believe that changes are necessary, we will propose them in a future 
rule.
    Comment: Several commenters argued that packaging the first 8 hours 
of observation was arbitrary and would be difficult to document. We 
also received comments that we should eliminate our minimum time 
requirement for observation or reduce it to 6 hours. The following 
reasons were given for these comments: asthma patients do not require 8 
hours of observation; no evaluation and management (E/M) service lasts 
for more than 1 hour and 45 minutes; and emergency visits typically 
last 3-4 hours so any potential for abuse of observation would be 
reduced with a minimum time requirement of 6 hours because 6 hours does 
not overlap with the length of a typical emergency visit.
    Response: We believe it is important to ensure that payment for 
clinic and emergency department services does not duplicate payments 
for observation. We also want to make clear that we do not consider a 
long emergency room visit to be ``observation.'' We believe that 
observation is a specific type of service that should be specifically 
ordered by a physician and should involve specific goals and a plan of 
care that is distinct from the goals and plan of care for an emergency 
or clinic visit. We believe that requiring 8 hours of care as a 
condition for separate payment of observation is reasonable and will 
minimize confusion for hospitals. We will be including the first 8 
hours of observation care as a packaged service and make payment as 
part of the clinic or emergency visit with which it occurs. Therefore, 
the payment rate for emergency and clinic visit will reflect the extent 
to which patients are observed for less than 8 hours. Although 
occasionally patients with asthma may require less than 8 hours of 
observation, we believe that intensity and variety of services provided 
to patients with an acute asthma exacerbation or status asthmaticus who 
require 8 or more hours of observation is different from the service 
provided when they require less than 8 hours of observation. The less 
intensive services provided to asthma patients who require less than 8 
hours of observation is appropriately paid for as part of an emergency 
or clinic visit. We note that we received no comments disagreeing with 
our minimum time requirement for patients with chest pain and 
congestive heart failure. Finally, we believe that a clear requirement 
of 8 hours will allow hospitals to prospectively develop clinical 
protocols and plans of care facilitating the appropriate use of 
observation services. However, we will closely monitor the impact of 
the 8-hour time requirement and, if appropriate, consider changes for a 
future proposed rule.
    Comment: Commenters raised concerns about our requirement that 
physicians write progress notes in the medical record. They believe 
that admission and discharge notes are generally sufficient to document 
observation care. The commenters also raised questions about 
determining when observation starts and ends, with one commenter 
describing the proposed documentation requirement as ``rigid and 
inflexible.'' Others expected documentation to be difficult in 
hospitals without emergency department staff or house staff. One 
commenter stated that specific requirements for determining the time 
observation stops would not reflect the variety of methods hospitals 
and physicians have to document time in the medical record. Commenters 
asserted that the period of treatment and monitoring can continue 
beyond the time that a discharge order is written by the physician or 
taken off by the nurse.
    One commenter discussed the difficulty in determining when a 
patient is ``moved to observation status'' and the need for physicians 
to be able to write orders specifying discharge at a ``future time.'' 
Several commenters expressed concerns about requiring documentation 
that the physician used risk stratification criteria to determine that 
the beneficiary would benefit from observation care because documenting 
use of risk stratification criteria would be burdensome and is not 
required for any other services.
    Response: We appreciate these concerns and, although we are 
finalizing our proposal, we wish to clarify several aspects of these 
requirements to reassure commenters. With regard to writing progress 
notes, we wish to emphasize that the requirement is only to write 
``appropriate'' progress notes. We understand that, in many cases, 
writing a progress note is unnecessary (because the admission and 
discharge notes are sufficient), while in other cases it is necessary 
to write progress notes because of the length and complexity of care 
provided or because of a change in the patient's condition. We wish to 
clarify that progress notes are not required in every case but only in 
those cases in which the physician deems it appropriate to write a 
progress note.
    With regard to documenting the times that observation starts and 
ends, we have to balance the potential for improper billing of 
observation status against creating burdens for hospitals that will 
have to support their claims for observation treatment in the medical 
record. We believe that our policy strikes this balance appropriately. 
Typically both physicians' orders and nurses' removal of those orders 
are timed; therefore, we do not believe this requirement places a 
significant burden on physicians or hospitals because no change in the 
processes of care will be required. We do not believe that for chest 
pain, congestive heart failure, and asthma, orders are written for a 
future discharge time because those patients may not be discharged 
until treatment goals are met, and determining this requires current 
(not future) physician intervention (for example, to review lab tests 
or examine the patient).

[[Page 59883]]

    An important reason we are requiring clocked time to determine the 
period of observation is because we want to minimize confusion and 
separate observation care from prolonged emergency or clinic visits. 
Our requirements will assist hospitals to prospectively ensure that 
observation is appropriately billed. Although it is possible that 
treatment and monitoring may continue for a significant period of time 
after a discharge order is written or taken off, we believe such an 
occurrence is the exception rather than the rule; additionally, it is 
frequently difficult to determine exactly when facility services are 
discontinued. One problem is that it is typical for those patients to 
remain in the observation area for a significant period of time after 
treatment is finished, most commonly because the patient is waiting for 
transportation home. As stated above, we need a bright line rule with 
regard to the stop time for observation.
    With regard to documenting the use of risk stratification, we did 
not mean to require any extra documentation in the medical record. We 
just wish to put physicians and hospitals on notice as to what type of 
medical record evidence reviewers will use when reviewing claims for 
observation. We believe that a well-documented observation record will 
satisfy this requirement without any extra documentation. Therefore, we 
are clarifying that the manner in which documentation of risk 
stratification is made is at the discretion of the physician. As with 
all the criteria we are establishing for payment of APC 0339, we will 
monitor the effects of these requirements on the provision of 
observation care and consider making changes if appropriate.
    Comment: We received a variety of comments asking for clarification 
as to how observation services should be reported; whether notes may be 
written by house staff or fellows; whether orders may be phoned in; 
whether additional diagnostic tests during observation would be paid 
for; how observation would be treated by local medical review policies; 
whether short inpatient stays for congestive heart failure and asthma 
would no longer be allowed; how billing would occur for patients who 
are admitted directly to a chest pain center without being seen in the 
emergency department; and whether payment for observation is made per 
hour or per day.
    Response: Observation services should be tracked by the hour. If 
the number of hours is less than 8, then payment is packaged into the 
associated clinic or emergency visit. If more than 24 hours of 
observation are billed, payment for any time over 24 hours is packaged 
into the payment for 8 to 24 hours of observation. Therefore, the 
payment rate for observation will reflect those cases in which 
observation actually occurs for more than 24 hours. That is, just as 
the payment for emergency visits reflects payment for observation of up 
to 8 hours, so will payment for APC 0339 reflect payment for 
observation care up to 48 hours. Effective for services furnished on or 
after January 1, 2001, we have created a new HCPCS code for use with 
our new APC 0339 to help distinguish packaged observation form 
separately payable observation. The code is G0224, Observation care 
provided by a facility to a patient with CHF, chest pain, or asthma, 
minimum eight hours, maximum forty-eight hours. The previously 
available CPT codes for observation, 99234-99236, should continue to be 
used for packaged observation services.
    With regard to house staff writing notes and orders, teaching 
physician rules apply to Part B payments for observation care. With 
regard to facility payments, observation may be billed if the notes are 
written by house staff. Physicians may phone in orders but if those 
orders are for admission or discharge to observation, they must be 
timed. Moreover, the physician must write admission and discharge notes 
in the medical record.
    We note that we will pay separately for all nonpackaged diagnostic 
tests furnished to observation patients.
    We will continue pay for inpatient admissions for chest pain, 
asthma, and congestive heart failure when appropriate and our 
observation payment policy is subject to local medical review policies.
    With regard to direct admissions from physician offices, separate 
payment for observation will not be made unless a physician is present 
to order the initiation of observation services and to monitor the 
patient as clinically appropriate.
    The following are the final requirements for billing G0244 and 
assignment to APC 0339.
    The acceptable diagnosis codes are:

For Chest Pain

     391.8  Other acute rheumatic heart disease
     398.91  Rheumatic heart failure (congestive)
     402.01  Malignant hypertensive heart disease with 
congestive heart failure
     402.11  Benign hypertensive heart disease with congestive 
heart failure
     402.91  Unspecified hypertensive heart disease with 
congestive heart failure
     404.01  Malignant hypertensive heart and renal disease 
with congestive heart failure
     404.03  Malignant hypertensive heart and renal disease 
with congestive heart and renal failure
     404.11  Benign hypertensive heart and renal disease with 
congestive heart failure
     404.13  Benign hypertensive heart and renal disease with 
congestive heart and renal failure
     404.91  Unspecified hypertensive heart and renal disease 
with congestive heart failure
     404.93  Unspecified hypertensive heart and renal disease 
with congestive heart and renal failure
     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
     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

    The required 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).
    For congestive heart failure, a chest x-ray, an electrocardiogram, 
and pulse oximetry.

[[Page 59884]]

5. List of Procedures That Will Be Paid Only As Inpatient Procedures
    Section 1833(t)(1)(B)(i) of the Act gives the Secretary broad 
authority to determine the services to be covered and paid for under 
OPPS. In the April 7, 2000 final 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 (65 FR 18455). This set of 
services is referred to as the ``inpatient list.'' The inpatient list 
specifies those services that are appropriate to provide only in an 
inpatient setting and that, therefore, are only paid when provided in 
an inpatient setting. 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.
    At its February 2001 meeting, the APC Advisory Panel generally 
favored the elimination of the inpatient list. In the proposed rule, we 
stated that we disagreed with the position taken by the Panel and we 
proposed 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 stated that 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).
    In the proposed rule, we indicated that 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 proposed 
no further changes to the inpatient list, which we set forth in 
Addendum E to the proposed rule.
    Comment: Several specialty organizations, hospitals, and device 
manufacturers recommended that we remove certain procedures from the 
inpatient only list and assign them to APCs.
    Response: We reviewed these requests in accordance with our 
previously published criteria and moved several of the procedures from 
the list. However, in our clinical judgment, the remainder of the 
procedures should not be moved. We are referring some of them to the 
APC Advisory Panel for review and further discussion at the next 
meeting. As noted in the proposed rule, we plan to continue updating 
the list on a quarterly basis, as needed. Set forth below is the list 
of procedures that commenters requested be moved off the inpatient list 
and the final action that we are taking in this rule.

Procedures That Remain Inpatient

 34800--Endovascular repair of infrarenal abdominal aortic 
aneurysm or dissection
 34802--Endovascular repair of infrarenal abdominal aortic 
aneurysm or dissection
 34804--Endovascular repair of infrarenal abdominal aortic 
aneurysm or dissection
 34808--Endovascular placement of iliac artery occlusion device
 34812--Open femoral artery exposure for delivery of aortic 
endovascular prosthesis
 34813--Placement of femoral-femoral prosthetic graft
 34820--Occlusion during endovascular therapy
 34825--Placement of proximal or distal extension prosthesis
 34826--Infrarenal abdominal aortic aneurysm
 33968--Removal of intra-aortic balloon assist device, 
percutaneous
 44901--Incision and drainage of appendiceal abscess; 
percutaneous
 49021--Drainage of peritoneal abscess or localized 
peritonitis; percutaneous
 49041--Drainage of subdiaphragmatic or subphrenic abscess; 
percutaneous
 49061--Drainage of retroperitoneal abscess; percutaneous
 61624--Transcatheter occlusion or embolization (e.g., for 
tumor destruction, to achieve hemostasis, to occlude a vascular 
malformation), percutaneous, any method; central nervous system 
(intracranial, spinal cord)

Procedures Referred to the APC Advisory Panel

 21390--Open treatment of orbital floor blowout fracture
 27216--Percutaneous skeletal fixation of posterior pelvic ring 
fracture and/or dislocation
 27235--Percutaneous skeletal fixation of femoral fracture, 
proximal end, neck
 32201--Pneumonostomy; with percutaneous drainage of abscess or 
cyst
 47490--Percutaneous cholecystostomy
 64820--Sympathectomy, digital arteries, with magnification, 
each digit
 92986--Percutaneous balloon valvuloplasty; aortic valve
 92987--Percutaneous balloon valvuloplasty; mitral valve
 92990--Percutaneous balloon valvuloplasty; pulmonary valve
 92997--Percutaneous transluminal pulmonary artery balloon 
angioplasty; single vessel
 92998--Percutaneous transluminal pulmonary artery balloon 
angioplasty; each additional vessel (list separately in addition to 
code for primary procedure)

Procedures Moved to APCs

 23440--Resection or transplantation of long tendon of biceps 
(APC 0052)
 23470--Arthroplasty, glenohumeral joint; hemiarthroplasty (APC 
0048)
 47011--Hepatotomy; for percutaneous drainage of abscess or 
cyst, one or two stages (APC 0005)
 48511--External drainage, pseudocyst of pancreas; percutaneous 
(APC 0005)
 49200--Excision or destruction by any method of intra-
abdominal or retroperitoneal tumors or cysts or endometriomas (APC 
0130)
 50021--Drainage of perirenal or renal abscess; percutaneous 
(APC 0005)
 58823--Drainage of pelvic abscess, transvaginal or transrectal 
approach, percutaneous (APC 0193)
 61626--Transcatheter occlusion or embolization (e.g., for 
tumor destruction, to achieve hemostasis, to occlude a vascular 
malformation), percutaneous, any method; non-central nervous system, 
head or neck extracranial, brachiocephalic branch) (APC 0081)
 61791--Creation of lesion by stereotactic method, 
percutaneous, by neurolytic agent (e.g., alcohol, thermal, electrical, 
radiofrequency); trigeminal medullary tract (APC 0204)
 63655--Laminectomy for implantation of neurostimulator 
electrodes, plate/paddle, epidural (APC 0225)
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

[[Page 59885]]

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 proposed 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 for assigning services to 
new technology APCs that we are implementing in this final rule.
    We received no comments on adding a new technology APC group and 
have included this change in the final APCs. However, we note that in 
this final rule, we are making additional changes to the new technology 
APCs to improve our ability to pay appropriately for new technology 
services.
    We are designating 16 additional APC groups, APCs 0706 through 
0721, as new technology APCs and reassigning some services currently 
assigned to APC groups 0970 through 0985 so that, beginning with 
services furnished on or after January 1, 2002, there will be two 
parallel sets of new technology APCs. This is an administrative 
adjustment to distinguish between those new technology services 
designated with a status indicator of ``S'' and those designated ``T.'' 
The new APCs will allow us to assign to the same APC group procedures 
that are appropriately subject to a multiple procedure payment 
reduction (T) with those that should not be so discounted (S). Each set 
of new technology APC groups will have identical group titles, payment 
rates, and minimum unadjusted copayments, but a different status 
indicator. That is, the new technology APC groups 0970 through 0985 
will, effective January 1, 2002, be assigned status indicator ``T'' and 
all services grouped in APCs 970 through 985 will be subject to the 
multiple procedure reduction. Each of the new technology APC groups 
0706 through 0721 will be assigned status indicator ``S.'' Therefore, 
effective January 1, 2002, new technology services currently grouped 
under APC 0971, 0974, 0976, and 0981 are reassigned to APC 0707, 0710, 
0712, and 0717, respectively, in order to retain the payment status 
indicator ``S.''

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 proposed 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 proposed to use the most recent available data 
to construct the database for calculating APC group weights. For the 
purpose of recalibrating the proposed 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 final APC relative 
weights for CY 2002 is similar to the proposed except that there are 
now over 107 million final action claims and as discussed below in 
section VII of this preamble, we have incorporated a portion of pass-
through device costs into device-related procedures. That action has 
increased the median costs for those procedures. The methodology for 
calculating the final APC relative weights is as follows:
     We excluded from the data approximately 16.2 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 in 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 2.1 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 89.1 million claims to CCRs of 5,672 hospitals.
     We separated the 89.1 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 39.9 million 
single-procedure claims and 49.2 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

[[Page 59886]]

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 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, 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 in which 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 used to calculate per-service costs. In 
addition, for device-related procedures, we incorporated 75 percent of 
the estimated cost of the pass-through device into the 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 2002 hospital inpatient 
prospective payment system wage index published in the Federal Register 
on August 1, 2001 (65 FR 40038). 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 ensures 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 final 
weights. Based on this comparison, in this final rule we are making an 
adjustment of 0.945 to the weights; that is, each weight is reduced by 
this factor (the scaler). The final weights for 2002, which incorporate 
the recalibration adjustments explained in this section, are listed in 
Addendum A and Addendum B of the final rule.
    We note that in the proposed rule, we inadvertently applied the 
weight adjustment factor of 1.022 to the relative weights of the new 
technology APCs. This was incorrect. The payment rates for the new 
technology APCs are based on the mid-point of the cost range 
represented by the APC. Therefore the payment rates should be static 
from year to year. In this final rule, the payment rates for APCs 0970-
0985 correctly reflect no adjustment.
    Comment: We received numerous comments regarding HCPCS codes and 
APC groups for which the payment rate proposed for 2002 is lower than 
the current payment rate. Commenters expressed concern that the 
proposed decrease in payment would have adverse effects both on 
beneficiary access to services and hospital solvency. Many commenters 
suggested that a lower rate was a data or a calculation error and 
requested that a particular weight be confirmed. Many commenters stated 
that because the lower proposed payment rate was inadequate to pay 
hospital costs for the service, we should adjust the rate to a more 
appropriate level.
    Response: As explained above, the methodology we used to 
recalibrate the final 2002 relative weights is essentially the same 
methodology that we followed to recalibrate the weights in the August 
24, 2001 proposed rule, with the exception of the additional step of 
folding pass-through device costs into certain base APC costs. (We 
discuss the reason for this additional step in the November 2, 2001 
OPPS final rule (66 FR 55857).)
    In both the proposed rule and this final rule, the relative weights 
for the APC groups change for two reasons: The use of more recent 
claims data, and the statutory requirements governing how payment for 
all services under the OPPS must be determined.
    The use of more recent claims data: We calibrated the relative 
weights published in the April 7, 2000 final rule using, as required by 
the statute, claims from 1996 and data from the most recent available 
hospital cost reports. These relative payment weights were implemented 
on August 1, 2000 and they have remained largely unchanged throughout 
2001. In the August 24 proposed rule, we proposed to use the same basic 
methodology to recalibrate the weights that we described in the April 
7, 2000 final rule (65 FR 18482). But we also proposed to use the most 
recent available data, rather than 1996 data, to construct the database 
for calculating APC group weights. For 2002, the most recent data are 
from final action claims for hospital outpatient services furnished 
beginning July 1, 1999 through June 30, 2000. In recalibrating the 
final weights for 2002, we had the benefit of data from additional 
claims that had not been received when we recalibrated the relative 
payment weights for the August 24, 2001 proposed rule. We matched these 
claims to the most recent cost report filed by the various hospitals 
represented in the claims data. Hospital costs reflected in claims for 
the period July 1, 1999 through June 30, 2000 have

[[Page 59887]]

changed from those taken from 1996 claims.
    Statutory requirements governing how payment for OPPS services is 
to be determined. Section 1833(t)(9)(B) of the Act requires that 
estimated spending for services covered under the OPPS be neither 
greater nor less than it would have been had we not recalibrated the 
APC weights nor made changes in the APC groups. Because of this, the 
weights and, therefore, the payment rates for a specific service may 
increase or decrease depending on the change in charges hospitals 
report for that service relative to the change in charges hospitals 
report for other outpatient services.
    Under any prospective payment system or fee schedule that bases 
rates on a system of relative weights within limits imposed by a budget 
neutrality requirement, some weights will increase and others will 
decrease from year to year. A decrease in the relative weight for an 
APC is the result of a decrease in the relative level of charges for 
the services in that APC that hospitals reported for the period from 
July 1, 1999 through June 30, 2000, compared to the relative level of 
charges the same hospitals reported for all other outpatient services 
furnished during the same period. In addition, the application of the 
budget neutrality adjustment required by section 1833(t)(9)(B) of the 
Act will further decrease a relative weight if the adjustment is less 
than 1.000.
    In this final rule, some weights are lower than what we had 
proposed. The further lowering of weights for some APCs is the result 
of our incorporating a portion of the cost of pass-through devices into 
the basic costs of the APCs with which the devices are associated. As 
we explained in the final rule published on November 2, 2001 (66 FR 
55857), the portion of the pass-through device costs that were 
incorporated into APC costs are not evenly distributed among the APCs, 
but rather are concentrated in a relatively small number of APCs that 
include the procedures that use pass-through devices. Whereas the 
weights of these APCs have increased as a result of the added device 
costs, the weights for all APCs that do not include device costs have 
decreased.
    In preparing the weights for this final rule, we were particularly 
attentive to APCs such as APC 0169, Lithotripsy, APC 0245, Level I 
Cataract Procedures without IOL Insert, and APC 0246, Cataract 
Procedures with IOL Insert, about which commenters had expressed 
concern. As a result, we have a high level of confidence in the 
appropriateness of the weights that are in this final rule. Therefore, 
we are not increasing the relative weight or payment rate for an APC 
group simply because its payment is lower in 2002 than it was in 2001 
nor are we reducing the relative weight or payment rate for an APC 
group simply because its payment is higher in 2002 than it was in 2001.

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 May 4, 2001 proposed Federal fiscal year (FY) 2002 
hospital inpatient PPS wage index (66 FR 22646) to make wage 
adjustments in determining the proposed payment rates set forth in the 
proposed rule. We also proposed to use the final FY 2002 hospital 
inpatient wage index to calculate the final CY 2002 payment rates and 
coinsurance amounts for OPPS. We received no comments on this issue and 
are implementing our proposed policy in final.
    The final FY 2002 hospital inpatient wage index published in the 
August 1, 2001 Federal Register (66 FR 39828) is reprinted in this 
final 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. Those wage index values will be used to calculate the 
OPPS payment rates and coinsurance amounts 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 are making 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 proposed to revise Sec. 419.41 to conform the regulations text 
to this provision.
    We received no comments on this proposal and are implementing the 
required 55 percent limit on the national unadjusted coinsurance rate 
of the final APCs. We are also adopting as final the proposed changes 
to the regulations text.

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 
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

[[Page 59888]]

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 proposed to 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.
    We received no comments on this issue, and we are implementing the 
changes to the regulations text in final.

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 the proposed rule, we 
provided 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. We also 
discussed the issues we considered in developing a proposed approach to 
be used in determining copayments for new or revised APCs.
    The following describes how we proposed 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 as 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, a 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.
    These changes will in general reduce beneficiary copayment for 
services in affected APCs. For 2002, we believe the size of these 
changes will be modest. If in the future the size of such changes 
appears likely to be large, we may revisit this policy.
    5. If an APC payment rate is increased due to a conversion factor 
update, the unadjusted copayment amount for the APC would not change.
    We received no comments on this proposal. Therefore, we are 
implementing the proposed methodology for calculating copayment amounts 
in this final rule.

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. However, beginning January 
1, 2002, we proposed to calculate outlier payments based on each 
individual OPPS service. That is, we proposed 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 OPPS 
services furnished on or after January 1, 2002.
    In the proposed rule, we discussed in detail the difficulties we 
faced with calculating outliers based on individual services. We also 
discussed possible solutions to those problems including requiring 
hospitals to submit separate bills for each OPPS service and allocating 
the charges for any packaged service among the individual OPPS services 
that appear on the bill. We stated that we prefer using one of the 
approaches that would allocate packaged charges among the APCs on a 
bill to avoid disruptive billing changes. We proposed 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 also proposed 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. In the proposed rule, we explained 
that, for purposes of calculating outlier payments under the OPPS, the 
use of departmental cost-to-charge ratios is not feasible given 
currently available information because we do not have a way of 
defining, in a uniform manner that is accurate for all hospitals, which 
departmental cost-to charge ratio to

[[Page 59889]]

apply to a revenue code billed by a hospital. We also explained that 
collecting the data necessary to make it feasible to use departmental 
cost-to-charge ratios would impose significant burden and 
administrative costs on hospitals and our contractors. We then stated 
that 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 proposed 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 that, for purposes of simulating payments to calculate 
outlier thresholds, 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 proposed CY 2002 outlier threshold and payment 
percentage, we accounted for the change to service level rather than 
claim level outlier calculation. We proposed to set the target for 
outlier payment at 2.0 percent as we had for CY 2001. We believe that 
the claims data we are using to set the 2002 payment rates reflect much 
better coding of services than did the 1996 data so we set the proposed 
threshold and proposed payment percentage based on simulations of 
payments so that the percentage of outlier payments under the 
simulations was 2.0 percent, rather than 2.5 percent as we did in 
simulating payments to set the outlier criteria for the April 7, 2000 
final rule. 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. Based on the 
simulations using the updated claims data from July 1, 1999 to June 30, 
2000, the final threshold for 2002 is 3 times the service costs and the 
final payment percentage for costs above that threshold is set at 50 
percent (the same as the proposed thresholds).
    We received many comments on our proposed changes to the outlier 
policy, which are summarized below along with our responses.
    Comment: Several commenters expressed concern that we proposed to 
increase the outlier threshold while lowering the payment percentage 
without providing sufficient analysis in the proposed rule to document 
and justify these changes. A number of commenters contended that the 
quality of the data is not sufficient to justify these dramatic changes 
and urged us to maintain the current threshold and payment percentage 
until better data become available. One commenter recommended that we 
either furnish hospitals with the information that explains the 
significant changes, providing an additional opportunity to comment, or 
maintain the current threshold and payment percentage amounts. Another 
commenter stated that, in the annual proposed and final rules for 
hospital inpatient PPS, the data to support any modifications to 
outlier payments are presented in detail and the commenter believes we 
should include similar information in the annual proposed and final 
OPPS rules.
    Response: In the April 7, 2000 final rule (65 FR 18498), we 
described the general methodology that we use to set the outlier 
threshold and payment percentage. We use historical claims data and 
simulate payments for those claims by applying the payment rates and 
policies for the upcoming year. We calibrate the threshold and payment 
percentage by applying an iterative process in which we try different 
combinations of thresholds and payment percentages until an appropriate 
combination results in outlier payments under the simulation equal to 
the target percentage (for purposes of the simulation) of total OPPS 
payments under the simulation.
    There are two major sources of the changes between the threshold 
and payment percentage for 2001 and these proposed 2002. First, the 
outlier payment simulations for the proposed rule reflected the 
proposed change in the outlier payment policy from a bill-level 
calculation to service-level calculation. Second, the outlier payment 
simulations for the proposed rule were based on updated claims data 
which were considerably more recent than the 1996 claims we used 
previously. We believe that the updated data reflect more accurate 
coding of the outpatient services hospitals furnished compared to the 
1996 data.
    When updated data or a change in policy (or, as in this case, both) 
dictate a significant change in the outlier parameters, we believe it 
is, in general, a better policy to adjust both the threshold and the 
outlier payment percentage. For 2002, an adjustment made only to the 
threshold amount would greatly limit the number of services that would 
qualify for an outlier payment. Conversely, an adjustment only to the 
outlier payment percentage would have significantly decreased the 
amount of the outlier payment made for the services that do qualify. By 
adjusting both of the parameters, we hope to strike a balance. That is, 
for 2002 as compared to 2001, we do not wish to drastically lower the 
number of services qualifying for outlier payment nor do we wish to 
significantly decrease the amount of payment hospitals may receive for 
services that qualify as outliers. Based on this premise, we both 
raised the outlier threshold and decreased the payment percentage in 
order to prevent, to the extent possible, large changes in the outlier 
payments made to hospitals.
    Comment: One commenter stated that, because we provided no data to 
demonstrate that the target for CY 2001 would be exceeded, we should 
provide that if the proposed changes are put into place and actual 
outlier payments in 2002 are significantly less than the 2002 outlier 
target, the ``shortfall'' from 2001 and 2002 will be made up by 
increased outlier payments in subsequent years.
    Response: The outlier threshold and payment percentage are 
determined each year based on our best estimate of what threshold and 
payment percentage are needed to achieve a certain level of outlier 
payments. For example, for CY 2002, we set the threshold and payment 
percentage based on estimates so that outlier payments are projected to 
equal 2.0 percent of total OPPS payments.
    Section 1833(t)(5)(C) of the Act requires that the outlier payment 
estimate for a year be made by the Secretary before the beginning of 
the year. Consistent with our outlier policies in other prospective 
payment systems, we will not adjust outlier payments in subsequent 
years to account for an underestimation (or overestimation) of outlier 
payments in a previous year. The statute does not provide for such an 
adjustment. We set the outlier policies prospectively, using the best 
available data. Outlier payments, like many aspects of a prospective 
payment system, reflect estimates, and we believe it would be 
inappropriate to adjust the outlier payments (upward or downward) for a 
given year simply because an estimate for a previous year ultimately 
turned out to be inaccurate. If we underestimate or overestimate the 
percentage of outlier payments, the divergence of our estimate from 
actual experience may

[[Page 59890]]

provide information that might help us improve future estimates, but it 
would have no direct effect on the amount of outlier payments for any 
following year.
    Comment: One commenter suggested that we lack reliable data on 
actual claims experience that are critical in determining which 
hospitals are receiving outlier payments and for which specific 
services. The commenter believes that once such data become available, 
they can be used to improve the APC system, reducing the overall need 
for outliers and to refine the outlier methodology to target outlier 
payments as most appropriate.
    Response: As coding on outpatient claims improves, the median costs 
we use to calculate APC weights and, ultimately, APC payment rates will 
also more accurately reflect the resources associated with furnishing 
the services within each APC. It is possible that this may reduce the 
incidence of outlier payments for specific services as well as decrease 
the need for outlier payments across all services.
    Comment: One commenter pointed out that the increase in the outlier 
threshold and the decrease in the percent of the excess costs that will 
be paid as an outlier payment are based on an outlier target of 2.0 
percent of estimated total OPPS payments. In order to not penalize 
hospitals that treat high cost cases, the commenter recommended that 
the outlier target be set at 3.0 percent of estimated total OPPS 
payments.
    Response: Section 1833(t)(5)(C) of the Act limits projected outlier 
payments for years prior to 2004 to no more than 2.5 percent of 
projected total OPPS payments. For CY 2002, we proposed to set the 
target for outlier payments at 2.0 percent. Although we could increase 
that amount to 2.5 percent, we have chosen not to do so because 
increasing the outlier target percentage would require a corresponding 
decrease to APC payment amounts due to budget neutrality. Given the 
decrease in many of the APC payment rates that results from the 
incorporation of 75 percent of device pass-through costs into the APCs 
(see section II.D. of this preamble), we believe it is appropriate not 
to increase the outlier target percentage so that there is no 
additional reduction in the APC payments. Once we have claims data that 
reflect payments made under the OPPS, our analysis of those data may 
lead us to revise our policy of setting the outlier target below the 
limit allowed.
    Comment: One commenter estimated that the proposed changes in the 
threshold and the payment percentage would reduce outlier payments by 
as much as 50 percent. Several other commenters claimed that the 
proposed changes would result in drastic cuts in outlier payments to 
certain community mental health centers (CMHCs) in Louisiana and 
Mississippi. These commenters contended that the payment reductions 
would be so severe that CMHCs would be forced to close, thereby 
eliminating services for the seriously and persistently mentally ill. 
These commenters requested that the CY 2002 outlier payments for CMHCs 
continue to be calculated using the CY 2001 outlier threshold and 
payment percentage.
    Another commenter asked that we provide data on outlier payments 
made since the implementation of the OPPS to provide greater 
information about the impact of outliers on cancer care. The commenter 
stated that, in the area of cancer care, hospital outpatient 
departments often provide the only access point for patients needing 
complex therapies or new therapies not yet specifically recognized by 
the coding system and outlier payments provide an important safeguard 
against any adverse impact of providing this care. The commenter 
specifically requested information on how the outlier payments have 
been applied to cancer patients across the country. If actual outlier 
payments are less than the 2.0 percent target, the commenter urged us 
to direct more of the outlier monies to cancer care or apply any 
difference between projected and actual outlier amounts to the 
transitional pass-through payments for drugs and devices.
    Response: As discussed above, the difference between the 2001 and 
proposed 2002 outlier threshold and payment percentage arises from the 
use of newer claims data and the change to a service-level rather than 
claim-level outlier payment calculation. In accordance with section 
1833(t)(5) of the act, we set a ``fixed'' threshold that applies to all 
OPPS services. Thus, we apply a uniform threshold to all OPPS services 
in a given calendar year; the statute does not provide for different 
thresholds for different classes of providers or different types of 
OPPS services. Similarly, we set the payment percentage prospectively 
before the beginning of each year and apply it to all OPPS services 
qualifying for outlier payments in that year.
    Currently, we do not have adequate data for OPPS claims to perform 
a useful analysis of actual outlier payments under the OPPS, but we 
expect to discuss information on actual outlier payments in future 
regulation documents after sufficient information becomes available.
    For the suggestion concerning the redistribution of outlier 
payments to pass-through drugs and devices, we note that the statute 
provides for both the outlier and transitional pass-through payments 
and establishes the 2.5 percent limits on those payments for the years 
before 2004 (when the limit for outliers increases to 3.0 percent and 
the limit for transitional pass-throughs decreases to 2.0 percent). 
Thus, we do not have the administrative authority to make the change 
that this commenter has recommended. Rather, legislative action would 
be required to make any of these changes.
    Comment: Although some commenters were in favor of calculating 
outlier payments on an individual service basis, several commenters 
requested that we reconsider our proposal and recommended that we 
continue to use the aggregate bill method. Another commenter believes 
that the increased specificity gained under the proposed outlier 
methodology would not offset the additional costs and administrative 
burden to hospitals of making information system changes necessary to 
calculate and verify outlier payments. One commenter asserted that 
multiple service claims are not used in calculating the APC relative 
weights because we are unable to accurately allocate packaged items and 
services when more than one service is billed on a claim. The commenter 
is concerned that the same problem would occur with the proposed 
methodology for paying outliers and recommends that, to avoid 
inappropriate outlier payments, we should continue to calculate 
outliers on a claim-level basis until an equitable method of assigning 
packaged costs is developed.
    Another commenter believes that the current methodology more 
accurately meets the intent of outlier payments, which is to pay 
facilities for unusual expenses incurred on behalf of patients, not 
specific line items or individual services. The commenter stated that 
the allocation of charges to develop service-by-service outliers 
presents an administrative problem to those hospitals that must 
significantly alter their systems in order to monitor and audit their 
payments.
    Several commenters expressed concern that the proposed service-
level approach could result in very few services qualifying for 
additional payment and asked for a delay in the policy. One hospital 
association requested a delay so it would have an opportunity to 
evaluate CYs 2000 and 2001 data to better understand the impact the 
change would have on its member hospitals. Another hospital

[[Page 59891]]

association believes that the data that are currently available (that 
is, data for services furnished prior to implementation of the OPPS) 
may not accurately reflect the financial impact of the proposed change 
and asked for a delay in calculating service-level outliers until OPPS 
data are available and can be provided to the hospital industry for 
analysis. Several commenters urged us to delay implementation of 
service-level outlier calculations until hospitals and fiscal 
intermediaries had adequate time to perform systems testing related to 
the change.
    Response: We believe that calculating outliers on a service-by-
service basis is the most appropriate way to calculate outliers for 
outpatient services. Outliers on a bill basis requires both the 
aggregation of costs and the aggregation of OPPS payments thereby 
introducing some degree of offset among services; that is, the 
aggregation of low cost services and high cost services on a bill may 
result in no outlier payment being made. While service-based outliers 
are somewhat more complex to administer, under this method, outlier 
payments will be more appropriately directed to those specific services 
for which a hospital incurs significantly increased costs. We are 
revising the outpatient PRICER program to calculate outliers on a 
service-by-service basis, and we do not anticipate that our contractors 
will have any significant problems being able to calculate outlier 
payments under this revised policy.
    Comment: Two commenters requested clarification concerning how 
outlier payments would be calculated on a service-by-service basis in 
the case of multiple surgical procedures appearing on the same claim 
when all of the surgical charges are combined into a single line on the 
claim. One commenter stated that if hospitals will be required to 
change the practice of combining surgical charges for all procedures on 
a single line item, they may require significant resources to comply 
with such a change.
    Response: The commenters raise a valid concern. When a hospital 
performs several surgical procedures during the same operative session, 
it is an acceptable billing practice to show the entire charge for use 
of the operating room or treatment room on the line with one of the 
surgical HCPCS codes and zero charges on the lines with the remaining 
surgical HCPCS codes. We do not intend to require that hospitals change 
this practice. Hospitals will continue to have the option of splitting 
out the charges among the individual surgical procedures based on the 
resources that are attributable to each procedure or they may show a 
single combined charge with one of the surgical HCPCS codes and zero 
charges with the others. If the hospital chooses the latter option, in 
calculating outliers on a service-by-service basis, we will allocate 
the combined operating or treatment room charge among all of the 
surgical procedures on the bill. The charges will be allocated to each 
surgical procedure based on the proportion that the APC payment for the 
procedure bears to the total APC payments for all surgical procedures 
performed on that day.
    Comment: One commenter supported calculating outliers on a service-
by-service basis and agreed with using an overall cost-to-charge ratio, 
but disagreed with the proposal to allocate packaged services. Several 
commenters asserted that while it is not possible to directly assign 
packaged services to a payable procedure in all cases, it is possible 
in some cases. As an example, the commenters stated that on a claim 
with a surgical procedure and a visit or diagnostic service, it would 
be logical and reasonable to assign anesthesia, recovery room, and 
device charges completely to the surgical procedure, instead of 
allocating a portion to the visit or diagnostic service.
    Another commenter recommended that we modify our proposal for 
allocating packaged services and develop a set of rules to directly 
assign the packaged services for those obvious situations when there is 
a clear relationship of the packaged item or service to the payable 
service or procedure.
    Response: We believe that the policy the commenters are 
recommending is problematic. For example, anesthesia and recovery room 
services are not limited to surgical procedures but may also be billed 
with certain diagnostic procedures. Although we agree that we may in 
the future be able to improve the allocation of packaged services for a 
service-level outlier calculation, we also must be careful that the 
calculation does not become so complex that hospitals are unable to 
understand how their outlier payments have been determined. Therefore, 
we are not adopting the commenter's suggestion. We will however 
continue to analyze possible refinements to this policy.
    Comment: One commenter acknowledged the complexities we would face 
in using a cost report line-specific method of calculating the cost-to-
charge ratios (CCRs) for outlier payments but believes the issue 
warrants further study. The commenter contends that using line-specific 
CCRs is the only way to ensure that outlier payments are equitable on a 
service level.
    Response: We agree with the commenter that applying appropriate 
departmental cost-to-charge ratios (CCRs) would generally be more 
accurate than using an overall outpatient CCR. However, as discussed 
above and in the proposed rule, it is currently unfeasible to use 
departmental cost-to-charge ratios for purposes of outlier payments 
under the OPPS because we currently do not have the necessary 
information. We continue to believe that the increased accuracy that 
would be achieved by use of departmental CCRs would not justify the 
significant administrative burden that would be placed on both 
hospitals and fiscal intermediaries.
    Comment: A number of commenters raised concerns about the hospital-
specific CCRs we have used since the beginning of OPPS to calculate 
outlier payments as well as transitional pass-through payments and 
interim transitional corridor payments. The commenters raised issues 
relating to the accuracy of CCR calculations, the basis of future CCR 
updates, and the timing of CCR updates.
    Response: We are working on instructions to our fiscal 
intermediaries that will address both how and when the CCRs will be 
revised and updated and those instructions will be published in a 
forthcoming program memorandum.

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 
(1) is entitled to benefits under Part A but has exhausted benefits for 
inpatient hospital services during a spell of illness, or (2) 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. These 
services, which are specified in section 3110 of the Medicare 
Intermediary Manual and section 2255C of the Medicare Carriers Manual 
include diagnostic tests; X-ray and radioactive isotope therapy; 
surgical dressings, splints and casts; prosthetic

[[Page 59892]]

devices; and limb braces and trusses and artificial limbs and eyes.
    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). In the proposed rule, we discussed some hospitals' 
concerns 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 proposed to revise Sec. 419.22 by adding paragraph (r) to 
exclude Part B-only services that are furnished to inpatients of 
hospitals that do no other billing for hospital outpatient services 
under Part B from payment under the OPPS.
    We noted that 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 received several comments on this proposal, which are summarized 
below.
    Comment: Several commenters requested that the proposed change be 
made retroactive to the implementation of OPPS on August 1, 2000. These 
commenters observed that, without retroactive effect, the hospitals 
would be unable to bill for inpatient ancillary services provided to 
beneficiaries with Part B-only coverage during the period from August 
1, 2000 until January 1, 2002. Another commenter contended that the 
proposed policy should have retroactive effect. The commenter raised 
two alternative reasons for this contention. One was that section 
1833(t)(1)(B)(ii) of the Act should not have been interpreted to apply 
to inpatients who have exhausted their Part A coverage because of the 
190-day lifetime limit on inpatient psychiatric days, because the 
statutory language refers only to hospital inpatients who have 
``exhausted benefits for inpatient hospital services during a spell of 
illness.'' The other was that, allegedly, CMS had never designated 
through formal regulations those Part B services that are subject to 
the OPPS. Until such a rule is adopted, the commenter contended, no 
service provided on an inpatient basis to beneficiaries with Part B-
only coverage can be subject to OPPS.
    Response: Contrary to the assertion of the commenter, we have in 
fact designated those Part B services to be covered under the OPPS 
through formal regulations. In the April 7, 2000, final rule, we 
specifically included services furnished to inpatients who have 
exhausted their Part A benefits in the list of ``Services Included 
Within the Scope of the Hospital Outpatient PPS,'' and provided 
examples of those services (65 FR 18444). The statutory language gives 
the agency broad authority to define the services that are to be 
included under the OPPS. The statute broadly includes both ``hospital 
outpatient services designated by the Secretary'' and ``inpatient 
hospital services designated by the Secretary that are covered under 
this part and furnished to a hospital inpatient who (1) is entitled to 
benefits under Part A but has exhausted benefits for inpatient hospital 
services during a spell of illness, or (2) is not so entitled'' within 
the definition.
    We designated Part B-only services as OPPS services through notice 
and comment rulemaking, and the policy has been in effect since the 
inception of OPPS. As discussed in the proposed rule, representatives 
of hospitals approached us after publication of the April 7, 2000 final 
rule to express concerns about the policy. We have considered those 
concerns, and we are changing the policy prospectively. We believe not 
only that applying the policy change on a prospective basis only is 
fair (particularly given that the current policy was established 
through notice and comment rulemaking) but also that applying the 
policy change on a retroactive basis would constitute impermissible 
retroactive rulemaking.
    Comment: Several commenters requested that CMS clarify that those 
hospitals to which this change applies may resume billing under the per 
diem based methodology that they employed prior to the implementation 
of OPPS.
    Response: As we stated in the proposed rule (66 FR 44699), ``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.'' The hospitals to which this change applies may therefore 
resume billing under the per diem or reasonable cost methodology that 
was applicable to them prior to the implementation of the OPPS.
    Comment: One commenter asked that we recognize the situation of two 
other classes of hospitals. Some hospitals that have outpatient 
departments submit claims for only a limited range of outpatient 
services under Part B. Other hospitals have outpatient departments (for 
example, for children's psychiatric services) but submit no claims 
under Medicare Part B. The commenter contended that these hospitals do 
not have the capacity to bill for the full range of inpatient ancillary 
services under the OPPS.
    Response: We believe that it is very important to restrict this 
exception to those hospitals that do not provide Medicare Part B 
services through an outpatient department. As stated in the April 7, 
2000 final rule, in developing a hospital OPPS, we ``wanted to ensure 
that all services furnished in a hospital outpatient setting will be 
paid on a prospective basis.'' (65 FR 18442.) We believe that hospitals 
that have outpatient departments and that bill for some outpatient 
services under Part B should also be paid for the services in question 
under the OPPS. Therefore, those hospitals will not be excluded from 
billing under the OPPS. On the other hand, the exception will apply to 
those hospitals that do not bill under Medicare Part B, even if they 
have outpatient departments; that is, they do not treat Medicare 
beneficiaries in their outpatient departments.
    Comment: Several commenters requested that CMS clarify whether the 
proposed provision in Sec. 419.22(r) of the regulations would include 
therapy services (for example, physical therapy) so that the State 
psychiatric hospitals included in the exception could resume billing 
therapies at the per diem all-inclusive rate. The commenters pointed 
out that these services are currently included in the list of ancillary 
services under section 3110 of the Medicare Intermediary Manual and 
section 2255C of the Medicare Carrier Manual. In the proposed rule, CMS 
specified that the Part B-only services to which the proposed exception 
would apply were ancillary services listed in those manual sections, 
but did not specifically list the therapy services in the proposed 
rule. Some of these commenters raised the same question about 
diagnostic laboratory services, which CMS had also not specifically 
listed in the preamble text, but which are included in the list of 
ancillary services under section 3110

[[Page 59893]]

of the Medicare Intermediary Manual and section 2255C of the Medicare 
Carrier Manual.
    Response: Section 1833(t)(1)(B)(iv) of the Act specifically 
excludes outpatient physical therapy, outpatient speech-language 
pathology, and outpatient occupational therapy from the definition of 
services payable under the OPPS. Therefore, we specifically did not 
include them in the list of Part-B only services to which the exception 
would apply in the proposed rule. These services are subject to fee 
schedules that were established prior to the OPPS.
    We agree with the commenters that diagnostic laboratory services 
are included in the list of ancillary services that are excluded from 
the OPPS under this policy.

B. Categories of Hospitals Subject To and Excluded from the OPPS

    Under Sec. 419.20(b), 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), which 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.
    In the proposed rule, we noted that under the statute, hospitals 
located in Guam, Saipan, American Samoa, and the Virgin Islands are 
excluded from the hospital inpatient PPS. We proposed 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 proposed to revise paragraph (b)(4) of 
that section to include the hospitals of the IHS to clarify that they 
are excluded from OPPS until we develop a plan to include them. We 
noted that it might also be possible to include the hospitals in the 
territories in the OPPS in the future.
    We received one comment on this proposal, as set forth below.
    Comment: A commenter asked for clarification about the meaning of 
``hospital of the Indian Health Service'' in the context of our 
proposal. The commenter requested that CMS define the term to include 
several classes of hospitals, not only those owned and operated by the 
IHS, but also those that are operated by Tribes and Tribal 
organizations, but owned or leased by the IHS.
    Response: We agree with the commenter that clarification of the 
term ``hospital of the Indian Health Service'' is appropriate, and we 
are taking this opportunity to do so. Specifically, we will use here 
the definition at 42 CFR 413.65(l), where the term is defined to 
include facilities and organizations that, on or before April 7, 2000, 
furnished only services that were billed as if they were furnished by a 
hospital operated by the IHS or by a Tribe and that are: owned and 
operated by the Indian Health Service; owned by a Tribe or Tribal 
organization but leased from the Tribe or Tribal organization by the 
IHS under the Indian Self-Determination Act (Pub. L. 93-638) in 
accordance with applicable regulations and policies of the Indian 
Health Service in consultation with Tribes; or owned by the Indian 
Health Service but leased and operated by the Tribe or Tribal 
organization under the Indian Self-Determination Act (Pub. L. 93-638) 
in accordance with applicable regulations and policies of the Indian 
Health Service in consultation with Tribes.

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 proposed to revise Sec. 419.2(c) to make conforming changes that 
reflect the exclusion of these costs from the OPPS rates.
    We received one comment on this proposal, as follows.
    Comment: The commenter supported the clarification, but requested a 
statement concerning how CMS will ensure that the appropriate interim 
biweekly payments for these services are made.
    Response: We are working on appropriate operating instructions to 
our intermediaries with directions to ensure that the appropriate 
interim payments for these items and services are made.

D. Hospital Coding for Evaluation and Management 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. In the proposed rule, 
we stated that 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.
    In the proposed rule, we solicited comments from hospitals and 
other interested parties on this issue. We stated that we would 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. We 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

1. Payment for Drugs and Biologicals
    Under the OPPS, we pay for drugs and biologicals in one of three 
ways.

[[Page 59894]]

    a. Packaged Payment. As we explained 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.
    b. Transitional Pass-Through Payments for Eligible Drugs and 
Biologicals. As we also explained 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 before 
January 1, 1997 and for which the cost is not insignificant in relation 
to the payment for the APC to which it is assigned. In the proposed 
rule, we discussed in detail the statutory basis and payment 
methodology for transitional pass-through payments for drugs and 
biologicals. In addition, we included an illustration of the payment 
methodology.
    Section 1833(t)(6)(D)(i) of the Act sets the payment rate for pass-
through eligible drugs (assuming that no pro rata reduction in pass-
through payment is necessary) 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 explained in the April 7, 2000 
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 
explained in the April 7, 2000 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 
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 the hospital acquisition cost from the 
applicable 95 percent of AWP. The Medicare program payment is the sum 
of the acquisition cost and the pass-through amount, 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 of $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 copayment ($13.60), plus pass-
through payment ($27)). In the proposed rule, we clarified 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,

[[Page 59895]]

2000 final rule to designate a ``new'' drug/biological pass-through. 
Instead, we stated that 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 of this final rule lists the 
definition of the OPPS payment status indicators.)
    c. Separate APCs for Drugs Not Eligible for Transitional Pass-
Through Payment. There are some drugs and biologicals for which we did 
not yet have adequate cost data 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 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 used 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, multi, or generic source) 
based on data collected in an external survey of hospital drug 
acquisition costs.
    We set beneficiary copayment amounts for these drugs 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 of this final rule to identify 
these APCs.
2. 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 proposed rule we 
referred to a discussion in the November 13, 2000 interim final rule. 
When we developed that interim final rule, 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. Thus, we proposed 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. 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 proposed 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 preamble.
    We received several comments on our discussion of the payment for 
drugs under the OPPS. These comments are summarized below.
    Comment: One commenter expressed concern that the ``three 
methodologies for drug payment reductions in the proposed rule'' may 
not take into account the most recent data. The commenter requested an 
estimate of the magnitude of the expected reduction, and the data used 
to develop the estimate.
    Response: We did not propose three methodologies for drug payment 
reductions in the proposed rule. Rather we described, in greater detail 
than we have previously, the three methods by which drug costs are paid 
under the OPPS. In the final rule that we published on November 2, 2001 
(66 FR 55857), we announced that we would be implementing a reduction 
in the payments made for one category of drugs, namely those drugs that 
qualify for transitional pass-through payments. As we described in that 
final rule, this reduction is applied on a uniform basis to all pass-
through payments (including payments for devices) and is required to 
enforce a statutory limit on the size of those estimated payments 
relative to the estimate of all spending under the OPPS.
    Comment: One commenter was confused by an apparent discrepancy 
between our description of how the pass-through payment amount for a 
drug is calculated and our example of how the amount is calculated. The 
description indicated that the beneficiary coinsurance is subtracted 
from the applicable 95 percent of AWP and imputed acquisition cost, but 
the example did not include this subtraction.
    Response: We regret that the written description was not entirely 
clear. The example was accurate. The pass-through payment is the 
difference between 95 percent of AWP and imputed acquisition cost. The 
beneficiary coinsurance is 20 percent of the imputed acquisition cost. 
The Medicare program payment is the pass-through amount, plus the 
imputed acquisition cost, minus the beneficiary copayment. Total 
payment to the hospital is the pass-through amount, plus the imputed 
acquisition cost, plus the beneficiary copayment. In our example (see 
above), the AWP for the drug was $100, and 95 percent of AWP was thus 
$95. The imputed acquisition cost for the drug was 68 percent of AWP, 
or $68. Beneficiary coinsurance was 20 percent of $68, or $13.60. The 
Medicare program payment is $27 (the pass-through amount), plus $68 
(the imputed acquisition cost), minus $13.60 (the beneficiary 
copayment), for a total of $81.40. Total payment to the hospital is 
$81.40 (the Medicare program payment) plus $13.60 (the beneficiary 
copayment), for a total of $95.
    Comment: Several commenters objected that our drug pricing is based 
on annual updates using 6-month old data and on ratios of drug 
acquisition costs to AWP that derive from outdated and limited data. 
Some of these commenters objected to the use of the acquisition cost 
study to establish the ratios of drug acquisition costs to AWP. One 
commenter asked that CMS clarify why the new system is too complex to 
undertake quarterly updates of drug prices.
    Response: We are placing the updates for the drugs that are 
eligible for pass-through payments on the same annual update schedule 
as the rest of the OPPS. We will always use the most recent available 
version of the Red Book in doing this update. Assuming that the October 
Red Book becomes available in time for use in the final rule 
establishing the annual OPPS updates, our drug

[[Page 59896]]

pricing may be based on data that are only 3 months old when it becomes 
effective. In any event, it is not unusual for updates to prospective 
payment systems to reflect data that are 6 months old or older. We have 
always considered the use of the study-derived ratios of drug costs to 
AWP to be an interim measure until we are able to obtain data on 
hospitals' actual costs for drugs from claims. We anticipate having 
this data available for use in setting payment rates for 2003. 
Revisions to our payment systems require a long lead-time, and thus it 
would be very difficult to implement more than one update in a year. We 
note that rate-based payment systems are commonly updated annually, and 
we see no compelling reason why the update of drug prices under the 
OPPS should be updated more frequently than the other payment rates 
under the system.
    Comment: Several commenters requested more information about the 
methodology that CMS uses to compute payment rates for drugs, 
radiopharmaceuticals, and biologicals, particularly those that are not 
sole source.
    Response: We employ the methodology provided in 42 CFR 
Sec. 405.517(c) to determine the payment rates. Specifically, we 
compute the median price of each drug, radiopharmaceutical, or 
biological, using the median price of the generic versions or the 
lowest of the prices of the brand versions from the Red Book. (For 
drugs with both generic and brand manufacturers, we use the lower cost 
of the two.) For the denominator, we employ measures of dosage and 
concentration that are compatible with the HCPCS code descriptor. We 
also consider route of administration (for example, intravenous or 
perenteral) and dose. As an example, if drug A has a descriptor of 10 
mg As the dose, we usually utilize the AWP for 5 mg and 10 mg doses, 
but not for 25 mg or 50 mg doses. This is because the latter two doses 
could not be administered to provide a 10 mg dose. If drug B has a 
descriptor for 25 mg injection and the drug is manufactured in 5 mg per 
ml, 25 mg per ml, and 50 mg per ml concentrations, we would utilize the 
AWP for the 25 and 50 mg per ml concentrations, but not the 5 mg per ml 
concentration. This is because we would not expect a beneficiary to 
receive a 5 ml injection, which would be necessary to utilize the 
lowest concentration dose to provide 25 mg of the drug at the 5 mg per 
ml concentration.
    However, we lack precise information for many drugs in the Red Book 
concerning the size of vials/ampules and the numbers of vials/ampules 
per packaging. In these cases, we are unable to employ this 
methodology, and we simply use the list price. We are continuously 
seeking further information on these drugs, and we will revise the 
pricing as we obtain additional information.
    Comment: Several commenters called our attention to instances in 
which the Medicare payment is higher than the cost for certain drugs, 
especially radiopharmaceuticals.
    Response: We thank the commenters for bringing these cases to our 
attention. We have experienced some difficulty in determining 
appropriate payment rates for radiopharmaceuticals due to several 
factors. First, the Red Book lacks information concerning the dosage 
per vial after the elements are compounded to create the radioactive 
substance, the numbers of doses that can be obtained per vial, and the 
cost per vial when more than one dose may be given from the vial. 
Nuclear medicine experts have informed us that multiple doses for 
multiple patients can often be obtained with one vial and that we have 
often unnecessarily assumed the cost for the entire vial. At the same 
time, there are circumstances in which an entire vial is appropriately 
charged for one patient. We have made the appropriate modifications for 
those agents that have been identified to us. We welcome any additional 
information that would help us to ensure that payment rates reflect as 
accurately as possible the cost and usage of these agents.
    Comment: One commenter requested that CMS clarify whether 
repackaged products are included in its calculations.
    Response: There is no separate calculation for any repackaging 
process. We use only AWPs to calculate drugs and biological prices.
    Comment: One commenter asked us to clarify how we pay for the 
pharmacy overhead costs associated with administering drugs. The 
commenter expressed concern that the data in the survey of drug costs 
did not capture these costs.
    Response: For the drugs paid for under the OPPS, hospitals can bill 
both for the drug and for the administration of the drug. The overhead 
cost is captured in the administration codes, along with the costs of 
all drugs that are not paid for separately. Each time a drug is billed 
with an administration code, the total payment thus includes the 
acquisition cost for the billed drug, the packaged cost of all other 
drugs, and the overhead costs.

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).
    In the proposed rule, we discussed issues that have come to our 
attention regarding reprocessed single-use devices. We noted 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. We 
proposed to follow FDA's guidance on reprocessed single-use devices. We 
stated that 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. We proposed to consider reprocessed 
devices adhering to these guidelines 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. We also stated our 
expectation that hospital charges on claims submitted for pass-through 
payments for reprocessed single-use devices would reflect the lower 
cost of these devices.
    We received several comments on this proposal, which are summarized 
below.
    Comment: One commenter expressed agreement with our decision to 
allow hospitals to submit claims for pass-through payment for 
reprocessed devices, as long as the device is reprocessed in accordance 
with FDA policy on reprocessing.
    Response: We appreciate the comment. It is important to emphasize 
that, in order to qualify for pass-through payment, a reprocessed 
device must clearly fit into one of the currently open device 
categories established for pass-

[[Page 59897]]

through payment. We also expect that the charges for the reprocessed 
device will accurately reflect any lower cost of reprocessed devices.
    Comment: One commenter recommended that CMS not expect hospitals to 
charge less for reprocessed devices, claiming that paying hospitals 
less for reprocessed devices would perpetuate an incentive to use new 
devices instead of reprocessed devices.
    Response: We disagree. Hospitals would not necessarily have a 
greater incentive to use new devices if their charges for reprocessed 
devices are in accordance with their costs. If the charges reflect the 
lower costs of the reprocessed devices to the hospital, the margins for 
reprocessed versus new devices should remain relatively constant. This 
would not create an incentive for hospitals to use either new or 
reprocessed devices. On the other hand, if hospitals to charge the same 
amount for reprocessed and original devices, this would inflate the 
margins of pass-through payment for reprocessed devices and create an 
incentive to use reprocessed over new devices.
    Comment: Several commenters asked that CMS clarify how we will 
implement and enforce our pass-through payment policy for reprocessed 
single-use devices. A device manufacturer pointed out that Pre-Market 
Approval and 510k submissions for approval of reprocessed single-use 
devices are still pending with the FDA, awaiting final decisions. These 
commenters also asked how CMS would prohibit noncompliant single-use 
devices from receiving Medicare payment.
    Response: As we indicated in the proposed rule, we will follow the 
most recent FDA guidance or regulatory criteria on the issue of 
reprocessed single-use devices. When the FDA requires reprocessors, 
including hospitals, to have FDA approval or clearance regarding safety 
and effectiveness, prior to use in a health setting. Hospitals must 
adhere to these requirements, and will not be entitled to receive a 
pass-though payment if they do not comply. We will employ our standard 
procedures for claims reviews to enforce these requirements.
    Comment: One commenter recommended that CMS develop and implement a 
tracking mechanism to differentiate and collect data on reprocessed 
versus original device costs and use. This commenter also recommended 
either creating a modifier or establishing pairs of categories for 
original and reprocessed devices.
    Response: Reprocessed devices will be subsumed under the same 
categories as the original devices, and the average cost for the 
category will accurately reflect the cost of reprocessed and new 
devices. We do not believe that it is practical or advisable to create 
special modifiers or categories for items that will be receiving pass-
though payments for only a limited period of time.
    Comment: One commenter recommended that CMS provide hospitals with 
guidance on how to adjust their charges for reprocessed devices 
eligible for pass-through payment, taking into account the costs of 
reprocessing and amortization of the initial cost of the device.
    Response: We expect those hospitals' charges for reprocessed 
single-use devices will reflect their costs, just as in the case of the 
first-use devices. The device's full cost to the hospital is reflected 
in the payment the first time it is used for a Medicare patient. The 
cost of the reprocessed device to the hospital will already include the 
cost of reprocessing. No amortization of the initial cost of the device 
will apply for single use devices, since they are intended for one time 
use only.

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. New technology APCs are intended to pay for new technology 
services that are not addressed by the transitional pass-through 
provisions of the BBRA 1999 and BIPA 2000. New technology APCs are 
defined on the basis of costs and not the clinical characteristics of a 
service. The payment rate for each new technology APC is based on the 
midpoint of a range of costs.
    The new technology APCs that were implemented on August 1, 2000 
were populated with 11 new technology services. We stated 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. 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 proposed in the 
August 24 proposed rule to revise--(1) the definition of what is 
appropriately paid for under the new technology APCs; (2) the criteria 
for determining whether a service may be paid under the new technology 
APCs; (3) the information that we will require to determine eligibility 
for assignment to a new technology APC; and 4) the length of time we 
will pay for a service in a new technology APC.
    We invited comment on the changes to the definition, criteria, 
application process, and timeframe that we proposed for services and 
procedures that may qualify for assignment to a new technology APC 
under the OPPS. We received numerous comments on the proposed changes, 
primarily from drug and device manufacturers and their trade 
associations, but also from medical specialty societies and hospital 
associations. Although several commenters supported the changes that we 
proposed, most commenters expressed concern that the new requirements 
might make it extremely difficult or virtually impossible for any new 
technology to qualify for

[[Page 59898]]

assignment to a new technology APC. Many commenters urged us to 
maintain flexibility in approving services and products for new 
technology APCs rather than adhering to rigid criteria. The comments 
are summarized below.
    a. Services Paid Under New Technology APCs. We proposed to limit 
eligibility for placement in new technology APCs to complete services 
or procedures. That is, items, materials, supplies, apparatuses, 
instruments, implements, or equipment that are used to accomplish a 
more comprehensive service or procedure would not be eligible for 
placement in a new technology APC. Devices or any drug, biologic, 
radiopharmaceutical, product, or commodity for which payment could be 
made under the transitional pass-through provisions would continue to 
be excluded from assignment to a new technology APC. We proposed to 
limit new technology APCs to comprehensive services or procedures that 
are truly new. In addition, we clarified that we do not consider a 
different approach to an existing treatment or procedure to qualify a 
service for assignment to a new technology APC.
    A few commenters supported our proposal to limit eligibility to 
complete services and procedures, and to exclude changes to an existing 
service or procedure from new technology APCs. They cited this approach 
as a means of better controlling and managing payment and improving the 
predictability of cost estimates for new services or procedures under 
the OPPS. However, most commenters were opposed to these proposals. (In 
our responses to comments in this section VI.G., we use ``HCPCS code'' 
to mean a Level II HCPCS/National Code and ``CPT code'' to mean a Level 
I HCPCS code.)
    Comment: One commenter was concerned that the new criteria for 
identifying devices that will be eligible for assignment to a new 
technology APC will make it more difficult for new devices to qualify.
    Response: The commenter is correct. The changes that we proposed 
are intended to clarify, sharpen, and refine the scope of what we 
assign and pay for under a new technology APC. We want to clarify that 
new technology APCs are not meant to be the payment vehicle for items 
that can be paid under a transitional pass-through device category. Nor 
are new technology APCs meant to be a means of paying for drugs, 
biologicals, or radiopharmaceutical drugs that are otherwise eligible 
for transitional pass-through payments. The cost of a device that is 
not eligible for transitional pass-through payment and that is not 
associated with a comprehensive service or treatment eligible for 
assignment to a new technology APC will become incorporated into the 
weight of the APC or APCs associated with its use as hospitals begin to 
use it. The same is true for other items, supplies, and equipment that 
are furnished incident to a service or procedure and are used as a tool 
or serve as an aid in performing a variety of procedures.
    Comment: A number of commenters were opposed to limiting new 
technology APCs to services and procedures that are ``truly new'' 
because what constitutes ``truly new'' is vague and difficult to define 
and does not reflect the significant advances in medical technology 
that are incremental and build on existing technology or procedures. 
One commenter argued that transformational technology often changes 
significantly the way that a procedure is done, for example, changing a 
traditionally human resource (for example, labor) or time intensive 
procedure to one that is technology intensive. Commenters were 
concerned that the requirement that a new technology be ``truly new'' 
could result in lack of adequate payment for important new therapies 
and severely limit patient access to such therapies. For example, a new 
interventional radiology or other minimally invasive procedure such as 
the recent advances in endovascular techniques and device technology 
that replace traditional open surgery could be viewed as a ``different 
approach to an existing treatment'' and therefore not qualify for 
assignment to a new technology APC. One commenter concluded that this 
requirement would limit new technology APCs to inpatient procedures 
that move to an outpatient setting or procedures that are fundamentally 
different enough to qualify for a new CPT code. Many commenters 
recommended that innovation that improves current procedures be 
recognized and paid for in addition to ``truly new'' services. Several 
commenters stated that we should publish the definition of ``truly 
new'' in the Federal Register for public comment before implementing 
this criterion.
    Response: In fact, we do want to limit new technology APCs to those 
services that would be eligible for a new HCPCS code. For example, 
there are existing codes for wound repair which hospitals have been 
using to bill for Medicare services for many years. The use of a new, 
expensive instrument for tissue debridement or a new, expensive wound 
dressing does not in and of itself warrant creation of a new HCPCS code 
to describe the instrument or dressing; rather, the existing wound 
repair code appropriately describes the service that is being 
furnished, that is, the service is a wound repair, regardless of 
whether or not a new instrument or a new wound dressing is involved. We 
would consider it inappropriate to pay for the wound repair performed 
with the new, expensive dressing or instrument under a new technology 
APC because an APC group that includes the wound repair procedure 
already exists. (However, we note that the dressing or instrument could 
qualify for transitional pass-through payments.) Similarly, the 
invention of a new endoscope or new suturing material would not qualify 
for a new technology APC unless the procedure in which it is used 
cannot be appropriately billed under an existing code.
    By contrast, new services such as cryosurgery of the prostate, 
coronary artery brachytherapy, and 3-D electrophysiologic mapping of 
the heart are not adequately described with current codes, and they do 
not fit appropriately within an existing APC group. The new technology 
APCs are intended to address appropriate payment for these latter types 
of services, which cannot be accurately described by existing codes and 
are not similar either clinically or in terms of resource use with an 
existing APC group.
    We want to ensure appropriate allocation of Medicare expenditures 
and access for our beneficiaries to breakthrough technologies. The 
appropriate method of reflecting changes in the costs of supplies and 
equipment used to provide existing services is to incorporate those 
changes into the payment for such services during the yearly 
reclassification and recalibration of the APCs. We believe it is 
appropriate for those new technologies that can be appropriately 
reported by existing codes and do not qualify for transitional pass-
through payments to be grouped with older technologies, and have their 
costs gradually incorporated into APCs when APC weights are adjusted.
    In summary, the most important criterion that will determine 
whether a technology is ``truly new'' and appropriate for a new 
technology APC is the inability to appropriately, and without 
redundancy, describe the new, complete (or comprehensive) service with 
any combination of existing HCPCS and CPT codes. We acknowledge the 
need to critically evaluate, on an ongoing basis, our criteria for new 
technology APCs. We remind interested parties that eligibility

[[Page 59899]]

of a procedure for a temporary HCPCS code and assignment to a new 
technology APC does not guarantee that a permanent code will ultimately 
be approved for the service or procedure. Conversely, the fact that a 
new CPT or HCPCS code has been assigned to a service or procedure does 
not automatically qualify it for placement in a new technology APC 
unless it meets the criteria we have established for this purpose.
    Comment: A few commenters indicated that we need to better define 
``complete services or procedures'' and ``a more comprehensive 
service'' with a clearer explanation of the underlying intent and 
examples to clarify when assignment to a new technology APC would be 
appropriate and when it would not. A couple of commenters stated that 
our proposal to permit only ``complete'' or ``comprehensive'' services 
or procedures to qualify for assignment to a new technology APC is 
contrary to the underlying concepts of the OPPS. These commenters 
argued that hospital outpatient departments, in order to provide a 
``complete'' or ``comprehensive'' service, are allowed and expected to 
bill the appropriate set of CPT and HCPCS codes that combine to 
describe a particular service, often resulting in claims with multiple 
codes matched to multiple APCs. The same commenters asserted that a new 
technology or procedure will likely consist of multiple codes and 
multiple APCs and that this can be most effectively evaluated as part 
of the data collection during the period that the technology or 
procedure is assigned to a new technology APC. One commenter stated 
that medical technologies, even when considered transformational, are 
not usually ``complete services and procedures.''
    Response: These comments focus on our concept of the type of 
services appropriate for assignment to new technology APCs under the 
OPPS. A service that qualifies for a new technology APC may be a 
complete, stand-alone service (for example, water-induced thermotherapy 
of the prostate or cryosurgery of the prostate) or it may be a service 
that would always be billed in combination with other services (for 
example, coronary artery brachytherapy). In the latter case, the new 
technology procedure, even though billed in combination with other, 
previously existing procedures, describes a distinct procedure with a 
beginning, middle, and end. Drugs, supplies, devices, and equipment in 
and of themselves are not a distinct procedure with a beginning, 
middle, and end. Rather, drugs, supplies, devices, and equipment are 
used in the performance of a procedure. Therefore, taken individually 
and apart from the procedure or service with which they are used, these 
items will not be eligible for new technology APCs. (As noted above, 
these items may qualify for transitional pass-through payments.) 
Furthermore, unbundled components that are integral to a service or 
procedure (for example, preparing a patient for surgery or preparation 
and application of a wound dressing for wound care) are not eligible 
for consideration for a new technology APC.
    We understand that hospitals frequently bill multiple codes to 
describe multiple services furnished to a given patient. Therefore, we 
are not making eligibility for new technology APCs contingent on 
whether hospitals would bill other HCPCS codes in conjunction with a 
proposed new technology procedure. However, we reiterate that the 
inability to describe appropriately, and without redundancy, a complete 
(or comprehensive) service with any combination of current CPT or HCPCS 
codes is crucial to determining eligibility for a new technology APC. 
It is possible that a procedure for which assignment to a new 
technology APC is sought can only be described by several current codes 
and the applicant believes it is important to establish a single HCPCS 
code to describe the procedure in a more comprehensive manner (for 
example, stereotactic radiosurgery or intensity modulated 
radiotherapy). We agree with this and will consider creating such new 
HCPCS codes if reporting a combination of current codes does not 
adequately describe the service or does not properly account for the 
resources used to deliver the comprehensive service.
    In short, we consider that a ``truly new'' service is one that 
cannot be appropriately described by existing HCPCS codes and that a 
new HCPCS code needs to be established in order to describe the new 
procedure.
    Claims for services assigned to new technology APCs should include, 
in addition to other HCPCS codes billed, the appropriate revenue codes 
and charges for the resources required to deliver the service. We 
evaluate these data to identify the complete package of resources 
required to perform the new technology service, the cost of this 
package of services, and, subsequently, the extent to which the new 
technology service is, or is not, consistent with services in an 
existing APC. If, over time, our claims data indicate that the package 
of resources and the clinical components of the new technology are 
unique and bear no similarity to services in any existing APC, we may 
create a separate APC for the new technology service when it is 
reassigned from a new technology APC. Examples of services that are 
currently in new technology APCs due to lack of data include water-
induced thermotherapy, coronary artery thrombectomy, and coronary 
artery brachytherapy.
    Comment: Several commenters stated that we should eliminate the 
proposed criteria for defining services eligible for new technology 
APCs and suggested, instead, that we be flexible and work closely with 
manufacturers, providers, the APC Panel, and other experts ``to 
consider circumstances unique to the individual technology'' when 
determining whether a new technology APC is appropriate.
    Response: We will continue to work with manufacturers and their 
representative associations, with hospitals, with the APC Panel, with 
other experts, and with applicants as we evaluate requests for new 
technology APC assignments and determine which are appropriate for new 
technology APCs. The review of an application for new technology APC 
assignment by our medical officers and clinical experts is a dynamic, 
interactive process that involves ongoing consultation with the 
applicant, with hospitals and physicians who are furnishing the service 
or who participated in clinical trials, with the manufacturers of the 
new technology, and with other agencies such as the FDA that may have 
pertinent information. We believe that the criteria that we proposed 
serve to inform, guide, and expedite the review process and help to 
guard against inappropriate assignment of services to a new technology 
APC simply on the basis of those services being characterized as 
``new.''
    Comment: One commenter recommended that an applicant be the one to 
determine whether to seek pass-through payment for a drug used as part 
of the service or new technology APC status for the entire service, 
including the drug.
    Response: We agree. Application for pass-through payment or new 
technology APC status is voluntary and the determination of which 
application(s) to submit is left solely to the interested party. 
However, as part of the review process, we would expect to work with 
the applicant to arrive at the most appropriate classification for the 
service under consideration.
    Comment: Several commenters recommended that we further clarify the 
proposed criteria to ensure that all new technologies and services that 
do not

[[Page 59900]]

qualify for pass-through status and that would not be adequately paid 
under existing APCs can be assigned to new technology APCs. These 
commenters also recommended that, when a pass-through category expires, 
we consider reclassifying medical devices in the expired category into 
a new technology APC to give beneficiaries seamless access to expensive 
new medical technology.
    Response: As we discussed above, devices eligible for pass-through 
payments fall outside the scope of services appropriate for new 
technology APCs. As data associated with pass-through items are 
collected and incorporated into the APCs with which they are 
associated, they will be reflected in the weight of the APC. The 
services assigned to the new technology APCs are those for which we do 
not have adequate data to make an appropriate APC assignment. Thus, it 
would not be appropriate to assign a pass-through device for which we 
have collected data to a new technology APC.
    b. Criteria for Assignment to New Technology APC. In the proposed 
rule, we proposed that the following criteria be used to determine 
whether a service be assigned to a new technology APC. These proposals 
represent modifications to criteria that 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. (This criterion for assignment to a new technology APC is implied 
but not explicitly stated in the April 7, 2000 final rule.)
     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 further proposed to delete the criterion that the service must 
have a HCPCS code in order to be assigned to a new technology APC. We 
wish to clarify that our proposal to delete the criterion that a 
service must have a HCPCS code refers to the discussion in the April 7, 
2000 final rule which implied that assignment of a HCPCS code through 
the annual HCPCS cycle is required. On the contrary, as we state 
throughout this section, in order to be considered for a new technology 
APC, a truly new service cannot be adequately described by existing 
codes. Therefore, in the absence of an appropriate HCPCS code, we would 
consider creating a HCPCS code that describes the new technology 
service. These HCPCS codes would be solely for hospitals to use when 
billing under the OPPS.
    Most commenters supported the proposal not to require a HCPCS code 
for products or services in order to be considered for assignment to a 
new technology APC. The few commenters that addressed the proposed 
criterion that would define a new technology APC service as one that 
could not have been adequately represented in the claims data being 
used for the most current annual payment update (rather than on 1996 
claims data) concurred with the proposed change; no one opposed the 
change. The remaining comments on these proposed criteria are 
summarized below.
    Comment: One commenter wanted to confirm our intention to assign a 
new service or procedure to an existing APC only in those instances 
where a clinically similar APC exists and the associated APC payment 
rate meets or exceeds the cost of furnishing the new technology service 
as itemized in the application for a new technology APC.
    Response: Our experience to date in evaluating requests for new 
technology APC classification prompted us to propose changes regarding 
the information that would be required in an application. One of the 
principal reasons that we proposed to require submission of a clinical 
vignette, including a detailed description of the resources used to 
furnish the service, was to enable us to determine whether a clinically 
similar APC exists and whether the APC payment rate adequately 
addresses the costs associated with the nominated new technology 
service. However, we will not limit our determination of the cost of 
the procedure to information submitted by the applicant. Our staff will 
obtain information on cost from other appropriate sources before making 
a determination of the cost of the procedure to hospitals.
    Comment: A number of commenters strongly opposed the criterion 
excluding any service involving a new drug or biological that qualifies 
for transitional pass-through payment from possible eligibility as a 
new technology APC. Commenters stated that continuing to exclude drugs 
or biologicals eligible for pass-through payments from being eligible 
for a new technology APC seems to suggest that an entirely new service 
that includes a new drug would only be eligible for pass-through 
payments for the drug, rather than the entire service being eligible 
for payment under a new technology APC. Under this criterion, novel 
treatments such as those in the growing field of radioimmunotherapy 
that involve both a new drug and new procedures for both calculating 
appropriate dosages and administering treatment would not be paid as a 
new technology APC. Instead, the hospital would be paid for the cost of 
the drug through the applicable pass-through payment, which may result 
in underpaying hospitals for the total package of items and services 
associated with the treatment.
    Commenters requested that we clarify that a brand new service in 
which a pass-through drug or device is used could be eligible for 
either a pass-through payment for the drug or device or for a new 
technology APC for the entire service and that we permit a new 
technology that includes the provision of a new drug or biological to 
be eligible for payments under a new technology APC. A few commenters 
recommended that we eliminate this requirement altogether and allow new 
medical device technology to be included in new tech APCs.
    Response: In the April 7, 2000 final rule we adopted a criterion 
that provided that an item or service that qualifies as a transitional 
pass-through item would not be considered for assignment to a new 
technology APC. We proposed to retain that criterion without 
modification. We have never intended new technology APCs to be a 
substitute payment vehicle for individual items that qualify for 
payment under a transitional pass-through device category. Nor are new 
technology APCs meant to be the means of payment for drugs, 
biologicals, or radiopharmaceutical drugs that are otherwise eligible 
for transitional pass-through payments. From the outset of the OPPS, 
our policy regarding payment for devices, drugs, and biologicals that 
do not qualify for transitional pass-through payment has been to 
package payment with the items' associated APCs, with the exception of 
a few drugs for which we had insufficient data.
    Many commenters expressed concern and disagreement with this 
criterion. We believe the commenters misunderstood our explanation of 
this

[[Page 59901]]

criterion. Therefore, we reiterate that we have never intended to 
disqualify from assignment to a new technology APC a truly new, 
comprehensive service, procedure, or therapy that involves the use of a 
drug or device which, on its own, might also qualify for a transitional 
pass-through payment. That is, a truly new, comprehensive service could 
qualify for assignment to a new technology APC even if it involves a 
device or drug that could, on its own, qualify for a pass-through 
payment.
    Take, for example, a case in which a drug that qualifies for a 
pass-through payment is integral to a service that may be considered a 
new, comprehensive procedure or service appropriate for a new 
technology APC. In this case, an interested party has several options. 
The first option is to simply submit a request for the drug pass-
through payment. Under this option, the therapy or procedure or service 
associated with administration of the drug would be paid through an 
existing APC that most closely approximates the service clinically and 
in terms of resources. (In this option, if the new service associated 
with the drug can be appropriately described by one or more existing 
HCPCS codes, it is possible that the new service might not qualify for 
a new technology APC.) A second option would be for the interested 
party to apply for a pass-through payment for the drug and submit a 
separate application for assignment of the therapy or procedure 
associated with administration of the drug to a new technology APC. A 
third option is to submit an application to have the entire service, 
including the potential pass-through drug, which is an integral part of 
the service, assigned to a new technology APC. In that case, the cost 
of the drug would be taken into account and packaged with the other 
costs associated with the service so that the drug cost is reflected 
and accounted for within the new technology APC payment rate for the 
service. We believe the third option represents a simple, unburdensome 
approach that would ensure timely and appropriate payment in a new 
technology APC for a new service that includes administration of a new 
drug or biological and that meets the other criteria for a new 
technology APC. For both options two and three, we would first consider 
whether assigning a new HCPCS code is appropriate and, if it is, we 
would then determine whether the new code should be assigned to an 
existing APC. If not, we would assign it to a new technology APC.
    c. Revision of Application for New Technology Status. In the August 
24 proposed rule we proposed to change the information that interested 
parties must submit to have a service or procedure considered for 
assignment to a new technology APC. Specifically, to be considered, we 
proposed 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.
     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.
     A description of where the service is currently being 
performed (by location) and the approximate number of patients 
receiving the service in each location.
     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.
     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.
     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.)
    One commenter stated that, on the whole, the proposed changes to 
the information that interested parties must submit to have a service 
or procedures considered for assignment to a new technology APC seem 
reasonable and designed to minimize the need for time-consuming 
requests for supplemental information from applicants. Other comments 
on the proposed changes are summarized below.
    Comment: A few commenters stated that the significant amount of 
additional data required to file an application is unnecessarily 
burdensome, and, in some cases, may not be available when new products 
are launched. In particular, one commenter was concerned that the 
information needed to provide a clinical vignette (patient diagnoses 
that the service is intended to treat, the typical patient, a 
description of resources used to furnish the service such as staff, 
equipment, supplies, and similar facility and professional resources) 
may not always be available when a new product is launched. The 
commenter was also concerned that upcoming implementation of the Health 
Insurance Portability and Accountability Act of 1996 (HIPAA) will make 
providers reluctant to furnish necessary data to manufacturers. The 
need for consent releases and storage retention required by the HIPAA 
regulations are added administrative costs that will have to be 
incurred. Instead, the commenter recommended that we request a detailed 
description of the service which, if possible, includes the resources 
used during the procedure.
    Response: Our experience with new technology applications has 
revealed the critical need for the information on clinical factors and 
resource utilization that is described as part of a ``clinical 
vignette.'' Without this information, it is difficult to understand 
what the nominated service involves in both clinical and resource 
terms. We need the fullest possible description of every aspect of the 
service to help us understand how it is being furnished in hospitals 
and the costs associated with the service. This information is 
indispensable in assessing the appropriate payment rate for the

[[Page 59902]]

nominated service. We believe that those seeking to apply for new 
technology APC status for a service will have sufficient expertise and 
experience with the service to enable them to furnish the full and 
detailed description of the service that is required as part of the 
clinical vignette. Based on our experience to date in reviewing 
applications for new technology APCs, there is strong evidence that 
close cooperative working relationships exist among manufacturers, 
hospitals, and clinicians who seek to have a service assigned to a new 
technology APC. When we have had to ask for additional information of 
the type we proposed to require for future applications, this 
information has been readily available and promptly supplied.
    Comment: One commenter stated that the requirement for ``a 
description of where the service is currently being performed (by 
location) and the approximate number of patients receiving the service 
in each location'' appears excessive if all that is sought through this 
requirement is the identification of medical contacts. A commenter 
expressed concern that having to identify all facilities or physicians 
performing the procedure would in many cases appear to be 
administratively excessive and a potential breach of confidentiality. A 
commenter recommended that, if medical contacts are desired, the 
requirement should be for the names, contact information and 
approximate number of patients treated for a ``representative'' sample 
of facilities and/or physicians performing the procedure or service who 
are willing to serve as such contacts.
    Response: While this requirement would furnish us with medical 
contacts, it also provides us with other significant information. For 
example, knowing the locations where the service is being performed and 
the approximate number of patients receiving the service provides 
insight into the extent to which the service is being performed 
(rarely, occasionally, or frequently); the types of hospitals where it 
is being performed (small rural or suburban hospitals, large urban 
teaching hospitals); and a geographic profile of where the service is 
currently available. We believe it is crucial to our evaluation of 
nominated procedures that we have a detailed understanding of, among 
other things, the indications and contraindications for the procedure, 
the current utilization of the procedure, the patient populations for 
which the procedure is performed, the types of hospitals where it is 
performed, the sites (for example, inpatient hospital, physician 
office) and locations (for example, teaching hospitals, community 
hospitals) where the procedure is performed. Without such information, 
we cannot make an appropriate determination as to whether the procedure 
is ``truly new''. This information, along with information about the 
specialties of physicians performing the service, assists our medical 
advisors and clinicians in their evaluation of whether or not the 
service should be assigned to a new technology APC.
    Comment: One commenter wanted assurance that ``information about 
the clinical use and efficacy of the service such as peer-reviewed 
articles' would be referred to the Office of Clinical Standards and 
Quality if the intent of this new requirement were to determine whether 
the new technology should be ``covered.''
    Response: The purpose of this requirement is to help us better 
understand the clinical dimensions of the service. Neither assignment 
of one or more new HCPCS code(s) to a procedure or assignment of a 
procedure to a new technology APC assures that Medicare will cover the 
procedure. In order for a procedure to be covered by Medicare, it must 
be determined, either locally, or nationally, that the procedure is 
medically reasonable and necessary. Information about how to obtain a 
national coverage decision is posted on the CMS website at http://www.hcfa.gov/coverage. To receive Medicare payment, services must be 
considered reasonable and necessary and each use of a service is 
subject to medical review for determination of whether its use was 
reasonable and necessary.
    d. Length of Time in a New Technology APC. We proposed to change 
the period of time during which a service may be paid under a new 
technology APC. We noted that 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. We proposed 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 policy would allow us to 
move a service from a new technology APC in less than 2 years if 
sufficient data were available and would also allow us to retain a 
service in a new technology APC for more than 3 years if sufficient 
data upon which to base a decision had not been collected.
    Comment: One commenter supported eliminating the 2 to 3 year 
assignment to a new tech APC, which would give CMS greater flexibility 
to base future payment on adequate pricing data that could take less 
than 2 or more than 3 years to collect.
    Several commenters stated that we should clarify at the time of the 
assignment to the new technology APC how the decision will be made to 
move it into a permanent APC. Specifically, these commenters indicated 
that we should publish the methodology used to reassign services from 
new technology APCs into existing APC categories, including how we will 
evaluate clinical and cost data to determine whether or not a service 
in a new technology APC should be reassigned to an existing APC.
    Most commenters supported keeping a procedure in a new technology 
APC for a minimum of 2 years of data collection to ensure that an 
adequate claims database is available to make appropriate decisions 
about ultimate APC assignment, structuring, packaging, and payment. 
These commenters noted that limited procedure volume and coding 
confusion immediately following market release of a new technology 
could limit the amount of useful data that would be available in the 
first year.
    Response: We agree with commenters that adequate claims data is 
more important than completion of a fixed time span for determining 
when to reassign a new technology APC service. We expect that, 
practically speaking, we will need a full year of available claims 
data. We use the same methodology to reassign services from a new 
technology APC to an existing APC group, or to a new APC group if that 
is indicated, that we use in our annual review of all APC weights and 
assignments. That is, we review claims-based charge and utilization 
data and the most recent available cost report data. This process may 
include consulting the APC Advisory Panel for its recommendations 
regarding appropriate APC assignments.
    Comment: Several commenters urged us not to reassign new medical 
procedures from one new technology APC to another during the yearly 
updates to the APC system absent current and complete data. These 
commenters asserted that during the period when a new procedure is 
assigned to a new technology APC, there may be reasons why claims data 
used for the annual updates to the APC system are not representative of 
actual hospital experience in providing the service. Therefore, we 
should recognize that the reasons that support a multi-

[[Page 59903]]

year assignment to a new technology APC, that is, the need to gather 
data, also argue for caution in moving services from one new technology 
APC (and payment rate) to another.
    Response: In general, we agree that once a device has been assigned 
to a new technology APC, it will remain there until we have collected 
the data necessary to move it to a clinically appropriate APC. However, 
we have on occasion, made an assignment to a new technology APC based 
on information that later was found to have been inaccurate. In those 
cases, we believe that it is appropriate to move the service to the new 
technology APC that better reflects the cost. We note that when we have 
made these changes in the past, services were moved to higher-paying 
APCs as well as lower-paying APCs.
    Comment: One commenter urged that any new criteria that we adopt be 
applied prospectively to those applications submitted after the 
effective date of the final rules.
    Response: Changes in the criteria and application process for 
assigning services to a new technology APC will be made prospectively, 
effective upon implementation of this final rule.
    Comment: Although the new technology APCs and pass-through device 
categories were to be updated on a quarterly basis, many applications 
have taken much longer to process. CMS should establish a mechanism to 
process applications in a timely manner. One commenter suggested 
monthly updates.
    Response: The volume of applications and changes we have had to 
make in the OPPS following enactment of BIPA have combined to stretch 
our resources to the maximum. Also, the need to seek additional 
information to enable us to complete a thorough and rigorous evaluation 
of applications for new technology APC assignments has often caused 
delays in making a final determination. We believe the additional 
information that we proposed to require in an application for new 
technology APC status will assist us in completing our reviews and 
making final determinations in a timely manner. CMS and our fiscal 
intermediaries' systems constraints preclude making updates more 
frequently than quarterly.
    Comment: One commenter stated that the amount of information 
provided in the proposed rule does not satisfy the requirement of the 
Administrative Procedures Act that the public be informed and allowed 
to comment on major regulatory changes. The commenter requested full 
disclosure of data, methodology and options considered prior to 
implementation of the methodology with a suitable time of at least 60 
days for public comment. The commenter requested that we retain the 
criteria established in the April 2000 final rule but that we eliminate 
the need for a HCPCS code.
    Response: We believe that our description of the proposed changes 
to the criteria and application process for new technology APCs allowed 
ample opportunity for substantive comment, and we did receive numerous 
substantive comments on the proposed changes. In addition, changes in 
the process and information required to apply for new technology APC 
status under the OPPS are subject to provisions of the Paperwork 
Reduction Act (PRA) of 1995, as further explained in section XII of 
this final rule.
    Final Action: We are making final the changes we proposed regarding 
the definition of what is appropriately paid for under a new technology 
APC, the criteria for determining assignment to a new APC, the 
information that must be supplied for a request to be considered, and 
the period of time during which payment in a new technology APC can be 
made. The schedule for submission of applications and the process and 
information required for a new technology APC designation is posted on 
the CMS website at http://www.hcfa.gov/medlearn.

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. On November 2, 
2001, we published an interim final rule with comment that established 
the criteria for new categories (66 FR 55850).
    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. The application process for new categories can 
be found on the CMS web site at http://www.hcfa.gov//medicare/newcatapp1030f.rtf.

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,

[[Page 59904]]

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.
    As discussed above, on November 2, 2001, we published a final rule 
that announced the implementation of a pro rata reduction for CY 2002. 
That document describes the methodology for estimating pass-through 
payments and indicates that we expected the reduction would be between 
65 and 70 percent. Based on the final APC weights, which incorporate 75 
percent of the estimated device pass-through costs, the final pro rata 
reduction is 68.9 percent.

C. Reducing Transitional Pass-Through Payments To Offset Costs Packaged 
Into APC Groups

    As discussed in the proposed rule, in the November 13, 2000 interim 
final rule (65 FR 67806 and 67825), we had excluded costs in revenue 
codes 274 (Prosthetic/orthotic devices), 275 (Pacemaker), and 278 
(Other implants) from the calculation of APC payment rates. This was 
because, before enactment of the BBRA 1999, we had proposed to pay for 
implantable devices outside of the OPPS. 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-
          For item billed under HCPCS code. * * *              through
                                                             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-responsive           2,843.00
 (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, we estimated in the proposed rule 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.
    We described our methodology for calculating these reductions for 
the proposed rule. 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 column 3 of Table 5, we show the amount of the offset that we 
have computed with this methodology for each of the 25 APCs that we 
determined to have device costs represented in their rates. We note 
that the list of 25 APCs with device costs in their rates has changed 
slightly since the publication of the proposed rule. Specifically, APC 
0185, Removal or Repair of Penile

[[Page 59905]]

Prosthesis, is no longer on the list, and APC 0259, Level VI ENT 
Procedures, has been added to the list. These changes result from the 
application of the limit on the variation of costs of services 
classified within a group (the ``two-times'' rule). APC 0185 has been 
deleted due to the application of this rule. The device-related 
procedures that had been included with APC 0185 have been incorporated 
into APC 0259. As a result, APC 0259 has been added to the list of APCs 
with device costs reflected in their rates, on the basis of the same 
costs that had been included in APC 0185.
    We received several comments on this proposal, which are summarized 
below.
    Comment: Several commenters asked for clarification of the 
methodology used in selecting the 25 APCs for which we calculated 
reductions.
    Response: We described our methodology for selecting the 25 APCs in 
some detail in the proposed rule (66 FR 44706). As we stated there, 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 carefully examined those APCs with a high 
frequency of claims in the data, and those that were associated with 
high-cost devices. We selected those APCs with patterns of billing that 
could be reasonably associated with devices, that is, with charges in 
revenue centers that are likely to be used for devices (revenue codes 
272 (sterile supplies), 275 (pacemakers), and 278 (other implants)).
    Comment: Several commenters noted that for 11 of the 25 APCs for 
which we have identified offsets, the amount of the proposed APC 
payment for 2002 has either decreased or increased by less than the 
amount of the offset. For these 11 APCs, Medicare's combined payments 
for the device and procedure would thus be reduced effective January 1, 
2002.
    Response: The estimate of the offset did not affect the APC rates. 
Any changes in the APC rates were due to the recalibration of the 
relative weights using the 1999-2000 data. The offset amount will be 
subtracted from the pass-through payment amount that would have been 
made otherwise. Thus, the combined payment for the device and procedure 
is necessarily reduced for all 25 APCs relative to what the payment 
would have been in 2002 without the offset. In other words, payments 
for all 25 device/procedure combinations would have been higher in 2002 
by the amount of the offset if we had not identified the packaged costs 
and applied the offset. We assume, however, that the commenter means 
that payments for the device/procedure combinations associated with 11 
of the 25 APCs will decrease in 2002 relative to the combined payments 
in 2001. Relative to the payments for 2001, the combined payment for 
the device and procedure could increase or decrease due to a number of 
factors affecting the relative weights for the APCs and the costs of 
the devices themselves. In the cases identified by the commenter, these 
factors decreased the proposed rates, or increased those rates by less 
than the amount of the offset, and thus decreased the payment in 2002 
for the device/procedure combination relative to the payment for the 
combination in 2001.
    Comment: One commenter endorsed the idea of making a reduction in 
pass-through payments for the costs already represented in the APC 
rates. However, the commenter expressed concern that reducing the pass-
through payment will likely result in underpayments to hospitals that 
are using the associated devices with procedures, and overpayments to 
hospitals performing procedures without using the associated devices.
    Response: We are not certain that the commenter understands how the 
pass-through offset works. The purpose of this measure is to ensure 
that the Medicare program pays only for the incremental costs of the 
new technology, over and above what is already represented in the APC 
rate for the associated procedure. The offset is applied only when a 
hospital bills for a device or other pass-through item in conjunction 
with billing for a procedure in an associated APC. When a hospital 
bills for a pass-through item along with a procedure, the hospital 
receives the full APC payment for the procedure. The offset is 
subtracted from the cost of the pass-through item. The hospital thus 
receives payment for the cost of the pass-through item over and above 
the offset amount. Without applying the offset, hospitals would be paid 
twice for the same costs. There is thus no underpayment for hospitals 
that are using pass-through items. When a hospital does not bill for a 
pass-through item with an APC, the hospital receives the full APC 
payment but no pass-through payment. The offset is not applied in the 
absence of a bill for a pass-through item. There is thus no overpayment 
for hospitals that are not using pass-through items. The hospital is 
paid only for the technology costs incorporated into the base APC rate, 
not for the incremental costs of new technologies.
    Comment: One commenter raised a question about a possible 
consequence of applying predetermined amounts to subtract from pass-
through payments as offsets for the device-related costs already 
included in the APC rates. The commenter observed that use of a 
hospital-wide cost-to-charge ratio in determining the amount of a pass-
through payment makes it possible for the predetermined offset amount 
to exceed the calculated cost of a device to the hospital. The 
commenter therefore recommended that the reduction for the costs 
included in the APC rates never exceed the amount of the pass-through 
payment.
    Response: We agree that the application of the pass-through offset 
should never result in a negative payment amount to the hospital. Our 
systems do not in fact compute pass-through payment amounts of less 
than zero.
    Comment: One commenter recommended that, if we implement a pro rata 
reduction in the transitional pass-through payments, the same 
percentage reduction should be applied to the offsets for the 
technology costs already represented in the APCs associated with pass-
through items. Such a reduction in the offset would help hospitals to 
maintain beneficiary access to new technology services in the event of 
a substantial pro rata reduction.
    Response: The statute provides for applying a pro rata reduction 
only to the pass-through payments themselves, not to the offsets that 
are required to account for the costs that are represented in the 
payment rates for associated APCs. Reducing the offset would also 
increase the estimate of pass-through spending and require a larger pro 
rata reduction. We are therefore unable to accept the commenter's 
recommendation. We note, however, that the pro rata reduction is 
applied to the pass-through payment amount only after the offset.
    Comment: One commenter endorsed the concept of incorporating pass-
through device costs into their associated APCs, but raised a specific 
question about the device costs associated with APC 0182, Insertion of 
Penile Prosthesis. The commenter contended that a review of the median 
cost files suggests that numerous claims could not have included device 
costs, even though the whole point of the procedure is to implant a 
device. As a result, the commenter contended that both the pass-through 
offset for the device and any upward adjustment to incorporate device 
costs into the APC can only be understated. Two commenters inquired 
about APC 0108, Insertion/Replacement/Repair of Cardioverter-
Defibrillator Leads. The

[[Page 59906]]

commenter contended that the $5,768 that we have determined as 
representing device costs in that APC is far too low, since the average 
device costs between $22,000 and $23,000 in 1996.
    Response: The first commenter is mistaken in thinking that we 
published a methodology for incorporating device costs into the APCs in 
the proposed rule. Rather, we published a methodology for identifying 
device costs that are already represented in the rates. (We published a 
methodology for incorporating device costs into the APCs in the 
November 2, 2001 final rule announcing the CY 2002 conversion factor 
and the pro rata reduction of transitional pass-through payments (66 FR 
55857).) In developing our estimate of the device costs included in the 
APC rates, we used that portion of hospital costs that were allocated 
to those revenue centers in which device charges were likely to be 
billed. Hospitals have considerable flexibility in determining which 
revenue centers to assign charges, and we believe that in many cases 
they have allocated device charges to general supply centers. We are 
unable to separate the device charges from the other charges assigned 
to those revenue centers. We were thus unable to use costs from those 
centers in developing our estimates of the device costs associated with 
the APC rates. As a result, our estimate of the device costs in the APC 
rates might conceivably be understated. We believe that it does 
represent, however, a reasonably conservative estimate. We do not know 
the source of the other commenter's information about the cost for a 
specific device, but we believe that our offsets accurately capture the 
costs for device costs that are included in the current APC rates, net 
of all discounts, rebates, etc.
    Comment: Several commenters questioned whether we would deduct from 
pass-through payments the full amount of the offset for the device 
costs reflected in associated APCs in cases where the payment for the 
associated APC is reduced due to the multiple procedures discount. Some 
of these commenters also recommended a methodology for making an 
appropriate adjustment. Specifically, they recommended that the 
multiple procedure discount be applied only to the nondevice-related 
portion of the APC payment amount.
    Response: We agree with the commenters that the full pass-through 
offset should not be applied when the APC associated with the use of 
the device is subject to the multiple procedure discount of 50 percent. 
The purpose of the offset is to ensure that the program is not making 
double payment for any portion of the cost associated with the use of a 
pass-through item. The offset should therefore reflect that portion of 
the cost for the pass-through item actually reflected in the payment 
that is received for the associated APC. We believe that the most 
straightforward methodology for applying this principle is simply to 
reduce the offset amount by 50 percent whenever the multiple procedure 
discount applies to the associated APC.
    Comment: One commenter asked how the offset is applied when one 
pass-through device is billed with more than one of the 25 APCs in 
which we have identified costs associated with pass-through items. And 
conversely, the commenter wondered what happens when two or more 
devices are billed with only one of the 25 APCs with offsets.
    Response: The purpose of the offset is to avoid paying twice for 
costs that are represented both in the APC rates and in the costs of 
pass-through items. When one pass-through device is billed with two or 
more APCs with device-related costs, we would be double paying for some 
costs if we applied only one offset to the pass-through payment. We 
therefore apply all the offsets for the APCs on a bill when only one 
device is billed. As we have discussed above, however, the offset for 
the second APC would be reduced by 50 percent when the multiple service 
discount applies to that APC. Conversely, the offset is applied only 
once when one APC is billed, no matter how many devices are billed 
along with the APC. To apply the offset more than once would be to 
double-count the pass-through costs represented in that APC.
    We employed the following methodology in incorporating 75 percent 
of the device pass-through costs into the costs that are used to 
establish the APC relative weights. We used a crosswalk that we 
developed as part of the methodology for estimating total pass-through 
spending as the basis for determining the device costs that are to be 
included in setting the relative weight for each APC. This crosswalk 
matches devices to the primary procedures in which they are used. In 
developing the total pass-through estimate, we used this crosswalk to 
produce a device package for each APC associated with device use, based 
on the one or more devices used in the procedures included in the APC. 
We then adjusted the costs of each package by subtracting the costs 
already represented in the payment amount for the APC. (These are the 
costs that are shown in column 3 of Table 5 below.) In order to account 
for these costs in determining the new relative weights, we added 75 
percent of the costs in this adjusted package to the costs at the claim 
level for each procedure that uses the package of devices in the APC. 
At this point, we determined a revised median cost for the APC. That 
new median cost in turn was used as the basis for calculating the APC's 
new relative weight.
    It is important to note that the median cost of an APC will not 
necessarily increase by the same amount as the costs that are folded 
into the APC. The middle number (that is, the median) in the ordered 
sequence of the costs for services in an APC would only vary by the 
same amount as the folded-in costs if every number in the sequence were 
increased by the amount of those folded-in costs. However, as we 
explained in the November 2, 2001 final rule concerning the pro rata 
reduction on transitional pass-through payments (FR 66 55862-5863), the 
device costs folded into an APC will not be uniformly distributed among 
the procedures in that APC. This is because procedures in an APC may 
require different types or numbers of devices, and some procedures may 
not require devices at all. Therefore, the increase in median cost for 
an APC is unlikely to exactly equal the amount of the costs folded into 
the APC. In the November 2, 2001 final rule, we also discuss in detail 
how the increase in APC rates due to the incorporation of these pass-
through costs will be offset against the 2002 pass-through payments.
    Table 5 shows the amount of the offsets that we will apply for each 
APC that contains device costs. Column 4 of Table 5 shows the amount of 
the offset for each APC into which costs have been folded employing the 
methodology we have just described. Column 5 then shows the total 
offset that is to be applied for each APC. For the 25 APCs in which we 
had previously identified device costs, the amount of the offset in 
column 5 is the sum of the amount in column 3 (the amount of the offset 
due to the device costs that we had previously identified in the APC) 
and the amount in column 4 (the amount of the offset due to the costs 
that have just been folded in). For all the other APCs listed in the 
table, the amounts in column 4 and column 5 are identical (and there is 
no entry in column 3). This is because we had not previously identified 
device costs that were already represented in the payment amounts for 
these APCs.

[[Page 59907]]



                     Table 5.--Offsets To Be Applied for Each APC That Contains Device Costs
----------------------------------------------------------------------------------------------------------------
                                                                        Device costs   Additional
                                                                           already    device costs  Total office
              APC                             Description               reflected in   folded into   for device
                                                                          APC rate      APC rate        costs
----------------------------------------------------------------------------------------------------------------
1                                2....................................             3             4             5
----------------------------------------------------------------------------------------------------------------
0032...........................  Insertion of Central Venous/Arterial         $73.79       $276.41       $350.20
                                  Catheter.
0046...........................  Open/Percutaneous Treatment Fracture             NA         91.63         91.63
                                  or Dislocation.
0048...........................  Arthroplasty with Prosthesis.........            NA        501.91        501.91
0057...........................  Bunion Procedures....................            NA        155.76        155.76
0070...........................  Thoracentesis/Lavage Procedures......            NA         24.94         24.94
0080...........................  Diagnostic Cardiac Catheterization...        164.27        124.21        288.48
0081...........................  Non-Coronary Angioplasty or                  307.06        353.78        660.84
                                  Atherectomy.
0082...........................  Coronary Atherectomy.................        242.95      1,187.08      1,430.03
0083...........................  Coronary Angioplasty.................        528.64        365.49        894.13
0084...........................  Level I Electrophysiologic Evaluation            NA      9,783.24      9,783.24
0085...........................  Level II Electrophysiologic                      NA        580.82        580.82
                                  Evaluation.
0086...........................  Ablate Heart Dysrhythm Focus.........            NA      1,299.58      1,299.58
0087...........................  Cardiac Electrophysiologic Recording/            NA      1,964.38      1,964.38
                                  Mapping.
0088...........................  Thrombectomy.........................        162.72        251.47        414.19
0089...........................  Insertion/Replacement of Permanent         3,175.70      3,242.08      6,417.78
                                  Pacemaker and Electrodes.
0090...........................  Insertion/Replacement of Pacemaker         2,921.06      2,196.00      5,117.06
                                  Pulse Generator.
0094...........................  Resuscitation and Cardioversion......            NA         17.31         17.31
0103...........................  Miscellaneous Vascular Procedures....            NA        202.60        202.60
0104...........................  Transcatheter Placement of                   428.16        798.68      1,226.84
                                  Intracoronary Stents.
0106...........................  Insertion/Replacement/Repair of              657.59      1,038.44      1,696.03
                                  Pacemaker and/or Electrodes.
0107...........................  Insertion of Cardioverter-                 6,803.85     10,987.63     17,791.48
                                  Defibrillator.
0108...........................  Insertion/Replacement/Repair of            6,940.27     19,438.20     26,378.47
                                  Cardioverter-Defibrillator Leads.
0111...........................  Blood Product Exchange...............            NA        203.11        203.11
0115...........................  Cannula/Access Device Procedures.....            NA        121.15        121.15
0117...........................  Chemotherapy Administration by                   NA         29.02         29.02
                                  Infusion Only.
0118...........................  Chemotherapy Administration by Both              NA         27.49         27.49
                                  Infusion and Other Technique.
0119...........................  Implantation of Devices..............            NA      3,325.05      3,325.05
0120...........................  Infusion Therapy Except Chemotherapy.            NA         34.10         34.10
0121...........................  Level I Tube Changes and                         NA          5.09          5.09
                                  Repositioning.
0122...........................  Level II Tube Changes and                     72.55        212.27        284.82
                                  Repositioning.
0124...........................  Revision of Implanted Infusion Pump..            NA      3,282.80      3,282.80
0144...........................  Diagnostic Anoscopy..................            NA        126.75        126.75
0151...........................  Endoscopic Retrograde Cholangio-              60.92          0.00         60.92
                                  Pancreatography (ERCP).
0152...........................  Percutaneous Biliary Endoscopic              107.61          0.00        107.61
                                  Procedures.
0153...........................  Peritoneal and Abdominal Procedures..            NA         33.60         33.60
0154...........................  Hernia/Hydrocele Procedures..........        108.11        369.57        477.68
0161...........................  Level II Cystourethroscopy and other             NA          7.12          7.12
                                  Genitourinary Procedures.
0162...........................  Level III Cystourethroscopy and other            NA        312.55        312.55
                                  Genitourinary Procedures.
0163...........................  Level IV Cystourethroscopy and other             NA        889.80        889.80
                                  Genitourinary Procedures.
0179...........................  Urinary Incontinence Procedures......            NA      3,359.66      3,359.66
0182...........................  Insertion of Penile Prosthesis.......      2,238.90        543.66      2,782.56
0202...........................  Level VIII Female Reproductive Proc..        505.32      1,215.08      1,720.40
0203...........................  Level V Nerve Injections.............            NA        416.39        416.39
0207...........................  Level IV Nerve Injections............            NA         61.60         61.60
0222...........................  Implantation of Neurological Device..      4,458.57      9,510.40     13,968.97
0223...........................  Implantation of Pain Management              421.33      3,307.74      3,729.07
                                  Device.
0225...........................  Implantation of Neurostimulator            1,182.00     11,862.15     13,044.15
                                  Electrodes.
0226...........................  Implantation of Drug Infusion                    NA      3,341.85      3,341.85
                                  Reservoir.
0227...........................  Implantation of Drug Infusion Device.      3,810.46      2,354.31      6,164.77
0229...........................  Transcatherter Placement of                1,074.41        391.45      1,465.86
                                  Intravascular Shunts.
0237...........................  Level III Posterior Segment Eye                  NA        138.46        138.46
                                  Procedures.
0246...........................  Cataract Procedures with IOL Insert..        146.82          0.00        146.82
0248...........................  Laser Retinal Procedures.............            NA      1,262.93      1,262.93
0259...........................  Level VI ENT Procedures..............     12,407.52      3,724.65     16,132.17
0264...........................  Level II Miscellaneous Radiology                 NA         60.06         60.06
                                  Procedures.
0312...........................  Radioelement Applications............            NA      1,201.84      1,201.84
0685...........................  Level III Needle Biopsy/Aspiration               NA        208.20        208.20
                                  Except Bone Marrow.
0686...........................  Level V Skin Repair..................            NA        458.65        458.65
0687...........................  Revision/Removal of Neurostimulator              NA      1,432.44      1,432.44
                                  Electrodes.
0688...........................  Revision/Removal of Neurostimulator              NA      6,195.52      6,195.52
                                  Pulse Generator Receiver.
0692...........................  Electronic Analysis of                           NA        639.86        639.86
                                  Neurostimulator Pulse Generators.


[[Page 59908]]

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.
    In the November 2, 2001 final rule, we announced that the 
conversion factor for CY 2002 is $50.904 (66 FR 55864) based on an 
increase factor of 2.3 percent for 2002 and a wage index budget 
neutrality adjustment of 0.9936.

IX. Summary of and Responses to MedPAC Recommendations

    On March 1, 2001 the Medicare Payment Advisory Commission (MedPAC) 
issued its annual report to Congress, including several recommendations 
related to the OPPS. In the August 24, 2001 proposed rule, we responded 
to these recommendations (66 FR 44707-44708).
    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

[[Page 59909]]

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 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 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.
    We received no comments on our responses to the MedPAC 
recommendations.

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 before that date, found in 
Section 2446 of the Provider Reimbursement Manual--Part 1 (PRM-

[[Page 59910]]

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

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

    On December 21, 2000, the Medicare, Medicaid, and SCHIP 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) of BIPA 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) responsibilities of 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 responsibility of off-campus 
facilities provide written notices to Medicare beneficiaries of 
coinsurance liability. These rules are not pre-empted by the 
grandfather provisions of BIPA section 404 because they do not set 
forth criteria that must be met for provider-based status as a 
department of a hospital, but instead identify responsibilities that 
flow from that status. These responsibilities become effective for 
hospitals on the first day of the hospital's cost reporting period 
beginning on or after January 10, 2001.
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 ensure 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 2-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
    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 shall be treated as 
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) of BIPA, a 
request for provider-based status should be submitted to the 
appropriate CMS Regional Office (RO). Until a uniform application is 
available, 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 
effective 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

[[Page 59911]]

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.

D. Commitment To Re-Examine EMTALA Applicability to Off-Campus Hospital 
Locations, and to Further Revise Provider-Based Regulations

    As explained in the proposed rule published on August 24, 2001, (p. 
44709) 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. We plan to review these 
regulations with a view toward ensuring that these locations are 
treated in ways that are appropriate to the responsibility for EMTALA 
compliance of the hospital as a whole. At the same time, we want to 
ensure that those departments that Medicare pays as hospital-based 
departments are appropriately integrated with the hospital as a whole. 
Because of these considerations, we stated in the preamble to our 
August 24, 2001 proposals that we intend to publish a proposed rule to 
address these issues more fully.
    In response to our statements, we received several comments, which 
are summarized below.
    Comment: Several commenters expressed approval of the statement, in 
the preamble to the August 24, 2001 proposed rule, that CMS plans to 
reconsider the appropriateness of applying EMTALA to off-campus 
hospital locations. The commenters offered to work with CMS in 
establishing further policy in this area.
    Response: We appreciate the commenters' support, and look forward 
to working with them on these important issues.
    Comment: One commenter stated that since CMS is planning to 
reconsider the appropriateness of applying EMTALA to off-campus 
hospital locations it should, while the review is taking place, either 
withdraw the regulations requiring EMTALA compliance at off-campus 
hospital facilities, or not implement those regulations.
    Response: We agree that the issues need to be reviewed carefully. 
EMTALA affords important protections to individuals who come to 
hospitals to seek care for possible emergency medical conditions. Thus, 
any change in the scope of the EMTALA regulations must be considered 
very thoroughly before it is undertaken. At the same time, we are well 
aware that many hospitals continue to be concerned about what they view 
as the excessive financial and administrative burden of complying with 
EMTALA at off-campus locations. In view of the complexity of the issues 
under view, and in consideration of the very significant impact that 
any change could have on the health and safety of hospital patients, we 
remain convinced that it would not be appropriate to anticipate the 
conclusion of that review by withdrawing or rescinding the regulations 
at this time. For the same reason, we are not adopting the suggestion 
that we suspend implementation of the current regulations.
    Comment: Several commenters recommended that CMS publish additional 
regulations clarifying various issues related to the criteria for 
provider-based status. The commenters offered to work with CMS in 
establishing further policy in this area.
    Response: We appreciate the commenters' support, and look forward 
to working with them on these important issues.

E. 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 Qs and As on 
provider-based status, as described above, we proposed 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 proposed to revise that 
paragraph to clarify its meaning. In addition, for further clarity, we 
proposed to revise the coding and title of that material. We proposed 
to redesignate Sec. 413.24(d)(6)(i) as Sec. 413.24(d)(6) and 
Sec. 413.24(d)(6)(ii) as 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 that duplicates the directly assigned costs. This 
duplication could result in improper Medicare payment to the provider. 
Therefore, when 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 
proposed to 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

[[Page 59912]]

final rule. We received no comments on this proposal and are adopting 
it without change.
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 proposed 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.
    We received a few comments on this proposal, which are summarized 
below.
    Comment: One commenter expressed approval of the proposed revision, 
but suggested that we expand the list of facilities or organizations 
for which provider-based status is not required to include specific 
types of neonatal intensive care units and outpatient departments 
providing specialty pediatric care. The commenter believed such a 
change would permit these facilities to be treated as provider-based 
after the grandfather provisions of BIPA section 404 expire, even 
though they do not meet all criteria in 42 CFR 413.65(d).
    Response: In Q/A 9 published on the CMS web site at www.hcfa.gov/medlearn/provqa.htm we identified specific types of facilities for 
which provider-based determinations will not be made because any 
determinations regarding their status would not affect either Medicare 
payment levels or beneficiary liability. In the August 24, 2001 
proposed rule, we proposed to codify this list of facilities. Because 
the comment was submitted in response to this part of our proposal, we 
considered it in that context. However, the commenter did not succeed 
in establishing that the units and specialized outpatient departments 
meet the criteria for inclusion on a list of facilities for which a 
determination about provider-based status would not affect either 
Medicare payment levels or beneficiary liability. (On the contrary, the 
commenter argued that if determinations were made on such units and 
departments, payments would be reduced significantly.) Moreover, the 
primary focus of the comment is not to ask that no determinations be 
made for these units and departments, but instead that those facilities 
be treated as provider-based even though they do not meet some or all 
of the provider-based criteria in Sec. 413.65(d). We did not propose to 
extend provider-based status to such facilities (except insofar as BIPA 
section 404 requires us to do so), nor can such a proposal be logically 
inferred from the provisions included in the proposed rule. Thus, while 
we reviewed this comment with interest, we did not adopt it. We 
received no other comments on this proposed revision and are adopting 
it without change.
3. BIPA Provisions on Grandfathering and Temporary Treatment as 
Provider-Based (Secs. 413.65(b)(2) and (b)(5))
    Currently, Sec. 413.65(b)(2) states that a main provider or a 
facility must contact CMS (formerly, HCFA), and CMS must determine that 
the facility is 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 proposed 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 further proposed that for 
purposes of paragraph (b)(2), a facility would 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.
    In addition, we proposed 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.
    We received one comment on this proposal, which is summarized 
below.
    Comment: One commenter stated that our proposed revision to these 
sections does not adequately implement section 404(c) of BIPA, in that 
it would require temporary treatment as provider-based for a facility 
or organization for which such status is requested on or before October 
1, 2000 only from October 1, 2000 forward. The commenter believes this 
is inappropriate because section 404(c) of BIPA provides that such a 
facility or organization is to be treated as provider-based for ``any 
period before a determination is made.'' Under the commenter's 
recommended interpretation of the provision, such temporary treatment 
would also be available for any period before October 1, 2000.
    Response: We believe this interpretation of the provision is overly 
literal, and does not accurately reflect the role of paragraph (c) in 
the total statutory scheme established by section 404 of BIPA. Section 
404(a)(1) describes the treatment to be accorded to facilities treated 
as provider-based on October 1, 2000, by providing that such facilities 
will continue to be treated as provider-based until October 1, 2002. 
Thus, paragraph (a) of section 404 addresses the situation of 
facilities that existed and were treated as provider based on October 
1, 2000. Section 404(c) of BIPA complements this provision by mandating 
a grace period for those facilities seeking provider-based status 
determinations on or after October 1, 2000 that either (i) existed on 
October 1, 2000 but were not treated as provider-based, or (ii) did not 
exist as of October

[[Page 59913]]

1, 2000 (that is, were opened after that date). Taken together, 
paragraphs (a) and (c) specify the treatment to be given to facilities 
treated as provider-based on the reference date of October 1, 2000 and 
to those facilities for which provider-based status is sought within 2 
years after the reference date. However, we find no indication that the 
statute was intended to extend provider-based status for any period 
before the reference date. Such an extension would not be necessary to 
protect a provider from possible retroactive liability based on 
possible delay in considering a provider-based application, and could 
inappropriately prevent collection of overpayments incurred well before 
October 1, 2000. Thus, we did not adopt this comment.
    We received no other comments on this proposal and we are adopting 
it without change.
4. Reporting (Sec. 413.65(c)(1))
    Currently, Sec. 413.65(c) states that a main provider that creates 
or acquires a facility or organization for which it wishes to claim 
provider-based status, including any physician offices that a hospital 
wishes to operate as a hospital outpatient department or clinic, must 
report its acquisition of the facility or organization to 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 
proposed to delete the current requirement from Sec. 413.65(c)(1). We 
proposed, however, to 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.
    We received one comment on this proposal, which is summarized 
below.
    Comment: A commenter stated that more guidance is needed on the 
rules regarding reporting to CMS any significant changes in the 
relationship between a main provider and its provider-based facilities. 
The commenter asked that we explain the meaning of ``significant 
changes,'' prescribe the format of such reporting, and specify to whom 
such reports are to be made.
    Response: Although the commenter refers to reporting any 
significant changes, the regulations at Sec. 413.65(c)(1) speak of 
reporting any ``material'' changes in the relationship between it and 
any provider-based facility. As explained in the August 24, 2001 
proposed rule, we would consider a ``material'' change to be anything 
that may interfere with compliance with the provider-based rules. The 
August 24, 2001 document further explains that such a change may 
include but is not limited to a change of ownership, entry into a new 
or different management contract, or change in the financial operations 
of the facility or the main provider. The main provider may report such 
material changes in the form of a letter submitted to its CMS Regional 
Office with a copy to its fiscal intermediary. While we are responding 
in this preamble to the commenter's questions and hope that this 
information is helpful, we do not believe it is essential to include 
this level of detail in the Code of Federal Regulations. Therefore, we 
did not revise the regulations based on this comment.
    We received no other comments on the proposal and are adopting it 
without change.
5. Geographic Location Criteria (Sec. 413.65(d)(7))
    As explained earlier in X.C.2 of this preamble, 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 
proposed to revise Sec. 413.65(d)(7) to state that a 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 ensure 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.
    We received no comments on this proposal and we are adopting it 
without change.
6. Notice to Beneficiaries of Coinsurance Liability (Sec. 413.65(g)(7))
    Currently Sec. 413.65(g)(7) states 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, 
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.
    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 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

[[Page 59914]]

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.
    We proposed to amend Sec. 413.65(g)(7) to include this clarifying 
language. We received no comments on this proposal, and we are adopting 
it without change.
7. Clarification of Protocols for Off-Campus Departments 
(Sec. 489.24(i)(2)(ii))
    Currently, Sec. 489.24(i) specifies the anti-dumping obligations 
that hospitals have for individuals who come to off-campus hospital 
departments for the examination or treatment of a potential emergency 
medical condition. These obligations are sometimes known as EMTALA 
obligations, after the Emergency Medical Treatment and 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 in which 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, prior to transfer, contacting the main hospital campus 
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 in which doing otherwise would endanger a patient 
subject to EMTALA protection.
    We proposed to amend Sec. 489.24(i)(2)(ii) to include this 
clarifying language. We received two comments on this proposal, which 
are summarized below.
    Comment: Two commenters expressed approval of the change and 
recommended that it be adopted in the final rule. However, the 
commenter recommended that we further clarify the rule by spelling out 
the circumstances under which personnel at off-campus locations would 
be expected to call EMS before seeking guidance from the emergency 
department staff at the main campus delay.
    Response: As noted above, we plan to reconsider the general issue 
of the appropriateness of applying EMTALA to off-campus hospital 
locations. We will consider the commenter's specific suggestion in the 
course of that more general review. Therefore, we have not made any 
change in the final rule based on this comment.
    Comment: One commenter expressed approval of the proposed 
clarification at Sec. 489.24(i)(2)(ii), under which personnel in off-
campus departments that are not routinely staffed with physicians, RNs, 
or LPNs, may delay contacting the main hospital's emergency department 
according to protocols if, prior to transfer, contacting the main 
hospital campus would significantly jeopardize the individual's life or 
health. However, the commenter pointed out that the introductory 
paragraph of Sec. 489.24(i)(2) applies the protocol requirement to all 
off-campus departments (whether or not staffed by physicians and 
nurses). Therefore, the commenter suggested that we move this provision 
to the introductory paragraph of Sec. 489.24(i)(2), and so that it will 
apply to all off-campus departments. The commenter believes that this 
change would be consistent with the policy stated by CMS on its website 
(CMS EMTALA guidance, 7/20/01, Q/A ##7 and 13-16).
    Response: We agree that it would be appropriate, and consistent 
with our policy in this area, to apply this provision concerning the 
delay of contact in certain situations to all off-campus departments. 
As the commeter suggested, we are amending Sec. 489.24(i)(2) to include 
the clarifying language that had been proposed at 
Sec. 489.24(i)(2)(ii).
8. Other Changes
    In addition to the changes cited previously, we proposed to make 
the following conforming and clarifying changes:
     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.
     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).
    We received no comments on these proposals and are adopting them 
without change.

F. Comments on Other Issues

    We also received a number of comments recommending various changes 
in the provider-based regulations that were not in our August 24, 
proposed rule and cannot logically be inferred from those proposals. 
While we read these comments with interest, we have not made any 
changes in the final rule based on them.

XI. Summary of the Final Rule

    This final rule revises 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 describes changes to the amounts and factors used to determine the 
payment rates for Medicare hospital outpatient services paid under the 
prospective payment system. This final rule also announces a uniform 
reduction of 68.9 percent to be applied to each of the transitional 
pass-through payments.
    This final rule finalizes a number of policies discussed in the 
August 24, 2001 proposed rule as follows:
     We are implementing BIPA provisions that affect the OPPS 
in 2002, including the following:
    + The national coinsurance rate for OPPS services is limited to 55 
percent of the APC payment rate established for a procedure or service.
    + Children s hospitals receive the same hold-harmless protection 
accorded to cancer hospitals under BBRA.
    + Special payment provisions for certain services, including 
screening for glaucoma, payment for contrast agents, and new technology 
diagnostic mammography.
     We adjust payments to hospitals for geographic wage 
differences, as required by the statute, using the FY 2002 hospital 
inpatient PPS wage index. We have recalibrated the APC weights, also as 
required by the statute, using median costs drawn from claims data for 
hospital services furnished on or after July 1, 1999 through June 30, 
2000.
     The methodology that we followed to calculate the final 
APC relative weights for CY 2002 is similar to the proposed methodology 
except that we have incorporated pass-through device

[[Page 59915]]

costs in device-related procedures. Specifically, we have incorporated 
75 percent of the estimated cost for pass-through devices into the base 
APC costs.
     We have revised and updated the APC groups in accordance 
with several factors. These changes would affect more than half of the 
approximately 340 existing APC groups.
     As a result of consultations with the advisory panel on 
APC groups, we have reviewed and are accepting a number of the Panel's 
recommendations. In some cases, we have made additional changes to the 
APCs based on the use of new data and application of the 2 times rule.
     We have received recommendations from commenters and 
interested parties to establish separate APCs for observation services. 
As proposed, we are creating a new APC to make separate payment for 
observation services for patients with chest pain, asthma, and 
congestive heart failure, when certain clinical criteria are met. We 
have made some minor changes based on public comment.
     Based on public comment, we made several modifications to 
our proposed coding scheme for stereotactic radiosurgery.
     We have revised the criteria for the new technology APC 
groups that we created to allow payment at an appropriate level for new 
technologies that do not meet the statutory requirements for pass-
through payments. These changes are intended to allow us to reserve 
these special new technology APC groups for services that are a new, 
``complete'' procedure and not just modifications of existing 
technologies.
     We are changing the aggregate method currently used for 
calculating outlier payments and will begin determining outliers on an 
APC-by-APC basis rather than the entire bill. To do this, we allocate 
packaged items on a bill to APCs based on their relative weight.
     We are excluding from the OPPS the Part B-only services 
furnished to inpatients of hospitals that do no other billing for 
hospital outpatient services under Part B. This is in response to 
complaints we received from State psychiatric hospitals that did not 
have outpatient departments and, therefore, bill under OPPS only for 
inpatients. This policy would exempt them from having to make costly 
revisions to their billing systems.
     We are excluding from the OPPS hospitals that are located 
outside the 50 States or the District of Columbia or Puerto Rico, that 
is, hospitals in Guam, Saipan, American Samoa, and the Virgin Islands. 
This policy is consistent with their current exclusion from the 
inpatient PPS and will also save these hospitals from billing system 
revisions.
     We will continue to use a list of certain procedures that 
are designated as inpatient procedures and therefore are not paid by 
Medicare under the OPPS. Based on comments, we have made minor changes 
to this list.
     We are revising the regulations affecting provider-based 
entities to implement technical BIPA provisions on grandfathering, 
temporary treatment as provider-based, and certain geographic location 
criteria; and to clarify requirements for adequate cost data and cost 
finding, certain reporting requirements, requirements regarding notice 
to beneficiaries of coinsurance liability, and clarification of anti-
patient dumping rules (EMTALA obligations) in off-campus departments.
     In response to public comments regarding provider-based 
issues, we are moving the provision concerning the delay of contact in 
certain situations to the introductory paragraph of Sec. 489.24(i)(2) 
so that it will apply to all off-campus departments.
     In addition, we are making editorial and technical 
revisions to our regulations. We made minor editorial changes in 
paragraphs (b)(2), (b)(4), (b)(5), (c), (d)(7)(iv), and (g)(7) of 
Sec. 413.65. In Sec. 413.65(i)(2), we modified the presentation of our 
language to more clearly present our policy.

XII. Collection of Information Requirements

    Under the Paperwork Reduction Act of 1995, we are required to 
provide 30-day notice in the Federal Register and solicit public 
comment before a collection of information requirement is submitted to 
the Office of Management and Budget (OMB) for review and approval. In 
order to fairly evaluate whether an information collection should be 
approved by OMB, section 3506(c)(2)(A) of the 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 final rule 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 December 31, 2001.

Process and Information Required To Apply for Transitional Pass-through 
Payment for Eligible Drugs and Biological Agents, Including 
Radiopharmaceuticals, Under the Hospital Outpatient Prospective Payment 
System

    The application itself for Transitional Pass-Through Payment for 
Eligible Drugs and Biological Agents, Including Radiopharmaceuticals, 
may be found at www.hcfa.gov>. 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. The application process for new 
categories can be found on the CMS web site at http://www.hcfa.gov//medicare/newcatapp1030f.rtf.
    We estimate that approximately 100 entities will file an 
application yearly. We believe it will take each of these entities 
around 16 hours to gather the necessary information and fill out the 
application.
    We have submitted a copy of this final rule to OMB for its review 
of the information collection requirement described above. The 
requirement is not effective until it has been approved by OMB.

XIV. Regulatory Impact Analysis

A. General

    We have examined the impacts of this final 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

[[Page 59916]]

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 provisions of this final rule do not result in impacts that 
exceed $100 million per year. The effects of the changes in this rule 
are redistributional and do not result in additional expenditures. The 
impacts discussed below reflect the effects of the final rule published 
on November 2, 2001. Therefore, this final rule is not an economically 
significant rule under Executive Order 12866, nor a major rule under 5 
U.S.C. 804(2).
    We note, however, that on November 2, 2001, we published a final 
rule that announced the updated conversion factor for payments under 
the OPPS (66 FR 55857). As discussed in more detail in that document, 
we estimated that the total impact of the changes for CY 2002 payments 
compared to CY 2001 payments as set forth in the November 2 rule would 
be approximately a $450 million increase (66 FR 55864).
    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 or 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 604 of the RFA. With 
the exception of hospitals located in certain New England counties, for 
purposes of section 1102(b) of the Act, we define a small rural 
hospital as a hospital 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 final rule 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 final 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 final rule does 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 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 final 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 Final Rule

    In this final rule, we are making several changes to the OPPS that 
are required by the statute. We are required under section 
1833(t)(9)(A) of the Act to revise, not less often than annually, the 
wage index and other adjustments used to determine the APC payment 
rates. In addition, we must review the clinical integrity of payment 
groups and the relative weights at least annually. Accordingly, in this 
final rule, we are updating the wage index adjustment for hospital 
outpatient services furnished beginning January 1, 2002. We are also 
revising the relative APC payment weights based on claims data from 
July 1, 1999 through June 30, 2000. Finally, we are beginning to 
calculate outlier payments on an APC-specific basis rather than the 
current method of calculating outlier payments for each claim. In 
addition, as an administrative action, we have incorporated 75 percent 
of the estimated cost of the pass-through devices into the base APC 
rates.
    As described in the preamble, budget neutrality adjustments are 
made to the weights to assure that the revisions in the wage index, APC 
groups, and relative weights do not affect aggregate payments. In 
addition, the parameters for outlier payments have been modified so 
that outlier payments for 2002 are projected to equal 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 index, APC reclassification and 
recalibration, and outlier changes do vary somewhat by hospital group. 
Estimates of these impacts are displayed on Table 6.
    We received no specific comments on the impact analysis. However, 
in commenting on certain proposed policies, commenters sometimes 
referred to the impact of a policy on hospitals or a specific group of 
hospitals. We have addressed these comments elsewhere in the preamble 
to this final rule. The following is a discussion of how the final 
policies set forth in this rule affect hospitals and beneficiaries. As 
an informational matter, the impact of changes set forth in Table 6 
include the impact of the update to the conversion factor, which was 
implemented in the November 2 final rule.

C. Limitations of Our Analysis

    The distributional impacts represent the projected effects of the 
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. Finally, 
we do not model the impact of the transitional corridor payments, which 
protect hospitals from losses in 2002 compared to their 1996 payments. 
We are unable to model this impact because we do not yet have filed 
cost reports from hospitals for the services furnished under the PPS. 
The raw cost report data are generally not available until at least 7 
months after the end of the cost reporting period.

D. Estimated Impacts of This Final Rule on Hospital Payments

    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 change in the wage index, the 
APC reclassification and recalibration changes (including the 
incorporation of pass-through device

[[Page 59917]]

costs), 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 Pacific Region, a decrease of 0.1 percent. 
Conversely, the urban hospitals are generally negatively affected by 
these changes, with the largest effect on those with 500 or more beds 
(a 0.5 percent decrease) and those in the Middle Atlantic (a 0.5 
percent decrease) and West South Central (a 0.9 percent decrease) 
Regions.
    We estimate that the APC reclassification and recalibration changes 
have generally an opposite impact from the wage index, causing 
increases in payments for all urban hospitals except those with fewer 
than 200 beds and volumes of fewer than 21,000 services per year and 
those located in the New England (a 0.6 percent decrease), Middle 
Atlantic (a 0.8 percent decrease), and Puerto Rico (an 8.1 percent 
decrease) Regions.
    The incorporation of 75 percent of the estimated costs of pass-
through devices into the base APC rates has a relatively large negative 
effect on rural hospitals. In the proposed rule, the estimated impact 
of the APC reclassification and recalibration changes on rural 
hospitals was a 1.5 percent decrease in payments. With the 
incorporation of the device costs, the impact is now estimated to be a 
3.8 percent decrease. This impact does not include the effects of any 
additional transitional corridor payments to rural hospitals. The 
negative effect is particularly pronounced for rural hospitals with 
fewer than 100 beds (a decrease of 5.6 percent for hospitals with fewer 
than 50 beds and a 4.9 percent decrease for hospitals with 50-99 beds). 
This impact is due to the large increase in payment rates for device-
related APCs and the corresponding decrease in nondevice-related APCs, 
as discussed in more detail above in section II.C. of this preamble. 
The decrease in the payment rates for clinic visits and diagnostic and 
preventive services affect rural hospitals disproportionately because 
they perform far more of these services as compared to the device-
related APCs for which payment rates have increased. These impact 
estimates do not reflect the effects of the hold harmless transitional 
corridor payments in 2002 for the smallest rural hospitals.
    We also note that it is not the large academic medical centers that 
are most positively affected by the incorporation of pass-through 
device costs. While the group of hospitals that receives the largest 
increase in payments is hospitals with 500 or more beds (a 3.4 percent 
increase), minor teaching hospitals will receive an increase of only 
2.0 percent and major teaching hospitals, an increase of 0.5 percent.
    Although teaching hospitals perform many device-related procedures, 
they also provide a very large number of clinic and emergency room 
visits, both of which will experience a projected decrease in payment 
rates of approximately 8 percent. In fact, teaching hospitals that do 
not also receive disproportionate share payments will experience a 
projected decrease of 2.1 percent. The largest negative impact for 
urban hospitals is for those with no teaching adjustment that also do 
not serve a disproportionate share of low-income patients. Even though 
this is a relatively small group of hospitals, their payments are 
projected to decrease by 15.5 percent.
    The change in outlier policy to an APC-specific payment has a 
slight negative effect on rural hospitals as a group (a 0.1 percent 
decrease), no effect on urban hospitals as a group, and slight negative 
effects on all small hospitals (fewer than 100 beds) as well as those 
with lower volumes of services. For urban hospitals, other than a 
projected increase in payments of 0.3 percent for hospitals in the 
Middle Atlantic Region, no geographic group of hospitals is affected by 
more than 0.1 percent. For rural hospitals, the Middle Atlantic Region 
will also experience a positive impact, a 0.2 percent increase. For the 
rest of the regions, rural hospitals will experience no more than a 0.2 
percent decrease, except for hospitals in the Pacific Region, where 
there is no impact.
    The overall projected increase in payments for urban hospitals (3.0 
percent) is greater than the average increase for all hospitals (2.3 
percent). However, due to the large decrease in payments attributable 
to the APC changes, rural hospitals will experience an average decrease 
in payments of 0.7 percent. While rural hospitals gain 1.0 percent from 
the wage index change, they lose a combined 3.9 percent from the APC 
changes (-3.8 percent) and the change in method of determining outlier 
payments (a slight decrease of 0.1 percent). These impacts do not 
include the effects of any additional transitional corridor payments to 
rural hospitals. Rural hospitals with 100 or more beds will experience 
an overall increase in payments, however, those with fewer than 100 
beds are projected to receive large decreases in payments (-3.5 percent 
for hospitals with fewer than 50 beds and -2.4 percent for those with 
50 to 99 beds). We note that these smallest rural hospitals will be 
protected by the hold harmless transitional corridor payments for 2002. 
That is, their Medicare payment margin for services furnished under the 
OPPS cannot be less than their margin for the services in 1996.
    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 5,000 services are projected to 
experience a relatively large decline in payments (-3.6 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 6 percent due to these changes.
    Urban hospitals in all regions except Puerto Rico (with a decrease 
of 5.1 percent) receive an increase on overall payments. The lowest 
increase is in the Middle Atlantic Region, where hospitals are 
projected to receive a 1.2 percent increase in payments. Except for 
increases for hospitals in the South Atlantic (0.3 percent) and West 
South Central (0.5) Regions and no change in the Mountain Region, rural 
hospitals experience an overall loss in payments. Again, this is due to 
the decrease in payments as a result of the APC changes.
    Major teaching hospitals are projected to experience a smaller 
increase in overall payments (2.4 percent) than do hospitals with the 
less intensive teaching programs due to the negative impacts of the 
wage index (-0.4 percent), a relatively small increase due to the APC 
recalibration (0.5 percent), and outlier changes (-0.2 percent). Among 
hospitals with varying shares of low-income patients, those with a DSH 
patient percentage of zero experience a large decrease in payments 
because of the APC changes (-7.6 percent) and the outlier changes (-0.3 
percent). For hospitals with a greater than 0 percent of low-income 
patients, the impact on all hospitals is positive, with the lowest 
increase of 0.3 percent attributable to hospitals with the highest 
share.

E. Estimated Impacts of This Final Rule on Beneficiary Copayments

    In general, the increase in the APC rates for procedures that use 
pass-through devices results in increased copayments for beneficiaries 
who receive those procedures. Many of the device-related APC rates 
(approximately 50 APCs) have increased by over 100

[[Page 59918]]

percent and a small number by over 750 percent. Under the statute, the 
copayment amount for an APC cannot be less than 20 percent of the 
payment rate. Therefore, beneficiaries will experience an increase in 
copayments for most of the device-related APCs. This increase is 
countered by small decreases in the copayments for some other APCs, 
particularly clinic and emergency room visits.
    One important thing to note is that beneficiaries receive far more 
clinic and emergency visits in a year than they do device-related 
procedures. For example, in the 1999-2000 claims data base, there are 
almost 7 million low-level clinic visits, over 3 million mid-level 
clinic visits, and almost 2 million high-level clinic visits. However, 
for APC 0084, Level I Electrophysiologic Evaluation (the device-related 
APC with the largest increase), there were only about 7,000 procedures 
performed. Thus, the number of services received by beneficiaries with 
small decreases in copayments far outweighs the number of services for 
which they will incur some incremental costs.
    In addition, we note that section 1833(t)(8)(C)(i) of the Act 
places a limit on the copayment amount for any procedure; that is, the 
copayment may not be more than the applicable inpatient hospital 
deductible for the year in which the procedure is performed. For CY 
2002, the inpatient deductible is $812. We further note that the 
complete incorporation of the costs of the current pass-through devices 
into the base APCs must be done in CY 2003. Therefore, any increase in 
copayments that occur in 2002 are a transition to increases that must, 
by statute, occur in 2003. Finally, as discussed in section IV. C 
above, we have minimized the effects of changes in APC groupings on 
beneficiary coinsurance and copayments.

             Table 6.--Impact of Changes for CY 2002 Hospital Outpatient Prospective Payment System
    [Percent change in total payment to hospitals (program and beneficiary); does not include the effects of
                                   additional transitional corridors payments]
----------------------------------------------------------------------------------------------------------------
                                                                            APC/WGTS/
                                                  Number of     New wage   75% fold in  New outlier   All CY2002
                                                  hosps \1\    index \2\       \3\       policy \4\  changes \5\
----------------------------------------------------------------------------------------------------------------
                                                         (1)          (2)          (3)          (4)          (5)
----------------------------------------------------------------------------------------------------------------
All Hospitals..................................        5,084          0.0          0.0          0.0          2.3
Non-Tefra Hospitals............................        4,671          0.0          0.0          0.0          2.3
Urban Hosps....................................        2,550         -0.2          1.0          0.0          3.0
Large Urban (GT 1 Mill.).......................        1,459         -0.4          0.8          0.1          2.7
Other Urban (LE 1 Mill.).......................        1,091          0.0          1.3          0.0          3.5
Rural Hosps....................................        2,121          1.0         -3.8         -0.1         -0.7
Beds (Urban):
    0-99 Beds..................................          646         -0.1         -3.2         -0.1         -1.2
    100-199 Beds...............................          908         -0.2         -1.2          0.0          0.9
    200-299 Beds...............................          490         -0.2          0.8          0.0          2.8
    300-499 Beds...............................          363         -0.2          2.9          0.0          5.0
    500 + Beds.................................          143         -0.5          3.4          0.1          5.3
Beds (Rural):
    0-49 Beds..................................        1,278          0.2         -5.6         -0.2         -3.5
    50-99 Beds.................................          508          0.4         -4.9         -0.1         -2.4
    100-149 Beds...............................          196          1.5         -3.0         -0.1          0.6
    150-199 Beds...............................           73          1.5         -1.6         -0.1          2.0
    200 + Beds.................................           66          2.3         -1.7          0.0          2.8
Volume (Urban)
    LT 5,000...................................          307         -0.4          0.7         -0.2          2.3
    5,000-10,999...............................          445         -0.3         -2.4          0.0         -0.5
    11,000-20,999..............................          570         -0.3         -0.9          0.0          1.1
    21,000-42,999..............................          739         -0.3          1.0          0.0          3.0
    GT 42,999..................................          489         -0.2          1.8          0.0          4.0
Volume (Rural):
    LT 5,000...................................          945          0.3         -5.6         -0.4         -3.6
    5,000-10,999...............................          602          0.2         -5.7         -0.2         -3.5
    11,000-20,999..............................          332          0.7         -3.9         -0.1         -1.2
    21,000-42,999..............................          198          1.4         -2.5          0.0          1.1
    GT 42,999..................................           44          2.3         -2.2          0.0          2.3
Region (Urban):
    New England................................          135          0.6         -0.6          0.0          2.2
    Middle Atlantic............................          379         -0.5         -0.8          0.3          1.2
    South Atlantic.............................          386         -0.1          2.8          0.0          5.0
    East North Cent............................          441         -0.4          0.1          0.0          1.9
    East South Cent............................          154          1.2          2.1         -0.1          5.5
    West North Cent............................          181         -0.4          1.5          0.0          3.3
    West South Cent............................          321         -0.9          2.1         -0.1          3.4
    Mountain...................................          128         -0.1          2.4          0.0          4.5
    Pacific....................................          386         -0.4          1.6         -0.1          3.5
    Puerto Rico................................           39          1.0         -8.1         -0.1         -5.1
Region (Rural):
    New England................................           52          0.0         -4.1         -0.1         -2.1
    Middle Atlantic............................           74          0.5         -4.9          0.2         -2.0
    South Atlantic.............................          270          1.4         -3.2         -0.1          0.3
    East North Cent............................          279          1.1         -4.6         -0.1         -1.5
    East South Cent............................          250          1.3         -3.8         -0.1         -0.4

[[Page 59919]]

 
    West North Cent............................          506          1.2         -3.9         -0.2         -0.9
    West South Cent............................          328          1.5         -3.0         -0.1          0.5
    Mountain...................................          215          1.3         -3.2         -0.2          0.0
    Pacific....................................          142         -0.8         -2.8          0.0         -1.5
    Puerto Rico................................            5          4.5         -6.8         -0.1         -0.5
Teaching Status:
    Non-Teaching...............................        3,576          0.2         -1.4          0.0          0.9
    Minor......................................          803          0.0          2.0          0.0          4.4
    Major......................................          291         -0.4          0.5          0.0          2.4
DSH Patient Percent:
    0..........................................           32          0.7         -7.6         -1.3         -6.4
    GT 0-0.10..................................        1,261          0.0          0.2          0.0          2.5
    0.10-0.16..................................        1,035          0.1         -0.1          0.1          2.4
    0.16-0.23..................................          869         -0.1          0.6          0.0          2.7
    0.23-0.35..................................          786          0.1          0.3         -0.1          2.6
    GE 0.35....................................          688         -0.2         -1.6         -0.1          0.3
Urban IME/DSH:
    IME & DSH..................................        1,000         -0.3          1.8          0.1          3.8
    IME/No DSH.................................            3          0.0         -2.1         -2.0         -2.3
    No IME/DSH.................................        1,531         -0.2         -0.1          0.0          2.0
    No IME/No DSH..............................           16          0.8        -15.5         -0.3        -13.2
Rural Hosp. Types:
    No Special Status..........................          794          0.2         -4.8         -0.1         -2.6
    RRC........................................          172          2.1         -2.0          0.0          2.3
    SCH/Each...................................          666          0.4         -4.8         -0.1         -2.4
    MDH........................................          329          0.2         -6.2         -0.3         -4.2
    SCH and RRC................................           71          2.0         -2.1         -0.1          2.0
Type of Ownership:
    Voluntary..................................        2,774          0.0          0.2          0.0          2.4
    Proprietary................................          757          0.0          1.0          0.0          3.3
    Government.................................        1,140          0.3         -1.7         -0.1          0.6
Specialty Hospitals:
    Eye and Ear................................           12          0.8         -4.8          0.0         -1.8
    Trauma.....................................          151         -0.1          1.5          0.0          3.7
    Cancer.....................................           10         -1.3         -0.4          0.4          0.7
Tefra Hospitals (Not Included on Other Lines):
    Rehab......................................          169          0.3          7.5         -0.3          9.2
    Psych......................................          103         -0.7         -7.4         -1.7         -7.8
    LTC........................................           99         -0.7         -4.3         -0.4         -3.3
    Children...................................           42         -0.6         -0.9         -1.0        -0.5
Note: For CY 2002, under the OPPS transitional corridor policy cancer, children's, and rural hospitals with 100
  or fewer beds are held harmless compared to their 1996 payment margin for these services. All other hospitals
  are protected to some extent when their payment margins are less than they were in 1996 (see Sec.  419.70(b)).
  These additional payments are not reflected below.
\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 final FY 2002
  hospital inpatient wage index after geographic reclassification by the Medicare Geographic Classification
  Review Board. The hospital inpatient final rule for FY 2002 was published in the Federal Register on September
  1, 2001.
\3\ This column shows the impact of recalibrating the APC weights based on the 1999-2000 hospital claims data
  and on the reassignment of some HCPCs to APCs as well as the incorporation of the device costs discussed in
  this rule.
\4\ This column shows the difference in calculating outliers on an APC-specific rather than bill basis and with
  the final thresholds.
\5\ This column shows changes in total payment from CY2001 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 
final 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 
&

[[Page 59920]]

Medicaid Services amends 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 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

[[Page 59921]]

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. 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 is considered as provider-based 
on October 1, 2000, if on that date it either had a written 
determination from CMS that it was provider-based, 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 as a free-
standing facility, unless CMS determines the facility has provider-
based status.
    (5) A facility that has requested provider-based status in relation 
to a hospital or CAH 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 provider-based facility, such as 
a change in ownership of the facility or entry into a new or different 
management contract that would 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 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, or 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 must provide 
written notice to the beneficiary, before the delivery of services, of 
the amount of the beneficiary's potential financial liability (that is, 
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 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--
* * * * *

[[Page 59922]]

    (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 were 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--
    (i) CMS will recover the difference between the amount of payments 
that actually were made and the amount of payments that CMS estimates 
would have been made in the absence of a determination of provider-
based status.
    (ii) CMS will not make recovery payments for any period before the 
beginning of the hospital's first cost reporting period beginning on 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.

* * * * *
    (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. As revised, Sec. 419.40 
reads 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

[[Page 59923]]

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) * * *
    (ii) 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.
    (iii) The national unadjusted coinsurance rate for an APC cannot 
exceed 55 percent in calendar years 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 to read 
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 H--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, paragraphs (i)(2) introductory text and 
(i)(2)(ii) are 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. The hospital must 
establish protocols for the handling of individuals with potential 
emergency conditions at off-campus departments. These protocols must 
provide for direct contact between personnel at the off-campus 
department and emergency personnel at the main hospital campus and may 
provide for dispatch of practitioners, when appropriate, from the main 
hospital campus to the off-campus department to provide screening or 
stabilization services. 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 contacting the main hospital campus prior 
to transfer would significantly jeopardize the life or health of the 
individual.
* * * * *
    (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.
* * * * *

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


[[Page 59924]]


    Dated: November 20, 2001.
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.
    Approved: November 23, 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                             0.43       $21.89        $7.88        $4.38
    0002  Fine needle Biopsy/          T                             0.42       $21.38       $11.76        $4.28
           Aspiration.
    0003  Bone Marrow Biopsy/          T                             1.03       $52.43       $27.99       $10.49
           Aspiration.
    0004  Level I Needle Biopsy/       T                             2.47      $125.73       $32.57       $25.15
           Aspiration Except Bone
           Marrow.
    0005  Level II Needle Biopsy /     T                             4.03      $205.14       $90.26       $41.03
           Aspiration Except Bone
           Marrow.
    0006  Level I Incision & Drainage  T                             2.18      $110.97       $33.95       $22.19
    0007  Level II Incision &          T                             6.75      $343.60       $72.03       $68.72
           Drainage.
    0008  Level III Incision and       T                            10.93      $556.38      $113.67      $111.28
           Drainage.
    0009  Nail Procedures............  T                             0.63       $32.07        $8.34        $6.41
    0010  Level I Destruction of       T                             0.66       $33.60        $9.86        $6.72
           Lesion.
    0011  Level II Destruction of      T                             1.47       $74.83       $27.69       $14.97
           Lesion.
    0012  Level I Debridement &        T                             0.66       $33.60        $9.18        $6.72
           Destruction.
    0013  Level II Debridement &       T                             1.36       $69.23       $17.66       $13.85
           Destruction.
    0015  Level IV Debridement &       T                             2.07      $105.37       $31.20       $21.07
           Destruction.
    0016  Level V Debridement &        T                             3.02      $153.73       $64.57       $30.75
           Destruction.
    0017  Level VI Debridement &       T                             9.68      $492.75      $226.67       $98.55
           Destruction.
    0018  Biopsy of Skin/Puncture of   T                             1.05       $53.45       $17.66       $10.69
           Lesion.
    0019  Level I Excision/ Biopsy...  T                             4.22      $214.81       $78.91       $42.96
    0020  Level II Excision/ Biopsy..  T                             8.44      $429.63      $130.53       $85.93
    0021  Level IV Excision/ Biopsy..  T                            11.82      $601.69      $236.51      $120.34
    0022  Level V Excision/ Biopsy...  T                            13.91      $708.07      $292.94      $141.61
    0023  Exploration Penetrating      T                             2.08      $105.88       $40.37       $21.18
           Wound.
    0024  Level I Skin Repair........  T                             2.28      $116.06       $41.78       $23.21
    0025  Level II Skin Repair.......  T                             3.39      $172.56       $65.57       $34.51
    0026  Level III Skin Repair......  T                            12.62      $642.41      $277.92      $128.48
    0027  Level IV Skin Repair.......  T                            18.02      $917.29      $383.10      $183.46
    0028  Level I Breast Surgery.....  T                            14.00      $712.66      $303.74      $142.53
    0029  Level II Breast Surgery....  T                            23.76    $1,209.48      $628.93      $241.90
    0030  Level III Breast Surgery...  T                            34.20    $1,740.92      $763.55      $348.18
    0032  Insertion of Central Venous/ T                            12.64      $643.43  ...........      $128.69
           Arterial Catheter.
    0033  Partial Hospitalization....  P                             4.17      $212.27       $48.17       $42.45
    0035  Placement of Arterial or     T                             0.12        $6.11        $2.69        $1.22
           Central Venous Catheter.
    0041  Level I Arthroscopy........  T                            23.61    $1,201.84      $576.88      $240.37
    0042  Level II Arthroscopy.......  T                            35.76    $1,820.33      $804.74      $364.07
    0043  Closed Treatment Fracture    T                             4.05      $206.16  ...........       $41.23
           Finger/Toe/Trunk.
    0044  Closed Treatment Fracture/   T                             2.52      $128.28       $38.08       $25.66
           Dislocation Except Finger/
           Toe/Trunk.
    0045  Bone/Joint Manipulation      T                            11.67      $594.05      $277.12      $118.81
           Under Anesthesia.
    0046  Open/Percutaneous Treatment  T                            27.69    $1,409.53      $535.76      $281.91
           Fracture or Dislocation.
    0047  Arthroplasty without         T                            26.36    $1,341.83      $537.03      $268.37
           Prosthesis.
    0048  Arthroplasty with            T                            43.19    $2,198.54      $725.94      $439.71
           Prosthesis.
    0049  Level I Musculoskeletal      T                            15.84      $806.32      $356.95      $161.26
           Procedures Except Hand and
           Foot.
    0050  Level II Musculoskeletal     T                            20.63    $1,050.15      $504.07      $210.03
           Procedures Except Hand and
           Foot.
    0051  Level III Musculoskeletal    T                            28.56    $1,453.82      $675.24      $290.76
           Procedures Except Hand and
           Foot.
    0052  Level IV Musculoskeletal     T                            35.94    $1,829.49      $930.91      $365.90
           Procedures Except Hand and
           Foot.
    0053  Level I Hand                 T                            11.69      $595.07      $253.49      $119.01
           Musculoskeletal Procedures.
    0054  Level II Hand                T                            19.83    $1,009.43      $472.33      $201.89
           Musculoskeletal Procedures.
    0055  Level I Foot                 T                            15.44      $785.96      $355.34      $157.19
           Musculoskeletal Procedures.
    0056  Level II Foot                T                            18.85      $959.54      $405.81      $191.91
           Musculoskeletal Procedures.
    0057  Bunion Procedures..........  T                            24.35    $1,239.51      $496.65      $247.90
    0058  Level I Strapping and Cast   S                             1.28       $65.16       $19.27       $13.03
           Application.
    0059  Level II Strapping and Cast  S                             2.22      $113.01       $29.59       $22.60
           Application.
    0060  Manipulation Therapy.......  S                             0.23       $11.71  ...........        $2.34
    0068  CPAP Initiation............  S                             3.02      $153.73       $84.55       $30.75
    0069  Thoracoscopy...............  T                            23.57    $1,199.81  ...........      $239.96
    0070  Thoracentesis/Lavage         T                             4.58      $233.14       $79.60       $46.63
           Procedures.
    0071  Level I Endoscopy Upper      T                             1.03       $52.43       $14.22       $10.49
           Airway.
    0072  Level II Endoscopy Upper     T                             1.21       $61.59       $33.87       $12.32
           Airway.
    0073  Level III Endoscopy Upper    T                             3.29      $167.47       $73.69       $33.49
           Airway.
    0074  Level IV Endoscopy Upper     T                            11.32      $576.23      $293.88      $115.25
           Airway.
    0075  Level V Endoscopy Upper      T                            17.42      $886.75      $443.38      $177.35
           Airway.
    0076  Endoscopy Lower Airway.....  T                             7.56      $384.83      $188.57       $76.97
    0077  Level I Pulmonary Treatment  S                             0.39       $19.85       $10.92        $3.97
    0078  Level II Pulmonary           S                             0.86       $43.78       $18.83        $8.76
           Treatment.
    0079  Ventilation Initiation and   S                             0.60       $30.54       $16.80        $6.11
           Management.
    0080  Diagnostic Cardiac           T                            34.73    $1,767.90      $838.92      $353.58
           Catheterization.
    0081  Non-Coronary Angioplasty or  T                            29.24    $1,488.43      $710.91      $297.69
           Atherectomy.
    0082  Coronary Atherectomy.......  T                            92.00    $4,683.17    $1,351.74      $936.63

[[Page 59925]]

 
    0083  Coronary Angioplasty.......  T                            59.49    $3,028.28      $794.30      $605.66
    0084  Level I Electrophysiologic   S                           199.65   $10,162.98  ...........    $2,032.60
           Evaluation.
    0085  Level II Electrophysiologic  T                            38.69    $1,969.48      $654.48      $393.90
           Evaluation.
    0086  Ablate Heart Dysrhythm       T                            72.72    $3,701.74    $1,265.37      $740.35
           Focus.
    0087  Cardiac Electrophysiologic   T                            52.46    $2,670.42  ...........      $534.08
           Recording/Mapping.
    0088  Thrombectomy...............  T                            34.38    $1,750.08      $678.68      $350.02
    0089  Insertion/Replacement of     T                           149.52    $7,611.17    $2,246.59    $1,522.23
           Permanent Pacemaker and
           Electrodes.
    0090  Insertion/Replacement of     T                           117.54    $5,983.26    $2,133.88    $1,196.65
           Pacemaker Pulse Generator.
    0091  Level I Vascular Ligation..  T                            20.34    $1,035.39      $348.23      $207.08
    0092  Level II Vascular Ligation.  T                            19.91    $1,013.50      $503.71      $202.70
    0093  Vascular Repair/Fistula      T                            14.16      $720.80      $277.34      $144.16
           Construction.
    0094  Resuscitation and            S                             6.08      $309.50      $105.29       $61.90
           Cardioversion.
    0095  Cardiac Rehabilitation.....  S                             0.61       $31.05       $16.46        $6.21
    0096  Non-Invasive Vascular        S                             1.71       $87.05       $47.88       $17.41
           Studies.
    0097  Cardiac Monitoring for 30    X                             0.84       $42.76       $23.52        $8.55
           days.
    0098  Injection of Sclerosing      T                             1.24       $63.12       $20.88       $12.62
           Solution.
    0099  Electrocardiograms.........  S                             0.35       $17.82        $9.80        $3.56
    0100  Stress Tests and Continuous  X                             1.47       $74.83       $41.16       $14.97
           ECG.
    0101  Tilt Table Evaluation......  S                             3.74      $190.38      $104.71       $38.08
    0103  Miscellaneous Vascular       T                            15.95      $811.92      $295.70      $162.38
           Procedures.
    0104  Transcatheter Placement of   T                            87.98    $4,478.53  ...........      $895.71
           Intracoronary Stents.
    0105  Revision/Removal of          T                            14.76      $751.34      $368.16      $150.27
           Pacemakers, AICD, or
           Vascular.
    0106  Insertion/Replacement/       T                            36.64    $1,865.12      $503.07      $373.02
           Repair of Pacemaker and/or
           Electrodes.
    0107  Insertion of Cardioverter-   T                           379.46   $19,316.03    $4,224.27    $3,863.21
           Defibrillator.
    0108  Insertion/Replacement/       T                           573.46   $29,191.41  ...........    $5,838.28
           Repair of Cardioverter-
           Defibrillator Leads.
    0109  Removal of Implanted         T                             6.27      $319.17      $130.86       $63.83
           Devices.
    0110  Transfusion................  S                             5.30      $269.79      $113.31       $53.96
    0111  Blood Product Exchange.....  S                            21.08    $1,073.06      $300.74      $214.61
    0112  Apheresis, Photopheresis,    S                            36.25    $1,845.27      $608.94      $369.05
           and Plasmapheresis.
    0113  Excision Lymphatic System..  T                            15.53      $790.54      $326.55      $158.11
    0114  Thyroid/Lymphadenectomy      T                            29.28    $1,490.47      $493.78      $298.09
           Procedures.
    0115  Cannula/Access Device        T                            21.35    $1,086.80      $506.74      $217.36
           Procedures.
    0116  Chemotherapy Administration  S                             0.91       $46.32  ...........        $9.26
           by Other Technique Except
           Infusion.
    0117  Chemotherapy Administration  S                             4.01      $204.13       $52.69       $40.83
           by Infusion Only.
    0118  Chemotherapy Administration  S                             4.20      $213.80       $72.03       $42.76
           by Both Infusion and Other
           Technique.
    0119  Implantation of Devices....  T                            79.67    $4,055.52  ...........      $811.10
    0120  Infusion Therapy Except      T                             3.08      $156.78       $42.67       $31.36
           Chemotherapy.
    0121  Level I Tube changes and     T                             2.54      $129.30       $52.53       $25.86
           Repositioning.
    0122  Level II Tube changes and    T                             9.89      $503.44      $114.93      $100.69
           Repositioning.
    0123  Bone Marrow Harvesting and   S                             8.56      $435.74  ...........       $87.15
           Bone Marrow/Stem Cell
           Transplant.
    0124  Revision of Implanted        T                            89.07    $4,534.02  ...........      $906.80
           Infusion Pump.
    0125  Refilling of Infusion Pump.  T                             3.00      $152.71  ...........       $30.54
    0130  Level I Laparoscopy........  T                            25.91    $1,318.92      $659.53      $263.78
    0131  Level II Laparoscopy.......  T                            37.63    $1,915.52      $996.07      $383.10
    0132  Level III Laparoscopy......  T                            56.06    $2,853.68    $1,239.22      $570.74
    0140  Esophageal Dilation without  T                             5.65      $287.61      $107.24       $57.52
           Endoscopy.
    0141  Upper GI Procedures........  T                             7.21      $367.02      $184.67       $73.40
    0142  Small Intestine Endoscopy..  T                             6.94      $353.27      $151.91       $70.65
    0143  Lower GI Endoscopy.........  T                             7.27      $370.07      $185.04       $74.01
    0144  Diagnostic Anoscopy........  T                             4.43      $225.50       $49.32       $45.10
    0145  Therapeutic Anoscopy.......  T                            10.81      $550.27      $179.39      $110.05
    0146  Level I Sigmoidoscopy......  T                             2.73      $138.97       $63.93       $27.79
    0147  Level II Sigmoidoscopy.....  T                             5.71      $290.66      $136.61       $58.13
    0148  Level I Anal/Rectal          T                             2.40      $122.17       $43.59       $24.43
           Procedure.
    0149  Level III Anal/Rectal        T                            13.53      $688.73      $293.06      $137.75
           Procedure.
    0150  Level IV Anal/Rectal         T                            18.08      $920.34      $437.12      $184.07
           Procedure.
    0151  Endoscopic Retrograde        T                            15.29      $778.32      $245.46      $155.66
           Cholangio-Pancreatography
           (ERCP).
    0152  Percutaneous Biliary         T                            16.13      $821.08      $207.38      $164.22
           Endoscopic Procedures.
    0153  Peritoneal and Abdominal     T                            23.55    $1,198.79      $496.31      $239.76
           Procedures.
    0154  Hernia/Hydrocele Procedures  T                            31.40    $1,598.39      $556.98      $319.68
    0155  Level II Anal/Rectal         T                             5.26      $267.76  ...........       $53.55
           Procedure.
    0156  Level II Urinary and Anal    T                             2.45      $124.71       $37.41       $24.94
           Procedures.
    0157  Colorectal Cancer            S                             1.98      $100.79       $22.19       $20.16
           Screening: Barium Enema.
    0158  Colorectal Cancer            T                             6.55      $333.42       $83.36       $66.68
           Screening: Colonoscopy.
    0159  Colorectal Cancer            S                             2.33      $118.61       $29.65       $23.72
           Screening: Flexible
           Sigmoidoscopy.
    0160  Level I Cystourethroscopy    T                             5.13      $261.14      $104.46       $52.23
           and other Genitourinary
           Procedures.
    0161  Level II Cystourethroscopy   T                            13.72      $698.40      $249.36      $139.68
           and other Genitourinary
           Procedures.
    0162  Level III Cystourethroscopy  T                            25.09    $1,277.18      $427.49      $255.44
           and other Genitourinary
           Procedures.
    0163  Level IV Cystourethroscopy   T                            40.40    $2,056.52      $792.58      $411.30
           and other Genitourinary
           Procedures.
    0164  Level I Urinary and Anal     T                             1.01       $51.41       $15.42       $10.28
           Procedures.
    0165  Level III Urinary and Anal   T                             5.22      $265.72       $91.76       $53.14
           Procedures.
    0166  Level I Urethral Procedures  T                            12.20      $621.03      $218.73      $124.21
    0167  Level II Urethral            T                            22.28    $1,134.14      $555.84      $226.83
           Procedures.
    0168  Level III Urethral           T                            18.42      $937.65      $403.19      $187.53
           Procedures.
    0169  Lithotripsy................  T                            39.62    $2,016.82    $1,109.25      $403.36
    0170  Dialysis for Other Than      S                             0.28       $14.25        $3.14        $2.85
           ESRD Patients.
    0179  Urinary Incontinence         T                           139.33    $7,092.45    $2,340.51    $1,418.49
           Procedures.

[[Page 59926]]

 
    0180  Circumcision...............  T                            15.02      $764.58      $304.87      $152.92
    0181  Penile Procedures..........  T                            22.09    $1,124.47      $618.46      $224.89
    0182  Insertion of Penile          T                            87.54    $4,456.14    $1,492.28      $891.23
           Prosthesis.
    0183  Testes/Epididymis            T                            18.87      $960.56      $448.94      $192.11
           Procedures.
    0184  Prostate Biopsy............  T                             4.83      $245.87      $122.94       $49.17
    0187  Miscellaneous Placement/     X                             4.22      $214.81  ...........       $42.96
           Repositioning.
    0188  Level II Female              T                             0.80       $40.72       $11.81        $8.14
           Reproductive Proc.
    0189  Level III Female             T                             1.26       $64.14       $17.96       $12.83
           Reproductive Proc.
    0190  Surgical Hysteroscopy......  T                            16.91      $860.79      $421.79      $172.16
    0191  Level I Female Reproductive  T                             0.23       $11.71        $3.40        $2.34
           Proc.
    0192  Level IV Female              T                             2.50      $127.26       $35.33       $25.45
           Reproductive Proc.
    0193  Level V Female Reproductive  T                            11.16      $568.09      $171.13      $113.62
           Proc.
    0194  Level VI Female              T                            15.86      $807.34      $395.60      $161.47
           Reproductive Proc.
    0195  Level VII Female             T                            20.62    $1,049.64      $483.80      $209.93
           Reproductive Proc.
    0196  Dilation and Curettage.....  T                            13.48      $686.19      $336.23      $137.24
    0197  Infertility Procedures.....  T                             2.40      $122.17       $49.55       $24.43
    0198  Pregnancy and Neonatal Care  T                             1.31       $66.68       $32.67       $13.34
           Procedures.
    0199  Vaginal Delivery...........  T                             5.09      $259.10       $72.55       $51.82
    0200  Therapeutic Abortion.......  T                            11.34      $577.25      $305.94      $115.45
    0201  Spontaneous Abortion.......  T                            14.33      $729.45      $329.65      $145.89
    0202  Level VIII Female            T                            63.54    $3,234.44    $1,487.84      $646.89
           Reproductive Proc.
    0203  Level V Nerve Injections...  T                            15.79      $803.77      $369.73      $160.75
    0204  Level VI Nerve Injections..  T                             2.24      $114.02       $43.33       $22.80
    0206  Level III Nerve Injections.  T                             3.59      $182.75       $74.93       $36.55
    0207  Level IV Nerve Injections..  T                             5.36      $272.85      $122.78       $54.57
    0208  Laminotomies and             T                            29.12    $1,482.32  ...........      $296.46
           Laminectomies.
    0209  Extended EEG Studies and     S                            10.54      $536.53      $279.00      $107.31
           Sleep Studies, Level II.
    0212  Level II Nervous System      T                             3.77      $191.91       $88.78       $38.38
           Injections.
    0213  Extended EEG Studies and     S                             2.65      $134.90       $70.15       $26.98
           Sleep Studies, Level I.
    0214  Electroencephalogram.......  S                             2.10      $106.90       $53.45       $21.38
    0215  Level I Nerve and Muscle     S                             0.66       $33.60       $17.47        $6.72
           Tests.
    0216  Level III Nerve and Muscle   S                             2.61      $132.86       $59.79       $26.57
           Tests.
    0218  Level II Nerve and Muscle    S                             1.03       $52.43       $23.59       $10.49
           Tests.
    0220  Level I Nerve Procedures...  T                            13.60      $692.29      $325.38      $138.46
    0221  Level II Nerve Procedures..  T                            21.43    $1,090.87      $463.62      $218.17
    0222  Implantation of              T                           302.53   $15,399.99  ...........    $3,080.00
           Neurological Device.
    0223  Implantation of Pain         T                            75.39    $3,837.65  ...........      $767.53
           Management Device.
    0224  Implantation of Reservoir/   T                            28.48    $1,449.75      $453.41      $289.95
           Pump/Shunt.
    0225  Implantation of              T                           267.56   $13,619.87  ...........    $2,723.97
           Neurostimulator Electrodes.
    0226  Implantation of Drug         T                            75.81    $3,859.03  ...........      $771.81
           Infusion Reservoir.
    0227  Implantation of Drug         T                           139.55    $7,103.65  ...........    $1,420.73
           Infusion Device.
    0228  Creation of Lumbar           T                            53.77    $2,737.11      $696.46      $547.42
           Subarachnoid Shunt.
    0229  Transcatherter Placement of  T                            67.22    $3,421.77      $996.86      $684.35
           Intravascular Shunts.
    0230  Level I Eye Tests &          S                             0.61       $31.05       $14.28        $6.21
           Treatments.
    0231  Level III Eye Tests &        S                             2.03      $103.34       $46.50       $20.67
           Treatments.
    0232  Level I Anterior Segment     T                             3.50      $178.16       $78.39       $35.63
           Eye Procedures.
    0233  Level II Anterior Segment    T                            10.83      $551.29      $264.62      $110.26
           Eye Procedures.
    0234  Level III Anterior Segment   T                            19.08      $971.25      $466.20      $194.25
           Eye Procedures.
    0235  Level I Posterior Segment    T                             5.57      $283.54       $78.91       $56.71
           Eye Procedures.
    0236  Level II Posterior Segment   T                            16.21      $825.15  ...........      $165.03
           Eye Procedures.
    0237  Level III Posterior Segment  T                            36.32    $1,848.83  ...........      $369.77
           Eye Procedures.
    0238  Level I Repair and Plastic   T                             3.01      $153.22       $58.96       $30.64
           Eye Procedures.
    0239  Level II Repair and Plastic  T                             5.80      $295.24      $115.14       $59.05
           Eye Procedures.
    0240  Level III Repair and         T                            13.83      $704.00      $315.34      $140.80
           Plastic Eye Procedures.
    0241  Level IV Repair and Plastic  T                            18.12      $922.38      $384.47      $184.48
           Eye Procedures.
    0242  Level V Repair and Plastic   T                            23.72    $1,207.44      $597.36      $241.49
           Eye Procedures.
    0243  Strabismus/Muscle            T                            17.70      $901.00      $429.78      $180.20
           Procedures.
    0244  Corneal Transplant.........  T                            38.46    $1,957.77      $851.42      $391.55
    0245  Level I Cataract Procedures  T                            10.44      $531.44      $249.78      $106.29
           without IOL Insert.
    0246  Cataract Procedures with     T                            21.20    $1,079.16      $507.21      $215.83
           IOL Insert.
    0247  Laser Eye Procedures Except  T                             4.03      $205.14       $94.36       $41.03
           Retinal.
    0248  Laser Retinal Procedures...  T                            29.51    $1,502.18  ...........      $300.44
    0249  Level II Cataract            T                            21.80    $1,109.71      $521.56      $221.94
           Procedures without IOL
           Insert.
    0250  Nasal Cauterization/Packing  T                             2.10      $106.90       $37.42       $21.38
    0251  Level I ENT Procedures.....  T                             2.43      $123.70       $27.99       $24.74
    0252  Level II ENT Procedures....  T                             5.95      $302.88      $114.24       $60.58
    0253  Level III ENT Procedures...  T                            12.33      $627.65      $284.00      $125.53
    0254  Level IV ENT Procedures....  T                            17.37      $884.20      $272.41      $176.84
    0256  Level V ENT Procedures.....  T                            26.61    $1,354.56      $623.05      $270.91
    0258  Tonsil and Adenoid           T                            17.43      $887.26      $434.76      $177.45
           Procedures.
    0259  Level VI ENT Procedures....  T                           376.56   $19,168.41    $8,798.30    $3,833.68
    0260  Level I Plain Film Except    X                             0.70       $35.63       $19.60        $7.13
           Teeth.
    0261  Level II Plain Film Except   X                             1.21       $61.59       $33.87       $12.32
           Teeth Including Bone
           Density Measurement.
    0262  Plain Film of Teeth........  X                             0.65       $33.09       $10.90        $6.62
    0263  Level I Miscellaneous        X                             1.61       $81.96       $44.26       $16.39
           Radiology Procedures.
    0264  Level II Miscellaneous       X                             3.71      $188.85      $103.87       $37.77
           Radiology Procedures.
    0265  Level I Diagnostic           S                             0.95       $48.36       $26.60        $9.67
           Ultrasound Except Vascular.

[[Page 59927]]

 
    0266  Level II Diagnostic          S                             1.54       $78.39       $43.11       $15.68
           Ultrasound Except Vascular.
    0267  Vascular Ultrasound........  S                             2.33      $118.61       $65.24       $23.72
    0269  Level I Echocardiogram       S                             3.85      $195.98      $101.91       $39.20
           Except Transesophageal.
    0270  Transesophageal              S                             5.30      $269.79      $145.69       $53.96
           Echocardiogram.
    0271  Mammography................  S                             0.60       $30.54       $16.80        $6.11
    0272  Level I Fluoroscopy........  X                             1.38       $70.25       $38.64       $14.05
    0274  Myelography................  S                             5.24      $266.74      $128.12       $53.35
    0275  Arthrography...............  S                             2.59      $131.84       $68.56       $26.37
    0276  Level I Digestive Radiology  S                             1.48       $75.34       $41.44       $15.07
    0277  Level II Digestive           S                             2.16      $109.95       $60.47       $21.99
           Radiology.
    0278  Diagnostic Urography.......  S                             2.34      $119.12       $65.52       $23.82
    0279  Level I Angiography and      S                             7.72      $392.98      $174.57       $78.60
           Venography except
           Extremity.
    0280  Level II Angiography and     S                            13.54      $689.24      $351.51      $137.85
           Venography except
           Extremity.
    0281  Venography of Extremity....  S                             4.32      $219.91      $114.35       $43.98
    0282  Miscellaneous Computerized   S                             1.58       $80.43       $44.24       $16.09
           Axial Tomography.
    0283  Computerized Axial           S                             4.48      $228.05      $125.43       $45.61
           Tomography with Contrast
           Material.
    0284  Magnetic Resonance Imaging   S                             7.15      $363.96      $200.18       $72.79
           and Magnetic Resonance
           Angiography with Contrast
           Material.
    0285  Positron Emission            S                            18.72      $952.92      $415.21      $190.58
           Tomography (PET).
    0286  Myocardial Scans...........  S                             5.41      $275.39      $151.46       $55.08
    0287  Complex Venography.........  S                             4.06      $206.67       $90.93       $41.33
    0288  CT, Bone Density...........  S                             1.17       $59.56       $32.76       $11.91
    0289  Needle Localization for      X                             1.63       $82.97       $44.80       $16.59
           Breast Biopsy.
    0290  Standard Non-Imaging         S                             1.75       $89.08       $48.99       $17.82
           Nuclear Medicine.
    0291  Level I Diagnostic Nuclear   S                             3.50      $178.16       $90.20       $35.63
           Medicine Excluding
           Myocardial Scans.
    0292  Level II Diagnostic Nuclear  S                             4.20      $213.80      $117.59       $42.76
           Medicine Excluding
           Myocardial Scans.
    0294  Level I Therapeutic Nuclear  S                             5.01      $255.03      $140.27       $51.01
           Medicine.
    0295  Level II Therapeutic         S                            12.10      $615.94      $338.77      $123.19
           Nuclear Medicine.
    0296  Level I Therapeutic          S                             3.39      $172.56       $94.91       $34.51
           Radiologic Procedures.
    0297  Level II Therapeutic         S                             7.07      $359.89      $172.51       $71.98
           Radiologic Procedures.
    0299  Miscellaneous Radiation      S                             0.21       $10.69        $4.06        $2.14
           Treatment.
    0300  Level I Radiation Therapy..  S                             2.07      $105.37       $47.72       $21.07
    0301  Level II Radiation Therapy.  S                             5.15      $262.16       $52.53       $52.43
    0302  Level III Radiation Therapy  S                            11.16      $568.09      $216.55      $113.62
    0303  Treatment Device             X                             3.00      $152.71       $69.28       $30.54
           Construction.
    0304  Level I Therapeutic          X                             1.63       $82.97       $41.52       $16.59
           Radiation Treatment
           Preparation.
    0305  Level II Therapeutic         X                             3.71      $188.85       $90.65       $37.77
           Radiation Treatment
           Preparation.
    0310  Level III Therapeutic        X                            14.51      $738.62      $339.05      $147.72
           Radiation Treatment
           Preparation.
    0312  Radioelement Applications..  S                            32.40    $1,649.29  ...........      $329.86
    0313  Brachytherapy..............  S                            14.84      $755.42      $164.02      $151.08
    0314  Hyperthermic Therapies.....  S                             3.90      $198.53      $101.25       $39.71
    0320  Electroconvulsive Therapy..  S                             3.88      $197.51       $80.06       $39.50
    0321  Biofeedback and Other        S                             0.93       $47.34       $21.78        $9.47
           Training.
    0322  Brief Individual             S                             1.15       $58.54       $12.29       $11.71
           Psychotherapy.
    0323  Extended Individual          S                             1.73       $88.06       $21.13       $17.61
           Psychotherapy.
    0324  Family Psychotherapy.......  S                             2.69      $136.93       $20.19       $27.39
    0325  Group Psychotherapy........  S                             1.38       $70.25       $18.27       $14.05
    0330  Dental Procedures..........  S                            10.97      $558.42  ...........      $111.68
    0332  Computerized Axial           S                             3.24      $164.93       $90.71       $32.99
           Tomography and
           Computerized Angiography
           without Contrast Material.
    0333  Computerized Axial           S                             5.22      $265.72      $146.15       $53.14
           Tomography and
           Computerized Angio w/o
           Contrast Material followed
           by Contrast.
    0335  Magnetic Resonance Imaging,  S                             5.39      $274.37      $150.90       $54.87
           Miscellaneous.
    0336  Magnetic Resonance Imaging   S                             6.29      $320.19      $176.10       $64.04
           and Magnetic Resonance
           Angiography without
           Contrast.
    0337  MRI and Magnetic Resonance   S                             8.54      $434.72      $239.10       $86.94
           Angiography without
           Contrast Material followed
           by Contrast Material.
    0339  Observation................  X                             6.85      $348.69  ...........       $69.74
    0340  Minor Ancillary Procedures.  X                             0.84       $42.76       $10.69        $8.55
    0341  Skin Tests and               X                             0.10        $5.09        $2.80        $1.02
           Miscellaneous Red Blood
           Cell Tests.
    0342  Level I Pathology..........  X                             0.21       $10.69        $5.88        $2.14
    0343  Level II Pathology.........  X                             0.39       $19.85       $10.72        $3.97
    0344  Level III Pathology........  X                             0.56       $28.51       $15.68        $5.70
    0345  Level I Transfusion          X                             0.26       $13.24        $5.37        $2.65
           Laboratory Procedures.
    0346  Level II Transfusion         X                             0.77       $39.20       $12.03        $7.84
           Laboratory Procedures.
    0347  Level III Transfusion        X                             1.56       $79.41       $20.13       $15.88
           Laboratory Procedures.
    0348  Fertility Laboratory         X                             0.77       $39.20  ...........        $7.84
           Procedures.
    0352  Level II Injections........  X                             0.41       $20.87  ...........        $4.17
    0353  Level II Allergy Injections  X                             0.25       $12.73  ...........        $2.55
    0354  Administration of Influenza/ K                             0.10        $5.09  ...........  ...........
           Pneumonia Vaccine.
    0355  Level I Immunizations......  K                             0.19        $9.67  ...........        $1.93
    0356  Level II Immunizations.....  K                             1.11       $56.50  ...........       $11.30
    0359  Level II Injections........  X                             1.79       $91.12  ...........       $18.22
    0360  Level I Alimentary Tests...  X                             1.35       $68.72       $34.36       $13.74
    0361  Level II Alimentary Tests..  X                             3.25      $165.44       $82.72       $33.09
    0362  Fitting of Vision Aids.....  X                             0.86       $43.78        $9.63        $8.76
    0363  Otorhinolaryngologic         X                             1.73       $88.06       $32.58       $17.61
           Function Tests.

[[Page 59928]]

 
    0364  Level I Audiometry.........  X                             0.58       $29.52       $11.51        $5.90
    0365  Level II Audiometry........  X                             1.31       $66.68       $20.00       $13.34
    0367  Level I Pulmonary Test.....  X                             0.70       $35.63       $17.82        $7.13
    0368  Level II Pulmonary Tests...  X                             1.47       $74.83       $38.16       $14.97
    0369  Level III Pulmonary Tests..  X                             3.49      $177.65       $58.50       $35.53
    0370  Allergy Tests..............  X                             0.80       $40.72       $11.81        $8.14
    0371  Level I Allergy Injections.  X                             0.70       $35.63  ...........        $7.13
    0372  Therapeutic Phlebotomy.....  X                             0.53       $26.98       $10.09        $5.40
    0373  Neuropsychological Testing.  X                             1.00       $50.90       $14.25       $10.18
    0374  Monitoring Psychiatric       X                             0.89       $45.30        $9.97        $9.06
           Drugs.
    0600  Low Level Clinic Visits....  V                             0.86       $43.78  ...........        $8.76
    0601  Mid Level Clinic Visits....  V                             0.95       $48.36  ...........        $9.67
    0602  High Level Clinic Visits...  V                             1.38       $70.25  ...........       $14.05
    0610  Low Level Emergency Visits.  V                             1.23       $62.61       $19.41       $12.52
    0611  Mid Level Emergency Visits.  V                             2.16      $109.95       $36.47       $21.99
    0612  High Level Emergency Visits  V                             3.49      $177.65       $54.14       $35.53
    0620  Critical Care..............  S                             8.40      $427.59      $149.66       $85.52
    0685  Level III Needle Biopsy/     T                             9.16      $466.28      $205.16       $93.26
           Aspiration Except Bone
           Marrow.
    0686  Level V Skin Repair........  T                            24.01    $1,222.21      $277.92      $244.44
    0687  Revision/Removal of          T                            42.34    $2,155.28  ...........      $431.06
           Neurostimulator Electrodes.
    0688  Revision/Removal of          T                           145.27    $7,394.82  ...........    $1,478.96
           Neurostimulator Pulse
           Generator Receiver.
    0689  Electronic Analysis of       S                             0.43       $21.89       $12.04        $4.38
           Cardioverter-
           defibrillators.
    0690  Electronic Analysis of       S                             0.37       $18.83       $10.36        $3.77
           Pacemakers and other
           Cardiac Devices.
    0691  Electronic Analysis of       S                             3.17      $161.37       $88.75       $32.27
           Programmable Shunts/Pumps.
    0692  Electronic Analysis of       S                            14.34      $729.96      $401.48      $145.99
           Neurostimulator Pulse
           Generators.
    0693  Level II Breast              T                            31.81    $1,619.26      $712.47      $323.85
           Reconstruction.
    0694  Level III Excision/Biopsy..  T                             3.99      $203.11       $60.93       $40.62
    0695  Level VII Debridement &      T                            15.78      $803.27      $369.50      $160.65
           Destruction.
    0697  Level II Echocardiogram      S                             2.08      $105.88       $55.06       $21.18
           Except Transesophageal.
    0698  Level II Eye Tests &         S                             1.03       $52.43       $19.92       $10.49
           Treatments.
    0699  Level IV Eye Tests &         T                             6.46      $328.84      $147.98       $65.77
           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                      ...........    $1,591.25  ...........      $227.80
           per dose.
    0705  TC 99M tetrofosmin, per      G                      ...........      $114.00  ...........       $16.32
           dose.
    0706  New Technology--Level I ($0- S                      ...........       $25.00  ...........        $5.00
           $50).
    0707  New Technology--Level II     S                      ...........       $75.00  ...........       $15.00
           ($50-$100).
    0708  New Technology--Level III    S                      ...........      $150.00  ...........       $30.00
           ($100-$200).
    0709  New Technology--Level IV     S                      ...........      $250.00  ...........       $50.00
           ($200-$300).
    0710  New Technology--Level V      S                      ...........      $400.00  ...........       $80.00
           ($300-$500).
    0711  New Technology--Level VI     S                      ...........      $625.00  ...........      $125.00
           ($500-$750).
    0712  New Technology--Level VII    S                      ...........      $875.00  ...........      $175.00
           ($750-$1000).
    0713  New Technology--Level VIII   S                      ...........    $1,125.00  ...........      $225.00
           ($1000-$1250).
    0714  New Technology--Level IX     S                      ...........    $1,375.00  ...........      $275.00
           ($1250-$1500).
    0715  New Technology--Level X      S                      ...........    $1,625.00  ...........      $325.00
           ($1500-$1750).
    0716  New Technology--Level XI     S                      ...........    $1,875.00  ...........      $375.00
           ($1750-$2000).
    0717  New Technology--Level XII    S                      ...........    $2,250.00  ...........      $450.00
           ($2000-$2500).
    0718  New Technology--Level XIII   S                      ...........    $2,750.00  ...........      $550.00
           ($2500-$3000).
    0719  New Technology--Level XIV    S                      ...........    $3,250.00  ...........      $650.00
           ($3000-$3500).
    0720  New Technology--Level XV     S                      ...........    $4,250.00  ...........      $850.00
           ($3500-$5000).
    0721  New Technology--Level XVI    S                      ...........    $5,500.00  ...........    $1,100.00
           ($5000-$6000).
    0725  Leucovorin calcium inj, 50   G                      ...........        $4.15  ...........         $.38
           mg.
    0726  Dexrazoxane hcl injection,   G                      ...........      $194.52  ...........       $24.98
           250 mg.
    0727  Etidronate disodium inj 300  G                      ...........       $63.65  ...........        $9.11
           mg.
    0728  Filgrastim 300 mcg           G                      ...........      $179.08  ...........       $23.00
           injection.
    0730  Pamidronate disodium , 30    G                      ...........      $265.87  ...........       $38.06
           mg.
    0731  Sargramostim injection 50    G                      ...........       $29.06  ...........        $4.16
           mcg.
    0732  Mesna injection 200 mg.....  G                      ...........       $36.48  ...........        $3.30
    0733  Non esrd epoetin alpha inj,  G                      ...........       $12.26  ...........        $1.57
           1000 u.
    0750  Dolasetron mesylate, 10 mg.  G                      ...........       $16.45  ...........        $2.11
    0754  Metoclopramide hcl           G                      ...........        $1.17  ...........         $.11
           injection up to 10 mg.
    0755  Thiethylperazine maleate     G                      ...........        $4.60  ...........         $.66
           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  ...........        $2.65
           10 mcg.
    0765  Granisetron hcl 1 mg oral..  G                      ...........       $44.69  ...........        $6.40
    0768  Ondansetron hcl injection 1  G                      ...........        $6.09  ...........         $.78
           mg.
    0769  Ondansetron hcl 8mg oral...  G                      ...........       $26.41  ...........        $3.39
    0800  Leuprolide acetate, 3.75 mg  G                      ...........       $93.47  ...........       $12.00
    0801  Cyclophosphamide oral 25 mg  G                      ...........        $2.03  ...........         $.18
    0802  Etoposide oral 50 mg.......  G                      ...........       $52.43  ...........        $6.73
    0803  Melphalan oral 2 mg........  G                      ...........        $2.29  ...........         $.33
    0807  Aldesleukin/single use vial  G                      ...........      $672.60  ...........       $96.29
    0809  Bcg live intravesical vac..  G                      ...........      $166.49  ...........       $21.38
    0810  Goserelin acetate implant    G                      ...........      $446.49  ...........       $63.92
           3.6 mg.
    0811  Carboplatin injection 50 mg  G                      ...........      $114.46  ...........       $16.39
    0812  Carmus bischl nitro inj 100  G                      ...........      $117.84  ...........       $16.87
           mg.

[[Page 59929]]

 
    0813  Cisplatin 10 mg injection..  G                      ...........       $42.18  ...........        $3.82
    0814  Asparaginase injection       G                      ...........       $62.61  ...........        $8.96
           10,000 u.
    0815  Cyclophosphamide 100 mg inj  G                      ...........        $5.82  ...........         $.75
    0816  Cyclophosphamide             G                      ...........        $4.89  ...........         $.63
           lyophilized 100 mg.
    0817  Cytarabine hcl 100 mg inj..  G                      ...........        $6.10  ...........         $.55
    0818  Dactinomycin 0.5 mg........  G                      ...........       $13.87  ...........        $1.99
    0819  Dacarbazine 100 mg inj.....  G                      ...........       $12.68  ...........        $1.15
    0820  Daunorubicin 10 mg.........  G                      ...........       $76.62  ...........        $6.94
    0821  Daunorubicin citrate         G                      ...........       $64.60  ...........        $9.25
           liposom 10 mg.
    0822  Diethylstilbestrol           G                      ...........       $14.41  ...........        $1.30
           injection 250 mg.
    0823  Docetaxel, 20 mg...........  G                      ...........      $297.83  ...........       $42.64
    0824  Etoposide 10 mg inj........  G                      ...........       $10.45  ...........         $.95
    0826  Methotrexate Oral 2.5 mg...  G                      ...........        $3.45  ...........         $.31
    0827  Floxuridine injection 500    G                      ...........      $129.56  ...........       $16.64
           mg.
    0828  Gemcitabine HCL 200 mg.....  G                      ...........      $106.72  ...........       $15.28
    0830  Irinotecan injection 20 mg.  G                      ...........      $134.25  ...........       $19.22
    0831  Ifosfomide injection 1 gm..  G                      ...........      $156.64  ...........       $22.42
    0832  Idarubicin hcl injection 5   G                      ...........      $412.21  ...........       $59.01
           mg.
    0833  Interferon alfacon-1, 1 mcg  G                      ...........        $4.10  ...........         $.59
    0834  Interferon alfa-2a inj       G                      ...........       $34.86  ...........        $4.99
           recombinant 3 million u.
    0836  Interferon alfa-2b inj       G                      ...........       $11.28  ...........        $1.45
           recombinant, 1 million.
    0838  Interferon gamma 1-b inj, 3  G                      ...........      $285.65  ...........       $40.89
           million u.
    0839  Mechlorethamine hcl inj 10   G                      ...........       $12.01  ...........        $1.72
           mg.
    0840  Melphalan hydrochl 50 mg...  G                      ...........      $400.74  ...........       $57.37
    0841  Methotrexate sodium inj 5    G                      ...........         $.45  ...........         $.04
           mg.
    0842  Fludarabine phosphate inj    G                      ...........      $271.82  ...........       $38.91
           50 mg.
    0844  Pentostatin injection, 10    G                      ...........    $1,654.14  ...........      $236.80
           mg.
    0847  Doxorubicin hcl 10 mg vl     G                      ...........       $37.46  ...........        $4.81
           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  ...........       $10.59
    0852  Topotecan, 4 mg............  G                      ...........      $664.19  ...........       $95.08
    0853  Vinblastine sulfate inj, 1   G                      ...........        $4.11  ...........         $.37
           mg.
    0854  Vincristine sulfate 1 mg     G                      ...........       $30.16  ...........        $3.87
           inj.
    0855  Vinorelbine tartrate, 10 mg  G                      ...........       $88.83  ...........       $12.72
    0856  Porfimer sodium, 75 mg.....  G                      ...........    $2,603.67  ...........      $372.74
    0857  Bleomycin sulfate injection  G                      ...........      $289.37  ...........       $37.16
           15 u.
    0858  Cladribine, 1mg............  G                      ...........       $53.39  ...........        $4.83
    0859  Fluorouracil injection 500   G                      ...........        $2.73  ...........         $.25
           mg.
    0860  Plicamycin (mithramycin)     G                      ...........       $93.80  ...........       $13.43
           inj 2.5 mg.
    0861  Leuprolide acetate           G                      ...........       $69.79  ...........        $6.32
           injection 1 mg.
    0862  Mitomycin 5 mg inj.........  G                      ...........      $121.65  ...........       $11.01
    0863  Paclitaxel injection, 30 mg  G                      ...........      $173.50  ...........       $22.28
    0864  Mitoxantrone hcl, 5 mg.....  G                      ...........      $244.21  ...........       $34.96
    0865  Interferon alfa-n3 inj,      G                      ...........        $7.86  ...........        $1.12
           human leukocyte derived, 2.
    0884  Rho d immune globulin inj,   G                      ...........       $34.11  ...........        $4.38
           1 dose pkg.
    0886  Azathioprine oral 50mg.....  G                      ...........        $1.25  ...........         $.11
    0887  Azathioprine parenteral 100  G                      ...........        $1.06  ...........         $.10
           mg.
    0888  Cyclosporine oral 100 mg...  G                      ...........        $5.22  ...........         $.67
    0889  Cyclosporin parenteral       G                      ...........       $25.08  ...........        $3.22
           250mg.
    0890  Lymphocyte immune globulin   G                      ...........      $269.06  ...........       $38.52
           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 unit  G                      ...........        $4.39  ...........         $.63
    0903  Cytomegalovirus imm IV/vial  G                      ...........      $370.50  ...........       $47.58
    0905  Immune globulin 500 mg.....  G                      ...........       $35.63  ...........        $3.23
    0906  RSV-ivig, 50 mg............  G                      ...........       $15.51  ...........        $1.99
    0907  Ganciclovir Sodium 500 mg    K                             0.42       $21.38  ...........        $4.28
           injection.
    0908  Tetanus immune globulin inj  G                      ...........      $102.60  ...........       $13.18
           up to 250 u.
    0909  Interferon beta-1a, 33 mcg.  G                      ...........      $225.22  ...........       $32.24
    0910  Interferon beta-1b /0.25 mg  G                      ...........       $68.40  ...........        $9.79
    0911  Streptokinase per 250,000    K                             1.66       $84.50  ...........       $16.90
           iu.
    0913  Ganciclovir long act         G                      ...........    $4,750.00  ...........      $680.00
           implant 4.5 mg.
    0916  Injection imiglucerase /     G                      ...........        $3.75  ...........         $.54
           unit.
    0917  Pharmacologic stressors....  K                             0.34       $17.31  ...........        $3.46
    0925  Factor viii per iu.........  G                      ...........         $.87  ...........         $.08
    0926  Factor VIII (porcine) per    G                      ...........        $2.09  ...........         $.30
           iu.
    0927  Factor viii recombinant per  G                      ...........        $1.12  ...........         $.14
           iu.
    0928  Factor ix complex per iu...  G                      ...........         $.48  ...........         $.04
    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                      ...........       $26.13  ...........        $3.74
           per iu.
    0932  Factor IX recombinant, per   G                      ...........        $1.12  ...........         $.16
           iu.
    0949  Plasma, Pooled Multiple      K                             2.78      $141.51  ...........       $28.30
           Donor, Solvent/Detergent T.
    0950  Blood (Whole) For            K                             1.97      $100.28  ...........       $20.06
           Transfusion.
    0952  Cryoprecipitate............  K                             0.66       $33.60  ...........        $6.72

[[Page 59930]]

 
    0954  RBC leukocytes reduced.....  K                             2.67      $135.91  ...........       $27.18
    0955  Plasma, Fresh Frozen.......  K                             2.13      $108.43  ...........       $21.69
    0956  Plasma Protein Fraction....  K                             1.19       $60.58  ...........       $12.12
    0957  Platelet Concentrate.......  K                             0.93       $47.34  ...........        $9.47
    0958  Platelet Rich Plasma.......  K                             1.10       $55.99  ...........       $11.20
    0959  Red Blood Cells............  K                             1.93       $98.24  ...........       $19.65
    0960  Washed Red Blood Cells.....  K                             3.60      $183.25  ...........       $36.65
    0961  Infusion, Albumin (Human)    K                             2.07      $105.37  ...........       $21.07
           5%, 50 ml.
    0962  Infusion, Albumin (Human)    K                             1.04       $52.94  ...........       $10.59
           25%, 50 ml.
    0963  Albumin (human), 5%, 250 ml  K                            10.35      $526.86  ...........      $105.37
    0964  Albumin (human), 25%, 20 ml  K                             2.08      $105.88  ...........       $21.18
    0965  Albumin (human), 25%, 50ml.  K                             5.20      $264.70  ...........       $52.94
    0966  Plasmaprotein                K                             5.95      $302.88  ...........       $60.58
           fract,5%,250ml.
    0970  New Technology--Level I ($0- T                      ...........       $25.00  ...........        $5.00
           $50).
    0971  New Technology--Level II     T                      ...........       $75.00  ...........       $15.00
           ($50-$100).
    0972  New Technology--Level III    T                      ...........      $150.00  ...........       $30.00
           ($100-$200).
    0973  New Technology--Level IV     T                      ...........      $250.00  ...........       $50.00
           ($200-$300).
    0974  New Technology--Level V      T                      ...........      $400.00  ...........       $80.00
           ($300-$500).
    0975  New Technology--Level VI     T                      ...........      $625.00  ...........      $125.00
           ($500-$750).
    0976  New Technology--Level VII    T                      ...........      $875.00  ...........      $175.00
           ($750-$1000).
    0977  New Technology--Level VIII   T                      ...........    $1,125.00  ...........      $225.00
           ($1000-$1250).
    0978  New Technology--Level IX     T                      ...........    $1,375.00  ...........      $275.00
           ($1250-$1500).
    0979  New Technology--Level X      T                      ...........    $1,625.00  ...........      $325.00
           ($1500-$1750).
    0980  New Technology--Level XI     T                      ...........    $1,875.00  ...........      $375.00
           ($1750-$2000).
    0981  New Technology--Level XII    T                      ...........    $2,250.00  ...........      $450.00
           ($2000-$2500).
    0982  New Technology--Level XIII   T                      ...........    $2,750.00  ...........      $550.00
           ($2500-$3000).
    0983  New Technology--Level XIV    T                      ...........    $3,250.00  ...........      $650.00
           ($3000- $3500).
    0984  New Technology--Level XV     T                      ...........    $4,250.00  ...........      $850.00
           ($3500-$5000).
    0985  New Technology--Level XVI    T                      ...........    $5,500.00  ...........    $1,100.00
           ($5000-$6000).
    1009  Cryoprecip reduced plasma..  K                             0.82       $41.74  ...........        $8.35
    1010  Blood, L/R, CMV-neg........  K                             2.72      $138.46  ...........       $27.69
    1011  Platelets, HLA-m, L/R, unit  K                            11.21      $570.63  ...........      $114.13
    1012  Platelet concentrate, L/R,   K                             1.81       $92.14  ...........       $18.43
           irradiated, unit.
    1013  Platelet concentrate, L/R,   K                             1.11       $56.50  ...........       $11.30
           unit.
    1014  Platelets, aph/pher, L/R,    K                             8.45      $430.14  ...........       $86.03
           unit.
    1016  Blood, L/R, froz/deglycerol/ K                             6.76      $344.11  ...........       $68.82
           washed.
    1017  Platelets, aph/pher, L/R,    K                             8.82      $448.97  ...........       $89.79
           CMV-neg, unit.
    1018  Blood, L/R, irradiated.....  K                             2.96      $150.68  ...........       $30.14
    1019  Platelets, aph/pher, L/R,    K                             9.11      $463.74  ...........       $92.75
           irradiated, unit.
    1024  Quinupristin/dalfopristin    G                      ...........      $102.05  ...........       $13.11
           500 mg (150/350).
    1045  Iobenguane sulfate I-131...  G                      ...........      $495.65  ...........       $70.96
    1058  TC 99M oxidronate, per vial  G                      ...........       $36.74  ...........        $5.26
    1059  Cultured chondrocytes        G                      ...........   $14,250.00  ...........    $2,040.00
           implnt.
    1064  I-131 cap, each add mCi....  G                      ...........        $5.86  ...........         $.75
    1065  I-131 sol, each add mCi....  G                      ...........       $15.81  ...........        $2.03
    1066  IN 111 satumomab pendetide.  G                      ...........    $1,591.25  ...........      $227.80
    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                      ...........        $6.05  ...........         $.87
    1087  I-123 per 100 uci..........  G                      ...........         $.65  ...........         $.06
    1089  Coo 57, 0.5 Mci............  G                      ...........       $81.10  ...........       $10.41
    1091  IN 111 Oxyquinoline, per .5  G                      ...........      $427.50  ...........       $61.20
           mCi.
    1092  IN 111 Pentetate, per 0.5    G                      ...........      $256.50  ...........       $23.22
           mCi.
    1094  TC 99M Albumin aggr,1.0      G                      ...........       $33.09  ...........        $4.25
           cmCi.
    1095  Technetium TC 99M            G                      ...........       $38.00  ...........        $5.44
           Depreotide.
    1096  TC 99M Exametazime, per      G                      ...........      $445.31  ...........       $63.75
           dose.
    1097  TC 99M Mebrofenin, per vial  G                      ...........       $51.44  ...........        $7.36
    1098  TC 99M Pentetate, per vial.  G                      ...........       $22.43  ...........        $2.88
    1099  TC 99M Pyrophosphate, per    G                      ...........       $39.11  ...........        $5.60
           vial.
    1122  TC 99M arcitumomab, per      G                      ...........    $1,235.00  ...........      $176.80
           vial.
    1166  Cytarabine liposomal, 10 mg  G                      ...........      $371.45  ...........       $53.18
    1167  Epirubicin hcl, 2 mg.......  G                      ...........       $24.94  ...........        $3.57
    1178  Busulfan IV, 6 mg..........  G                      ...........       $26.48  ...........        $3.79
    1188  I-131 cap, per 1-5 mCi.....  G                      ...........      $117.25  ...........       $15.06
    1200  TC 99M Sodium                G                      ...........       $22.61  ...........        $3.24
           Glucoheptonate.
    1201  TC 99M succimer, per vial..  G                      ...........      $135.66  ...........       $19.42
    1202  TC 99M Sulfur Colloid, per   G                      ...........       $76.00  ...........        $9.76
           dose.
    1203  Verteporfin for injection..  G                      ...........    $1,458.25  ...........      $208.76
    1205  Technetium Tc 99m disofenin  G                      ...........       $79.17  ...........       $11.33
    1207  Octreotide acetate depot     G                      ...........      $138.08  ...........       $19.77
           1mg.
    1305  Apligraf...................  G                      ...........    $1,157.81  ...........      $165.75
    1348  I-131 sol, per 1-6 mCi.....  G                      ...........      $146.57  ...........       $18.82
    1400  Diphenhydramine hcl 50mg...  G                      ...........         $.23  ...........         $.02
    1401  Prochlorperazine maleate     G                      ...........         $.65  ...........         $.06
           5mg.
    1402  Promethazine hcl 12.5mg      G                      ...........         $.01  ...........         $.00
           oral.
    1403  Chlorpromazine hcl 10mg      G                      ...........         $.27  ...........         $.02
           oral.
    1404  Trimethobenzamide hcl 250mg  G                      ...........         $.38  ...........         $.03

[[Page 59931]]

 
    1405  Thiethylperazine             G                      ...........         $.56  ...........         $.08
           maleate10mg.
    1406  Perphenazine 4mg oral......  G                      ...........         $.62  ...........         $.06
    1407  Hydroxyzine pamoate 25mg...  G                      ...........         $.28  ...........         $.03
    1409  Factor viia recombinant,     G                      ...........    $1,596.00  ...........      $228.48
           per 1.2 mg.
    1600  Technetium TC 99M sestamibi  G                      ...........      $121.70  ...........       $17.42
    1601  Technetium TC 99M medronate  G                      ...........       $42.18  ...........        $5.42
    1602  Technetium TC 99M apcitide.  G                      ...........      $475.00  ...........       $68.00
    1603  Thallous chloride TL 201,    G                      ...........       $78.16  ...........        $7.08
           per mCi.
    1604  IN 111 capromab pendetide,   G                      ...........    $2,192.13  ...........      $313.82
           per dose.
    1605  Abciximab injection, 10 mg.  G                      ...........      $513.02  ...........       $73.44
    1606  Anistreplase, 30 u.........  G                      ...........    $2,693.80  ...........      $385.64
    1607  Eptifibatide injection, 5    G                      ...........       $11.31  ...........        $1.45
           mg.
    1608  Etanercept injection, 25 mg  G                      ...........      $141.01  ...........       $20.19
    1609  Rho(D) immune globulin h,    G                      ...........       $20.55  ...........        $2.64
           sd, 100 iu.
    1611  Hylan G-F 20 injection, 16   G                      ...........      $213.87  ...........       $27.47
           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                      ...........    $1,437.78  ...........      $205.83
    1617  Lepirudin..................  G                      ...........      $131.96  ...........       $18.89
    1618  Vonwillebrandfactrcmplx,     G                      ...........         $.95  ...........         $.14
           per iu.
    1619  Ga 67, per mCi.............  G                      ...........       $25.62  ...........        $2.32
    1620  Technetium tc99m bicisate..  G                      ...........      $403.99  ...........       $57.83
    1621  Xenin xe 133...............  G                      ...........       $29.93  ...........        $2.71
    1622  Technetium tc99m mertiatide  G                      ...........      $137.75  ...........       $19.72
    1623  Technetium tc99m             G                      ...........       $22.61  ...........        $3.24
           glucepatate.
    1624  Sodium phosphate p32.......  G                      ...........       $54.34  ...........        $7.78
    1625  Indium 111-in pentetreotide  G                      ...........      $935.75  ...........      $133.96
    1626  Technetium tc99m oxidronate  G                      ...........        $1.47  ...........         $.21
    1627  Technetium tc99mlabeled      G                      ...........       $40.90  ...........        $5.85
           rbcs.
    1628  Chromic phosphate p32......  G                      ...........      $150.86  ...........       $21.60
    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                      ...........  ...........  ...........  ...........
    1724  Cath, trans                  H                      ...........  ...........  ...........  ...........
           atherec,rotation.
    1725  Cath, translumin non-laser.  H                      ...........  ...........  ...........  ...........
    1726  Cath, bal dil, non-vascular  H                      ...........  ...........  ...........  ...........
    1727  Cath, bal tis dis, non-vas.  H                      ...........  ...........  ...........  ...........
    1728  Cath, brachytx seed adm....  H                      ...........  ...........  ...........  ...........
    1729  Cath, drainage.............  H                      ...........  ...........  ...........  ...........
    1730  Cath, EP, 19 or fewer elect  H                      ...........  ...........  ...........  ...........
    1731  Cath, EP, 20 or more elec..  H                      ...........  ...........  ...........  ...........
    1732  Cath, EP, diag/abl, 3D/vect  H                      ...........  ...........  ...........  ...........
    1733  Cath, EP, othr than cool-    H                      ...........  ...........  ...........  ...........
           tip.
    1750  Cath, hemodialysis,long-     H                      ...........  ...........  ...........  ...........
           term.
    1751  Cath, inf, per/cent/midline  H                      ...........  ...........  ...........  ...........
    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/embolect  H                      ...........  ...........  ...........  ...........
    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                      ...........  ...........  ...........  ...........
    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, programmable  H                      ...........  ...........  ...........  ...........
    1773  Retrieval dev, insert......  H                      ...........  ...........  ...........  ...........
    1776  Joint device (implantable).  H                      ...........  ...........  ...........  ...........
    1777  Lead, AICD, endo single      H                      ...........  ...........  ...........  ...........
           coil.
    1778  Lead, neurostimulator......  H                      ...........  ...........  ...........  ...........

[[Page 59932]]

 
    1779  Lead, pmkr, transvenous VDD  H                      ...........  ...........  ...........  ...........
    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, neuro  H                      ...........  ...........  ...........  ...........
    1817  Septal defect imp sys......  H                      ...........  ...........  ...........  ...........
    1874  Stent, coated/cov w/del sys  H                      ...........  ...........  ...........  ...........
    1875  Stent, coated/cov w/o del    H                      ...........  ...........  ...........  ...........
           sy.
    1876  Stent, non-coa/no-cov w/del  H                      ...........  ...........  ...........  ...........
    1877  Stent, non-coat/cov w/o del  H                      ...........  ...........  ...........  ...........
    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-prog,perm  H                      ...........  ...........  ...........  ...........
    1892  Intro/sheath,fixed,peel-     H                      ...........  ...........  ...........  ...........
           away.
    1893  Intro/sheath,fixed,non-peel  H                      ...........  ...........  ...........  ...........
    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 combination  H                      ...........  ...........  ...........  ...........
    2615  Sealant, pulmonary, liquid.  H                      ...........  ...........  ...........  ...........
    2616  Brachytx seed, Yttrium-90..  H                      ...........  ...........  ...........  ...........
    2617  Stent, non-cor, tem w/o del  H                      ...........  ...........  ...........  ...........
    2618  Probe, cryoablation........  H                      ...........  ...........  ...........  ...........
    2619  Pmkr, dual, non rate-resp..  H                      ...........  ...........  ...........  ...........
    2620  Pmkr, single, non rate-resp  H                      ...........  ...........  ...........  ...........
    2621  Pmkr, other than sing/dual.  H                      ...........  ...........  ...........  ...........
    2622  Prosthesis, penile, non-inf  H                      ...........  ...........  ...........  ...........
    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 sling  H                      ...........  ...........  ...........  ...........
    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                      ...........       $12.04  ...........        $1.72
           mg.
    7005  Gonadorelin hydroch, 100     G                      ...........      $192.37  ...........       $27.54
           mcg.
    7007  Milrinone lactate, per 5     K                             0.44       $22.40  ...........        $4.48
           ml, inj.
    7010  Morphine sulfate             G                      ...........        $1.02  ...........         $.09
           (preservative free) 10 mg.
    7011  Oprelvekin injection, 5 mg.  G                      ...........      $245.81  ...........       $35.19
    7014  Fentanyl citrate injection.  G                      ...........        $1.23  ...........         $.11
    7015  Busulfan, oral, 2 mg.......  G                      ...........        $1.91  ...........         $.27
    7019  Aprotinin, 10,000 kiu......  G                      ...........        $2.16  ...........         $.31
    7022  Elliot's B solution, per ml  G                      ...........        $1.43  ...........         $.20
    7023  Bladder calculi irrig sol..  G                      ...........       $24.70  ...........        $3.54
    7024  Corticorelin ovine           G                      ...........      $368.03  ...........       $52.69
           triflutat.
    7025  Digoxin immune FAB (ovine).  G                      ...........      $551.66  ...........       $78.97
    7026  Ethanolamine oleate, 100 mg  G                      ...........       $39.73  ...........        $5.69
    7027  Fomepizole, 15 mg..........  G                      ...........       $10.93  ...........        $1.56
    7028  Fosphenytoin, 50 mg........  G                      ...........        $5.73  ...........         $.82
    7029  Glatiramer acetate, per      G                      ...........       $30.07  ...........        $4.30
           dose.
    7030  Hemin, per 1 mg............  G                      ...........         $.99  ...........         $.14
    7031  Octreotide acetate           G                      ...........      $138.08  ...........       $19.77
           injection.
    7032  Sermorelin acetate, 0.5 mg.  G                      ...........       $13.60  ...........        $1.95
    7033  Somatrem, 5mg..............  G                      ...........      $209.48  ...........       $29.99
    7034  Somatropin injection.......  G                      ...........       $39.90  ...........        $5.12
    7035  Teniposide, 50 mg..........  G                      ...........      $222.80  ...........       $31.90
    7036  Urokinase 250,000 iu inj...  K                             6.41      $326.29  ...........       $65.26
    7037  Urofollitropin, 75 iu......  G                      ...........       $73.29  ...........       $10.49
    7038  Muromonab-CD3, 5 mg........  G                      ...........      $269.06  ...........       $38.52

[[Page 59933]]

 
    7039  Pegademase bovine inj 25     G                      ...........      $139.33  ...........       $19.95
           I.U.
    7040  Pentastarch 10% solution...  G                      ...........       $15.11  ...........        $2.16
    7041  Tirofiban hydrochloride      G                      ...........      $436.41  ...........       $62.48
           12.5 mg.
    7042  Capecitabine, oral, 150 mg.  G                      ...........        $2.43  ...........         $.35
    7043  Infliximab injection 10 mg.  G                      ...........       $63.24  ...........        $9.05
    7045  Trimetrexate glucoronate...  G                      ...........      $118.75  ...........       $17.00
    7046  Doxorubicin hcl liposome     G                      ...........      $358.95  ...........       $51.39
           inj 10 mg.
    7048  Alteplase recombinant......  K                             0.36       $18.33  ...........        $3.67
    7049  Filgrastim 480 mcg           G                      ...........      $285.38  ...........       $36.65
           injection.
    7050  Prednisone oral............  G                      ...........         $.07  ...........         $.01
    7051  Leuprolide acetate implant,  G                      ...........    $5,399.80  ...........      $773.02
           65 mg.
    7315  Sodium hyaluronate           G                      ...........       $26.13  ...........        $3.74
           injection, 5mg.
    9000  Na chromate Cr51, per        G                      ...........         $.52  ...........         $.07
           0.25mCi.
    9001  Linezolid inj, 200mg.......  G                      ...........       $24.13  ...........        $3.45
    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.............  G                      ...........      $113.15  ...........       $16.20
    9007  Baclofen Intrathecal kit-    G                      ...........       $79.80  ...........       $11.42
           1amp.
    9008  Baclofen refill kit--per     G                      ...........       $11.69  ...........        $1.67
           500 mcg.
    9009  Baclofen refill kit--per     G                      ...........       $49.12  ...........        $7.03
           2000 mcg.
    9010  Baclofen refill kit--per     G                      ...........       $43.08  ...........        $6.17
           4000 mcg.
    9011  Caffeine Citrate, inj,.....  G                      ...........        $3.05  ...........         $.44
    9012  Arsenic Trioxide...........  G                      ...........       $23.75  ...........        $3.40
    9013  Co 57 Cobaltous CI.........  G                      ...........       $81.10  ...........       $10.41
    9015  Mycophenolate mofetil oral   G                      ...........        $2.40  ...........         $.34
           250 mg.
    9016  Echocardiography contrast..  G                      ...........      $118.75  ...........       $17.00
    9018  Botulinum tox B, per 100 u.  G                      ...........        $8.79  ...........        $1.26
    9019  Caspofungin acetate, 5 mg..  G                      ...........       $34.20  ...........        $4.90
    9020  Sirolimus tablet, 1 mg.....  G                      ...........        $6.51  ...........         $.93
    9100  Iodinated I-131 albumin....  G                      ...........       $10.34  ...........        $1.48
    9102  51 na chromate, per 50mCi..  G                      ...........       $64.84  ...........        $9.28
    9103  Na iothalamate I-125, per    G                      ...........       $17.18  ...........        $2.46
           10 uci.
    9104  Anti-thymocycte globulin     G                      ...........      $325.09  ...........       $46.54
           rabbit.
    9105  Hep B imm glob, per 1 ml...  G                      ...........      $133.00  ...........       $17.08
    9106  Sirolimus, 1 mg............  G                      ...........        $6.51  ...........         $.93
    9108  Thyrotropin alfa, per 1.1    G                      ...........      $531.05  ...........       $76.02
           mg.
    9109  Tirofliban hcl, per 6.25 mg  G                      ...........      $207.81  ...........       $29.75
    9110  Alemtuzumab, per ml........  G                      ...........      $486.88  ...........       $69.70
    9111  Inj, bivalirudin, per 250mg  G                      ...........      $397.81  ...........       $56.95
           vial.
    9112  Perflutren lipid micro, per  G                      ...........      $148.20  ...........       $21.22
           2ml.
    9113  Inj pantoprazole sodium,     G                      ...........       $22.80  ...........        $3.26
           vial.
    9114  Nesiritide, per 1.5 mg vial  G                      ...........      $433.20  ...........       $62.02
    9115  Inj, zoledronic acid, per 2  G                      ...........      $406.78  ...........       $58.23
           mg.
    9200  Orcel, per 36 cm2..........  G                      ...........    $1,135.25  ...........      $162.52
    9201  Dermagraft, per 37.5 sq cm.  G                      ...........      $577.60  ...........       $82.69
    9217  Leuprolide acetate           G                      ...........      $592.60  ...........       $84.84
           suspnsion, 7.5 mg.
    9500  Platelets, irradiated......  K                             1.68       $85.52  ...........       $17.10
    9501  Platelets, pheresis........  K                             9.16      $466.28  ...........       $93.26
    9502  Platelet pheresis            K                             9.94      $505.99  ...........      $101.20
           irradiated.
    9503  Fresh frozen plasma, ea      K                             1.56       $79.41  ...........       $15.88
           unit.
    9504  RBC deglycerolized.........  K                             4.11      $209.22  ...........       $41.84
    9505  RBC irradiated.............  K                             2.44      $124.21  ...........       $24.84
    9506  Granulocytes, pheresis.....  K                            27.75    $1,412.59  ...........      $282.52
----------------------------------------------------------------------------------------------------------------

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

Copyright American Dental Association. All rights reserved.

* Code is new in 2002.

[[Page 59933]]



              Addendum B.--Payment Status by HCPCS Code and Related Information Calender Year 2002
----------------------------------------------------------------------------------------------------------------
                                                                                          National     Minimum
  CPT/         Status           Description          APC        Relative     Payment     Unadjusted   Unadjusted
  HCPCS      Indicator                                           Weight        Rate      Copayment    Copayment
----------------------------------------------------------------------------------------------------------------
  *0001T  C                Endovas repr abdo ao  ...........  ...........  ...........  ...........  ...........
                            aneurys.
  *0002T  C                Endovas repr abdo ao  ...........  ...........  ...........  ...........  ...........
                            aneurys.
  *0003T  N                Cervicography.......  ...........  ...........  ...........  ...........  ...........
  *0005T  C                Perc cath stent/      ...........  ...........  ...........  ...........  ...........
                            brain cv art.
  *0006T  C                Perc cath stent/      ...........  ...........  ...........  ...........  ...........
                            brain cv art.
  *0007T  C                Perc cath stent/      ...........  ...........  ...........  ...........  ...........
                            brain cv art.
  *0008T  E                Upper gi endoscopy w/ ...........  ...........  ...........  ...........  ...........
                            suture.
  *0009T  T                Endometrial                  0193        11.16      $568.09      $171.13      $113.62
                            cryoablation.

[[Page 59934]]

 
   00100  N                Anesth, salivary      ...........  ...........  ...........  ...........  ...........
                            gland.
   00102  N                Anesth, repair of     ...........  ...........  ...........  ...........  ...........
                            cleft lip.
   00103  N                Anesth,               ...........  ...........  ...........  ...........  ...........
                            blepharoplasty.
   00104  N                Anesth, electroshock  ...........  ...........  ...........  ...........  ...........
  *0010T  A                Tb test, gamma        ...........  ...........  ...........  ...........  ...........
                            interferon.
   00120  N                Anesth, ear surgery.  ...........  ...........  ...........  ...........  ...........
   00124  N                Anesth, ear exam....  ...........  ...........  ...........  ...........  ...........
   00126  N                Anesth, tympanotomy.  ...........  ...........  ...........  ...........  ...........
  *0012T  T                Osteochondral knee           0041        23.61    $1,201.84      $576.88      $240.37
                            autograft.
  *0013T  T                Osteochondral knee           0041        23.61    $1,201.84      $576.88      $240.37
                            allograft.
   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....  ...........  ...........  ...........  ...........  ...........
  *0014T  T                Meniscal transplant,         0041        23.61    $1,201.84      $576.88      $240.37
                            knee.
   00160  N                Anesth, nose/sinus    ...........  ...........  ...........  ...........  ...........
                            surgery.
   00162  N                Anesth, nose/sinus    ...........  ...........  ...........  ...........  ...........
                            surgery.
   00164  N                Anesth, biopsy of     ...........  ...........  ...........  ...........  ...........
                            nose.
  *0016T  E                Thermotx choroid      ...........  ...........  ...........  ...........  ...........
                            vasc lesion.
   00170  N                Anesth, procedure on  ...........  ...........  ...........  ...........  ...........
                            mouth.
   00172  N                Anesth, cleft palate  ...........  ...........  ...........  ...........  ...........
                            repair.
   00174  C                Anesth, pharyngeal    ...........  ...........  ...........  ...........  ...........
                            surgery.
   00176  C                Anesth, pharyngeal    ...........  ...........  ...........  ...........  ...........
                            surgery.
  *0017T  E                Photocoagulat         ...........  ...........  ...........  ...........  ...........
                            macular drusen.
  *0018T  S                Transcranial                 0215         0.66       $33.60       $17.47        $6.72
                            magnetic stimul.
   00190  N                Anesth, face/skull    ...........  ...........  ...........  ...........  ...........
                            bone surg.
   00192  C                Anesth, facial bone   ...........  ...........  ...........  ...........  ...........
                            surgery.
  *0019T  A                Extracorp shock wave  ...........  ...........  ...........  ...........  ...........
                            tx, ms.
  *0020T  A                Extracorp shock wave  ...........  ...........  ...........  ...........  ...........
                            tx, ft.
   00210  N                Anesth, open head     ...........  ...........  ...........  ...........  ...........
                            surgery.
   00212  N                Anesth, skull         ...........  ...........  ...........  ...........  ...........
                            drainage.
   00214  C                Anesth, skull         ...........  ...........  ...........  ...........  ...........
                            drainage.
   00215  C                Anesth, skull repair/ ...........  ...........  ...........  ...........  ...........
                            fract.
   00216  N                Anesth, head vessel   ...........  ...........  ...........  ...........  ...........
                            surgery.
   00218  N                Anesth, special head  ...........  ...........  ...........  ...........  ...........
                            surgery.
  *0021T  C                Fetal oximetry,       ...........  ...........  ...........  ...........  ...........
                            trnsvag/cerv.
   00220  N                Anesth, spinal fluid  ...........  ...........  ...........  ...........  ...........
                            shunt.
   00222  N                Anesth, head nerve    ...........  ...........  ...........  ...........  ...........
                            surgery.
  *0023T  A                Phenotype drug test,  ...........  ...........  ...........  ...........  ...........
                            hiv 1.
  *0024T  C                Transcath cardiac     ...........  ...........  ...........  ...........  ...........
                            reduction.
  *0025T  S                Ultrasonic                   0230         0.61       $31.05       $14.28        $6.21
                            pachymetry.
  *0026T  A                Measure remnant       ...........  ...........  ...........  ...........  ...........
                            lipoproteins.
   00300  N                Anesth, head/neck/    ...........  ...........  ...........  ...........  ...........
                            ptrunk.
   00320  N                Anesth, neck organ    ...........  ...........  ...........  ...........  ...........
                            surgery.
   00322  N                Anesth, biopsy of     ...........  ...........  ...........  ...........  ...........
                            thyroid.
   00350  N                Anesth, neck vessel   ...........  ...........  ...........  ...........  ...........
                            surgery.
   00352  N                Anesth, neck vessel   ...........  ...........  ...........  ...........  ...........
                            surgery.
   00400  N                Anesth, skin, ext/    ...........  ...........  ...........  ...........  ...........
                            per/atrunk.
   00402  N                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            breast.
   00404  C                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            breast.
   00406  C                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            breast.
   00410  N                Anesth, correct       ...........  ...........  ...........  ...........  ...........
                            heart rhythm.
   00450  N                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            shoulder.
   00452  C                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            shoulder.
   00454  N                Anesth, collar bone   ...........  ...........  ...........  ...........  ...........
                            biopsy.
   00470  N                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            rib.
   00472  N                Anesth, chest wall    ...........  ...........  ...........  ...........  ...........
                            repair.
   00474  C                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            rib(s).
   00500  N                Anesth, esophageal    ...........  ...........  ...........  ...........  ...........
                            surgery.
   00520  N                Anesth, chest         ...........  ...........  ...........  ...........  ...........
                            procedure.
   00522  N                Anesth, chest lining  ...........  ...........  ...........  ...........  ...........
                            biopsy.
   00524  C                Anesth, chest         ...........  ...........  ...........  ...........  ...........
                            drainage.
   00528  N                Anesth, chest         ...........  ...........  ...........  ...........  ...........
                            partition view.
   00530  N                Anesth, pacemaker     ...........  ...........  ...........  ...........  ...........
                            insertion.
   00532  N                Anesth, vascular      ...........  ...........  ...........  ...........  ...........
                            access.
   00534  N                Anesth, cardioverter/ ...........  ...........  ...........  ...........  ...........
                            defib.
   00537  N                Anesth, cardiac       ...........  ...........  ...........  ...........  ...........
                            electrophys.
   00540  C                Anesth, chest         ...........  ...........  ...........  ...........  ...........
                            surgery.
   00542  C                Anesth, release of    ...........  ...........  ...........  ...........  ...........
                            lung.
   00544  C                Anesth, chest lining  ...........  ...........  ...........  ...........  ...........
                            removal.
   00546  C                Anesth, lung,chest    ...........  ...........  ...........  ...........  ...........
                            wall surg.
   00548  N                Anesth,               ...........  ...........  ...........  ...........  ...........
                            trachea,bronchi
                            surg.
   00550  N                Anesth, sternal       ...........  ...........  ...........  ...........  ...........
                            debridement.

[[Page 59935]]

 
   00560  C                Anesth, open heart    ...........  ...........  ...........  ...........  ...........
                            surgery.
   00562  C                Anesth, open heart    ...........  ...........  ...........  ...........  ...........
                            surgery.
   00563  N                Anesth, heart proc w/ ...........  ...........  ...........  ...........  ...........
                            pump.
   00566  N                Anesth, cabg w/o      ...........  ...........  ...........  ...........  ...........
                            pump.
   00580  C                Anesth heart/lung     ...........  ...........  ...........  ...........  ...........
                            transplant.
   00600  N                Anesth, spine, cord   ...........  ...........  ...........  ...........  ...........
                            surgery.
   00604  C                Anesth, sitting       ...........  ...........  ...........  ...........  ...........
                            procedure.
   00620  N                Anesth, spine, cord   ...........  ...........  ...........  ...........  ...........
                            surgery.
   00622  C                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            nerves.
   00630  N                Anesth, spine, cord   ...........  ...........  ...........  ...........  ...........
                            surgery.
   00632  C                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            nerves.
   00634  C                Anesth for            ...........  ...........  ...........  ...........  ...........
                            chemonucleolysis.
   00635  N                Anesth, lumbar        ...........  ...........  ...........  ...........  ...........
                            puncture.
   00670  C                Anesth, spine, cord   ...........  ...........  ...........  ...........  ...........
                            surgery.
   00700  N                Anesth, abdominal     ...........  ...........  ...........  ...........  ...........
                            wall surg.
   00702  N                Anesth, for liver     ...........  ...........  ...........  ...........  ...........
                            biopsy.
   00730  N                Anesth, abdominal     ...........  ...........  ...........  ...........  ...........
                            wall surg.
   00740  N                Anesth, upper gi      ...........  ...........  ...........  ...........  ...........
                            visualize.
   00750  N                Anesth, repair of     ...........  ...........  ...........  ...........  ...........
                            hernia.
   00752  N                Anesth, repair of     ...........  ...........  ...........  ...........  ...........
                            hernia.
   00754  N                Anesth, repair of     ...........  ...........  ...........  ...........  ...........
                            hernia.
   00756  N                Anesth, repair of     ...........  ...........  ...........  ...........  ...........
                            hernia.
   00770  N                Anesth, blood vessel  ...........  ...........  ...........  ...........  ...........
                            repair.
   00790  N                Anesth, surg upper    ...........  ...........  ...........  ...........  ...........
                            abdomen.
   00792  C                Anesth, hemorr/       ...........  ...........  ...........  ...........  ...........
                            excise liver.
   00794  C                Anesth, pancreas      ...........  ...........  ...........  ...........  ...........
                            removal.
   00796  C                Anesth, for liver     ...........  ...........  ...........  ...........  ...........
                            transplant.
  *00797  N                Anesth, surgery for   ...........  ...........  ...........  ...........  ...........
                            obesity.
   00800  N                Anesth, abdominal     ...........  ...........  ...........  ...........  ...........
                            wall surg.
   00802  C                Anesth, fat layer     ...........  ...........  ...........  ...........  ...........
                            removal.
   00810  N                Anesth, low           ...........  ...........  ...........  ...........  ...........
                            intestine scope.
   00820  N                Anesth, abdominal     ...........  ...........  ...........  ...........  ...........
                            wall surg.
   00830  N                Anesth, repair of     ...........  ...........  ...........  ...........  ...........
                            hernia.
   00832  N                Anesth, repair of     ...........  ...........  ...........  ...........  ...........
                            hernia.
   00840  N                Anesth, surg lower    ...........  ...........  ...........  ...........  ...........
                            abdomen.
   00842  N                Anesth,               ...........  ...........  ...........  ...........  ...........
                            amniocentesis.
   00844  C                Anesth, pelvis        ...........  ...........  ...........  ...........  ...........
                            surgery.
   00846  C                Anesth, hysterectomy  ...........  ...........  ...........  ...........  ...........
   00848  C                Anesth, pelvic organ  ...........  ...........  ...........  ...........  ...........
                            surg.
   00850  D                Anesth, cesarean      ...........  ...........  ...........  ...........  ...........
                            section.
  *00851  N                Anesth, tubal         ...........  ...........  ...........  ...........  ...........
                            ligation.
   00855  D                Anesth, hysterectomy  ...........  ...........  ...........  ...........  ...........
   00857  D                Analgesia, labor & c- ...........  ...........  ...........  ...........  ...........
                            section.
   00860  N                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            abdomen.
   00862  N                Anesth, kidney/       ...........  ...........  ...........  ...........  ...........
                            ureter surg.
   00864  C                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            bladder.
   00865  C                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            prostate.
   00866  C                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            adrenal.
   00868  C                Anesth, kidney        ...........  ...........  ...........  ...........  ...........
                            transplant.
  *00869  N                Anesth, vasectomy...  ...........  ...........  ...........  ...........  ...........
   00870  N                Anesth, bladder       ...........  ...........  ...........  ...........  ...........
                            stone surg.
   00872  N                Anesth kidney stone   ...........  ...........  ...........  ...........  ...........
                            destruct.
   00873  N                Anesth kidney stone   ...........  ...........  ...........  ...........  ...........
                            destruct.
   00880  N                Anesth, abdomen       ...........  ...........  ...........  ...........  ...........
                            vessel surg.
   00882  C                Anesth, major vein    ...........  ...........  ...........  ...........  ...........
                            ligation.
   00884  D                Anesth, major vein    ...........  ...........  ...........  ...........  ...........
                            revision.
   00902  N                Anesth, anorectal     ...........  ...........  ...........  ...........  ...........
                            surgery.
   00904  C                Anesth, perineal      ...........  ...........  ...........  ...........  ...........
                            surgery.
   00906  N                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            vulva.
   00908  C                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            prostate.
   00910  N                Anesth, bladder       ...........  ...........  ...........  ...........  ...........
                            surgery.
   00912  N                Anesth, bladder       ...........  ...........  ...........  ...........  ...........
                            tumor surg.
   00914  N                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            prostate.
   00916  N                Anesth, bleeding      ...........  ...........  ...........  ...........  ...........
                            control.
   00918  N                Anesth, stone         ...........  ...........  ...........  ...........  ...........
                            removal.
   00920  N                Anesth, genitalia     ...........  ...........  ...........  ...........  ...........
                            surgery.
   00922  N                Anesth, sperm duct    ...........  ...........  ...........  ...........  ...........
                            surgery.
   00924  N                Anesth, testis        ...........  ...........  ...........  ...........  ...........
                            exploration.
   00926  N                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            testis.
   00928  C                Anesth, removal of    ...........  ...........  ...........  ...........  ...........
                            testis.
   00930  N                Anesth, testis        ...........  ...........  ...........  ...........  ...........
                            suspension.
   00932  C                Anesth, amputation    ...........  ...........  ...........  ...........  ...........
                            of penis.
   00934  C                Anesth, penis, nodes  ...........  ...........  ...........  ...........  ...........
                            removal.
   00936  C                Anesth, penis, nodes  ...........  ...........  ...........  ...........  ...........
                            removal.
   00938  N                Anesth, insert penis  ...........  ...........  ...........  ...........  ...........
                            device.

[[Page 59936]]

 
   00940  N                Anesth, vaginal       ...........  ...........  ...........  ...........  ...........
                            procedures.
   00942  N                Anesth, surg on vag/  ...........  ...........  ...........  ...........  ...........
                            urethal.
   00944  C                Anesth, vaginal       ...........  ...........  ...........  ...........  ...........
                            hysterectomy.
   00946  D                Anesth, vaginal       ...........  ...........  ...........  ...........  ...........
                            delivery.
   00948  N                Anesth, repair of     ...........  ...........  ...........  ...........  ...........
                            cervix.
   00950  N                Anesth, vaginal       ...........  ...........  ...........  ...........  ...........
                            endoscopy.
   00952  N                Anesth, hysteroscope/ ...........  ...........  ...........  ...........  ...........
                            graph.
   00955  D                Analgesia, vaginal    ...........  ...........  ...........  ...........  ...........
                            delivery.
   01112  N                Anesth, bone          ...........  ...........  ...........  ...........  ...........
                            aspirate/bx.
   01120  N                Anesth, pelvis        ...........  ...........  ...........  ...........  ...........
                            surgery.
   01130  N                Anesth, body cast     ...........  ...........  ...........  ...........  ...........
                            procedure.
   01140  C                Anesth, amputation    ...........  ...........  ...........  ...........  ...........
                            at pelvis.
   01150  C                Anesth, pelvic tumor  ...........  ...........  ...........  ...........  ...........
                            surgery.
   01160  N                Anesth, pelvis        ...........  ...........  ...........  ...........  ...........
                            procedure.
   01170  N                Anesth, pelvis        ...........  ...........  ...........  ...........  ...........
                            surgery.
   01180  N                Anesth, pelvis nerve  ...........  ...........  ...........  ...........  ...........
                            removal.
   01190  C                Anesth, pelvis nerve  ...........  ...........  ...........  ...........  ...........
                            removal.
   01200  N                Anesth, hip joint     ...........  ...........  ...........  ...........  ...........
                            procedure.
   01202  N                Anesth, arthroscopy   ...........  ...........  ...........  ...........  ...........
                            of hip.
   01210  N                Anesth, hip joint     ...........  ...........  ...........  ...........  ...........
                            surgery.
   01212  C                Anesth, hip           ...........  ...........  ...........  ...........  ...........
                            disarticulation.
   01214  C                Anesth, replacement   ...........  ...........  ...........  ...........  ...........
                            of hip.
   01215  N                Anesth, revise hip    ...........  ...........  ...........  ...........  ...........
                            repair.
   01220  N                Anesth, procedure on  ...........  ...........  ...........  ...........  ...........
                            femur.
   01230  N                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            femur.
   01232  C                Anesth, amputation    ...........  ...........  ...........  ...........  ...........
                            of femur.
   01234  C                Anesth, radical       ...........  ...........  ...........  ...........  ...........
                            femur surg.
   01250  N                Anesth, upper leg     ...........  ...........  ...........  ...........  ...........
                            surgery.
   01260  N                Anesth, upper leg     ...........  ...........  ...........  ...........  ...........
                            veins surg.
   01270  N                Anesth, thigh         ...........  ...........  ...........  ...........  ...........
                            arteries surg.
   01272  C                Anesth, femoral       ...........  ...........  ...........  ...........  ...........
                            artery surg.
   01274  C                Anesth, femoral       ...........  ...........  ...........  ...........  ...........
                            embolectomy.
   01320  N                Anesth, knee area     ...........  ...........  ...........  ...........  ...........
                            surgery.
   01340  N                Anesth, knee area     ...........  ...........  ...........  ...........  ...........
                            procedure.
   01360  N                Anesth, knee area     ...........  ...........  ...........  ...........  ...........
                            surgery.
   01380  N                Anesth, knee joint    ...........  ...........  ...........  ...........  ...........
                            procedure.
   01382  N                Anesth, knee          ...........  ...........  ...........  ...........  ...........
                            arthroscopy.
   01390  N                Anesth, knee area     ...........  ...........  ...........  ...........  ...........
                            procedure.
   01392  N                Anesth, knee area     ...........  ...........  ...........  ...........  ...........
                            surgery.
   01400  N                Anesth, knee joint    ...........  ...........  ...........  ...........  ...........
                            surgery.
   01402  C                Anesth, replacement   ...........  ...........  ...........  ...........  ...........
                            of knee.
   01404  C                Anesth, amputation    ...........  ...........  ...........  ...........  ...........
                            at knee.
   01420  N                Anesth, knee joint    ...........  ...........  ...........  ...........  ...........
                            casting.
   01430  N                Anesth, knee veins    ...........  ...........  ...........  ...........  ...........
                            surgery.
   01432  N                Anesth, knee vessel   ...........  ...........  ...........  ...........  ...........
                            surg.
   01440  N                Anesth, knee          ...........  ...........  ...........  ...........  ...........
                            arteries surg.
   01442  C                Anesth, knee artery   ...........  ...........  ...........  ...........  ...........
                            surg.
   01444  C                Anesth, knee artery   ...........  ...........  ...........  ...........  ...........
                            repair.
   01462  N                Anesth, lower leg     ...........  ...........  ...........  ...........  ...........
                            procedure.
   01464  N                Anesth, ankle         ...........  ...........  ...........  ...........  ...........
                            arthroscopy.
   01470  N                Anesth, lower leg     ...........  ...........  ...........  ...........  ...........
                            surgery.
   01472  N                Anesth, achilles      ...........  ...........  ...........  ...........  ...........
                            tendon surg.
   01474  N                Anesth, lower leg     ...........  ...........  ...........  ...........  ...........
                            surgery.
   01480  N                Anesth, lower leg     ...........  ...........  ...........  ...........  ...........
                            bone surg.
   01482  N                Anesth, radical leg   ...........  ...........  ...........  ...........  ...........
                            surgery.
   01484  N                Anesth, lower leg     ...........  ...........  ...........  ...........  ...........
                            revision.
   01486  C                Anesth, ankle         ...........  ...........  ...........  ...........  ...........
                            replacement.
   01490  N                Anesth, lower leg     ...........  ...........  ...........  ...........  ...........
                            casting.
   01500  N                Anesth, leg arteries  ...........  ...........  ...........  ...........  ...........
                            surg.
   01502  C                Anesth, lwr leg       ...........  ...........  ...........  ...........  ...........
                            embolectomy.
   01520  N                Anesth, lower leg     ...........  ...........  ...........  ...........  ...........
                            vein surg.
   01522  N                Anesth, lower leg     ...........  ...........  ...........  ...........  ...........
                            vein surg.
   01610  N                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            shoulder.
   01620  N                Anesth, shoulder      ...........  ...........  ...........  ...........  ...........
                            procedure.
   01622  N                Anesth, shoulder      ...........  ...........  ...........  ...........  ...........
                            arthroscopy.
   01630  N                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            shoulder.
   01632  C                Anesth, surgery of    ...........  ...........  ...........  ...........  ...........
                            shoulder.
   01634  C                Anesth, shoulder      ...........  ...........  ...........  ...........  ...........
                            joint amput.
   01636  C                Anesth, forequarter   ...........  ...........  ...........  ...........  ...........
                            amput.
   01638  C                Anesth, shoulder      ...........  ...........  ...........  ...........  ...........
                            replacement.
   01650  N                Anesth, shoulder      ...........  ...........  ...........  ...........  ...........
                            artery surg.
   01652  C                Anesth, shoulder      ...........  ...........  ...........  ...........  ...........
                            vessel surg.
   01654  C                Anesth, shoulder      ...........  ...........  ...........  ...........  ...........
                            vessel surg.
   01656  C                Anesth, arm-leg       ...........  ...........  ...........  ...........  ...........
                            vessel surg.
   01670  N                Anesth, shoulder      ...........  ...........  ...........  ...........  ...........
                            vein surg.

[[Page 59937]]

 
   01680  N                Anesth, shoulder      ...........  ...........  ...........  ...........  ...........
                            casting.
   01682  N                Anesth, airplane      ...........  ...........  ...........  ...........  ...........
                            cast.
   01710  N                Anesth, elbow area    ...........  ...........  ...........  ...........  ...........
                            surgery.
   01712  N                Anesth, uppr arm      ...........  ...........  ...........  ...........  ...........
                            tendon surg.
   01714  N                Anesth, uppr arm      ...........  ...........  ...........  ...........  ...........
                            tendon surg.
   01716  N                Anesth, biceps        ...........  ...........  ...........  ...........  ...........
                            tendon repair.
   01730  N                Anesth, uppr arm      ...........  ...........  ...........  ...........  ...........
                            procedure.
   01732  N                Anesth, elbow         ...........  ...........  ...........  ...........  ...........
                            arthroscopy.
   01740  N                Anesth, upper arm     ...........  ...........  ...........  ...........  ...........
                            surgery.
   01742  N                Anesth, humerus       ...........  ...........  ...........  ...........  ...........
                            surgery.
   01744  N                Anesth, humerus       ...........  ...........  ...........  ...........  ...........
                            repair.
   01756  C                Anesth, radical       ...........  ...........  ...........  ...........  ...........
                            humerus surg.
   01758  N                Anesth, humeral       ...........  ...........  ...........  ...........  ...........
                            lesion surg.
   01760  N                Anesth, elbow         ...........  ...........  ...........  ...........  ...........
                            replacement.
   01770  N                Anesth, uppr arm      ...........  ...........  ...........  ...........  ...........
                            artery surg.
   01772  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  D                Anesth, skull x-ray   ...........  ...........  ...........  ...........  ...........
                            inject.
  *01905  N                Anes, spine inject,   ...........  ...........  ...........  ...........  ...........
                            x-ray/re.
   01906  D                Anesth, lumbar        ...........  ...........  ...........  ...........  ...........
                            myelography.
   01908  D                Anesth, cervical      ...........  ...........  ...........  ...........  ...........
                            myelography.
   01910  D                Anesth, skull         ...........  ...........  ...........  ...........  ...........
                            myelography.
   01912  D                Anesth, lumbar        ...........  ...........  ...........  ...........  ...........
                            diskography.
   01914  D                Anesth, cervical      ...........  ...........  ...........  ...........  ...........
                            diskography.
   01916  N                Anesth, head          ...........  ...........  ...........  ...........  ...........
                            arteriogram.
   01918  D                Anesth, limb          ...........  ...........  ...........  ...........  ...........
                            arteriogram.
   01920  N                Anesth, catheterize   ...........  ...........  ...........  ...........  ...........
                            heart.
   01921  D                Anesth, vessel        ...........  ...........  ...........  ...........  ...........
                            surgery.
   01922  N                Anesth, cat or MRI    ...........  ...........  ...........  ...........  ...........
                            scan.
  *01924  N                Anes, ther interven   ...........  ...........  ...........  ...........  ...........
                            rad, art.
  *01925  N                Anes, ther interven   ...........  ...........  ...........  ...........  ...........
                            rad, car.
  *01926  N                Anes, tx interv rad   ...........  ...........  ...........  ...........  ...........
                            hrt/cran.
  *01930  N                Anes, ther interven   ...........  ...........  ...........  ...........  ...........
                            rad, vei.
  *01931  N                Anes, ther interven   ...........  ...........  ...........  ...........  ...........
                            rad, tip.
  *01932  N                Anes, tx interv rad,  ...........  ...........  ...........  ...........  ...........
                            th vein.
  *01933  N                Anes, tx interv rad,  ...........  ...........  ...........  ...........  ...........
                            cran v.
   01951  N                Anesth, burn, less 1  ...........  ...........  ...........  ...........  ...........
                            percent.
   01952  N                Anesth, burn, 1-9     ...........  ...........  ...........  ...........  ...........
                            percent.
   01953  N                Anesth, burn, each 9  ...........  ...........  ...........  ...........  ...........
                            percent.
  *01960  N                Anesth, vaginal       ...........  ...........  ...........  ...........  ...........
                            delivery.
  *01961  N                Anesth, cs delivery.  ...........  ...........  ...........  ...........  ...........
  *01962  N                Anesth, emer          ...........  ...........  ...........  ...........  ...........
                            hysterectomy.
  *01963  N                Anesth, cs            ...........  ...........  ...........  ...........  ...........
                            hysterectomy.
  *01964  N                Anesth, abortion      ...........  ...........  ...........  ...........  ...........
                            procedures.
  *01967  N                Anesth/analg, vag     ...........  ...........  ...........  ...........  ...........
                            delivery.
  *01968  N                Anes/analg cs         ...........  ...........  ...........  ...........  ...........
                            deliver add-on.
  *01969  N                Anesth/analg cs hyst  ...........  ...........  ...........  ...........  ...........
                            add-on.
   01990  C                Support for organ     ...........  ...........  ...........  ...........  ...........
                            donor.
   01995  N                Regional anesthesia,  ...........  ...........  ...........  ...........  ...........
                            limb.
   01996  N                Manage daily drug     ...........  ...........  ...........  ...........  ...........
                            therapy.
   01999  N                Unlisted anesth       ...........  ...........  ...........  ...........  ...........
                            procedure.
  *10021  T                Fna w/o image.......         0002         0.42       $21.38       $11.75        $4.28
  *10022  T                Fna w/image.........         0002         0.42       $21.38       $11.75        $4.28
   10040  T                Acne surgery of skin         0006         2.18      $110.97       $33.95       $22.19
                            abscess.
   10060  T                Drainage of skin             0006         2.18      $110.97       $33.95       $22.19
                            abscess.
   10061  T                Drainage of skin             0006         2.18      $110.97       $33.95       $22.19
                            abscess.
   10080  T                Drainage of                  0006         2.18      $110.97       $33.95       $22.19
                            pilonidal cyst.
   10081  T                Drainage of                  0007         6.75      $343.60       $72.03       $68.72
                            pilonidal cyst.
   10120  T                Remove foreign body.         0006         2.18      $110.97       $33.95       $22.19
   10121  T                Remove foreign body.         0020         8.44      $429.63      $130.53       $85.93
   10140  T                Drainage of hematoma/        0007         6.75      $343.60       $72.03       $68.72
                            fluid.
   10160  T                Puncture drainage of         0018         1.05       $53.45       $17.66       $10.69
                            lesion.
   10180  T                Complex drainage,            0007         6.75      $343.60       $72.03       $68.72
                            wound.
   11000  T                Debride infected             0015         2.07      $105.37       $31.20       $21.07
                            skin.

[[Page 59938]]

 
   11001  T                Debride infected             0013         1.36       $69.23       $17.66       $13.85
                            skin add-on.
   11010  T                Debride skin, fx....         0022        13.91      $708.07      $292.94      $141.61
   11011  T                Debride skin/muscle,         0022        13.91      $708.07      $292.94      $141.61
                            fx.
   11012  T                Debride skin/muscle/         0022        13.91      $708.07      $292.94      $141.61
                            bone, fx.
   11040  T                Debride skin,                0015         2.07      $105.37       $31.20       $21.07
                            partial.
   11041  T                Debride skin, full..         0015         2.07      $105.37       $31.20       $21.07
   11042  T                Debride skin/tissue.         0016         3.02      $153.73       $64.57       $30.75
   11043  T                Debride tissue/              0016         3.02      $153.73       $64.57       $30.75
                            muscle.
   11044  T                Debride tissue/              0017         9.68      $492.75      $226.67       $98.55
                            muscle/bone.
   11055  T                Trim skin lesion....         0012         0.66       $33.60        $9.18        $6.72
   11056  T                Trim skin lesions, 2         0012         0.66       $33.60        $9.18        $6.72
                            to 4.
   11057  T                Trim skin lesions,           0012         0.66       $33.60        $9.18        $6.72
                            over 4.
   11100  T                Biopsy of skin               0018         1.05       $53.45       $17.66       $10.69
                            lesion.
   11101  T                Biopsy, skin add-on.         0018         1.05       $53.45       $17.66       $10.69
   11200  T                Removal of skin tags         0013         1.36       $69.23       $17.66       $13.85
   11201  T                Remove skin tags add-        0015         2.07      $105.37       $31.20       $21.07
                            on.
   11300  T                Shave skin lesion...         0012         0.66       $33.60        $9.18        $6.72
   11301  T                Shave skin lesion...         0012         0.66       $33.60        $9.18        $6.72
   11302  T                Shave skin lesion...         0013         1.36       $69.23       $17.66       $13.85
   11303  T                Shave skin lesion...         0015         2.07      $105.37       $31.20       $21.07
   11305  T                Shave skin lesion...         0013         1.36       $69.23       $17.66       $13.85
   11306  T                Shave skin lesion...         0013         1.36       $69.23       $17.66       $13.85
   11307  T                Shave skin lesion...         0013         1.36       $69.23       $17.66       $13.85
   11308  T                Shave skin lesion...         0013         1.36       $69.23       $17.66       $13.85
   11310  T                Shave skin lesion...         0013         1.36       $69.23       $17.66       $13.85
   11311  T                Shave skin lesion...         0013         1.36       $69.23       $17.66       $13.85
   11312  T                Shave skin lesion...         0013         1.36       $69.23       $17.66       $13.85
   11313  T                Shave skin lesion...         0016         3.02      $153.73       $64.57       $30.75
   11400  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11401  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11402  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11403  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11404  T                Removal of skin              0020         8.44      $429.63      $130.53       $85.93
                            lesion.
   11406  T                Removal of skin              0021        11.82      $601.69      $236.51      $120.34
                            lesion.
   11420  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11421  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11422  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11423  T                Removal of skin              0020         8.44      $429.63      $130.53       $85.93
                            lesion.
   11424  T                Removal of skin              0020         8.44      $429.63      $130.53       $85.93
                            lesion.
   11426  T                Removal of skin              0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   11440  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11441  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11442  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11443  T                Removal of skin              0020         8.44      $429.63      $130.53       $85.93
                            lesion.
   11444  T                Removal of skin              0020         8.44      $429.63      $130.53       $85.93
                            lesion.
   11446  T                Removal of skin              0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   11450  T                Removal, sweat gland         0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   11451  T                Removal, sweat gland         0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   11462  T                Removal, sweat gland         0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   11463  T                Removal, sweat gland         0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   11470  T                Removal, sweat gland         0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   11471  T                Removal, sweat gland         0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   11600  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11601  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11602  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11603  T                Removal of skin              0020         8.44      $429.63      $130.53       $85.93
                            lesion.
   11604  T                Removal of skin              0020         8.44      $429.63      $130.53       $85.93
                            lesion.
   11606  T                Removal of skin              0021        11.82      $601.69      $236.51      $120.34
                            lesion.
   11620  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11621  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11622  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11623  T                Removal of skin              0020         8.44      $429.63      $130.53       $85.93
                            lesion.
   11624  T                Removal of skin              0020         8.44      $429.63      $130.53       $85.93
                            lesion.
   11626  T                Removal of skin              0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   11640  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11641  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11642  T                Removal of skin              0019         4.22      $214.81       $78.91       $42.96
                            lesion.
   11643  T                Removal of skin              0020         8.44      $429.63      $130.53       $85.93
                            lesion.
   11644  T                Removal of skin              0020         8.44      $429.63      $130.53       $85.93
                            lesion.
   11646  T                Removal of skin              0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   11719  T                Trim nail(s)........         0009         0.63       $32.07        $8.34        $6.41
   11720  T                Debride nail, 1-5...         0009         0.63       $32.07        $8.34        $6.41
   11721  T                Debride nail, 6 or           0009         0.63       $32.07        $8.34        $6.41
                            more.
   11730  T                Removal of nail              0013         1.36       $69.23       $17.66       $13.85
                            plate.
   11732  T                Remove nail plate,           0012         0.66       $33.60        $9.18        $6.72
                            add-on.

[[Page 59939]]

 
   11740  T                Drain blood from             0009         0.63       $32.07        $8.34        $6.41
                            under nail.
   11750  T                Removal of nail bed.         0019         4.22      $214.81       $78.91       $42.96
   11752  T                Remove nail bed/             0022        13.91      $708.07      $292.94      $141.61
                            finger tip.
   11755  T                Biopsy, nail unit...         0019         4.22      $214.81       $78.91       $42.96
   11760  T                Repair of nail bed..         0024         2.28      $116.06       $41.78       $23.21
   11762  T                Reconstruction of            0024         2.28      $116.06       $41.78       $23.21
                            nail bed.
   11765  T                Excision of nail             0015         2.07      $105.37       $31.20       $21.07
                            fold, toe.
   11770  T                Removal of pilonidal         0021        11.82      $601.69      $236.51      $120.34
                            lesion.
   11771  T                Removal of pilonidal         0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   11772  T                Removal of pilonidal         0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   11900  T                Injection into skin          0012         0.66       $33.60        $9.18        $6.72
                            lesions.
   11901  T                Added skin lesions           0012         0.66       $33.60        $9.18        $6.72
                            injection.
   11920  T                Correct skin color           0024         2.28      $116.06       $41.78       $23.21
                            defects.
   11921  T                Correct skin color           0024         2.28      $116.06       $41.78       $23.21
                            defects.
   11922  T                Correct skin color           0024         2.28      $116.06       $41.78       $23.21
                            defects.
   11950  T                Therapy for contour          0024         2.28      $116.06       $41.78       $23.21
                            defects.
   11951  T                Therapy for contour          0024         2.28      $116.06       $41.78       $23.21
                            defects.
   11952  T                Therapy for contour          0024         2.28      $116.06       $41.78       $23.21
                            defects.
   11954  T                Therapy for contour          0024         2.28      $116.06       $41.78       $23.21
                            defects.
   11960  T                Insert tissue                0026        12.62      $642.41      $277.92      $128.48
                            expander(s).
   11970  T                Replace tissue               0026        12.62      $642.41      $277.92      $128.48
                            expander.
   11971  T                Remove tissue                0022        13.91      $708.07      $292.94      $141.61
                            expander(s).
   11975  E                Insert contraceptive  ...........  ...........  ...........  ...........  ...........
                            cap.
   11976  T                Removal of                   0019         4.22      $214.81       $78.91       $42.96
                            contraceptive cap.
   11977  E                Removal/reinsert      ...........  ...........  ...........  ...........  ...........
                            contra cap.
   11980  X                Implant hormone              0340         0.84       $42.76       $10.69        $8.55
                            pellet(s).
  *11981  X                Insert drug implant          0340         0.84       $42.76       $10.69        $8.55
                            device.
  *11982  X                Remove drug implant          0340         0.84       $42.76       $10.69        $8.55
                            device.
  *11983  X                Remove/insert drug           0340         0.84       $42.76       $10.69        $8.55
                            implant.
   12001  T                Repair superficial           0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12002  T                Repair superficial           0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12004  T                Repair superficial           0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12005  T                Repair superficial           0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12006  T                Repair superficial           0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12007  T                Repair superficial           0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12011  T                Repair superficial           0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12013  T                Repair superficial           0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12014  T                Repair superficial           0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12015  T                Repair superficial           0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12016  T                Repair superficial           0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12017  T                Repair superficial           0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12018  T                Repair superficial           0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12020  T                Closure of split             0024         2.28      $116.06       $41.78       $23.21
                            wound.
   12021  T                Closure of split             0024         2.28      $116.06       $41.78       $23.21
                            wound.
   12031  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12032  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12034  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12035  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12036  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12037  T                Layer closure of             0026        12.62      $642.41      $277.92      $128.48
                            wound(s).
   12041  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12042  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12044  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12045  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12046  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12047  T                Layer closure of             0026        12.62      $642.41      $277.92      $128.48
                            wound(s).
   12051  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12052  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12053  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12054  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12055  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12056  T                Layer closure of             0024         2.28      $116.06       $41.78       $23.21
                            wound(s).
   12057  T                Layer closure of             0026        12.62      $642.41      $277.92      $128.48
                            wound(s).
   13100  T                Repair of wound or           0025         3.39      $172.56       $65.57       $34.51
                            lesion.
   13101  T                Repair of wound or           0025         3.39      $172.56       $65.57       $34.51
                            lesion.
   13102  T                Repair wound/lesion          0025         3.39      $172.56       $65.57       $34.51
                            add-on.
   13120  T                Repair of wound or           0025         3.39      $172.56       $65.57       $34.51
                            lesion.
   13121  T                Repair of wound or           0025         3.39      $172.56       $65.57       $34.51
                            lesion.
   13122  T                Repair wound/lesion          0025         3.39      $172.56       $65.57       $34.51
                            add-on.
   13131  T                Repair of wound or           0025         3.39      $172.56       $65.57       $34.51
                            lesion.
   13132  T                Repair of wound or           0025         3.39      $172.56       $65.57       $34.51
                            lesion.
   13133  T                Repair wound/lesion          0025         3.39      $172.56       $65.57       $34.51
                            add-on.
   13150  T                Repair of wound or           0026        12.62      $642.41      $277.92      $128.48
                            lesion.
   13151  T                Repair of wound or           0025         3.39      $172.56       $65.57       $34.51
                            lesion.
   13152  T                Repair of wound or           0025         3.39      $172.56       $65.57       $34.51
                            lesion.

[[Page 59940]]

 
   13153  T                Repair wound/lesion          0025         3.39      $172.56       $65.57       $34.51
                            add-on.
   13160  T                Late closure of              0026        12.62      $642.41      $277.92      $128.48
                            wound.
   14000  T                Skin tissue                  0026        12.62      $642.41      $277.92      $128.48
                            rearrangement.
   14001  T                Skin tissue                  0026        12.62      $642.41      $277.92      $128.48
                            rearrangement.
   14020  T                Skin tissue                  0026        12.62      $642.41      $277.92      $128.48
                            rearrangement.
   14021  T                Skin tissue                  0026        12.62      $642.41      $277.92      $128.48
                            rearrangement.
   14040  T                Skin tissue                  0026        12.62      $642.41      $277.92      $128.48
                            rearrangement.
   14041  T                Skin tissue                  0026        12.62      $642.41      $277.92      $128.48
                            rearrangement.
   14060  T                Skin tissue                  0026        12.62      $642.41      $277.92      $128.48
                            rearrangement.
   14061  T                Skin tissue                  0026        12.62      $642.41      $277.92      $128.48
                            rearrangement.
   14300  T                Skin tissue                  0026        12.62      $642.41      $277.92      $128.48
                            rearrangement.
   14350  T                Skin tissue                  0026        12.62      $642.41      $277.92      $128.48
                            rearrangement.
   15000  T                Skin graft..........         0026        12.62      $642.41      $277.92      $128.48
   15001  T                Skin graft add-on...         0026        12.62      $642.41      $277.92      $128.48
   15050  T                Skin pinch graft....         0026        12.62      $642.41      $277.92      $128.48
   15100  T                Skin split graft....         0026        12.62      $642.41      $277.92      $128.48
   15101  T                Skin split graft add-        0026        12.62      $642.41      $277.92      $128.48
                            on.
   15120  T                Skin split graft....         0026        12.62      $642.41      $277.92      $128.48
   15121  T                Skin split graft add-        0026        12.62      $642.41      $277.92      $128.48
                            on.
   15200  T                Skin full graft.....         0026        12.62      $642.41      $277.92      $128.48
   15201  T                Skin full graft add-         0026        12.62      $642.41      $277.92      $128.48
                            on.
   15220  T                Skin full graft.....         0026        12.62      $642.41      $277.92      $128.48
   15221  T                Skin full graft add-         0026        12.62      $642.41      $277.92      $128.48
                            on.
   15240  T                Skin full graft.....         0026        12.62      $642.41      $277.92      $128.48
   15241  T                Skin full graft add-         0026        12.62      $642.41      $277.92      $128.48
                            on.
   15260  T                Skin full graft.....         0026        12.62      $642.41      $277.92      $128.48
   15261  T                Skin full graft add-         0026        12.62      $642.41      $277.92      $128.48
                            on.
   15342  T                Cultured skin graft,         0025         3.39      $172.56       $65.57       $34.51
                            25 cm.
   15343  T                Culture skn graft            0025         3.39      $172.56       $65.57       $34.51
                            addl 25 cm.
   15350  T                Skin homograft......         0686        24.01    $1,222.21      $277.92      $244.44
   15351  T                Skin homograft add-          0026        12.62      $642.41      $277.92      $128.48
                            on.
   15400  T                Skin heterograft....         0026        12.62      $642.41      $277.92      $128.48
   15401  T                Skin heterograft add-        0026        12.62      $642.41      $277.92      $128.48
                            on.
   15570  T                Form skin pedicle            0026        12.62      $642.41      $277.92      $128.48
                            flap.
   15572  T                Form skin pedicle            0026        12.62      $642.41      $277.92      $128.48
                            flap.
   15574  T                Form skin pedicle            0026        12.62      $642.41      $277.92      $128.48
                            flap.
   15576  T                Form skin pedicle            0026        12.62      $642.41      $277.92      $128.48
                            flap.
   15600  T                Skin graft..........         0026        12.62      $642.41      $277.92      $128.48
   15610  T                Skin graft..........         0026        12.62      $642.41      $277.92      $128.48
   15620  T                Skin graft..........         0026        12.62      $642.41      $277.92      $128.48
   15630  T                Skin graft..........         0026        12.62      $642.41      $277.92      $128.48
   15650  T                Transfer skin                0026        12.62      $642.41      $277.92      $128.48
                            pedicle flap.
   15732  T                Muscle-skin graft,           0027        18.02      $917.29      $383.10      $183.46
                            head/neck.
   15734  T                Muscle-skin graft,           0027        18.02      $917.29      $383.10      $183.46
                            trunk.
   15736  T                Muscle-skin graft,           0027        18.02      $917.29      $383.10      $183.46
                            arm.
   15738  T                Muscle-skin graft,           0027        18.02      $917.29      $383.10      $183.46
                            leg.
   15740  T                Island pedicle flap          0027        18.02      $917.29      $383.10      $183.46
                            graft.
   15750  T                Neurovascular                0027        18.02      $917.29      $383.10      $183.46
                            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        18.02      $917.29      $383.10      $183.46
   15770  T                Derma-fat-fascia             0027        18.02      $917.29      $383.10      $183.46
                            graft.
   15775  T                Hair transplant              0026        12.62      $642.41      $277.92      $128.48
                            punch grafts.
   15776  T                Hair transplant              0026        12.62      $642.41      $277.92      $128.48
                            punch grafts.
   15780  T                Abrasion treatment           0022        13.91      $708.07      $292.94      $141.61
                            of skin.
   15781  T                Abrasion treatment           0022        13.91      $708.07      $292.94      $141.61
                            of skin.
   15782  T                Abrasion treatment           0022        13.91      $708.07      $292.94      $141.61
                            of skin.
   15783  T                Abrasion treatment           0016         3.02      $153.73       $64.57       $30.75
                            of skin.
   15786  T                Abrasion, lesion,            0013         1.36       $69.23       $17.66       $13.85
                            single.
   15787  T                Abrasion, lesions,           0013         1.36       $69.23       $17.66       $13.85
                            add-on.
   15788  T                Chemical peel, face,         0012         0.66       $33.60        $9.18        $6.72
                            epiderm.
   15789  T                Chemical peel, face,         0015         2.07      $105.37       $31.20       $21.07
                            dermal.
   15792  T                Chemical peel,               0012         0.66       $33.60        $9.18        $6.72
                            nonfacial.
   15793  T                Chemical peel,               0013         1.36       $69.23       $17.66       $13.85
                            nonfacial.
   15810  T                Salabrasion.........         0016         3.02      $153.73       $64.57       $30.75
   15811  T                Salabrasion.........         0016         3.02      $153.73       $64.57       $30.75
   15819  T                Plastic surgery,             0026        12.62      $642.41      $277.92      $128.48
                            neck.
   15820  T                Revision of lower            0026        12.62      $642.41      $277.92      $128.48
                            eyelid.
   15821  T                Revision of lower            0026        12.62      $642.41      $277.92      $128.48
                            eyelid.
   15822  T                Revision of upper            0026        12.62      $642.41      $277.92      $128.48
                            eyelid.
   15823  T                Revision of upper            0026        12.62      $642.41      $277.92      $128.48
                            eyelid.
   15824  T                Removal of forehead          0027        18.02      $917.29      $383.10      $183.46
                            wrinkles.
   15825  T                Removal of neck              0026        12.62      $642.41      $277.92      $128.48
                            wrinkles.
   15826  T                Removal of brow              0026        12.62      $642.41      $277.92      $128.48
                            wrinkles.

[[Page 59941]]

 
   15828  T                Removal of face              0027        18.02      $917.29      $383.10      $183.46
                            wrinkles.
   15829  T                Removal of skin              0026        12.62      $642.41      $277.92      $128.48
                            wrinkles.
   15831  T                Excise excessive             0022        13.91      $708.07      $292.94      $141.61
                            skin tissue.
   15832  T                Excise excessive             0022        13.91      $708.07      $292.94      $141.61
                            skin tissue.
   15833  T                Excise excessive             0022        13.91      $708.07      $292.94      $141.61
                            skin tissue.
   15834  T                Excise excessive             0022        13.91      $708.07      $292.94      $141.61
                            skin tissue.
   15835  T                Excise excessive             0026        12.62      $642.41      $277.92      $128.48
                            skin tissue.
   15836  T                Excise excessive             0019         4.22      $214.81       $78.91       $42.96
                            skin tissue.
   15837  T                Excise excessive             0019         4.22      $214.81       $78.91       $42.96
                            skin tissue.
   15838  T                Excise excessive             0019         4.22      $214.81       $78.91       $42.96
                            skin tissue.
   15839  T                Excise excessive             0019         4.22      $214.81       $78.91       $42.96
                            skin tissue.
   15840  T                Graft for face nerve         0027        18.02      $917.29      $383.10      $183.46
                            palsy.
   15841  T                Graft for face nerve         0027        18.02      $917.29      $383.10      $183.46
                            palsy.
   15842  T                Flap for face nerve          0027        18.02      $917.29      $383.10      $183.46
                            palsy.
   15845  T                Skin and muscle              0027        18.02      $917.29      $383.10      $183.46
                            repair, face.
   15850  T                Removal of sutures..         0016         3.02      $153.73       $64.57       $30.75
   15851  T                Removal of sutures..         0013         1.36       $69.23       $17.66       $13.85
   15852  T                Dressing change, not         0013         1.36       $69.23       $17.66       $13.85
                            for burn.
   15860  N                Test for blood flow   ...........  ...........  ...........  ...........  ...........
                            in graft.
   15876  T                Suction assisted             0027        18.02      $917.29      $383.10      $183.46
                            lipectomy.
   15877  T                Suction assisted             0027        18.02      $917.29      $383.10      $183.46
                            lipectomy.
   15878  T                Suction assisted             0027        18.02      $917.29      $383.10      $183.46
                            lipectomy.
   15879  T                Suction assisted             0027        18.02      $917.29      $383.10      $183.46
                            lipectomy.
   15920  T                Removal of tail bone         0022        13.91      $708.07      $292.94      $141.61
                            ulcer.
   15922  T                Removal of tail bone         0027        18.02      $917.29      $383.10      $183.46
                            ulcer.
   15931  T                Remove sacrum                0022        13.91      $708.07      $292.94      $141.61
                            pressure sore.
   15933  T                Remove sacrum                0022        13.91      $708.07      $292.94      $141.61
                            pressure sore.
   15934  T                Remove sacrum                0027        18.02      $917.29      $383.10      $183.46
                            pressure sore.
   15935  T                Remove sacrum                0027        18.02      $917.29      $383.10      $183.46
                            pressure sore.
   15936  T                Remove sacrum                0027        18.02      $917.29      $383.10      $183.46
                            pressure sore.
   15937  T                Remove sacrum                0027        18.02      $917.29      $383.10      $183.46
                            pressure sore.
   15940  T                Remove hip pressure          0022        13.91      $708.07      $292.94      $141.61
                            sore.
   15941  T                Remove hip pressure          0022        13.91      $708.07      $292.94      $141.61
                            sore.
   15944  T                Remove hip pressure          0027        18.02      $917.29      $383.10      $183.46
                            sore.
   15945  T                Remove hip pressure          0027        18.02      $917.29      $383.10      $183.46
                            sore.
   15946  T                Remove hip pressure          0027        18.02      $917.29      $383.10      $183.46
                            sore.
   15950  T                Remove thigh                 0022        13.91      $708.07      $292.94      $141.61
                            pressure sore.
   15951  T                Remove thigh                 0022        13.91      $708.07      $292.94      $141.61
                            pressure sore.
   15952  T                Remove thigh                 0027        18.02      $917.29      $383.10      $183.46
                            pressure sore.
   15953  T                Remove thigh                 0027        18.02      $917.29      $383.10      $183.46
                            pressure sore.
   15956  T                Remove thigh                 0027        18.02      $917.29      $383.10      $183.46
                            pressure sore.
   15958  T                Remove thigh                 0027        18.02      $917.29      $383.10      $183.46
                            pressure sore.
   15999  T                Removal of pressure          0022        13.91      $708.07      $292.94      $141.61
                            sore.
   16000  T                Initial treatment of         0013         1.36       $69.23       $17.66       $13.85
                            burn(s).
   16010  T                Treatment of burn(s)         0016         3.02      $153.73       $64.57       $30.75
   16015  T                Treatment of burn(s)         0017         9.68      $492.75      $226.67       $98.55
   16020  T                Treatment of burn(s)         0013         1.36       $69.23       $17.66       $13.85
   16025  T                Treatment of burn(s)         0013         1.36       $69.23       $17.66       $13.85
   16030  T                Treatment of burn(s)         0015         2.07      $105.37       $31.20       $21.07
   16035  C                Incision of burn      ...........  ...........  ...........  ...........  ...........
                            scab, initi.
   16036  C                Incise burn scab,     ...........  ...........  ...........  ...........  ...........
                            addl incis.
   17000  T                Destroy benign/              0010         0.66       $33.60        $9.86        $6.72
                            premal lesion.
   17003  T                Destroy lesions, 2-          0010         0.66       $33.60        $9.86        $6.72
                            14.
   17004  T                Destroy lesions, 15          0011         1.47       $74.83       $27.69       $14.97
                            or more.
   17106  T                Destruction of skin          0011         1.47       $74.83       $27.69       $14.97
                            lesions.
   17107  T                Destruction of skin          0011         1.47       $74.83       $27.69       $14.97
                            lesions.
   17108  T                Destruction of skin          0011         1.47       $74.83       $27.69       $14.97
                            lesions.
   17110  T                Destruct lesion, 1-          0010         0.66       $33.60        $9.86        $6.72
                            14.
   17111  T                Destruct lesion, 15          0011         1.47       $74.83       $27.69       $14.97
                            or more.
   17250  T                Chemical cautery,            0013         1.36       $69.23       $17.66       $13.85
                            tissue.
   17260  T                Destruction of skin          0013         1.36       $69.23       $17.66       $13.85
                            lesions.
   17261  T                Destruction of skin          0013         1.36       $69.23       $17.66       $13.85
                            lesions.
   17262  T                Destruction of skin          0013         1.36       $69.23       $17.66       $13.85
                            lesions.
   17263  T                Destruction of skin          0013         1.36       $69.23       $17.66       $13.85
                            lesions.
   17264  T                Destruction of skin          0013         1.36       $69.23       $17.66       $13.85
                            lesions.
   17266  T                Destruction of skin          0016         3.02      $153.73       $64.57       $30.75
                            lesions.
   17270  T                Destruction of skin          0013         1.36       $69.23       $17.66       $13.85
                            lesions.
   17271  T                Destruction of skin          0012         0.66       $33.60        $9.18        $6.72
                            lesions.
   17272  T                Destruction of skin          0013         1.36       $69.23       $17.66       $13.85
                            lesions.
   17273  T                Destruction of skin          0015         2.07      $105.37       $31.20       $21.07
                            lesions.
   17274  T                Destruction of skin          0016         3.02      $153.73       $64.57       $30.75
                            lesions.
   17276  T                Destruction of skin          0016         3.02      $153.73       $64.57       $30.75
                            lesions.
   17280  T                Destruction of skin          0013         1.36       $69.23       $17.66       $13.85
                            lesions.
   17281  T                Destruction of skin          0013         1.36       $69.23       $17.66       $13.85
                            lesions.
   17282  T                Destruction of skin          0015         2.07      $105.37       $31.20       $21.07
                            lesions.

[[Page 59942]]

 
   17283  T                Destruction of skin          0015         2.07      $105.37       $31.20       $21.07
                            lesions.
   17284  T                Destruction of skin          0016         3.02      $153.73       $64.57       $30.75
                            lesions.
   17286  T                Destruction of skin          0013         1.36       $69.23       $17.66       $13.85
                            lesions.
   17304  T                Chemosurgery of skin         0694         3.99      $203.11       $60.93       $40.62
                            lesion.
   17305  T                2nd stage                    0694         3.99      $203.11       $60.93       $40.62
                            chemosurgery.
   17306  T                3rd stage                    0694         3.99      $203.11       $60.93       $40.62
                            chemosurgery.
   17307  T                Followup skin lesion         0694         3.99      $203.11       $60.93       $40.62
                            therapy.
   17310  T                Extensive skin               0694         3.99      $203.11       $60.93       $40.62
                            chemosurgery.
   17340  T                Cryotherapy of skin.         0012         0.66       $33.60        $9.18        $6.72
   17360  T                Skin peel therapy...         0012         0.66       $33.60        $9.18        $6.72
   17380  T                Hair removal by              0017         9.68      $492.75      $226.67       $98.55
                            electrolysis.
   17999  T                Skin tissue                  0004         2.47      $125.73       $32.57       $25.15
                            procedure.
   19000  T                Drainage of breast           0004         2.47      $125.73       $32.57       $25.15
                            lesion.
   19001  T                Drain breast lesion          0004         2.47      $125.73       $32.57       $25.15
                            add-on.
   19020  T                Incision of breast           0008        10.93      $556.38      $113.67      $111.28
                            lesion.
   19030  N                Injection for breast  ...........  ...........  ...........  ...........  ...........
                            x-ray.
   19100  T                Bx breast percut w/o         0005         4.03      $205.14       $90.26       $41.03
                            image.
   19101  T                Biopsy of breast,            0028        14.00      $712.66      $303.74      $142.53
                            open.
   19102  T                Bx breast percut w/          0005         4.03      $205.14       $90.26       $41.03
                            image.
   19103  S                Bx breast percut w/          0710  ...........      $400.00  ...........       $80.00
                            device.
   19110  T                Nipple exploration..         0028        14.00      $712.66      $303.74      $142.53
   19112  T                Excise breast duct           0028        14.00      $712.66      $303.74      $142.53
                            fistula.
   19120  T                Removal of breast            0028        14.00      $712.66      $303.74      $142.53
                            lesion.
   19125  T                Excision, breast             0028        14.00      $712.66      $303.74      $142.53
                            lesion.
   19126  T                Excision, addl               0028        14.00      $712.66      $303.74      $142.53
                            breast lesion.
   19140  T                Removal of breast            0028        14.00      $712.66      $303.74      $142.53
                            tissue.
   19160  T                Removal of breast            0028        14.00      $712.66      $303.74      $142.53
                            tissue.
   19162  T                Remove breast                0693        31.81    $1,619.26      $712.47      $323.85
                            tissue, nodes.
   19180  T                Removal of breast...         0029        23.76    $1,209.48      $628.93      $241.90
   19182  T                Removal of breast...         0029        23.76    $1,209.48      $628.93      $241.90
   19200  C                Removal of breast...  ...........  ...........  ...........  ...........  ...........
   19220  C                Removal of breast...  ...........  ...........  ...........  ...........  ...........
   19240  T                Removal of breast...         0030        34.20    $1,740.92      $763.55      $348.18
   19260  T                Removal of chest             0021        11.82      $601.69      $236.51      $120.34
                            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         0029        23.76    $1,209.48      $628.93      $241.90
   19318  T                Reduction of large           0693        31.81    $1,619.26      $712.47      $323.85
                            breast.
   19324  T                Enlarge breast......         0693        31.81    $1,619.26      $712.47      $323.85
   19325  T                Enlarge breast with          0693        31.81    $1,619.26      $712.47      $323.85
                            implant.
   19328  T                Removal of breast            0029        23.76    $1,209.48      $628.93      $241.90
                            implant.
   19330  T                Removal of implant           0029        23.76    $1,209.48      $628.93      $241.90
                            material.
   19340  T                Immediate breast             0030        34.20    $1,740.92      $763.55      $348.18
                            prosthesis.
   19342  T                Delayed breast               0693        31.81    $1,619.26      $712.47      $323.85
                            prosthesis.
   19350  T                Breast                       0029        23.76    $1,209.48      $628.93      $241.90
                            reconstruction.
   19355  T                Correct inverted             0029        23.76    $1,209.48      $628.93      $241.90
                            nipple(s).
   19357  T                Breast                       0693        31.81    $1,619.26      $712.47      $323.85
                            reconstruction.
   19361  C                Breast                ...........  ...........  ...........  ...........  ...........
                            reconstruction.
   19364  C                Breast                ...........  ...........  ...........  ...........  ...........
                            reconstruction.
   19366  T                Breast                       0029        23.76    $1,209.48      $628.93      $241.90
                            reconstruction.
   19367  C                Breast                ...........  ...........  ...........  ...........  ...........
                            reconstruction.
   19368  C                Breast                ...........  ...........  ...........  ...........  ...........
                            reconstruction.
   19369  C                Breast                ...........  ...........  ...........  ...........  ...........
                            reconstruction.
   19370  T                Surgery of breast            0029        23.76    $1,209.48      $628.93      $241.90
                            capsule.
   19371  T                Removal of breast            0029        23.76    $1,209.48      $628.93      $241.90
                            capsule.
   19380  T                Revise breast                0030        34.20    $1,740.92      $763.55      $348.18
                            reconstruction.
   19396  T                Design custom breast         0029        23.76    $1,209.48      $628.93      $241.90
                            implant.
   19499  T                Breast surgery               0028        14.00      $712.66      $303.74      $142.53
                            procedure.
   20000  T                Incision of abscess.         0006         2.18      $110.97       $33.95       $22.19
   20005  T                Incision of deep             0049        15.84      $806.32      $356.95      $161.26
                            abscess.
   20100  T                Explore wound, neck.         0023         2.08      $105.88       $40.37       $21.18
   20101  T                Explore wound, chest         0026        12.62      $642.41      $277.92      $128.48
   20102  T                Explore wound,               0026        12.62      $642.41      $277.92      $128.48
                            abdomen.
   20103  T                Explore wound,               0023         2.08      $105.88       $40.37       $21.18
                            extremity.
   20150  T                Excise epiphyseal            0051        28.56    $1,453.82      $675.24      $290.76
                            bar.
   20200  T                Muscle biopsy.......         0020         8.44      $429.63      $130.53       $85.93
   20205  T                Deep muscle biopsy..         0021        11.82      $601.69      $236.51      $120.34
   20206  T                Needle biopsy,               0005         4.03      $205.14       $90.26       $41.03
                            muscle.
   20220  T                Bone biopsy, trocar/         0019         4.22      $214.81       $78.91       $42.96
                            needle.
   20225  T                Bone biopsy, trocar/         0019         4.22      $214.81       $78.91       $42.96
                            needle.
   20240  T                Bone biopsy,                 0022        13.91      $708.07      $292.94      $141.61
                            excisional.
   20245  T                Bone biopsy,                 0022        13.91      $708.07      $292.94      $141.61
                            excisional.

[[Page 59943]]

 
   20250  T                Open bone biopsy....         0049        15.84      $806.32      $356.95      $161.26
   20251  T                Open bone biopsy....         0049        15.84      $806.32      $356.95      $161.26
   20500  T                Injection of sinus           0251         2.43      $123.70       $27.99       $24.74
                            tract.
   20501  N                Inject sinus tract    ...........  ...........  ...........  ...........  ...........
                            for x-ray.
   20520  T                Removal of foreign           0019         4.22      $214.81       $78.91       $42.96
                            body.
   20525  T                Removal of foreign           0022        13.91      $708.07      $292.94      $141.61
                            body.
  *20526  T                Ther injection               0204         2.24      $114.02       $43.33       $22.80
                            carpal tunnel.
   20550  T                Inject tendon/               0204         2.24      $114.02       $43.33       $22.80
                            ligament/cyst.
  *20551  T                Inject tendon origin/        0204         2.24      $114.02       $43.33       $22.80
                            insert.
  *20552  T                Inject trigger               0204         2.24      $114.02       $43.33       $22.80
                            point, 1 or 2.
  *20553  T                Inject trigger               0204         2.24      $114.02       $43.33       $22.80
                            points, > 3.
   20600  T                Drain/inject, joint/         0204         2.24      $114.02       $43.33       $22.80
                            bursa.
   20605  T                Drain/inject, joint/         0204         2.24      $114.02       $43.33       $22.80
                            bursa.
   20610  T                Drain/inject, joint/         0204         2.24      $114.02       $43.33       $22.80
                            bursa.
   20615  T                Treatment of bone            0004         2.47      $125.73       $32.57       $25.15
                            cyst.
   20650  T                Insert and remove            0049        15.84      $806.32      $356.95      $161.26
                            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        11.82      $601.69      $236.51      $120.34
                            implant.
   20680  T                Removal of support           0022        13.91      $708.07      $292.94      $141.61
                            implant.
   20690  T                Apply bone fixation          0050        20.63    $1,050.15      $504.07      $210.03
                            device.
   20692  T                Apply bone fixation          0050        20.63    $1,050.15      $504.07      $210.03
                            device.
   20693  T                Adjust bone fixation         0049        15.84      $806.32      $356.95      $161.26
                            device.
   20694  T                Remove bone fixation         0049        15.84      $806.32      $356.95      $161.26
                            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.
   20824  C                Replantation thumb,   ...........  ...........  ...........  ...........  ...........
                            complete.
   20827  C                Replantation thumb,   ...........  ...........  ...........  ...........  ...........
                            complete.
   20838  C                Replantation foot,    ...........  ...........  ...........  ...........  ...........
                            complete.
   20900  T                Removal of bone for          0050        20.63    $1,050.15      $504.07      $210.03
                            graft.
   20902  T                Removal of bone for          0050        20.63    $1,050.15      $504.07      $210.03
                            graft.
   20910  T                Remove cartilage for         0026        12.62      $642.41      $277.92      $128.48
                            graft.
   20912  T                Remove cartilage for         0026        12.62      $642.41      $277.92      $128.48
                            graft.
   20920  T                Removal of fascia            0026        12.62      $642.41      $277.92      $128.48
                            for graft.
   20922  T                Removal of fascia            0026        12.62      $642.41      $277.92      $128.48
                            for graft.
   20924  T                Removal of tendon            0050        20.63    $1,050.15      $504.07      $210.03
                            for graft.
   20926  T                Removal of tissue            0026        12.62      $642.41      $277.92      $128.48
                            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,              0006         2.18      $110.97       $33.95       $22.19
                            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        15.84      $806.32      $356.95      $161.26
                            stimulation.
   20979  A                Us bone stimulation.  ...........  ...........  ...........  ...........  ...........
   20999  N                Musculoskeletal       ...........  ...........  ...........  ...........  ...........
                            surgery.
   21010  T                Incision of jaw              0254        17.37      $884.20      $272.41      $176.84
                            joint.
   21015  T                Resection of facial          0252         5.95      $302.88      $114.24       $60.58
                            tumor.
   21025  T                Excision of bone,            0256        26.61    $1,354.56      $623.05      $270.91
                            lower jaw.
   21026  T                Excision of facial           0256        26.61    $1,354.56      $623.05      $270.91
                            bone(s).
   21029  T                Contour of face bone         0256        26.61    $1,354.56      $623.05      $270.91
                            lesion.
   21030  T                Removal of face bone         0254        17.37      $884.20      $272.41      $176.84
                            lesion.
   21031  T                Remove exostosis,            0254        17.37      $884.20      $272.41      $176.84
                            mandible.
   21032  T                Remove exostosis,            0254        17.37      $884.20      $272.41      $176.84
                            maxilla.
   21034  T                Removal of face bone         0256        26.61    $1,354.56      $623.05      $270.91
                            lesion.
   21040  T                Removal of jaw bone          0254        17.37      $884.20      $272.41      $176.84
                            lesion.
   21041  T                Removal of jaw bone          0256        26.61    $1,354.56      $623.05      $270.91
                            lesion.
   21044  T                Removal of jaw bone          0256        26.61    $1,354.56      $623.05      $270.91
                            lesion.
   21045  C                Extensive jaw         ...........  ...........  ...........  ...........  ...........
                            surgery.

[[Page 59944]]

 
   21050  T                Removal of jaw joint         0256        26.61    $1,354.56      $623.05      $270.91
   21060  T                Remove jaw joint             0256        26.61    $1,354.56      $623.05      $270.91
                            cartilage.
   21070  T                Remove coronoid              0256        26.61    $1,354.56      $623.05      $270.91
                            process.
   21076  T                Prepare face/oral            0254        17.37      $884.20      $272.41      $176.84
                            prosthesis.
   21077  T                Prepare face/oral            0256        26.61    $1,354.56      $623.05      $270.91
                            prosthesis.
   21079  T                Prepare face/oral            0256        26.61    $1,354.56      $623.05      $270.91
                            prosthesis.
   21080  T                Prepare face/oral            0256        26.61    $1,354.56      $623.05      $270.91
                            prosthesis.
   21081  T                Prepare face/oral            0256        26.61    $1,354.56      $623.05      $270.91
                            prosthesis.
   21082  T                Prepare face/oral            0256        26.61    $1,354.56      $623.05      $270.91
                            prosthesis.
   21083  T                Prepare face/oral            0256        26.61    $1,354.56      $623.05      $270.91
                            prosthesis.
   21084  T                Prepare face/oral            0256        26.61    $1,354.56      $623.05      $270.91
                            prosthesis.
   21085  T                Prepare face/oral            0253        12.33      $627.65      $284.00      $125.53
                            prosthesis.
   21086  T                Prepare face/oral            0256        26.61    $1,354.56      $623.05      $270.91
                            prosthesis.
   21087  T                Prepare face/oral            0256        26.61    $1,354.56      $623.05      $270.91
                            prosthesis.
   21088  T                Prepare face/oral            0256        26.61    $1,354.56      $623.05      $270.91
                            prosthesis.
   21089  T                Prepare face/oral            0253        12.33      $627.65      $284.00      $125.53
                            prosthesis.
   21100  T                Maxillofacial                0256        26.61    $1,354.56      $623.05      $270.91
                            fixation.
   21110  T                Interdental fixation         0252         5.95      $302.88      $114.24       $60.58
   21116  N                Injection, jaw joint  ...........  ...........  ...........  ...........  ...........
                            x-ray.
   21120  T                Reconstruction of            0254        17.37      $884.20      $272.41      $176.84
                            chin.
   21121  T                Reconstruction of            0254        17.37      $884.20      $272.41      $176.84
                            chin.
   21122  T                Reconstruction of            0254        17.37      $884.20      $272.41      $176.84
                            chin.
   21123  T                Reconstruction of            0254        17.37      $884.20      $272.41      $176.84
                            chin.
   21125  T                Augmentation, lower          0254        17.37      $884.20      $272.41      $176.84
                            jaw bone.
   21127  T                Augmentation, lower          0256        26.61    $1,354.56      $623.05      $270.91
                            jaw bone.
   21137  T                Reduction of                 0254        17.37      $884.20      $272.41      $176.84
                            forehead.
   21138  T                Reduction of                 0256        26.61    $1,354.56      $623.05      $270.91
                            forehead.
   21139  T                Reduction of                 0256        26.61    $1,354.56      $623.05      $270.91
                            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.
   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        17.37      $884.20      $272.41      $176.84
                            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        26.61    $1,354.56      $623.05      $270.91
                            segment.
   21199  T                Reconstr lwr jaw w/          0256        26.61    $1,354.56      $623.05      $270.91
                            advance.
   21206  T                Reconstruct upper            0256        26.61    $1,354.56      $623.05      $270.91
                            jaw bone.
   21208  T                Augmentation of              0256        26.61    $1,354.56      $623.05      $270.91
                            facial bones.
   21209  T                Reduction of facial          0256        26.61    $1,354.56      $623.05      $270.91
                            bones.
   21210  T                Face bone graft.....         0256        26.61    $1,354.56      $623.05      $270.91
   21215  T                Lower jaw bone graft         0256        26.61    $1,354.56      $623.05      $270.91
   21230  T                Rib cartilage graft.         0256        26.61    $1,354.56      $623.05      $270.91
   21235  T                Ear cartilage graft.         0254        17.37      $884.20      $272.41      $176.84
   21240  T                Reconstruction of            0256        26.61    $1,354.56      $623.05      $270.91
                            jaw joint.
   21242  T                Reconstruction of            0256        26.61    $1,354.56      $623.05      $270.91
                            jaw joint.
   21243  T                Reconstruction of            0256        26.61    $1,354.56      $623.05      $270.91
                            jaw joint.
   21244  T                Reconstruction of            0256        26.61    $1,354.56      $623.05      $270.91
                            lower jaw.
   21245  T                Reconstruction of            0256        26.61    $1,354.56      $623.05      $270.91
                            jaw.
   21246  T                Reconstruction of            0256        26.61    $1,354.56      $623.05      $270.91
                            jaw.
   21247  C                Reconstruct lower     ...........  ...........  ...........  ...........  ...........
                            jaw bone.
   21248  T                Reconstruction of            0256        26.61    $1,354.56      $623.05      $270.91
                            jaw.
   21249  T                Reconstruction of            0256        26.61    $1,354.56      $623.05      $270.91
                            jaw.
   21255  C                Reconstruct lower     ...........  ...........  ...........  ...........  ...........
                            jaw bone.
   21256  C                Reconstruction of     ...........  ...........  ...........  ...........  ...........
                            orbit.
   21260  T                Revise eye sockets..         0256        26.61    $1,354.56      $623.05      $270.91
   21261  T                Revise eye sockets..         0256        26.61    $1,354.56      $623.05      $270.91

[[Page 59945]]

 
   21263  T                Revise eye sockets..         0256        26.61    $1,354.56      $623.05      $270.91
   21267  T                Revise eye sockets..         0256        26.61    $1,354.56      $623.05      $270.91
   21268  C                Revise eye sockets..  ...........  ...........  ...........  ...........  ...........
   21270  T                Augmentation, cheek          0256        26.61    $1,354.56      $623.05      $270.91
                            bone.
   21275  T                Revision,                    0256        26.61    $1,354.56      $623.05      $270.91
                            orbitofacial bones.
   21280  T                Revision of eyelid..         0256        26.61    $1,354.56      $623.05      $270.91
   21282  T                Revision of eyelid..         0253        12.33      $627.65      $284.00      $125.53
   21295  T                Revision of jaw              0252         5.95      $302.88      $114.24       $60.58
                            muscle/bone.
   21296  T                Revision of jaw              0254        17.37      $884.20      $272.41      $176.84
                            muscle/bone.
   21299  T                Cranio/maxillofacial         0253        12.33      $627.65      $284.00      $125.53
                            surgery.
   21300  T                Treatment of skull           0253        12.33      $627.65      $284.00      $125.53
                            fracture.
   21310  X                Treatment of nose            0340         0.84       $42.76       $10.69        $8.55
                            fracture.
   21315  X                Treatment of nose            0340         0.84       $42.76       $10.69        $8.55
                            fracture.
   21320  X                Treatment of nose            0340         0.84       $42.76       $10.69        $8.55
                            fracture.
   21325  T                Treatment of nose            0254        17.37      $884.20      $272.41      $176.84
                            fracture.
   21330  T                Treatment of nose            0254        17.37      $884.20      $272.41      $176.84
                            fracture.
   21335  T                Treatment of nose            0254        17.37      $884.20      $272.41      $176.84
                            fracture.
   21336  T                Treat nasal septal           0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   21337  T                Treat nasal septal           0253        12.33      $627.65      $284.00      $125.53
                            fracture.
   21338  T                Treat nasoethmoid            0254        17.37      $884.20      $272.41      $176.84
                            fracture.
   21339  T                Treat nasoethmoid            0254        17.37      $884.20      $272.41      $176.84
                            fracture.
   21340  T                Treatment of nose            0256        26.61    $1,354.56      $623.05      $270.91
                            fracture.
   21343  C                Treatment of sinus    ...........  ...........  ...........  ...........  ...........
                            fracture.
   21344  C                Treatment of sinus    ...........  ...........  ...........  ...........  ...........
                            fracture.
   21345  T                Treat nose/jaw               0254        17.37      $884.20      $272.41      $176.84
                            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        26.61    $1,354.56      $623.05      $270.91
                            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.
   21400  T                Treat eye socket             0252         5.95      $302.88      $114.24       $60.58
                            fracture.
   21401  T                Treat eye socket             0253        12.33      $627.65      $284.00      $125.53
                            fracture.
   21406  T                Treat eye socket             0256        26.61    $1,354.56      $623.05      $270.91
                            fracture.
   21407  T                Treat eye socket             0256        26.61    $1,354.56      $623.05      $270.91
                            fracture.
   21408  C                Treat eye socket      ...........  ...........  ...........  ...........  ...........
                            fracture.
   21421  T                Treat mouth roof             0254        17.37      $884.20      $272.41      $176.84
                            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        17.37      $884.20      $272.41      $176.84
                            fracture.
   21445  T                Treat dental ridge           0254        17.37      $884.20      $272.41      $176.84
                            fracture.
   21450  T                Treat lower jaw              0251         2.43      $123.70       $27.99       $24.74
                            fracture.
   21451  T                Treat lower jaw              0252         5.95      $302.88      $114.24       $60.58
                            fracture.
   21452  T                Treat lower jaw              0253        12.33      $627.65      $284.00      $125.53
                            fracture.
   21453  T                Treat lower jaw              0256        26.61    $1,354.56      $623.05      $270.91
                            fracture.
   21454  T                Treat lower jaw              0254        17.37      $884.20      $272.41      $176.84
                            fracture.
   21461  T                Treat lower jaw              0256        26.61    $1,354.56      $623.05      $270.91
                            fracture.
   21462  T                Treat lower jaw              0256        26.61    $1,354.56      $623.05      $270.91
                            fracture.
   21465  T                Treat lower jaw              0256        26.61    $1,354.56      $623.05      $270.91
                            fracture.
   21470  T                Treat lower jaw              0256        26.61    $1,354.56      $623.05      $270.91
                            fracture.
   21480  T                Reset dislocated jaw         0251         2.43      $123.70       $27.99       $24.74
   21485  T                Reset dislocated jaw         0253        12.33      $627.65      $284.00      $125.53
   21490  T                Repair dislocated            0256        26.61    $1,354.56      $623.05      $270.91
                            jaw.
   21493  T                Treat hyoid bone             0252         5.95      $302.88      $114.24       $60.58
                            fracture.
   21494  T                Treat hyoid bone             0252         5.95      $302.88      $114.24       $60.58
                            fracture.
   21495  C                Treat hyoid bone      ...........  ...........  ...........  ...........  ...........
                            fracture.
   21497  T                Interdental wiring..         0253        12.33      $627.65      $284.00      $125.53
   21499  T                Head surgery                 0253        12.33      $627.65      $284.00      $125.53
                            procedure.
   21501  T                Drain neck/chest             0008        10.93      $556.38      $113.67      $111.28
                            lesion.
   21502  T                Drain chest lesion..         0049        15.84      $806.32      $356.95      $161.26
   21510  C                Drainage of bone      ...........  ...........  ...........  ...........  ...........
                            lesion.
   21550  T                Biopsy of neck/chest         0019         4.22      $214.81       $78.91       $42.96
   21555  T                Remove lesion, neck/         0022        13.91      $708.07      $292.94      $141.61
                            chest.

[[Page 59946]]

 
   21556  T                Remove lesion, neck/         0022        13.91      $708.07      $292.94      $141.61
                            chest.
   21557  C                Remove tumor, neck/   ...........  ...........  ...........  ...........  ...........
                            chest.
   21600  T                Partial removal of           0050        20.63    $1,050.15      $504.07      $210.03
                            rib.
   21610  T                Partial removal of           0050        20.63    $1,050.15      $504.07      $210.03
                            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             0006         2.18      $110.97       $33.95       $22.19
                            muscle.
   21705  C                Revision of neck      ...........  ...........  ...........  ...........  ...........
                            muscle/rib.
   21720  T                Revision of neck             0008        10.93      $556.38      $113.67      $111.28
                            muscle.
   21725  T                Revision of neck             0006         2.18      $110.97       $33.95       $22.19
                            muscle.
   21740  C                Reconstruction of     ...........  ...........  ...........  ...........  ...........
                            sternum.
   21750  C                Repair of sternum     ...........  ...........  ...........  ...........  ...........
                            separation.
   21800  T                Treatment of rib             0043         4.05      $206.16  ...........       $41.23
                            fracture.
   21805  T                Treatment of rib             0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   21810  C                Treatment of rib      ...........  ...........  ...........  ...........  ...........
                            fracture(s).
   21820  T                Treat sternum                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   21825  C                Treat sternum         ...........  ...........  ...........  ...........  ...........
                            fracture.
   21899  T                Neck/chest surgery           0252         5.95      $302.88      $114.24       $60.58
                            procedure.
   21920  T                Biopsy soft tissue           0019         4.22      $214.81       $78.91       $42.96
                            of back.
   21925  T                Biopsy soft tissue           0022        13.91      $708.07      $292.94      $141.61
                            of back.
   21930  T                Remove lesion, back          0022        13.91      $708.07      $292.94      $141.61
                            or flank.
   21935  T                Remove tumor, back..         0022        13.91      $708.07      $292.94      $141.61
   22100  C                Remove part of neck   ...........  ...........  ...........  ...........  ...........
                            vertebra.
   22101  C                Remove part, thorax   ...........  ...........  ...........  ...........  ...........
                            vertebra.
   22102  C                Remove part, lumbar   ...........  ...........  ...........  ...........  ...........
                            vertebra.
   22103  C                Remove extra spine    ...........  ...........  ...........  ...........  ...........
                            segment.
   22110  C                Remove part of neck   ...........  ...........  ...........  ...........  ...........
                            vertebra.
   22112  C                Remove part, thorax   ...........  ...........  ...........  ...........  ...........
                            vertebra.
   22114  C                Remove part, lumbar   ...........  ...........  ...........  ...........  ...........
                            vertebra.
   22116  C                Remove extra spine    ...........  ...........  ...........  ...........  ...........
                            segment.
   22210  C                Revision of neck      ...........  ...........  ...........  ...........  ...........
                            spine.
   22212  C                Revision of thorax    ...........  ...........  ...........  ...........  ...........
                            spine.
   22214  C                Revision of lumbar    ...........  ...........  ...........  ...........  ...........
                            spine.
   22216  C                Revise, extra spine   ...........  ...........  ...........  ...........  ...........
                            segment.
   22220  C                Revision of neck      ...........  ...........  ...........  ...........  ...........
                            spine.
   22222  C                Revision of thorax    ...........  ...........  ...........  ...........  ...........
                            spine.
   22224  C                Revision of lumbar    ...........  ...........  ...........  ...........  ...........
                            spine.
   22226  C                Revise, extra spine   ...........  ...........  ...........  ...........  ...........
                            segment.
   22305  T                Treat spine process          0043         4.05      $206.16  ...........       $41.23
                            fracture.
   22310  T                Treat spine fracture         0043         4.05      $206.16  ...........       $41.23
   22315  T                Treat spine fracture         0043         4.05      $206.16  ...........       $41.23
   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        11.67      $594.05      $277.12      $118.81
                            spine.
   22520  T                Percut                       0050        20.63    $1,050.15      $504.07      $210.03
                            vertebroplasty thor.
   22521  T                Percut                       0050        20.63    $1,050.15      $504.07      $210.03
                            vertebroplasty lumb.
   22522  T                Percut                       0050        20.63    $1,050.15      $504.07      $210.03
                            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.

[[Page 59947]]

 
   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         4.05      $206.16  ...........       $41.23
                            procedure.
   22900  T                Remove abdominal             0022        13.91      $708.07      $292.94      $141.61
                            wall lesion.
   22999  T                Abdomen surgery              0022        13.91      $708.07      $292.94      $141.61
                            procedure.
   23000  T                Removal of calcium           0021        11.82      $601.69      $236.51      $120.34
                            deposits.
   23020  T                Release shoulder             0051        28.56    $1,453.82      $675.24      $290.76
                            joint.
   23030  T                Drain shoulder               0008        10.93      $556.38      $113.67      $111.28
                            lesion.
   23031  T                Drain shoulder bursa         0008        10.93      $556.38      $113.67      $111.28
   23035  C                Drain shoulder bone   ...........  ...........  ...........  ...........  ...........
                            lesion.
   23040  T                Exploratory shoulder         0050        20.63    $1,050.15      $504.07      $210.03
                            surgery.
   23044  T                Exploratory shoulder         0050        20.63    $1,050.15      $504.07      $210.03
                            surgery.
   23065  T                Biopsy shoulder              0021        11.82      $601.69      $236.51      $120.34
                            tissues.
   23066  T                Biopsy shoulder              0022        13.91      $708.07      $292.94      $141.61
                            tissues.
   23075  T                Removal of shoulder          0021        11.82      $601.69      $236.51      $120.34
                            lesion.
   23076  T                Removal of shoulder          0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   23077  T                Remove tumor of              0022        13.91      $708.07      $292.94      $141.61
                            shoulder.
   23100  T                Biopsy of shoulder           0049        15.84      $806.32      $356.95      $161.26
                            joint.
   23101  T                Shoulder joint               0050        20.63    $1,050.15      $504.07      $210.03
                            surgery.
   23105  T                Remove shoulder              0050        20.63    $1,050.15      $504.07      $210.03
                            joint lining.
   23106  T                Incision of                  0050        20.63    $1,050.15      $504.07      $210.03
                            collarbone joint.
   23107  T                Explore treat                0050        20.63    $1,050.15      $504.07      $210.03
                            shoulder joint.
   23120  T                Partial removal,             0051        28.56    $1,453.82      $675.24      $290.76
                            collar bone.
   23125  C                Removal of collar     ...........  ...........  ...........  ...........  ...........
                            bone.
   23130  T                Remove shoulder              0051        28.56    $1,453.82      $675.24      $290.76
                            bone, part.
   23140  T                Removal of bone              0049        15.84      $806.32      $356.95      $161.26
                            lesion.
   23145  T                Removal of bone              0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   23146  T                Removal of bone              0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   23150  T                Removal of humerus           0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   23155  T                Removal of humerus           0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   23156  T                Removal of humerus           0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   23170  T                Remove collar bone           0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   23172  T                Remove shoulder              0050        20.63    $1,050.15      $504.07      $210.03
                            blade lesion.
   23174  T                Remove humerus               0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   23180  T                Remove collar bone           0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   23182  T                Remove shoulder              0050        20.63    $1,050.15      $504.07      $210.03
                            blade lesion.
   23184  T                Remove humerus               0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   23190  T                Partial removal of           0050        20.63    $1,050.15      $504.07      $210.03
                            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         4.22      $214.81       $78.91       $42.96
                            foreign body.
   23331  T                Remove shoulder              0022        13.91      $708.07      $292.94      $141.61
                            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        20.63    $1,050.15      $504.07      $210.03
                            muscle.
   23406  T                Incise tendon(s) &           0050        20.63    $1,050.15      $504.07      $210.03
                            muscle(s).
   23410  T                Repair of tendon(s).         0052        35.94    $1,829.49      $930.91      $365.90
   23412  T                Repair of tendon(s).         0052        35.94    $1,829.49      $930.91      $365.90
   23415  T                Release of shoulder          0051        28.56    $1,453.82      $675.24      $290.76
                            ligament.
   23420  T                Repair of shoulder..         0052        35.94    $1,829.49      $930.91      $365.90
   23430  T                Repair biceps tendon         0052        35.94    $1,829.49      $930.91      $365.90
   23440  T                Remove/transplant            0052        35.94    $1,829.49      $930.91      $365.90
                            tendon.
   23450  T                Repair shoulder              0052        35.94    $1,829.49      $930.91      $365.90
                            capsule.
   23455  T                Repair shoulder              0052        35.94    $1,829.49      $930.91      $365.90
                            capsule.

[[Page 59948]]

 
   23460  T                Repair shoulder              0052        35.94    $1,829.49      $930.91      $365.90
                            capsule.
   23462  T                Repair shoulder              0052        35.94    $1,829.49      $930.91      $365.90
                            capsule.
   23465  T                Repair shoulder              0052        35.94    $1,829.49      $930.91      $365.90
                            capsule.
   23466  T                Repair shoulder              0052        35.94    $1,829.49      $930.91      $365.90
                            capsule.
   23470  T                Reconstruct shoulder         0048        43.19    $2,198.54      $725.94      $439.71
                            joint.
   23472  C                Reconstruct shoulder  ...........  ...........  ...........  ...........  ...........
                            joint.
   23480  T                Revision of collar           0051        28.56    $1,453.82      $675.24      $290.76
                            bone.
   23485  T                Revision of collar           0051        28.56    $1,453.82      $675.24      $290.76
                            bone.
   23490  T                Reinforce clavicle..         0051        28.56    $1,453.82      $675.24      $290.76
   23491  T                Reinforce shoulder           0051        28.56    $1,453.82      $675.24      $290.76
                            bones.
   23500  T                Treat clavicle               0043         4.05      $206.16  ...........       $41.23
                            fracture.
   23505  T                Treat clavicle               0043         4.05      $206.16  ...........       $41.23
                            fracture.
   23515  T                Treat clavicle               0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   23520  T                Treat clavicle               0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   23525  T                Treat clavicle               0043         4.05      $206.16  ...........       $41.23
                            dislocation.
   23530  T                Treat clavicle               0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   23532  T                Treat clavicle               0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   23540  T                Treat clavicle               0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   23545  T                Treat clavicle               0043         4.05      $206.16  ...........       $41.23
                            dislocation.
   23550  T                Treat clavicle               0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   23552  T                Treat clavicle               0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   23570  T                Treat shoulder blade         0043         4.05      $206.16  ...........       $41.23
                            fx.
   23575  T                Treat shoulder blade         0044         2.52      $128.28       $38.08       $25.66
                            fx.
   23585  T                Treat scapula                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   23600  T                Treat humerus                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   23605  T                Treat humerus                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   23615  T                Treat humerus                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   23616  T                Treat humerus                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   23620  T                Treat humerus                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   23625  T                Treat humerus                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   23630  T                Treat humerus                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   23650  T                Treat shoulder               0043         4.05      $206.16  ...........       $41.23
                            dislocation.
   23655  T                Treat shoulder               0045        11.67      $594.05      $277.12      $118.81
                            dislocation.
   23660  T                Treat shoulder               0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   23665  T                Treat dislocation/           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   23670  T                Treat dislocation/           0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   23675  T                Treat dislocation/           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   23680  T                Treat dislocation/           0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   23700  T                Fixation of shoulder         0045        11.67      $594.05      $277.12      $118.81
   23800  T                Fusion of shoulder           0051        28.56    $1,453.82      $675.24      $290.76
                            joint.
   23802  T                Fusion of shoulder           0051        28.56    $1,453.82      $675.24      $290.76
                            joint.
   23900  C                Amputation of arm &   ...........  ...........  ...........  ...........  ...........
                            girdle.
   23920  C                Amputation at         ...........  ...........  ...........  ...........  ...........
                            shoulder joint.
   23921  T                Amputation follow-up         0026        12.62      $642.41      $277.92      $128.48
                            surgery.
   23929  T                Shoulder surgery             0043         4.05      $206.16  ...........       $41.23
                            procedure.
   23930  T                Drainage of arm              0008        10.93      $556.38      $113.67      $111.28
                            lesion.
   23931  T                Drainage of arm              0006         2.18      $110.97       $33.95       $22.19
                            bursa.
   23935  T                Drain arm/elbow bone         0049        15.84      $806.32      $356.95      $161.26
                            lesion.
   24000  T                Exploratory elbow            0050        20.63    $1,050.15      $504.07      $210.03
                            surgery.
   24006  T                Release elbow joint.         0050        20.63    $1,050.15      $504.07      $210.03
   24065  T                Biopsy arm/elbow             0020         8.44      $429.63      $130.53       $85.93
                            soft tissue.
   24066  T                Biopsy arm/elbow             0021        11.82      $601.69      $236.51      $120.34
                            soft tissue.
   24075  T                Remove arm/elbow             0021        11.82      $601.69      $236.51      $120.34
                            lesion.
   24076  T                Remove arm/elbow             0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   24077  T                Remove tumor of arm/         0022        13.91      $708.07      $292.94      $141.61
                            elbow.
   24100  T                Biopsy elbow joint           0049        15.84      $806.32      $356.95      $161.26
                            lining.
   24101  T                Explore/treat elbow          0050        20.63    $1,050.15      $504.07      $210.03
                            joint.
   24102  T                Remove elbow joint           0050        20.63    $1,050.15      $504.07      $210.03
                            lining.
   24105  T                Removal of elbow             0049        15.84      $806.32      $356.95      $161.26
                            bursa.
   24110  T                Remove humerus               0049        15.84      $806.32      $356.95      $161.26
                            lesion.
   24115  T                Remove/graft bone            0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   24116  T                Remove/graft bone            0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   24120  T                Remove elbow lesion.         0049        15.84      $806.32      $356.95      $161.26
   24125  T                Remove/graft bone            0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   24126  T                Remove/graft bone            0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   24130  T                Removal of head of           0050        20.63    $1,050.15      $504.07      $210.03
                            radius.
   24134  T                Removal of arm bone          0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   24136  T                Remove radius bone           0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   24138  T                Remove elbow bone            0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   24140  T                Partial removal of           0050        20.63    $1,050.15      $504.07      $210.03
                            arm bone.
   24145  T                Partial removal of           0050        20.63    $1,050.15      $504.07      $210.03
                            radius.
   24147  T                Partial removal of           0050        20.63    $1,050.15      $504.07      $210.03
                            elbow.
   24149  C                Radical resection of  ...........  ...........  ...........  ...........  ...........
                            elbow.
   24150  C                Extensive humerus     ...........  ...........  ...........  ...........  ...........
                            surgery.
   24151  C                Extensive humerus     ...........  ...........  ...........  ...........  ...........
                            surgery.

[[Page 59949]]

 
   24152  C                Extensive radius      ...........  ...........  ...........  ...........  ...........
                            surgery.
   24153  C                Extensive radius      ...........  ...........  ...........  ...........  ...........
                            surgery.
   24155  T                Removal of elbow             0051        28.56    $1,453.82      $675.24      $290.76
                            joint.
   24160  T                Remove elbow joint           0050        20.63    $1,050.15      $504.07      $210.03
                            implant.
   24164  T                Remove radius head           0050        20.63    $1,050.15      $504.07      $210.03
                            implant.
   24200  T                Removal of arm               0019         4.22      $214.81       $78.91       $42.96
                            foreign body.
   24201  T                Removal of arm               0021        11.82      $601.69      $236.51      $120.34
                            foreign body.
   24220  N                Injection for elbow   ...........  ...........  ...........  ...........  ...........
                            x-ray.
  *24300  T                Manipulate elbow w/          0045        11.67      $594.05      $277.12      $118.81
                            anesth.
   24301  T                Muscle/tendon                0050        20.63    $1,050.15      $504.07      $210.03
                            transfer.
   24305  T                Arm tendon                   0050        20.63    $1,050.15      $504.07      $210.03
                            lengthening.
   24310  T                Revision of arm              0049        15.84      $806.32      $356.95      $161.26
                            tendon.
   24320  T                Repair of arm tendon         0051        28.56    $1,453.82      $675.24      $290.76
   24330  T                Revision of arm              0051        28.56    $1,453.82      $675.24      $290.76
                            muscles.
   24331  T                Revision of arm              0051        28.56    $1,453.82      $675.24      $290.76
                            muscles.
  *24332  T                Tenolysis, triceps..         0049        15.84      $806.32      $356.95      $161.26
   24340  T                Repair of biceps             0051        28.56    $1,453.82      $675.24      $290.76
                            tendon.
   24341  T                Repair arm tendon/           0051        28.56    $1,453.82      $675.24      $290.76
                            muscle.
   24342  T                Repair of ruptured           0051        28.56    $1,453.82      $675.24      $290.76
                            tendon.
  *24343  T                Repr elbow lat               0050        20.63    $1,050.15      $504.07      $210.03
                            ligmnt w/tiss.
  *24344  T                Reconstruct elbow            0051        28.56    $1,453.82      $675.24      $290.76
                            lat ligmnt.
  *24345  T                Repr elbw med ligmnt         0050        20.63    $1,050.15      $504.07      $210.03
                            w/tiss.
  *24346  T                Reconstruct elbow            0051        28.56    $1,453.82      $675.24      $290.76
                            med ligmnt.
   24350  T                Repair of tennis             0050        20.63    $1,050.15      $504.07      $210.03
                            elbow.
   24351  T                Repair of tennis             0050        20.63    $1,050.15      $504.07      $210.03
                            elbow.
   24352  T                Repair of tennis             0050        20.63    $1,050.15      $504.07      $210.03
                            elbow.
   24354  T                Repair of tennis             0050        20.63    $1,050.15      $504.07      $210.03
                            elbow.
   24356  T                Revision of tennis           0050        20.63    $1,050.15      $504.07      $210.03
                            elbow.
   24360  T                Reconstruct elbow            0047        26.36    $1,341.83      $537.03      $268.37
                            joint.
   24361  T                Reconstruct elbow            0048        43.19    $2,198.54      $725.94      $439.71
                            joint.
   24362  T                Reconstruct elbow            0048        43.19    $2,198.54      $725.94      $439.71
                            joint.
   24363  T                Replace elbow joint.         0048        43.19    $2,198.54      $725.94      $439.71
   24365  T                Reconstruct head of          0047        26.36    $1,341.83      $537.03      $268.37
                            radius.
   24366  T                Reconstruct head of          0048        43.19    $2,198.54      $725.94      $439.71
                            radius.
   24400  T                Revision of humerus.         0050        20.63    $1,050.15      $504.07      $210.03
   24410  T                Revision of humerus.         0050        20.63    $1,050.15      $504.07      $210.03
   24420  T                Revision of humerus.         0051        28.56    $1,453.82      $675.24      $290.76
   24430  T                Repair of humerus...         0051        28.56    $1,453.82      $675.24      $290.76
   24435  T                Repair humerus with          0051        28.56    $1,453.82      $675.24      $290.76
                            graft.
   24470  T                Revision of elbow            0051        28.56    $1,453.82      $675.24      $290.76
                            joint.
   24495  T                Decompression of             0050        20.63    $1,050.15      $504.07      $210.03
                            forearm.
   24498  T                Reinforce humerus...         0051        28.56    $1,453.82      $675.24      $290.76
   24500  T                Treat humerus                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   24505  T                Treat humerus                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   24515  T                Treat humerus                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   24516  T                Treat humerus                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   24530  T                Treat humerus                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   24535  T                Treat humerus                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   24538  T                Treat humerus                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   24545  T                Treat humerus                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   24546  T                Treat humerus                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   24560  T                Treat humerus                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   24565  T                Treat humerus                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   24566  T                Treat humerus                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   24575  T                Treat humerus                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   24576  T                Treat humerus                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   24577  T                Treat humerus                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   24579  T                Treat humerus                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   24582  T                Treat humerus                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   24586  T                Treat elbow fracture         0046        27.69    $1,409.53      $535.76      $281.91
   24587  T                Treat elbow fracture         0046        27.69    $1,409.53      $535.76      $281.91
   24600  T                Treat elbow                  0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   24605  T                Treat elbow                  0045        11.67      $594.05      $277.12      $118.81
                            dislocation.
   24615  T                Treat elbow                  0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   24620  T                Treat elbow fracture         0044         2.52      $128.28       $38.08       $25.66
   24635  T                Treat elbow fracture         0046        27.69    $1,409.53      $535.76      $281.91
   24640  T                Treat elbow                  0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   24650  T                Treat radius                 0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   24655  T                Treat radius                 0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   24665  T                Treat radius                 0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   24666  T                Treat radius                 0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   24670  T                Treat ulnar fracture         0044         2.52      $128.28       $38.08       $25.66
   24675  T                Treat ulnar fracture         0044         2.52      $128.28       $38.08       $25.66
   24685  T                Treat ulnar fracture         0046        27.69    $1,409.53      $535.76      $281.91
   24800  T                Fusion of elbow              0051        28.56    $1,453.82      $675.24      $290.76
                            joint.

[[Page 59950]]

 
   24802  T                Fusion/graft of              0051        28.56    $1,453.82      $675.24      $290.76
                            elbow joint.
   24900  C                Amputation of upper   ...........  ...........  ...........  ...........  ...........
                            arm.
   24920  C                Amputation of upper   ...........  ...........  ...........  ...........  ...........
                            arm.
   24925  T                Amputation follow-up         0049        15.84      $806.32      $356.95      $161.26
                            surgery.
   24930  C                Amputation follow-up  ...........  ...........  ...........  ...........  ...........
                            surgery.
   24931  C                Amputate upper arm &  ...........  ...........  ...........  ...........  ...........
                            implant.
   24935  T                Revision of                  0052        35.94    $1,829.49      $930.91      $365.90
                            amputation.
   24940  C                Revision of upper     ...........  ...........  ...........  ...........  ...........
                            arm.
   24999  T                Upper arm/elbow              0044         2.52      $128.28       $38.08       $25.66
                            surgery.
   25000  T                Incision of tendon           0049        15.84      $806.32      $356.95      $161.26
                            sheath.
  *25001  T                Incise flexor carpi          0049        15.84      $806.32      $356.95      $161.26
                            radialis.
   25020  T                Decompression of             0049        15.84      $806.32      $356.95      $161.26
                            forearm.
   25023  T                Decompression of             0050        20.63    $1,050.15      $504.07      $210.03
                            forearm.
  *25024  T                Decompress forearm 2         0050        20.63    $1,050.15      $504.07      $210.03
                            spaces.
  *25025  T                Decompress forarm 2          0050        20.63    $1,050.15      $504.07      $210.03
                            spaces.
   25028  T                Drainage of forearm          0049        15.84      $806.32      $356.95      $161.26
                            lesion.
   25031  T                Drainage of forearm          0049        15.84      $806.32      $356.95      $161.26
                            bursa.
   25035  T                Treat forearm bone           0049        15.84      $806.32      $356.95      $161.26
                            lesion.
   25040  T                Explore/treat wrist          0050        20.63    $1,050.15      $504.07      $210.03
                            joint.
   25065  T                Biopsy forearm soft          0021        11.82      $601.69      $236.51      $120.34
                            tissues.
   25066  T                Biopsy forearm soft          0022        13.91      $708.07      $292.94      $141.61
                            tissues.
   25075  T                Removal of forearm           0020         8.44      $429.63      $130.53       $85.93
                            lesion.
   25076  T                Removal of forearm           0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   25077  T                Remove tumor,                0022        13.91      $708.07      $292.94      $141.61
                            forearm/wrist.
   25085  T                Incision of wrist            0049        15.84      $806.32      $356.95      $161.26
                            capsule.
   25100  T                Biopsy of wrist              0049        15.84      $806.32      $356.95      $161.26
                            joint.
   25101  T                Explore/treat wrist          0050        20.63    $1,050.15      $504.07      $210.03
                            joint.
   25105  T                Remove wrist joint           0050        20.63    $1,050.15      $504.07      $210.03
                            lining.
   25107  T                Remove wrist joint           0050        20.63    $1,050.15      $504.07      $210.03
                            cartilage.
   25110  T                Remove wrist tendon          0049        15.84      $806.32      $356.95      $161.26
                            lesion.
   25111  T                Remove wrist tendon          0053        11.69      $595.07      $253.49      $119.01
                            lesion.
   25112  T                Reremove wrist               0053        11.69      $595.07      $253.49      $119.01
                            tendon lesion.
   25115  T                Remove wrist/forearm         0049        15.84      $806.32      $356.95      $161.26
                            lesion.
   25116  T                Remove wrist/forearm         0049        15.84      $806.32      $356.95      $161.26
                            lesion.
   25118  T                Excise wrist tendon          0050        20.63    $1,050.15      $504.07      $210.03
                            sheath.
   25119  T                Partial removal of           0050        20.63    $1,050.15      $504.07      $210.03
                            ulna.
   25120  T                Removal of forearm           0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   25125  T                Remove/graft forearm         0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   25126  T                Remove/graft forearm         0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   25130  T                Removal of wrist             0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   25135  T                Remove & graft wrist         0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   25136  T                Remove & graft wrist         0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   25145  T                Remove forearm bone          0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   25150  T                Partial removal of           0050        20.63    $1,050.15      $504.07      $210.03
                            ulna.
   25151  T                Partial removal of           0050        20.63    $1,050.15      $504.07      $210.03
                            radius.
   25170  C                Extensive forearm     ...........  ...........  ...........  ...........  ...........
                            surgery.
   25210  T                Removal of wrist             0054        19.83    $1,009.43      $472.33      $201.89
                            bone.
   25215  T                Removal of wrist             0054        19.83    $1,009.43      $472.33      $201.89
                            bones.
   25230  T                Partial removal of           0050        20.63    $1,050.15      $504.07      $210.03
                            radius.
   25240  T                Partial removal of           0050        20.63    $1,050.15      $504.07      $210.03
                            ulna.
   25246  N                Injection for wrist   ...........  ...........  ...........  ...........  ...........
                            x-ray.
   25248  T                Remove forearm               0049        15.84      $806.32      $356.95      $161.26
                            foreign body.
   25250  T                Removal of wrist             0050        20.63    $1,050.15      $504.07      $210.03
                            prosthesis.
   25251  T                Removal of wrist             0050        20.63    $1,050.15      $504.07      $210.03
                            prosthesis.
  *25259  T                Manipulate wrist w/          0044         2.52      $128.28       $38.08       $25.66
                            anesthes.
   25260  T                Repair forearm               0050        20.63    $1,050.15      $504.07      $210.03
                            tendon/muscle.
   25263  T                Repair forearm               0050        20.63    $1,050.15      $504.07      $210.03
                            tendon/muscle.
   25265  T                Repair forearm               0050        20.63    $1,050.15      $504.07      $210.03
                            tendon/muscle.
   25270  T                Repair forearm               0050        20.63    $1,050.15      $504.07      $210.03
                            tendon/muscle.
   25272  T                Repair forearm               0050        20.63    $1,050.15      $504.07      $210.03
                            tendon/muscle.
   25274  T                Repair forearm               0050        20.63    $1,050.15      $504.07      $210.03
                            tendon/muscle.
  *25275  T                Repair forearm               0050        20.63    $1,050.15      $504.07      $210.03
                            tendon sheath.
   25280  T                Revise wrist/forearm         0050        20.63    $1,050.15      $504.07      $210.03
                            tendon.
   25290  T                Incise wrist/forearm         0050        20.63    $1,050.15      $504.07      $210.03
                            tendon.
   25295  T                Release wrist/               0049        15.84      $806.32      $356.95      $161.26
                            forearm tendon.
   25300  T                Fusion of tendons at         0050        20.63    $1,050.15      $504.07      $210.03
                            wrist.
   25301  T                Fusion of tendons at         0050        20.63    $1,050.15      $504.07      $210.03
                            wrist.
   25310  T                Transplant forearm           0051        28.56    $1,453.82      $675.24      $290.76
                            tendon.
   25312  T                Transplant forearm           0051        28.56    $1,453.82      $675.24      $290.76
                            tendon.
   25315  T                Revise palsy hand            0051        28.56    $1,453.82      $675.24      $290.76
                            tendon(s).
   25316  T                Revise palsy hand            0051        28.56    $1,453.82      $675.24      $290.76
                            tendon(s).
   25320  T                Repair/revise wrist          0051        28.56    $1,453.82      $675.24      $290.76
                            joint.
   25332  T                Revise wrist joint..         0047        26.36    $1,341.83      $537.03      $268.37
   25335  T                Realignment of hand.         0051        28.56    $1,453.82      $675.24      $290.76
   25337  T                Reconstruct ulna/            0051        28.56    $1,453.82      $675.24      $290.76
                            radioulnar.

[[Page 59951]]

 
   25350  T                Revision of radius..         0051        28.56    $1,453.82      $675.24      $290.76
   25355  T                Revision of radius..         0051        28.56    $1,453.82      $675.24      $290.76
   25360  T                Revision of ulna....         0050        20.63    $1,050.15      $504.07      $210.03
   25365  T                Revise radius & ulna         0050        20.63    $1,050.15      $504.07      $210.03
   25370  T                Revise radius or             0051        28.56    $1,453.82      $675.24      $290.76
                            ulna.
   25375  T                Revise radius & ulna         0051        28.56    $1,453.82      $675.24      $290.76
   25390  C                Shorten radius or     ...........  ...........  ...........  ...........  ...........
                            ulna.
   25391  C                Lengthen radius or    ...........  ...........  ...........  ...........  ...........
                            ulna.
   25392  C                Shorten radius &      ...........  ...........  ...........  ...........  ...........
                            ulna.
   25393  C                Lengthen radius &     ...........  ...........  ...........  ...........  ...........
                            ulna.
  *25394  T                Repair carpal bone,          0053        11.69      $595.07      $253.49      $119.01
                            shorten.
   25400  T                Repair radius or             0050        20.63    $1,050.15      $504.07      $210.03
                            ulna.
   25405  T                Repair/graft radius          0050        20.63    $1,050.15      $504.07      $210.03
                            or ulna.
   25415  T                Repair radius & ulna         0050        20.63    $1,050.15      $504.07      $210.03
   25420  C                Repair/graft radius   ...........  ...........  ...........  ...........  ...........
                            & ulna.
   25425  T                Repair/graft radius          0051        28.56    $1,453.82      $675.24      $290.76
                            or ulna.
   25426  T                Repair/graft radius          0051        28.56    $1,453.82      $675.24      $290.76
                            & ulna.
  *25430  T                Vasc graft into              0054        19.83    $1,009.43      $472.33      $201.89
                            carpal bone.
  *25431  T                Repair nonunion              0054        19.83    $1,009.43      $472.33      $201.89
                            carpal bone.
   25440  T                Repair/graft wrist           0051        28.56    $1,453.82      $675.24      $290.76
                            bone.
   25441  T                Reconstruct wrist            0048        43.19    $2,198.54      $725.94      $439.71
                            joint.
   25442  T                Reconstruct wrist            0048        43.19    $2,198.54      $725.94      $439.71
                            joint.
   25443  T                Reconstruct wrist            0048        43.19    $2,198.54      $725.94      $439.71
                            joint.
   25444  T                Reconstruct wrist            0048        43.19    $2,198.54      $725.94      $439.71
                            joint.
   25445  T                Reconstruct wrist            0048        43.19    $2,198.54      $725.94      $439.71
                            joint.
   25446  T                Wrist replacement...         0048        43.19    $2,198.54      $725.94      $439.71
   25447  T                Repair wrist                 0047        26.36    $1,341.83      $537.03      $268.37
                            joint(s).
   25449  T                Remove wrist joint           0047        26.36    $1,341.83      $537.03      $268.37
                            implant.
   25450  T                Revision of wrist            0051        28.56    $1,453.82      $675.24      $290.76
                            joint.
   25455  T                Revision of wrist            0051        28.56    $1,453.82      $675.24      $290.76
                            joint.
   25490  T                Reinforce radius....         0051        28.56    $1,453.82      $675.24      $290.76
   25491  T                Reinforce ulna......         0051        28.56    $1,453.82      $675.24      $290.76
   25492  T                Reinforce radius and         0051        28.56    $1,453.82      $675.24      $290.76
                            ulna.
   25500  T                Treat fracture of            0044         2.52      $128.28       $38.08       $25.66
                            radius.
   25505  T                Treat fracture of            0044         2.52      $128.28       $38.08       $25.66
                            radius.
   25515  T                Treat fracture of            0046        27.69    $1,409.53      $535.76      $281.91
                            radius.
   25520  T                Treat fracture of            0044         2.52      $128.28       $38.08       $25.66
                            radius.
   25525  T                Treat fracture of            0046        27.69    $1,409.53      $535.76      $281.91
                            radius.
   25526  T                Treat fracture of            0046        27.69    $1,409.53      $535.76      $281.91
                            radius.
   25530  T                Treat fracture of            0044         2.52      $128.28       $38.08       $25.66
                            ulna.
   25535  T                Treat fracture of            0044         2.52      $128.28       $38.08       $25.66
                            ulna.
   25545  T                Treat fracture of            0046        27.69    $1,409.53      $535.76      $281.91
                            ulna.
   25560  T                Treat fracture               0044         2.52      $128.28       $38.08       $25.66
                            radius & ulna.
   25565  T                Treat fracture               0044         2.52      $128.28       $38.08       $25.66
                            radius & ulna.
   25574  T                Treat fracture               0046        27.69    $1,409.53      $535.76      $281.91
                            radius & ulna.
   25575  T                Treat fracture               0046        27.69    $1,409.53      $535.76      $281.91
                            radius/ulna.
   25600  T                Treat fracture               0044         2.52      $128.28       $38.08       $25.66
                            radius/ulna.
   25605  T                Treat fracture               0044         2.52      $128.28       $38.08       $25.66
                            radius/ulna.
   25611  T                Treat fracture               0046        27.69    $1,409.53      $535.76      $281.91
                            radius/ulna.
   25620  T                Treat fracture               0046        27.69    $1,409.53      $535.76      $281.91
                            radius/ulna.
   25622  T                Treat wrist bone             0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   25624  T                Treat wrist bone             0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   25628  T                Treat wrist bone             0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   25630  T                Treat wrist bone             0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   25635  T                Treat wrist bone             0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   25645  T                Treat wrist bone             0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   25650  T                Treat wrist bone             0044         2.52      $128.28       $38.08       $25.66
                            fracture.
  *25651  T                Pin ulnar styloid            0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
  *25652  T                Treat fracture ulnar         0046        27.69    $1,409.53      $535.76      $281.91
                            styloid.
   25660  T                Treat wrist                  0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   25670  T                Treat wrist                  0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
  *25671  T                Pin radioulnar               0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   25675  T                Treat wrist                  0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   25676  T                Treat wrist                  0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   25680  T                Treat wrist fracture         0044         2.52      $128.28       $38.08       $25.66
   25685  T                Treat wrist fracture         0046        27.69    $1,409.53      $535.76      $281.91
   25690  T                Treat wrist                  0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   25695  T                Treat wrist                  0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   25800  T                Fusion of wrist              0051        28.56    $1,453.82      $675.24      $290.76
                            joint.
   25805  T                Fusion/graft of              0051        28.56    $1,453.82      $675.24      $290.76
                            wrist joint.
   25810  T                Fusion/graft of              0051        28.56    $1,453.82      $675.24      $290.76
                            wrist joint.
   25820  T                Fusion of hand bones         0053        11.69      $595.07      $253.49      $119.01
   25825  T                Fuse hand bones with         0054        19.83    $1,009.43      $472.33      $201.89
                            graft.
   25830  T                Fusion, radioulnar           0051        28.56    $1,453.82      $675.24      $290.76
                            jnt/ulna.
   25900  C                Amputation of         ...........  ...........  ...........  ...........  ...........
                            forearm.

[[Page 59952]]

 
   25905  C                Amputation of         ...........  ...........  ...........  ...........  ...........
                            forearm.
   25907  T                Amputation follow-up         0049        15.84      $806.32      $356.95      $161.26
                            surgery.
   25909  C                Amputation follow-up  ...........  ...........  ...........  ...........  ...........
                            surgery.
   25915  C                Amputation of         ...........  ...........  ...........  ...........  ...........
                            forearm.
   25920  C                Amputate hand at      ...........  ...........  ...........  ...........  ...........
                            wrist.
   25922  T                Amputate hand at             0049        15.84      $806.32      $356.95      $161.26
                            wrist.
   25924  C                Amputation follow-up  ...........  ...........  ...........  ...........  ...........
                            surgery.
   25927  C                Amputation of hand..  ...........  ...........  ...........  ...........  ...........
   25929  T                Amputation follow-up         0026        12.62      $642.41      $277.92      $128.48
                            surgery.
   25931  C                Amputation follow-up  ...........  ...........  ...........  ...........  ...........
                            surgery.
   25999  T                Forearm or wrist             0044         2.52      $128.28       $38.08       $25.66
                            surgery.
   26010  T                Drainage of finger           0006         2.18      $110.97       $33.95       $22.19
                            abscess.
   26011  T                Drainage of finger           0007         6.75      $343.60       $72.03       $68.72
                            abscess.
   26020  T                Drain hand tendon            0053        11.69      $595.07      $253.49      $119.01
                            sheath.
   26025  T                Drainage of palm             0053        11.69      $595.07      $253.49      $119.01
                            bursa.
   26030  T                Drainage of palm             0053        11.69      $595.07      $253.49      $119.01
                            bursa(s).
   26034  T                Treat hand bone              0053        11.69      $595.07      $253.49      $119.01
                            lesion.
   26035  T                Decompress fingers/          0053        11.69      $595.07      $253.49      $119.01
                            hand.
   26037  T                Decompress fingers/          0053        11.69      $595.07      $253.49      $119.01
                            hand.
   26040  T                Release palm                 0054        19.83    $1,009.43      $472.33      $201.89
                            contracture.
   26045  T                Release palm                 0054        19.83    $1,009.43      $472.33      $201.89
                            contracture.
   26055  T                Incise finger tendon         0053        11.69      $595.07      $253.49      $119.01
                            sheath.
   26060  T                Incision of finger           0053        11.69      $595.07      $253.49      $119.01
                            tendon.
   26070  T                Explore/treat hand           0053        11.69      $595.07      $253.49      $119.01
                            joint.
   26075  T                Explore/treat finger         0053        11.69      $595.07      $253.49      $119.01
                            joint.
   26080  T                Explore/treat finger         0053        11.69      $595.07      $253.49      $119.01
                            joint.
   26100  T                Biopsy hand joint            0053        11.69      $595.07      $253.49      $119.01
                            lining.
   26105  T                Biopsy finger joint          0053        11.69      $595.07      $253.49      $119.01
                            lining.
   26110  T                Biopsy finger joint          0053        11.69      $595.07      $253.49      $119.01
                            lining.
   26115  T                Removal of hand              0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   26116  T                Removal of hand              0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   26117  T                Remove tumor, hand/          0022        13.91      $708.07      $292.94      $141.61
                            finger.
   26121  T                Release palm                 0054        19.83    $1,009.43      $472.33      $201.89
                            contracture.
   26123  T                Release palm                 0054        19.83    $1,009.43      $472.33      $201.89
                            contracture.
   26125  T                Release palm                 0054        19.83    $1,009.43      $472.33      $201.89
                            contracture.
   26130  T                Remove wrist joint           0053        11.69      $595.07      $253.49      $119.01
                            lining.
   26135  T                Revise finger joint,         0054        19.83    $1,009.43      $472.33      $201.89
                            each.
   26140  T                Revise finger joint,         0053        11.69      $595.07      $253.49      $119.01
                            each.
   26145  T                Tendon excision,             0053        11.69      $595.07      $253.49      $119.01
                            palm/finger.
   26160  T                Remove tendon sheath         0053        11.69      $595.07      $253.49      $119.01
                            lesion.
   26170  T                Removal of palm              0053        11.69      $595.07      $253.49      $119.01
                            tendon, each.
   26180  T                Removal of finger            0053        11.69      $595.07      $253.49      $119.01
                            tendon.
   26185  T                Remove finger bone..         0053        11.69      $595.07      $253.49      $119.01
   26200  T                Remove hand bone             0053        11.69      $595.07      $253.49      $119.01
                            lesion.
   26205  T                Remove/graft bone            0054        19.83    $1,009.43      $472.33      $201.89
                            lesion.
   26210  T                Removal of finger            0053        11.69      $595.07      $253.49      $119.01
                            lesion.
   26215  T                Remove/graft finger          0053        11.69      $595.07      $253.49      $119.01
                            lesion.
   26230  T                Partial removal of           0053        11.69      $595.07      $253.49      $119.01
                            hand bone.
   26235  T                Partial removal,             0053        11.69      $595.07      $253.49      $119.01
                            finger bone.
   26236  T                Partial removal,             0053        11.69      $595.07      $253.49      $119.01
                            finger bone.
   26250  T                Extensive hand               0053        11.69      $595.07      $253.49      $119.01
                            surgery.
   26255  T                Extensive hand               0054        19.83    $1,009.43      $472.33      $201.89
                            surgery.
   26260  T                Extensive finger             0053        11.69      $595.07      $253.49      $119.01
                            surgery.
   26261  T                Extensive finger             0053        11.69      $595.07      $253.49      $119.01
                            surgery.
   26262  T                Partial removal of           0053        11.69      $595.07      $253.49      $119.01
                            finger.
   26320  T                Removal of implant           0020         8.44      $429.63      $130.53       $85.93
                            from hand.
  *26340  T                Manipulate finger w/         0043         4.05      $206.16  ...........       $41.23
                            anesth.
   26350  T                Repair finger/hand           0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26352  T                Repair/graft hand            0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26356  T                Repair finger/hand           0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26357  T                Repair finger/hand           0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26358  T                Repair/graft hand            0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26370  T                Repair finger/hand           0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26372  T                Repair/graft hand            0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26373  T                Repair finger/hand           0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26390  T                Revise hand/finger           0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26392  T                Repair/graft hand            0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26410  T                Repair hand tendon..         0053        11.69      $595.07      $253.49      $119.01
   26412  T                Repair/graft hand            0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26415  T                Excision, hand/              0054        19.83    $1,009.43      $472.33      $201.89
                            finger tendon.
   26416  T                Graft hand or finger         0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26418  T                Repair finger tendon         0053        11.69      $595.07      $253.49      $119.01
   26420  T                Repair/graft finger          0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26426  T                Repair finger/hand           0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26428  T                Repair/graft finger          0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.

[[Page 59953]]

 
   26432  T                Repair finger tendon         0053        11.69      $595.07      $253.49      $119.01
   26433  T                Repair finger tendon         0053        11.69      $595.07      $253.49      $119.01
   26434  T                Repair/graft finger          0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26437  T                Realignment of               0053        11.69      $595.07      $253.49      $119.01
                            tendons.
   26440  T                Release palm/finger          0053        11.69      $595.07      $253.49      $119.01
                            tendon.
   26442  T                Release palm &               0054        19.83    $1,009.43      $472.33      $201.89
                            finger tendon.
   26445  T                Release hand/finger          0053        11.69      $595.07      $253.49      $119.01
                            tendon.
   26449  T                Release forearm/hand         0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26450  T                Incision of palm             0053        11.69      $595.07      $253.49      $119.01
                            tendon.
   26455  T                Incision of finger           0053        11.69      $595.07      $253.49      $119.01
                            tendon.
   26460  T                Incise hand/finger           0053        11.69      $595.07      $253.49      $119.01
                            tendon.
   26471  T                Fusion of finger             0053        11.69      $595.07      $253.49      $119.01
                            tendons.
   26474  T                Fusion of finger             0053        11.69      $595.07      $253.49      $119.01
                            tendons.
   26476  T                Tendon lengthening..         0053        11.69      $595.07      $253.49      $119.01
   26477  T                Tendon shortening...         0053        11.69      $595.07      $253.49      $119.01
   26478  T                Lengthening of hand          0053        11.69      $595.07      $253.49      $119.01
                            tendon.
   26479  T                Shortening of hand           0053        11.69      $595.07      $253.49      $119.01
                            tendon.
   26480  T                Transplant hand              0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26483  T                Transplant/graft             0054        19.83    $1,009.43      $472.33      $201.89
                            hand tendon.
   26485  T                Transplant palm              0054        19.83    $1,009.43      $472.33      $201.89
                            tendon.
   26489  T                Transplant/graft             0054        19.83    $1,009.43      $472.33      $201.89
                            palm tendon.
   26490  T                Revise thumb tendon.         0054        19.83    $1,009.43      $472.33      $201.89
   26492  T                Tendon transfer with         0054        19.83    $1,009.43      $472.33      $201.89
                            graft.
   26494  T                Hand tendon/muscle           0054        19.83    $1,009.43      $472.33      $201.89
                            transfer.
   26496  T                Revise thumb tendon.         0054        19.83    $1,009.43      $472.33      $201.89
   26497  T                Finger tendon                0054        19.83    $1,009.43      $472.33      $201.89
                            transfer.
   26498  T                Finger tendon                0054        19.83    $1,009.43      $472.33      $201.89
                            transfer.
   26499  T                Revision of finger..         0054        19.83    $1,009.43      $472.33      $201.89
   26500  T                Hand tendon                  0053        11.69      $595.07      $253.49      $119.01
                            reconstruction.
   26502  T                Hand tendon                  0054        19.83    $1,009.43      $472.33      $201.89
                            reconstruction.
   26504  T                Hand tendon                  0054        19.83    $1,009.43      $472.33      $201.89
                            reconstruction.
   26508  T                Release thumb                0053        11.69      $595.07      $253.49      $119.01
                            contracture.
   26510  T                Thumb tendon                 0054        19.83    $1,009.43      $472.33      $201.89
                            transfer.
   26516  T                Fusion of knuckle            0054        19.83    $1,009.43      $472.33      $201.89
                            joint.
   26517  T                Fusion of knuckle            0054        19.83    $1,009.43      $472.33      $201.89
                            joints.
   26518  T                Fusion of knuckle            0054        19.83    $1,009.43      $472.33      $201.89
                            joints.
   26520  T                Release knuckle              0053        11.69      $595.07      $253.49      $119.01
                            contracture.
   26525  T                Release finger               0053        11.69      $595.07      $253.49      $119.01
                            contracture.
   26530  T                Revise knuckle joint         0047        26.36    $1,341.83      $537.03      $268.37
   26531  T                Revise knuckle with          0048        43.19    $2,198.54      $725.94      $439.71
                            implant.
   26535  T                Revise finger joint.         0047        26.36    $1,341.83      $537.03      $268.37
   26536  T                Revise/implant               0048        43.19    $2,198.54      $725.94      $439.71
                            finger joint.
   26540  T                Repair hand joint...         0053        11.69      $595.07      $253.49      $119.01
   26541  T                Repair hand joint            0054        19.83    $1,009.43      $472.33      $201.89
                            with graft.
   26542  T                Repair hand joint            0053        11.69      $595.07      $253.49      $119.01
                            with graft.
   26545  T                Reconstruct finger           0054        19.83    $1,009.43      $472.33      $201.89
                            joint.
   26546  T                Repair nonunion hand         0054        19.83    $1,009.43      $472.33      $201.89
   26548  T                Reconstruct finger           0054        19.83    $1,009.43      $472.33      $201.89
                            joint.
   26550  T                Construct thumb              0054        19.83    $1,009.43      $472.33      $201.89
                            replacement.
   26551  C                Great toe-hand        ...........  ...........  ...........  ...........  ...........
                            transfer.
   26553  C                Single transfer, toe- ...........  ...........  ...........  ...........  ...........
                            hand.
   26554  C                Double transfer, toe- ...........  ...........  ...........  ...........  ...........
                            hand.
   26555  T                Positional change of         0054        19.83    $1,009.43      $472.33      $201.89
                            finger.
   26556  C                Toe joint transfer..  ...........  ...........  ...........  ...........  ...........
   26560  T                Repair of web finger         0053        11.69      $595.07      $253.49      $119.01
   26561  T                Repair of web finger         0054        19.83    $1,009.43      $472.33      $201.89
   26562  T                Repair of web finger         0054        19.83    $1,009.43      $472.33      $201.89
   26565  T                Correct metacarpal           0054        19.83    $1,009.43      $472.33      $201.89
                            flaw.
   26567  T                Correct finger               0054        19.83    $1,009.43      $472.33      $201.89
                            deformity.
   26568  T                Lengthen metacarpal/         0054        19.83    $1,009.43      $472.33      $201.89
                            finger.
   26580  T                Repair hand                  0054        19.83    $1,009.43      $472.33      $201.89
                            deformity.
   26585  D                Repair finger                0054        19.83    $1,009.43      $472.33      $201.89
                            deformity.
   26587  T                Reconstruct extra            0053        11.69      $595.07      $253.49      $119.01
                            finger.
   26590  T                Repair finger                0054        19.83    $1,009.43      $472.33      $201.89
                            deformity.
   26591  T                Repair muscles of            0054        19.83    $1,009.43      $472.33      $201.89
                            hand.
   26593  T                Release muscles of           0053        11.69      $595.07      $253.49      $119.01
                            hand.
   26596  T                Excision                     0054        19.83    $1,009.43      $472.33      $201.89
                            constricting tissue.
   26597  D                Release of scar              0054        19.83    $1,009.43      $472.33      $201.89
                            contracture.
   26600  T                Treat metacarpal             0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   26605  T                Treat metacarpal             0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   26607  T                Treat metacarpal             0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   26608  T                Treat metacarpal             0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   26615  T                Treat metacarpal             0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   26641  T                Treat thumb                  0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   26645  T                Treat thumb fracture         0044         2.52      $128.28       $38.08       $25.66

[[Page 59954]]

 
   26650  T                Treat thumb fracture         0046        27.69    $1,409.53      $535.76      $281.91
   26665  T                Treat thumb fracture         0046        27.69    $1,409.53      $535.76      $281.91
   26670  T                Treat hand                   0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   26675  T                Treat hand                   0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   26676  T                Pin hand dislocation         0046        27.69    $1,409.53      $535.76      $281.91
   26685  T                Treat hand                   0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   26686  T                Treat hand                   0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   26700  T                Treat knuckle                0043         4.05      $206.16  ...........       $41.23
                            dislocation.
   26705  T                Treat knuckle                0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   26706  T                Pin knuckle                  0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   26715  T                Treat knuckle                0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   26720  T                Treat finger                 0043         4.05      $206.16  ...........       $41.23
                            fracture, each.
   26725  T                Treat finger                 0043         4.05      $206.16  ...........       $41.23
                            fracture, each.
   26727  T                Treat finger                 0046        27.69    $1,409.53      $535.76      $281.91
                            fracture, each.
   26735  T                Treat finger                 0046        27.69    $1,409.53      $535.76      $281.91
                            fracture, each.
   26740  T                Treat finger                 0043         4.05      $206.16  ...........       $41.23
                            fracture, each.
   26742  T                Treat finger                 0044         2.52      $128.28       $38.08       $25.66
                            fracture, each.
   26746  T                Treat finger                 0046        27.69    $1,409.53      $535.76      $281.91
                            fracture, each.
   26750  T                Treat finger                 0043         4.05      $206.16  ...........       $41.23
                            fracture, each.
   26755  T                Treat finger                 0043         4.05      $206.16  ...........       $41.23
                            fracture, each.
   26756  T                Pin finger fracture,         0046        27.69    $1,409.53      $535.76      $281.91
                            each.
   26765  T                Treat finger                 0046        27.69    $1,409.53      $535.76      $281.91
                            fracture, each.
   26770  T                Treat finger                 0043         4.05      $206.16  ...........       $41.23
                            dislocation.
   26775  T                Treat finger                 0045        11.67      $594.05      $277.12      $118.81
                            dislocation.
   26776  T                Pin finger                   0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   26785  T                Treat finger                 0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   26820  T                Thumb fusion with            0054        19.83    $1,009.43      $472.33      $201.89
                            graft.
   26841  T                Fusion of thumb.....         0054        19.83    $1,009.43      $472.33      $201.89
   26842  T                Thumb fusion with            0054        19.83    $1,009.43      $472.33      $201.89
                            graft.
   26843  T                Fusion of hand joint         0054        19.83    $1,009.43      $472.33      $201.89
   26844  T                Fusion/graft of hand         0054        19.83    $1,009.43      $472.33      $201.89
                            joint.
   26850  T                Fusion of knuckle...         0054        19.83    $1,009.43      $472.33      $201.89
   26852  T                Fusion of knuckle            0054        19.83    $1,009.43      $472.33      $201.89
                            with graft.
   26860  T                Fusion of finger             0054        19.83    $1,009.43      $472.33      $201.89
                            joint.
   26861  T                Fusion of finger             0054        19.83    $1,009.43      $472.33      $201.89
                            jnt, add-on.
   26862  T                Fusion/graft of              0054        19.83    $1,009.43      $472.33      $201.89
                            finger joint.
   26863  T                Fuse/graft added             0054        19.83    $1,009.43      $472.33      $201.89
                            joint.
   26910  T                Amputate metacarpal          0054        19.83    $1,009.43      $472.33      $201.89
                            bone.
   26951  T                Amputation of finger/        0053        11.69      $595.07      $253.49      $119.01
                            thumb.
   26952  T                Amputation of finger/        0053        11.69      $595.07      $253.49      $119.01
                            thumb.
   26989  T                Hand/finger surgery.         0043         4.05      $206.16  ...........       $41.23
   26990  T                Drainage of pelvis           0049        15.84      $806.32      $356.95      $161.26
                            lesion.
   26991  T                Drainage of pelvis           0049        15.84      $806.32      $356.95      $161.26
                            bursa.
   26992  C                Drainage of bone      ...........  ...........  ...........  ...........  ...........
                            lesion.
   27000  T                Incision of hip              0049        15.84      $806.32      $356.95      $161.26
                            tendon.
   27001  T                Incision of hip              0050        20.63    $1,050.15      $504.07      $210.03
                            tendon.
   27003  T                Incision of hip              0050        20.63    $1,050.15      $504.07      $210.03
                            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.
   27033  T                Exploration of hip           0051        28.56    $1,453.82      $675.24      $290.76
                            joint.
   27035  C                Denervation of hip    ...........  ...........  ...........  ...........  ...........
                            joint.
   27036  C                Excision of hip       ...........  ...........  ...........  ...........  ...........
                            joint/muscle.
   27040  T                Biopsy of soft               0021        11.82      $601.69      $236.51      $120.34
                            tissues.
   27041  T                Biopsy of soft               0022        13.91      $708.07      $292.94      $141.61
                            tissues.
   27047  T                Remove hip/pelvis            0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   27048  T                Remove hip/pelvis            0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   27049  T                Remove tumor, hip/           0022        13.91      $708.07      $292.94      $141.61
                            pelvis.
   27050  T                Biopsy of sacroiliac         0049        15.84      $806.32      $356.95      $161.26
                            joint.
   27052  T                Biopsy of hip joint.         0049        15.84      $806.32      $356.95      $161.26
   27054  C                Removal of hip joint  ...........  ...........  ...........  ...........  ...........
                            lining.
   27060  T                Removal of ischial           0049        15.84      $806.32      $356.95      $161.26
                            bursa.
   27062  T                Remove femur lesion/         0049        15.84      $806.32      $356.95      $161.26
                            bursa.
   27065  T                Removal of hip bone          0049        15.84      $806.32      $356.95      $161.26
                            lesion.
   27066  T                Removal of hip bone          0050        20.63    $1,050.15      $504.07      $210.03
                            lesion.
   27067  T                Remove/graft hip             0050        20.63    $1,050.15      $504.07      $210.03
                            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        20.63    $1,050.15      $504.07      $210.03

[[Page 59955]]

 
   27086  T                Remove hip foreign           0019         4.22      $214.81       $78.91       $42.96
                            body.
   27087  T                Remove hip foreign           0049        15.84      $806.32      $356.95      $161.26
                            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        20.63    $1,050.15      $504.07      $210.03
                            tendon.
   27098  T                Transfer tendon to           0050        20.63    $1,050.15      $504.07      $210.03
                            pelvis.
   27100  T                Transfer of                  0051        28.56    $1,453.82      $675.24      $290.76
                            abdominal muscle.
   27105  T                Transfer of spinal           0051        28.56    $1,453.82      $675.24      $290.76
                            muscle.
   27110  T                Transfer of                  0051        28.56    $1,453.82      $675.24      $290.76
                            iliopsoas muscle.
   27111  T                Transfer of                  0051        28.56    $1,453.82      $675.24      $290.76
                            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         2.52      $128.28       $38.08       $25.66
                            fracture.
   27194  T                Treat pelvic ring            0045        11.67      $594.05      $277.12      $118.81
                            fracture.
   27200  T                Treat tail bone              0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27202  T                Treat tail bone              0046        27.69    $1,409.53      $535.76      $281.91
                            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         2.52      $128.28       $38.08       $25.66
                            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).
   27230  T                Treat thigh fracture         0044         2.52      $128.28       $38.08       $25.66
   27232  C                Treat thigh fracture  ...........  ...........  ...........  ...........  ...........
   27235  C                Treat thigh fracture  ...........  ...........  ...........  ...........  ...........
   27236  C                Treat thigh fracture  ...........  ...........  ...........  ...........  ...........
   27238  T                Treat thigh fracture         0044         2.52      $128.28       $38.08       $25.66
   27240  C                Treat thigh fracture  ...........  ...........  ...........  ...........  ...........
   27244  C                Treat thigh fracture  ...........  ...........  ...........  ...........  ...........
   27245  C                Treat thigh fracture  ...........  ...........  ...........  ...........  ...........
   27246  T                Treat thigh fracture         0043         4.05      $206.16  ...........       $41.23
   27248  C                Treat thigh fracture  ...........  ...........  ...........  ...........  ...........
   27250  T                Treat hip                    0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   27252  T                Treat hip                    0045        11.67      $594.05      $277.12      $118.81
                            dislocation.
   27253  C                Treat hip             ...........  ...........  ...........  ...........  ...........
                            dislocation.
   27254  C                Treat hip             ...........  ...........  ...........  ...........  ...........
                            dislocation.
   27256  T                Treat hip                    0043         4.05      $206.16  ...........       $41.23
                            dislocation.
   27257  T                Treat hip                    0045        11.67      $594.05      $277.12      $118.81
                            dislocation.
   27258  C                Treat hip             ...........  ...........  ...........  ...........  ...........
                            dislocation.
   27259  C                Treat hip             ...........  ...........  ...........  ...........  ...........
                            dislocation.
   27265  T                Treat hip                    0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   27266  T                Treat hip                    0047        26.36    $1,341.83      $537.03      $268.37
                            dislocation.
   27275  T                Manipulation of hip          0045        11.67      $594.05      $277.12      $118.81
                            joint.
   27280  C                Fusion of sacroiliac  ...........  ...........  ...........  ...........  ...........
                            joint.
   27282  C                Fusion of pubic       ...........  ...........  ...........  ...........  ...........
                            bones.
   27284  C                Fusion of hip joint.  ...........  ...........  ...........  ...........  ...........

[[Page 59956]]

 
   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         4.05      $206.16  ...........       $41.23
                            surgery.
   27301  T                Drain thigh/knee             0008        10.93      $556.38      $113.67      $111.28
                            lesion.
   27303  C                Drainage of bone      ...........  ...........  ...........  ...........  ...........
                            lesion.
   27305  T                Incise thigh tendon          0049        15.84      $806.32      $356.95      $161.26
                            & fascia.
   27306  T                Incision of thigh            0049        15.84      $806.32      $356.95      $161.26
                            tendon.
   27307  T                Incision of thigh            0049        15.84      $806.32      $356.95      $161.26
                            tendons.
   27310  T                Exploration of knee          0050        20.63    $1,050.15      $504.07      $210.03
                            joint.
   27315  T                Partial removal,             0220        13.60      $692.29      $325.38      $138.46
                            thigh nerve.
   27320  T                Partial removal,             0220        13.60      $692.29      $325.38      $138.46
                            thigh nerve.
   27323  T                Biopsy, thigh soft           0021        11.82      $601.69      $236.51      $120.34
                            tissues.
   27324  T                Biopsy, thigh soft           0022        13.91      $708.07      $292.94      $141.61
                            tissues.
   27327  T                Removal of thigh             0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   27328  T                Removal of thigh             0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   27329  T                Remove tumor, thigh/         0022        13.91      $708.07      $292.94      $141.61
                            knee.
   27330  T                Biopsy, knee joint           0050        20.63    $1,050.15      $504.07      $210.03
                            lining.
   27331  T                Explore/treat knee           0050        20.63    $1,050.15      $504.07      $210.03
                            joint.
   27332  T                Removal of knee              0050        20.63    $1,050.15      $504.07      $210.03
                            cartilage.
   27333  T                Removal of knee              0050        20.63    $1,050.15      $504.07      $210.03
                            cartilage.
   27334  T                Remove knee joint            0050        20.63    $1,050.15      $504.07      $210.03
                            lining.
   27335  T                Remove knee joint            0050        20.63    $1,050.15      $504.07      $210.03
                            lining.
   27340  T                Removal of kneecap           0049        15.84      $806.32      $356.95      $161.26
                            bursa.
   27345  T                Removal of knee cyst         0049        15.84      $806.32      $356.95      $161.26
   27347  T                Remove knee cyst....         0049        15.84      $806.32      $356.95      $161.26
   27350  T                Removal of kneecap..         0050        20.63    $1,050.15      $504.07      $210.03
   27355  T                Remove femur lesion.         0050        20.63    $1,050.15      $504.07      $210.03
   27356  T                Remove femur lesion/         0050        20.63    $1,050.15      $504.07      $210.03
                            graft.
   27357  T                Remove femur lesion/         0050        20.63    $1,050.15      $504.07      $210.03
                            graft.
   27358  T                Remove femur lesion/         0050        20.63    $1,050.15      $504.07      $210.03
                            fixation.
   27360  T                Partial removal, leg         0050        20.63    $1,050.15      $504.07      $210.03
                            bone(s).
   27365  C                Extensive leg         ...........  ...........  ...........  ...........  ...........
                            surgery.
   27370  N                Injection for knee x- ...........  ...........  ...........  ...........  ...........
                            ray.
   27372  T                Removal of foreign           0022        13.91      $708.07      $292.94      $141.61
                            body.
   27380  T                Repair of kneecap            0049        15.84      $806.32      $356.95      $161.26
                            tendon.
   27381  T                Repair/graft kneecap         0049        15.84      $806.32      $356.95      $161.26
                            tendon.
   27385  T                Repair of thigh              0049        15.84      $806.32      $356.95      $161.26
                            muscle.
   27386  T                Repair/graft of              0049        15.84      $806.32      $356.95      $161.26
                            thigh muscle.
   27390  T                Incision of thigh            0049        15.84      $806.32      $356.95      $161.26
                            tendon.
   27391  T                Incision of thigh            0049        15.84      $806.32      $356.95      $161.26
                            tendons.
   27392  T                Incision of thigh            0049        15.84      $806.32      $356.95      $161.26
                            tendons.
   27393  T                Lengthening of thigh         0050        20.63    $1,050.15      $504.07      $210.03
                            tendon.
   27394  T                Lengthening of thigh         0050        20.63    $1,050.15      $504.07      $210.03
                            tendons.
   27395  T                Lengthening of thigh         0051        28.56    $1,453.82      $675.24      $290.76
                            tendons.
   27396  T                Transplant of thigh          0050        20.63    $1,050.15      $504.07      $210.03
                            tendon.
   27397  T                Transplants of thigh         0051        28.56    $1,453.82      $675.24      $290.76
                            tendons.
   27400  T                Revise thigh muscles/        0051        28.56    $1,453.82      $675.24      $290.76
                            tendons.
   27403  T                Repair of knee               0050        20.63    $1,050.15      $504.07      $210.03
                            cartilage.
   27405  T                Repair of knee               0051        28.56    $1,453.82      $675.24      $290.76
                            ligament.
   27407  T                Repair of knee               0051        28.56    $1,453.82      $675.24      $290.76
                            ligament.
   27409  T                Repair of knee               0051        28.56    $1,453.82      $675.24      $290.76
                            ligaments.
   27418  T                Repair degenerated           0051        28.56    $1,453.82      $675.24      $290.76
                            kneecap.
   27420  T                Revision of unstable         0051        28.56    $1,453.82      $675.24      $290.76
                            kneecap.
   27422  T                Revision of unstable         0051        28.56    $1,453.82      $675.24      $290.76
                            kneecap.
   27424  T                Revision/removal of          0051        28.56    $1,453.82      $675.24      $290.76
                            kneecap.
   27425  T                Lateral retinacular          0050        20.63    $1,050.15      $504.07      $210.03
                            release.
   27427  T                Reconstruction, knee         0052        35.94    $1,829.49      $930.91      $365.90
   27428  T                Reconstruction, knee         0052        35.94    $1,829.49      $930.91      $365.90
   27429  T                Reconstruction, knee         0052        35.94    $1,829.49      $930.91      $365.90
   27430  T                Revision of thigh            0051        28.56    $1,453.82      $675.24      $290.76
                            muscles.
   27435  T                Incision of knee             0051        28.56    $1,453.82      $675.24      $290.76
                            joint.
   27437  T                Revise kneecap......         0047        26.36    $1,341.83      $537.03      $268.37
   27438  T                Revise kneecap with          0048        43.19    $2,198.54      $725.94      $439.71
                            implant.
   27440  T                Revision of knee             0047        26.36    $1,341.83      $537.03      $268.37
                            joint.
   27441  T                Revision of knee             0047        26.36    $1,341.83      $537.03      $268.37
                            joint.
   27442  T                Revision of knee             0047        26.36    $1,341.83      $537.03      $268.37
                            joint.
   27443  T                Revision of knee             0047        26.36    $1,341.83      $537.03      $268.37
                            joint.
   27445  C                Revision of knee      ...........  ...........  ...........  ...........  ...........
                            joint.
   27446  T                Revision of knee             0047        26.36    $1,341.83      $537.03      $268.37
                            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.  ...........  ...........  ...........  ...........  ...........

[[Page 59957]]

 
   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        15.84      $806.32      $356.95      $161.26
                            thigh/knee.
   27497  T                Decompression of             0049        15.84      $806.32      $356.95      $161.26
                            thigh/knee.
   27498  T                Decompression of             0049        15.84      $806.32      $356.95      $161.26
                            thigh/knee.
   27499  T                Decompression of             0049        15.84      $806.32      $356.95      $161.26
                            thigh/knee.
   27500  T                Treatment of thigh           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27501  T                Treatment of thigh           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27502  T                Treatment of thigh           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27503  T                Treatment of thigh           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27506  C                Treatment of thigh    ...........  ...........  ...........  ...........  ...........
                            fracture.
   27507  C                Treatment of thigh    ...........  ...........  ...........  ...........  ...........
                            fracture.
   27508  T                Treatment of thigh           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27509  T                Treatment of thigh           0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   27510  T                Treatment of thigh           0044         2.52      $128.28       $38.08       $25.66
                            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         2.52      $128.28       $38.08       $25.66
                            growth plate.
   27517  T                Treat thigh fx               0043         4.05      $206.16  ...........       $41.23
                            growth plate.
   27519  C                Treat thigh fx        ...........  ...........  ...........  ...........  ...........
                            growth plate.
   27520  T                Treat kneecap                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27524  T                Treat kneecap                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   27530  T                Treat knee fracture.         0044         2.52      $128.28       $38.08       $25.66
   27532  T                Treat knee fracture.         0044         2.52      $128.28       $38.08       $25.66
   27535  C                Treat knee fracture.  ...........  ...........  ...........  ...........  ...........
   27536  C                Treat knee fracture.  ...........  ...........  ...........  ...........  ...........
   27538  T                Treat knee                   0043         4.05      $206.16  ...........       $41.23
                            fracture(s).
   27540  C                Treat knee fracture.  ...........  ...........  ...........  ...........  ...........
   27550  T                Treat knee                   0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   27552  T                Treat knee                   0045        11.67      $594.05      $277.12      $118.81
                            dislocation.
   27556  C                Treat knee            ...........  ...........  ...........  ...........  ...........
                            dislocation.
   27557  C                Treat knee            ...........  ...........  ...........  ...........  ...........
                            dislocation.
   27558  C                Treat knee            ...........  ...........  ...........  ...........  ...........
                            dislocation.
   27560  T                Treat kneecap                0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   27562  T                Treat kneecap                0045        11.67      $594.05      $277.12      $118.81
                            dislocation.
   27566  T                Treat kneecap                0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   27570  T                Fixation of knee             0045        11.67      $594.05      $277.12      $118.81
                            joint.
   27580  C                Fusion of knee......  ...........  ...........  ...........  ...........  ...........
   27590  C                Amputate leg at       ...........  ...........  ...........  ...........  ...........
                            thigh.
   27591  C                Amputate leg at       ...........  ...........  ...........  ...........  ...........
                            thigh.
   27592  C                Amputate leg at       ...........  ...........  ...........  ...........  ...........
                            thigh.
   27594  T                Amputation follow-up         0049        15.84      $806.32      $356.95      $161.26
                            surgery.
   27596  C                Amputation follow-up  ...........  ...........  ...........  ...........  ...........
                            surgery.
   27598  C                Amputate lower leg    ...........  ...........  ...........  ...........  ...........
                            at knee.
   27599  T                Leg surgery                  0044         2.52      $128.28       $38.08       $25.66
                            procedure.
   27600  T                Decompression of             0049        15.84      $806.32      $356.95      $161.26
                            lower leg.
   27601  T                Decompression of             0049        15.84      $806.32      $356.95      $161.26
                            lower leg.
   27602  T                Decompression of             0049        15.84      $806.32      $356.95      $161.26
                            lower leg.
   27603  T                Drain lower leg              0008        10.93      $556.38      $113.67      $111.28
                            lesion.
   27604  T                Drain lower leg              0049        15.84      $806.32      $356.95      $161.26
                            bursa.
   27605  T                Incision of achilles         0055        15.44      $785.96      $355.34      $157.19
                            tendon.
   27606  T                Incision of achilles         0049        15.84      $806.32      $356.95      $161.26
                            tendon.
   27607  T                Treat lower leg bone         0049        15.84      $806.32      $356.95      $161.26
                            lesion.
   27610  T                Explore/treat ankle          0050        20.63    $1,050.15      $504.07      $210.03
                            joint.
   27612  T                Exploration of ankle         0050        20.63    $1,050.15      $504.07      $210.03
                            joint.
   27613  T                Biopsy lower leg             0019         4.22      $214.81       $78.91       $42.96
                            soft tissue.
   27614  T                Biopsy lower leg             0022        13.91      $708.07      $292.94      $141.61
                            soft tissue.
   27615  T                Remove tumor, lower          0046        27.69    $1,409.53      $535.76      $281.91
                            leg.
   27618  T                Remove lower leg             0021        11.82      $601.69      $236.51      $120.34
                            lesion.
   27619  T                Remove lower leg             0022        13.91      $708.07      $292.94      $141.61
                            lesion.
   27620  T                Explore/treat ankle          0050        20.63    $1,050.15      $504.07      $210.03
                            joint.
   27625  T                Remove ankle joint           0050        20.63    $1,050.15      $504.07      $210.03
                            lining.

[[Page 59958]]

 
   27626  T                Remove ankle joint           0050        20.63    $1,050.15      $504.07      $210.03
                            lining.
   27630  T                Removal of tendon            0049        15.84      $806.32      $356.95      $161.26
                            lesion.
   27635  T                Remove lower leg             0050        20.63    $1,050.15      $504.07      $210.03
                            bone lesion.
   27637  T                Remove/graft leg             0050        20.63    $1,050.15      $504.07      $210.03
                            bone lesion.
   27638  T                Remove/graft leg             0050        20.63    $1,050.15      $504.07      $210.03
                            bone lesion.
   27640  T                Partial removal of           0051        28.56    $1,453.82      $675.24      $290.76
                            tibia.
   27641  T                Partial removal of           0050        20.63    $1,050.15      $504.07      $210.03
                            fibula.
   27645  C                Extensive lower leg   ...........  ...........  ...........  ...........  ...........
                            surgery.
   27646  C                Extensive lower leg   ...........  ...........  ...........  ...........  ...........
                            surgery.
   27647  T                Extensive ankle/heel         0051        28.56    $1,453.82      $675.24      $290.76
                            surgery.
   27648  N                Injection for ankle   ...........  ...........  ...........  ...........  ...........
                            x-ray.
   27650  T                Repair achilles              0051        28.56    $1,453.82      $675.24      $290.76
                            tendon.
   27652  T                Repair/graft                 0051        28.56    $1,453.82      $675.24      $290.76
                            achilles tendon.
   27654  T                Repair of achilles           0051        28.56    $1,453.82      $675.24      $290.76
                            tendon.
   27656  T                Repair leg fascia            0049        15.84      $806.32      $356.95      $161.26
                            defect.
   27658  T                Repair of leg                0049        15.84      $806.32      $356.95      $161.26
                            tendon, each.
   27659  T                Repair of leg                0049        15.84      $806.32      $356.95      $161.26
                            tendon, each.
   27664  T                Repair of leg                0049        15.84      $806.32      $356.95      $161.26
                            tendon, each.
   27665  T                Repair of leg                0050        20.63    $1,050.15      $504.07      $210.03
                            tendon, each.
   27675  T                Repair lower leg             0049        15.84      $806.32      $356.95      $161.26
                            tendons.
   27676  T                Repair lower leg             0050        20.63    $1,050.15      $504.07      $210.03
                            tendons.
   27680  T                Release of lower leg         0050        20.63    $1,050.15      $504.07      $210.03
                            tendon.
   27681  T                Release of lower leg         0050        20.63    $1,050.15      $504.07      $210.03
                            tendons.
   27685  T                Revision of lower            0050        20.63    $1,050.15      $504.07      $210.03
                            leg tendon.
   27686  T                Revise lower leg             0050        20.63    $1,050.15      $504.07      $210.03
                            tendons.
   27687  T                Revision of calf             0050        20.63    $1,050.15      $504.07      $210.03
                            tendon.
   27690  T                Revise lower leg             0051        28.56    $1,453.82      $675.24      $290.76
                            tendon.
   27691  T                Revise lower leg             0051        28.56    $1,453.82      $675.24      $290.76
                            tendon.
   27692  T                Revise additional            0051        28.56    $1,453.82      $675.24      $290.76
                            leg tendon.
   27695  T                Repair of ankle              0050        20.63    $1,050.15      $504.07      $210.03
                            ligament.
   27696  T                Repair of ankle              0050        20.63    $1,050.15      $504.07      $210.03
                            ligaments.
   27698  T                Repair of ankle              0050        20.63    $1,050.15      $504.07      $210.03
                            ligament.
   27700  T                Revision of ankle            0047        26.36    $1,341.83      $537.03      $268.37
                            joint.
   27702  C                Reconstruct ankle     ...........  ...........  ...........  ...........  ...........
                            joint.
   27703  C                Reconstruction,       ...........  ...........  ...........  ...........  ...........
                            ankle joint.
   27704  T                Removal of ankle             0049        15.84      $806.32      $356.95      $161.26
                            implant.
   27705  T                Incision of tibia...         0051        28.56    $1,453.82      $675.24      $290.76
   27707  T                Incision of fibula..         0049        15.84      $806.32      $356.95      $161.26
   27709  T                Incision of tibia &          0050        20.63    $1,050.15      $504.07      $210.03
                            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        20.63    $1,050.15      $504.07      $210.03
                            epiphysis.
   27732  T                Repair of fibula             0050        20.63    $1,050.15      $504.07      $210.03
                            epiphysis.
   27734  T                Repair lower leg             0050        20.63    $1,050.15      $504.07      $210.03
                            epiphyses.
   27740  T                Repair of leg                0050        20.63    $1,050.15      $504.07      $210.03
                            epiphyses.
   27742  T                Repair of leg                0051        28.56    $1,453.82      $675.24      $290.76
                            epiphyses.
   27745  T                Reinforce tibia.....         0051        28.56    $1,453.82      $675.24      $290.76
   27750  T                Treatment of tibia           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27752  T                Treatment of tibia           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27756  T                Treatment of tibia           0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   27758  T                Treatment of tibia           0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   27759  T                Treatment of tibia           0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   27760  T                Treatment of ankle           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27762  T                Treatment of ankle           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27766  T                Treatment of ankle           0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   27780  T                Treatment of fibula          0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27781  T                Treatment of fibula          0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27784  T                Treatment of fibula          0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   27786  T                Treatment of ankle           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27788  T                Treatment of ankle           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27792  T                Treatment of ankle           0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   27808  T                Treatment of ankle           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27810  T                Treatment of ankle           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27814  T                Treatment of ankle           0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   27816  T                Treatment of ankle           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27818  T                Treatment of ankle           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27822  T                Treatment of ankle           0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   27823  T                Treatment of ankle           0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   27824  T                Treat lower leg              0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   27825  T                Treat lower leg              0044         2.52      $128.28       $38.08       $25.66
                            fracture.

[[Page 59959]]

 
   27826  T                Treat lower leg              0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   27827  T                Treat lower leg              0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   27828  T                Treat lower leg              0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   27829  T                Treat lower leg              0046        27.69    $1,409.53      $535.76      $281.91
                            joint.
   27830  T                Treat lower leg              0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   27831  T                Treat lower leg              0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   27832  T                Treat lower leg              0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   27840  T                Treat ankle                  0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   27842  T                Treat ankle                  0045        11.67      $594.05      $277.12      $118.81
                            dislocation.
   27846  T                Treat ankle                  0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   27848  T                Treat ankle                  0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   27860  T                Fixation of ankle            0045        11.67      $594.05      $277.12      $118.81
                            joint.
   27870  T                Fusion of ankle              0051        28.56    $1,453.82      $675.24      $290.76
                            joint.
   27871  T                Fusion of                    0051        28.56    $1,453.82      $675.24      $290.76
                            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        15.84      $806.32      $356.95      $161.26
                            surgery.
   27886  C                Amputation follow-up  ...........  ...........  ...........  ...........  ...........
                            surgery.
   27888  C                Amputation of foot    ...........  ...........  ...........  ...........  ...........
                            at ankle.
   27889  T                Amputation of foot           0050        20.63    $1,050.15      $504.07      $210.03
                            at ankle.
   27892  T                Decompression of leg         0049        15.84      $806.32      $356.95      $161.26
   27893  T                Decompression of leg         0049        15.84      $806.32      $356.95      $161.26
   27894  T                Decompression of leg         0049        15.84      $806.32      $356.95      $161.26
   27899  T                Leg/ankle surgery            0044         2.52      $128.28       $38.08       $25.66
                            procedure.
   28001  T                Drainage of bursa of         0008        10.93      $556.38      $113.67      $111.28
                            foot.
   28002  T                Treatment of foot            0049        15.84      $806.32      $356.95      $161.26
                            infection.
   28003  T                Treatment of foot            0049        15.84      $806.32      $356.95      $161.26
                            infection.
   28005  T                Treat foot bone              0055        15.44      $785.96      $355.34      $157.19
                            lesion.
   28008  T                Incision of foot             0055        15.44      $785.96      $355.34      $157.19
                            fascia.
   28010  T                Incision of toe              0055        15.44      $785.96      $355.34      $157.19
                            tendon.
   28011  T                Incision of toe              0055        15.44      $785.96      $355.34      $157.19
                            tendons.
   28020  T                Exploration of foot          0055        15.44      $785.96      $355.34      $157.19
                            joint.
   28022  T                Exploration of foot          0055        15.44      $785.96      $355.34      $157.19
                            joint.
   28024  T                Exploration of toe           0055        15.44      $785.96      $355.34      $157.19
                            joint.
   28030  T                Removal of foot              0220        13.60      $692.29      $325.38      $138.46
                            nerve.
   28035  T                Decompression of             0220        13.60      $692.29      $325.38      $138.46
                            tibia nerve.
   28043  T                Excision of foot             0021        11.82      $601.69      $236.51      $120.34
                            lesion.
   28045  T                Excision of foot             0055        15.44      $785.96      $355.34      $157.19
                            lesion.
   28046  T                Resection of tumor,          0055        15.44      $785.96      $355.34      $157.19
                            foot.
   28050  T                Biopsy of foot joint         0055        15.44      $785.96      $355.34      $157.19
                            lining.
   28052  T                Biopsy of foot joint         0055        15.44      $785.96      $355.34      $157.19
                            lining.
   28054  T                Biopsy of toe joint          0055        15.44      $785.96      $355.34      $157.19
                            lining.
   28060  T                Partial removal,             0056        18.85      $959.54      $405.81      $191.91
                            foot fascia.
   28062  T                Removal of foot              0056        18.85      $959.54      $405.81      $191.91
                            fascia.
   28070  T                Removal of foot              0056        18.85      $959.54      $405.81      $191.91
                            joint lining.
   28072  T                Removal of foot              0056        18.85      $959.54      $405.81      $191.91
                            joint lining.
   28080  T                Removal of foot              0055        15.44      $785.96      $355.34      $157.19
                            lesion.
   28086  T                Excise foot tendon           0055        15.44      $785.96      $355.34      $157.19
                            sheath.
   28088  T                Excise foot tendon           0055        15.44      $785.96      $355.34      $157.19
                            sheath.
   28090  T                Removal of foot              0055        15.44      $785.96      $355.34      $157.19
                            lesion.
   28092  T                Removal of toe               0055        15.44      $785.96      $355.34      $157.19
                            lesions.
   28100  T                Removal of ankle/            0055        15.44      $785.96      $355.34      $157.19
                            heel lesion.
   28102  T                Remove/graft foot            0056        18.85      $959.54      $405.81      $191.91
                            lesion.
   28103  T                Remove/graft foot            0056        18.85      $959.54      $405.81      $191.91
                            lesion.
   28104  T                Removal of foot              0055        15.44      $785.96      $355.34      $157.19
                            lesion.
   28106  T                Remove/graft foot            0056        18.85      $959.54      $405.81      $191.91
                            lesion.
   28107  T                Remove/graft foot            0056        18.85      $959.54      $405.81      $191.91
                            lesion.
   28108  T                Removal of toe               0055        15.44      $785.96      $355.34      $157.19
                            lesions.
   28110  T                Part removal of              0056        18.85      $959.54      $405.81      $191.91
                            metatarsal.
   28111  T                Part removal of              0055        15.44      $785.96      $355.34      $157.19
                            metatarsal.
   28112  T                Part removal of              0055        15.44      $785.96      $355.34      $157.19
                            metatarsal.
   28113  T                Part removal of              0055        15.44      $785.96      $355.34      $157.19
                            metatarsal.
   28114  T                Removal of                   0055        15.44      $785.96      $355.34      $157.19
                            metatarsal heads.
   28116  T                Revision of foot....         0055        15.44      $785.96      $355.34      $157.19
   28118  T                Removal of heel bone         0055        15.44      $785.96      $355.34      $157.19
   28119  T                Removal of heel spur         0055        15.44      $785.96      $355.34      $157.19
   28120  T                Part removal of              0055        15.44      $785.96      $355.34      $157.19
                            ankle/heel.
   28122  T                Partial removal of           0055        15.44      $785.96      $355.34      $157.19
                            foot bone.
   28124  T                Partial removal of           0055        15.44      $785.96      $355.34      $157.19
                            toe.
   28126  T                Partial removal of           0055        15.44      $785.96      $355.34      $157.19
                            toe.
   28130  T                Removal of ankle             0055        15.44      $785.96      $355.34      $157.19
                            bone.
   28140  T                Removal of                   0055        15.44      $785.96      $355.34      $157.19
                            metatarsal.
   28150  T                Removal of toe......         0055        15.44      $785.96      $355.34      $157.19
   28153  T                Partial removal of           0055        15.44      $785.96      $355.34      $157.19
                            toe.

[[Page 59960]]

 
   28160  T                Partial removal of           0055        15.44      $785.96      $355.34      $157.19
                            toe.
   28171  T                Extensive foot               0055        15.44      $785.96      $355.34      $157.19
                            surgery.
   28173  T                Extensive foot               0055        15.44      $785.96      $355.34      $157.19
                            surgery.
   28175  T                Extensive foot               0055        15.44      $785.96      $355.34      $157.19
                            surgery.
   28190  T                Removal of foot              0019         4.22      $214.81       $78.91       $42.96
                            foreign body.
   28192  T                Removal of foot              0021        11.82      $601.69      $236.51      $120.34
                            foreign body.
   28193  T                Removal of foot              0021        11.82      $601.69      $236.51      $120.34
                            foreign body.
   28200  T                Repair of foot               0055        15.44      $785.96      $355.34      $157.19
                            tendon.
   28202  T                Repair/graft of foot         0056        18.85      $959.54      $405.81      $191.91
                            tendon.
   28208  T                Repair of foot               0055        15.44      $785.96      $355.34      $157.19
                            tendon.
   28210  T                Repair/graft of foot         0055        15.44      $785.96      $355.34      $157.19
                            tendon.
   28220  T                Release of foot              0055        15.44      $785.96      $355.34      $157.19
                            tendon.
   28222  T                Release of foot              0055        15.44      $785.96      $355.34      $157.19
                            tendons.
   28225  T                Release of foot              0055        15.44      $785.96      $355.34      $157.19
                            tendon.
   28226  T                Release of foot              0055        15.44      $785.96      $355.34      $157.19
                            tendons.
   28230  T                Incision of foot             0055        15.44      $785.96      $355.34      $157.19
                            tendon(s).
   28232  T                Incision of toe              0055        15.44      $785.96      $355.34      $157.19
                            tendon.
   28234  T                Incision of foot             0055        15.44      $785.96      $355.34      $157.19
                            tendon.
   28238  T                Revision of foot             0056        18.85      $959.54      $405.81      $191.91
                            tendon.
   28240  T                Release of big toe..         0055        15.44      $785.96      $355.34      $157.19
   28250  T                Revision of foot             0056        18.85      $959.54      $405.81      $191.91
                            fascia.
   28260  T                Release of midfoot           0056        18.85      $959.54      $405.81      $191.91
                            joint.
   28261  T                Revision of foot             0056        18.85      $959.54      $405.81      $191.91
                            tendon.
   28262  T                Revision of foot and         0056        18.85      $959.54      $405.81      $191.91
                            ankle.
   28264  T                Release of midfoot           0056        18.85      $959.54      $405.81      $191.91
                            joint.
   28270  T                Release of foot              0055        15.44      $785.96      $355.34      $157.19
                            contracture.
   28272  T                Release of toe               0055        15.44      $785.96      $355.34      $157.19
                            joint, each.
   28280  T                Fusion of toes......         0055        15.44      $785.96      $355.34      $157.19
   28285  T                Repair of hammertoe.         0055        15.44      $785.96      $355.34      $157.19
   28286  T                Repair of hammertoe.         0055        15.44      $785.96      $355.34      $157.19
   28288  T                Partial removal of           0056        18.85      $959.54      $405.81      $191.91
                            foot bone.
   28289  T                Repair hallux                0056        18.85      $959.54      $405.81      $191.91
                            rigidus.
   28290  T                Correction of bunion         0056        18.85      $959.54      $405.81      $191.91
   28292  T                Correction of bunion         0057        24.35    $1,239.51      $496.65      $247.90
   28293  T                Correction of bunion         0057        24.35    $1,239.51      $496.65      $247.90
   28294  T                Correction of bunion         0056        18.85      $959.54      $405.81      $191.91
   28296  T                Correction of bunion         0056        18.85      $959.54      $405.81      $191.91
   28297  T                Correction of bunion         0057        24.35    $1,239.51      $496.65      $247.90
   28298  T                Correction of bunion         0056        18.85      $959.54      $405.81      $191.91
   28299  T                Correction of bunion         0057        24.35    $1,239.51      $496.65      $247.90
   28300  T                Incision of heel             0056        18.85      $959.54      $405.81      $191.91
                            bone.
   28302  T                Incision of ankle            0056        18.85      $959.54      $405.81      $191.91
                            bone.
   28304  T                Incision of midfoot          0056        18.85      $959.54      $405.81      $191.91
                            bones.
   28305  T                Incise/graft midfoot         0056        18.85      $959.54      $405.81      $191.91
                            bones.
   28306  T                Incision of                  0056        18.85      $959.54      $405.81      $191.91
                            metatarsal.
   28307  T                Incision of                  0056        18.85      $959.54      $405.81      $191.91
                            metatarsal.
   28308  T                Incision of                  0056        18.85      $959.54      $405.81      $191.91
                            metatarsal.
   28309  T                Incision of                  0056        18.85      $959.54      $405.81      $191.91
                            metatarsals.
   28310  T                Revision of big toe.         0055        15.44      $785.96      $355.34      $157.19
   28312  T                Revision of toe.....         0055        15.44      $785.96      $355.34      $157.19
   28313  T                Repair deformity of          0055        15.44      $785.96      $355.34      $157.19
                            toe.
   28315  T                Removal of sesamoid          0055        15.44      $785.96      $355.34      $157.19
                            bone.
   28320  T                Repair of foot bones         0056        18.85      $959.54      $405.81      $191.91
   28322  T                Repair of                    0056        18.85      $959.54      $405.81      $191.91
                            metatarsals.
   28340  T                Resect enlarged toe          0055        15.44      $785.96      $355.34      $157.19
                            tissue.
   28341  T                Resect enlarged toe.         0055        15.44      $785.96      $355.34      $157.19
   28344  T                Repair extra toe(s).         0056        18.85      $959.54      $405.81      $191.91
   28345  T                Repair webbed toe(s)         0056        18.85      $959.54      $405.81      $191.91
   28360  T                Reconstruct cleft            0056        18.85      $959.54      $405.81      $191.91
                            foot.
   28400  T                Treatment of heel            0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   28405  T                Treatment of heel            0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   28406  T                Treatment of heel            0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   28415  T                Treat heel fracture.         0046        27.69    $1,409.53      $535.76      $281.91
   28420  T                Treat/graft heel             0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   28430  T                Treatment of ankle           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   28435  T                Treatment of ankle           0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   28436  T                Treatment of ankle           0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   28445  T                Treat ankle fracture         0046        27.69    $1,409.53      $535.76      $281.91
   28450  T                Treat midfoot                0044         2.52      $128.28       $38.08       $25.66
                            fracture, each.
   28455  T                Treat midfoot                0044         2.52      $128.28       $38.08       $25.66
                            fracture, each.
   28456  T                Treat midfoot                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   28465  T                Treat midfoot                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture, each.
   28470  T                Treat metatarsal             0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   28475  T                Treat metatarsal             0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   28476  T                Treat metatarsal             0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.

[[Page 59961]]

 
   28485  T                Treat metatarsal             0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   28490  T                Treat big toe                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   28495  T                Treat big toe                0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   28496  T                Treat big toe                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   28505  T                Treat big toe                0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   28510  T                Treatment of toe             0043         4.05      $206.16  ...........       $41.23
                            fracture.
   28515  T                Treatment of toe             0043         4.05      $206.16  ...........       $41.23
                            fracture.
   28525  T                Treat toe fracture..         0046        27.69    $1,409.53      $535.76      $281.91
   28530  T                Treat sesamoid bone          0044         2.52      $128.28       $38.08       $25.66
                            fracture.
   28531  T                Treat sesamoid bone          0046        27.69    $1,409.53      $535.76      $281.91
                            fracture.
   28540  T                Treat foot                   0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   28545  T                Treat foot                   0045        11.67      $594.05      $277.12      $118.81
                            dislocation.
   28546  T                Treat foot                   0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   28555  T                Repair foot                  0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   28570  T                Treat foot                   0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   28575  T                Treat foot                   0043         4.05      $206.16  ...........       $41.23
                            dislocation.
   28576  T                Treat foot                   0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   28585  T                Repair foot                  0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   28600  T                Treat foot                   0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   28605  T                Treat foot                   0043         4.05      $206.16  ...........       $41.23
                            dislocation.
   28606  T                Treat foot                   0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   28615  T                Repair foot                  0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   28630  T                Treat toe                    0044         2.52      $128.28       $38.08       $25.66
                            dislocation.
   28635  T                Treat toe                    0045        11.67      $594.05      $277.12      $118.81
                            dislocation.
   28636  T                Treat toe                    0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   28645  T                Repair toe                   0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   28660  T                Treat toe                    0043         4.05      $206.16  ...........       $41.23
                            dislocation.
   28665  T                Treat toe                    0045        11.67      $594.05      $277.12      $118.81
                            dislocation.
   28666  T                Treat toe                    0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   28675  T                Repair of toe                0046        27.69    $1,409.53      $535.76      $281.91
                            dislocation.
   28705  T                Fusion of foot bones         0056        18.85      $959.54      $405.81      $191.91
   28715  T                Fusion of foot bones         0056        18.85      $959.54      $405.81      $191.91
   28725  T                Fusion of foot bones         0056        18.85      $959.54      $405.81      $191.91
   28730  T                Fusion of foot bones         0056        18.85      $959.54      $405.81      $191.91
   28735  T                Fusion of foot bones         0056        18.85      $959.54      $405.81      $191.91
   28737  T                Revision of foot             0055        15.44      $785.96      $355.34      $157.19
                            bones.
   28740  T                Fusion of foot bones         0056        18.85      $959.54      $405.81      $191.91
   28750  T                Fusion of big toe            0055        15.44      $785.96      $355.34      $157.19
                            joint.
   28755  T                Fusion of big toe            0055        15.44      $785.96      $355.34      $157.19
                            joint.
   28760  T                Fusion of big toe            0056        18.85      $959.54      $405.81      $191.91
                            joint.
   28800  C                Amputation of         ...........  ...........  ...........  ...........  ...........
                            midfoot.
   28805  C                Amputation thru       ...........  ...........  ...........  ...........  ...........
                            metatarsal.
   28810  T                Amputation toe &             0055        15.44      $785.96      $355.34      $157.19
                            metatarsal.
   28820  T                Amputation of toe...         0055        15.44      $785.96      $355.34      $157.19
   28825  T                Partial amputation           0055        15.44      $785.96      $355.34      $157.19
                            of toe.
   28899  T                Foot/toes surgery            0043         4.05      $206.16  ...........       $41.23
                            procedure.
   29000  S                Application of body          0059         2.22      $113.01       $29.59       $22.60
                            cast.
   29010  S                Application of body          0059         2.22      $113.01       $29.59       $22.60
                            cast.
   29015  S                Application of body          0059         2.22      $113.01       $29.59       $22.60
                            cast.
   29020  S                Application of body          0059         2.22      $113.01       $29.59       $22.60
                            cast.
   29025  S                Application of body          0059         2.22      $113.01       $29.59       $22.60
                            cast.
   29035  S                Application of body          0058         1.28       $65.16       $19.27       $13.03
                            cast.
   29040  S                Application of body          0059         2.22      $113.01       $29.59       $22.60
                            cast.
   29044  S                Application of body          0059         2.22      $113.01       $29.59       $22.60
                            cast.
   29046  S                Application of body          0059         2.22      $113.01       $29.59       $22.60
                            cast.
   29049  S                Application of               0059         2.22      $113.01       $29.59       $22.60
                            figure eight.
   29055  S                Application of               0059         2.22      $113.01       $29.59       $22.60
                            shoulder cast.
   29058  S                Application of               0059         2.22      $113.01       $29.59       $22.60
                            shoulder cast.
   29065  S                Application of long          0059         2.22      $113.01       $29.59       $22.60
                            arm cast.
   29075  S                Application of               0058         1.28       $65.16       $19.27       $13.03
                            forearm cast.
   29085  S                Apply hand/wrist             0058         1.28       $65.16       $19.27       $13.03
                            cast.
  *29086  S                Apply finger cast...         0058         1.28       $65.16       $19.27       $13.03
   29105  S                Apply long arm               0058         1.28       $65.16       $19.27       $13.03
                            splint.
   29125  S                Apply forearm splint         0058         1.28       $65.16       $19.27       $13.03
   29126  S                Apply forearm splint         0058         1.28       $65.16       $19.27       $13.03
   29130  S                Application of               0058         1.28       $65.16       $19.27       $13.03
                            finger splint.
   29131  S                Application of               0058         1.28       $65.16       $19.27       $13.03
                            finger splint.
   29200  S                Strapping of chest..         0058         1.28       $65.16       $19.27       $13.03
   29220  S                Strapping of low             0059         2.22      $113.01       $29.59       $22.60
                            back.
   29240  S                Strapping of                 0058         1.28       $65.16       $19.27       $13.03
                            shoulder.
   29260  S                Strapping of elbow           0058         1.28       $65.16       $19.27       $13.03
                            or wrist.
   29280  S                Strapping of hand or         0058         1.28       $65.16       $19.27       $13.03
                            finger.
   29305  S                Application of hip           0058         1.28       $65.16       $19.27       $13.03
                            cast.
   29325  S                Application of hip           0059         2.22      $113.01       $29.59       $22.60
                            casts.
   29345  S                Application of long          0059         2.22      $113.01       $29.59       $22.60
                            leg cast.

[[Page 59962]]

 
   29355  S                Application of long          0059         2.22      $113.01       $29.59       $22.60
                            leg cast.
   29358  S                Apply long leg cast          0059         2.22      $113.01       $29.59       $22.60
                            brace.
   29365  S                Application of long          0059         2.22      $113.01       $29.59       $22.60
                            leg cast.
   29405  S                Apply short leg cast         0058         1.28       $65.16       $19.27       $13.03
   29425  S                Apply short leg cast         0059         2.22      $113.01       $29.59       $22.60
   29435  S                Apply short leg cast         0058         1.28       $65.16       $19.27       $13.03
   29440  S                Addition of walker           0059         2.22      $113.01       $29.59       $22.60
                            to cast.
   29445  S                Apply rigid leg cast         0059         2.22      $113.01       $29.59       $22.60
   29450  S                Application of leg           0059         2.22      $113.01       $29.59       $22.60
                            cast.
   29505  S                Application, long            0059         2.22      $113.01       $29.59       $22.60
                            leg splint.
   29515  S                Application lower            0059         2.22      $113.01       $29.59       $22.60
                            leg splint.
   29520  S                Strapping of hip....         0058         1.28       $65.16       $19.27       $13.03
   29530  S                Strapping of knee...         0058         1.28       $65.16       $19.27       $13.03
   29540  S                Strapping of ankle..         0058         1.28       $65.16       $19.27       $13.03
   29550  S                Strapping of toes...         0058         1.28       $65.16       $19.27       $13.03
   29580  S                Application of paste         0058         1.28       $65.16       $19.27       $13.03
                            boot.
   29590  S                Application of foot          0058         1.28       $65.16       $19.27       $13.03
                            splint.
   29700  S                Removal/revision of          0058         1.28       $65.16       $19.27       $13.03
                            cast.
   29705  S                Removal/revision of          0058         1.28       $65.16       $19.27       $13.03
                            cast.
   29710  S                Removal/revision of          0058         1.28       $65.16       $19.27       $13.03
                            cast.
   29715  S                Removal/revision of          0058         1.28       $65.16       $19.27       $13.03
                            cast.
   29720  S                Repair of body cast.         0058         1.28       $65.16       $19.27       $13.03
   29730  S                Windowing of cast...         0058         1.28       $65.16       $19.27       $13.03
   29740  S                Wedging of cast.....         0058         1.28       $65.16       $19.27       $13.03
   29750  S                Wedging of clubfoot          0058         1.28       $65.16       $19.27       $13.03
                            cast.
   29799  N                Casting/strapping     ...........  ...........  ...........  ...........  ...........
                            procedure.
   29800  T                Jaw arthroscopy/             0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29804  T                Jaw arthroscopy/             0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
  *29805  T                Shoulder                     0041        23.61    $1,201.84      $576.88      $240.37
                            arthroscopy, dx.
  *29806  T                Shoulder arthroscopy/        0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
  *29807  T                Shoulder arthroscopy/        0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29815  D                Shoulder arthroscopy         0041        23.61    $1,201.84      $576.88      $240.37
   29819  T                Shoulder arthroscopy/        0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29820  T                Shoulder arthroscopy/        0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29821  T                Shoulder arthroscopy/        0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29822  T                Shoulder arthroscopy/        0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29823  T                Shoulder arthroscopy/        0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
  *29824  T                Shoulder arthroscopy/        0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29825  T                Shoulder arthroscopy/        0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29826  T                Shoulder arthroscopy/        0042        35.76    $1,820.33      $804.74      $364.07
                            surgery.
   29830  T                Elbow arthroscopy...         0041        23.61    $1,201.84      $576.88      $240.37
   29834  T                Elbow arthroscopy/           0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29835  T                Elbow arthroscopy/           0042        35.76    $1,820.33      $804.74      $364.07
                            surgery.
   29836  T                Elbow arthroscopy/           0042        35.76    $1,820.33      $804.74      $364.07
                            surgery.
   29837  T                Elbow arthroscopy/           0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29838  T                Elbow arthroscopy/           0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29840  T                Wrist arthroscopy...         0041        23.61    $1,201.84      $576.88      $240.37
   29843  T                Wrist arthroscopy/           0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29844  T                Wrist arthroscopy/           0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29845  T                Wrist arthroscopy/           0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29846  T                Wrist arthroscopy/           0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29847  T                Wrist arthroscopy/           0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29848  T                Wrist endoscopy/             0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29850  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29851  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29855  T                Tibial arthroscopy/          0042        35.76    $1,820.33      $804.74      $364.07
                            surgery.
   29856  T                Tibial arthroscopy/          0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29860  T                Hip arthroscopy, dx.         0041        23.61    $1,201.84      $576.88      $240.37
   29861  T                Hip arthroscopy/             0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29862  T                Hip arthroscopy/             0042        35.76    $1,820.33      $804.74      $364.07
                            surgery.
   29863  T                Hip arthroscopy/             0042        35.76    $1,820.33      $804.74      $364.07
                            surgery.
   29870  T                Knee arthroscopy, dx         0041        23.61    $1,201.84      $576.88      $240.37
   29871  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            drainage.
   29874  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29875  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29876  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29877  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29879  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29880  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29881  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29882  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29883  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29884  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29885  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29886  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.

[[Page 59963]]

 
   29887  T                Knee arthroscopy/            0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29888  T                Knee arthroscopy/            0042        35.76    $1,820.33      $804.74      $364.07
                            surgery.
   29889  T                Knee arthroscopy/            0042        35.76    $1,820.33      $804.74      $364.07
                            surgery.
   29891  T                Ankle arthroscopy/           0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29892  T                Ankle arthroscopy/           0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29893  T                Scope, plantar               0055        15.44      $785.96      $355.34      $157.19
                            fasciotomy.
   29894  T                Ankle arthroscopy/           0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29895  T                Ankle arthroscopy/           0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29897  T                Ankle arthroscopy/           0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
   29898  T                Ankle arthroscopy/           0041        23.61    $1,201.84      $576.88      $240.37
                            surgery.
  *29900  T                Mcp joint                    0053        11.69      $595.07      $253.49      $119.01
                            arthroscopy, dx.
  *29901  T                Mcp joint                    0053        11.69      $595.07      $253.49      $119.01
                            arthroscopy, surg.
  *29902  T                Mcp joint                    0053        11.69      $595.07      $253.49      $119.01
                            arthroscopy, surg.
   29909  D                Arthroscopy of joint         0041        23.61    $1,201.84      $576.88      $240.37
  *29999  T                Arthroscopy of joint         0041        23.61    $1,201.84      $576.88      $240.37
   30000  T                Drainage of nose             0251         2.43      $123.70       $27.99       $24.74
                            lesion.
   30020  T                Drainage of nose             0251         2.43      $123.70       $27.99       $24.74
                            lesion.
   30100  T                Intranasal biopsy...         0252         5.95      $302.88      $114.24       $60.58
   30110  T                Removal of nose              0253        12.33      $627.65      $284.00      $125.53
                            polyp(s).
   30115  T                Removal of nose              0253        12.33      $627.65      $284.00      $125.53
                            polyp(s).
   30117  T                Removal of                   0253        12.33      $627.65      $284.00      $125.53
                            intranasal lesion.
   30118  T                Removal of                   0254        17.37      $884.20      $272.41      $176.84
                            intranasal lesion.
   30120  T                Revision of nose....         0253        12.33      $627.65      $284.00      $125.53
   30124  T                Removal of nose              0252         5.95      $302.88      $114.24       $60.58
                            lesion.
   30125  T                Removal of nose              0256        26.61    $1,354.56      $623.05      $270.91
                            lesion.
   30130  T                Removal of turbinate         0253        12.33      $627.65      $284.00      $125.53
                            bones.
   30140  T                Removal of turbinate         0254        17.37      $884.20      $272.41      $176.84
                            bones.
   30150  T                Partial removal of           0256        26.61    $1,354.56      $623.05      $270.91
                            nose.
   30160  T                Removal of nose.....         0256        26.61    $1,354.56      $623.05      $270.91
   30200  T                Injection treatment          0253        12.33      $627.65      $284.00      $125.53
                            of nose.
   30210  T                Nasal sinus therapy.         0252         5.95      $302.88      $114.24       $60.58
   30220  T                Insert nasal septal          0252         5.95      $302.88      $114.24       $60.58
                            button.
   30300  X                Remove nasal foreign         0340         0.84       $42.76       $10.69        $8.55
                            body.
   30310  T                Remove nasal foreign         0253        12.33      $627.65      $284.00      $125.53
                            body.
   30320  T                Remove nasal foreign         0253        12.33      $627.65      $284.00      $125.53
                            body.
   30400  T                Reconstruction of            0256        26.61    $1,354.56      $623.05      $270.91
                            nose.
   30410  T                Reconstruction of            0256        26.61    $1,354.56      $623.05      $270.91
                            nose.
   30420  T                Reconstruction of            0256        26.61    $1,354.56      $623.05      $270.91
                            nose.
   30430  T                Revision of nose....         0254        17.37      $884.20      $272.41      $176.84
   30435  T                Revision of nose....         0256        26.61    $1,354.56      $623.05      $270.91
   30450  T                Revision of nose....         0256        26.61    $1,354.56      $623.05      $270.91
   30460  T                Revision of nose....         0256        26.61    $1,354.56      $623.05      $270.91
   30462  T                Revision of nose....         0256        26.61    $1,354.56      $623.05      $270.91
   30465  T                Repair nasal                 0256        26.61    $1,354.56      $623.05      $270.91
                            stenosis.
   30520  T                Repair of nasal              0256        26.61    $1,354.56      $623.05      $270.91
                            septum.
   30540  T                Repair nasal defect.         0256        26.61    $1,354.56      $623.05      $270.91
   30545  T                Repair nasal defect.         0256        26.61    $1,354.56      $623.05      $270.91
   30560  T                Release of nasal             0251         2.43      $123.70       $27.99       $24.74
                            adhesions.
   30580  T                Repair upper jaw             0256        26.61    $1,354.56      $623.05      $270.91
                            fistula.
   30600  T                Repair mouth/nose            0256        26.61    $1,354.56      $623.05      $270.91
                            fistula.
   30620  T                Intranasal                   0256        26.61    $1,354.56      $623.05      $270.91
                            reconstruction.
   30630  T                Repair nasal septum          0254        17.37      $884.20      $272.41      $176.84
                            defect.
   30801  T                Cauterization, inner         0252         5.95      $302.88      $114.24       $60.58
                            nose.
   30802  T                Cauterization, inner         0253        12.33      $627.65      $284.00      $125.53
                            nose.
   30901  T                Control of nosebleed         0250         2.10      $106.90       $37.42       $21.38
   30903  T                Control of nosebleed         0250         2.10      $106.90       $37.42       $21.38
   30905  T                Control of nosebleed         0250         2.10      $106.90       $37.42       $21.38
   30906  T                Repeat control of            0250         2.10      $106.90       $37.42       $21.38
                            nosebleed.
   30915  T                Ligation, nasal              0091        20.34    $1,035.39      $348.23      $207.08
                            sinus artery.
   30920  T                Ligation, upper jaw          0092        19.91    $1,013.50      $503.71      $202.70
                            artery.
   30930  T                Therapy, fracture of         0253        12.33      $627.65      $284.00      $125.53
                            nose.
   30999  T                Nasal surgery                0251         2.43      $123.70       $27.99       $24.74
                            procedure.
   31000  T                Irrigation,                  0251         2.43      $123.70       $27.99       $24.74
                            maxillary sinus.
   31002  T                Irrigation, sphenoid         0252         5.95      $302.88      $114.24       $60.58
                            sinus.
   31020  T                Exploration,                 0254        17.37      $884.20      $272.41      $176.84
                            maxillary sinus.
   31030  T                Exploration,                 0256        26.61    $1,354.56      $623.05      $270.91
                            maxillary sinus.
   31032  T                Explore sinus,remove         0256        26.61    $1,354.56      $623.05      $270.91
                            polyps.
   31040  T                Exploration behind           0254        17.37      $884.20      $272.41      $176.84
                            upper jaw.
   31050  T                Exploration,                 0256        26.61    $1,354.56      $623.05      $270.91
                            sphenoid sinus.
   31051  T                Sphenoid sinus               0256        26.61    $1,354.56      $623.05      $270.91
                            surgery.
   31070  T                Exploration of               0254        17.37      $884.20      $272.41      $176.84
                            frontal sinus.
   31075  T                Exploration of               0256        26.61    $1,354.56      $623.05      $270.91
                            frontal sinus.
   31080  T                Removal of frontal           0256        26.61    $1,354.56      $623.05      $270.91
                            sinus.
   31081  T                Removal of frontal           0256        26.61    $1,354.56      $623.05      $270.91
                            sinus.
   31084  T                Removal of frontal           0256        26.61    $1,354.56      $623.05      $270.91
                            sinus.

[[Page 59964]]

 
   31085  T                Removal of frontal           0256        26.61    $1,354.56      $623.05      $270.91
                            sinus.
   31086  T                Removal of frontal           0256        26.61    $1,354.56      $623.05      $270.91
                            sinus.
   31087  T                Removal of frontal           0256        26.61    $1,354.56      $623.05      $270.91
                            sinus.
   31090  T                Exploration of               0256        26.61    $1,354.56      $623.05      $270.91
                            sinuses.
   31200  T                Removal of ethmoid           0256        26.61    $1,354.56      $623.05      $270.91
                            sinus.
   31201  T                Removal of ethmoid           0256        26.61    $1,354.56      $623.05      $270.91
                            sinus.
   31205  T                Removal of ethmoid           0256        26.61    $1,354.56      $623.05      $270.91
                            sinus.
   31225  C                Removal of upper jaw  ...........  ...........  ...........  ...........  ...........
   31230  C                Removal of upper jaw  ...........  ...........  ...........  ...........  ...........
   31231  T                Nasal endoscopy, dx.         0071         1.03       $52.43       $14.22       $10.49
   31233  T                Nasal/sinus                  0072         1.21       $61.59       $33.87       $12.32
                            endoscopy, dx.
   31235  T                Nasal/sinus                  0074        11.32      $576.23      $293.88      $115.25
                            endoscopy, dx.
   31237  T                Nasal/sinus                  0075        17.42      $886.75      $443.38      $177.35
                            endoscopy, surg.
   31238  T                Nasal/sinus                  0074        11.32      $576.23      $293.88      $115.25
                            endoscopy, surg.
   31239  T                Nasal/sinus                  0075        17.42      $886.75      $443.38      $177.35
                            endoscopy, surg.
   31240  T                Nasal/sinus                  0074        11.32      $576.23      $293.88      $115.25
                            endoscopy, surg.
   31254  T                Revision of ethmoid          0075        17.42      $886.75      $443.38      $177.35
                            sinus.
   31255  T                Removal of ethmoid           0075        17.42      $886.75      $443.38      $177.35
                            sinus.
   31256  T                Exploration                  0075        17.42      $886.75      $443.38      $177.35
                            maxillary sinus.
   31267  T                Endoscopy, maxillary         0075        17.42      $886.75      $443.38      $177.35
                            sinus.
   31276  T                Sinus endoscopy,             0075        17.42      $886.75      $443.38      $177.35
                            surgical.
   31287  T                Nasal/sinus                  0075        17.42      $886.75      $443.38      $177.35
                            endoscopy, surg.
   31288  T                Nasal/sinus                  0075        17.42      $886.75      $443.38      $177.35
                            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         5.95      $302.88      $114.24       $60.58
                            procedure.
   31300  T                Removal of larynx            0256        26.61    $1,354.56      $623.05      $270.91
                            lesion.
   31320  T                Diagnostic incision,         0256        26.61    $1,354.56      $623.05      $270.91
                            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        26.61    $1,354.56      $623.05      $270.91
   31420  T                Removal of                   0256        26.61    $1,354.56      $623.05      $270.91
                            epiglottis.
   31500  S                Insert emergency             0094         6.08      $309.50      $105.29       $61.90
                            airway.
   31502  T                Change of windpipe           0121         2.54      $129.30       $52.53       $25.86
                            airway.
   31505  T                Diagnostic                   0072         1.21       $61.59       $33.87       $12.32
                            laryngoscopy.
   31510  T                Laryngoscopy with            0074        11.32      $576.23      $293.88      $115.25
                            biopsy.
   31511  T                Remove foreign body,         0072         1.21       $61.59       $33.87       $12.32
                            larynx.
   31512  T                Removal of larynx            0074        11.32      $576.23      $293.88      $115.25
                            lesion.
   31513  T                Injection into vocal         0073         3.29      $167.47       $73.69       $33.49
                            cord.
   31515  T                Laryngoscopy for             0074        11.32      $576.23      $293.88      $115.25
                            aspiration.
   31520  T                Diagnostic                   0072         1.21       $61.59       $33.87       $12.32
                            laryngoscopy.
   31525  T                Diagnostic                   0074        11.32      $576.23      $293.88      $115.25
                            laryngoscopy.
   31526  T                Diagnostic                   0075        17.42      $886.75      $443.38      $177.35
                            laryngoscopy.
   31527  T                Laryngoscopy for             0075        17.42      $886.75      $443.38      $177.35
                            treatment.
   31528  T                Laryngoscopy and             0074        11.32      $576.23      $293.88      $115.25
                            dilatation.
   31529  T                Laryngoscopy and             0074        11.32      $576.23      $293.88      $115.25
                            dilatation.
   31530  T                Operative                    0075        17.42      $886.75      $443.38      $177.35
                            laryngoscopy.
   31531  T                Operative                    0075        17.42      $886.75      $443.38      $177.35
                            laryngoscopy.
   31535  T                Operative                    0075        17.42      $886.75      $443.38      $177.35
                            laryngoscopy.
   31536  T                Operative                    0075        17.42      $886.75      $443.38      $177.35
                            laryngoscopy.
   31540  T                Operative                    0075        17.42      $886.75      $443.38      $177.35
                            laryngoscopy.
   31541  T                Operative                    0075        17.42      $886.75      $443.38      $177.35
                            laryngoscopy.
   31560  T                Operative                    0075        17.42      $886.75      $443.38      $177.35
                            laryngoscopy.
   31561  T                Operative                    0075        17.42      $886.75      $443.38      $177.35
                            laryngoscopy.
   31570  T                Laryngoscopy with            0074        11.32      $576.23      $293.88      $115.25
                            injection.
   31571  T                Laryngoscopy with            0075        17.42      $886.75      $443.38      $177.35
                            injection.
   31575  T                Diagnostic                   0071         1.03       $52.43       $14.22       $10.49
                            laryngoscopy.
   31576  T                Laryngoscopy with            0075        17.42      $886.75      $443.38      $177.35
                            biopsy.
   31577  T                Remove foreign body,         0073         3.29      $167.47       $73.69       $33.49
                            larynx.
   31578  T                Removal of larynx            0075        17.42      $886.75      $443.38      $177.35
                            lesion.
   31579  T                Diagnostic                   0073         3.29      $167.47       $73.69       $33.49
                            laryngoscopy.
   31580  T                Revision of larynx..         0256        26.61    $1,354.56      $623.05      $270.91
   31582  C                Revision of larynx..  ...........  ...........  ...........  ...........  ...........
   31584  C                Treat larynx          ...........  ...........  ...........  ...........  ...........
                            fracture.

[[Page 59965]]

 
   31585  T                Treat larynx                 0253        12.33      $627.65      $284.00      $125.53
                            fracture.
   31586  T                Treat larynx                 0256        26.61    $1,354.56      $623.05      $270.91
                            fracture.
   31587  C                Revision of larynx..  ...........  ...........  ...........  ...........  ...........
   31588  T                Revision of larynx..         0256        26.61    $1,354.56      $623.05      $270.91
   31590  T                Reinnervate larynx..         0256        26.61    $1,354.56      $623.05      $270.91
   31595  T                Larynx nerve surgery         0256        26.61    $1,354.56      $623.05      $270.91
   31599  T                Larynx surgery               0254        17.37      $884.20      $272.41      $176.84
                            procedure.
   31600  T                Incision of windpipe         0254        17.37      $884.20      $272.41      $176.84
   31601  T                Incision of windpipe         0254        17.37      $884.20      $272.41      $176.84
   31603  T                Incision of windpipe         0252         5.95      $302.88      $114.24       $60.58
   31605  T                Incision of windpipe         0253        12.33      $627.65      $284.00      $125.53
   31610  T                Incision of windpipe         0254        17.37      $884.20      $272.41      $176.84
   31611  T                Surgery/speech               0254        17.37      $884.20      $272.41      $176.84
                            prosthesis.
   31612  T                Puncture/clear               0254        17.37      $884.20      $272.41      $176.84
                            windpipe.
   31613  T                Repair windpipe              0254        17.37      $884.20      $272.41      $176.84
                            opening.
   31614  T                Repair windpipe              0256        26.61    $1,354.56      $623.05      $270.91
                            opening.
   31615  T                Visualization of             0076         7.56      $384.83      $188.57       $76.97
                            windpipe.
   31622  T                Dx bronchoscope/wash         0076         7.56      $384.83      $188.57       $76.97
   31623  T                Dx bronchoscope/             0076         7.56      $384.83      $188.57       $76.97
                            brush.
   31624  T                Dx bronchoscope/             0076         7.56      $384.83      $188.57       $76.97
                            lavage.
   31625  T                Bronchoscopy with            0076         7.56      $384.83      $188.57       $76.97
                            biopsy.
   31628  T                Bronchoscopy with            0076         7.56      $384.83      $188.57       $76.97
                            biopsy.
   31629  T                Bronchoscopy with            0076         7.56      $384.83      $188.57       $76.97
                            biopsy.
   31630  T                Bronchoscopy with            0076         7.56      $384.83      $188.57       $76.97
                            repair.
   31631  T                Bronchoscopy with            0076         7.56      $384.83      $188.57       $76.97
                            dilation.
   31635  T                Remove foreign body,         0076         7.56      $384.83      $188.57       $76.97
                            airway.
   31640  T                Bronchoscopy &               0076         7.56      $384.83      $188.57       $76.97
                            remove lesion.
   31641  T                Bronchoscopy, treat          0076         7.56      $384.83      $188.57       $76.97
                            blockage.
   31643  T                Diag bronchoscope/           0076         7.56      $384.83      $188.57       $76.97
                            catheter.
   31645  T                Bronchoscopy, clear          0076         7.56      $384.83      $188.57       $76.97
                            airways.
   31646  T                Bronchoscopy,                0076         7.56      $384.83      $188.57       $76.97
                            reclear airway.
   31656  T                Bronchoscopy, inj            0076         7.56      $384.83      $188.57       $76.97
                            for xray.
   31700  T                Insertion of airway          0072         1.21       $61.59       $33.87       $12.32
                            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         3.29      $167.47       $73.69       $33.49
                            biopsy.
   31720  T                Clearance of airways         0072         1.21       $61.59       $33.87       $12.32
   31725  C                Clearance of airways  ...........  ...........  ...........  ...........  ...........
   31730  T                Intro, windpipe wire/        0073         3.29      $167.47       $73.69       $33.49
                            tube.
   31750  T                Repair of windpipe..         0256        26.61    $1,354.56      $623.05      $270.91
   31755  T                Repair of windpipe..         0256        26.61    $1,354.56      $623.05      $270.91
   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        12.33      $627.65      $284.00      $125.53
                            lesion.
   31825  T                Repair of windpipe           0254        17.37      $884.20      $272.41      $176.84
                            defect.
   31830  T                Revise windpipe scar         0254        17.37      $884.20      $272.41      $176.84
   31899  T                Airways surgical             0076         7.56      $384.83      $188.57       $76.97
                            procedure.
   32000  T                Drainage of chest...         0070         4.58      $233.14       $79.60       $46.63
   32002  T                Treatment of                 0070         4.58      $233.14       $79.60       $46.63
                            collapsed lung.
   32005  T                Treat lung lining            0070         4.58      $233.14       $79.60       $46.63
                            chemically.
   32020  T                Insertion of chest           0070         4.58      $233.14       $79.60       $46.63
                            tube.
   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..  ...........  ...........  ...........  ...........  ...........

[[Page 59966]]

 
   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         4.03      $205.14       $90.26       $41.03
                            lining.
   32402  C                Open biopsy chest     ...........  ...........  ...........  ...........  ...........
                            lining.
   32405  T                Biopsy, lung or              0685         9.16      $466.28      $205.16       $93.26
                            mediastinum.
   32420  T                Puncture/clear lung.         0070         4.58      $233.14       $79.60       $46.63
   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        23.57    $1,199.81  ...........      $239.96
                            diagnostic.
   32602  T                Thoracoscopy,                0069        23.57    $1,199.81  ...........      $239.96
                            diagnostic.
   32603  T                Thoracoscopy,                0069        23.57    $1,199.81  ...........      $239.96
                            diagnostic.
   32604  T                Thoracoscopy,                0069        23.57    $1,199.81  ...........      $239.96
                            diagnostic.
   32605  T                Thoracoscopy,                0069        23.57    $1,199.81  ...........      $239.96
                            diagnostic.
   32606  T                Thoracoscopy,                0069        23.57    $1,199.81  ...........      $239.96
                            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         4.58      $233.14       $79.60       $46.63
                            pneumothorax.
   32997  C                Total lung lavage...  ...........  ...........  ...........  ...........  ...........
   32999  T                Chest surgery                0070         4.58      $233.14       $79.60       $46.63
                            procedure.
   33010  T                Drainage of heart            0070         4.58      $233.14       $79.60       $46.63
                            sac.
   33011  T                Repeat drainage of           0070         4.58      $233.14       $79.60       $46.63
                            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.

[[Page 59967]]

 
   33206  T                Insertion of heart           0089       149.52    $7,611.17    $2,246.59    $1,522.23
                            pacemaker.
   33207  T                Insertion of heart           0089       149.52    $7,611.17    $2,246.59    $1,522.23
                            pacemaker.
   33208  T                Insertion of heart           0089       149.52    $7,611.17    $2,246.59    $1,522.23
                            pacemaker.
   33210  T                Insertion of heart           0106        36.64    $1,865.12      $503.07      $373.02
                            electrode.
   33211  T                Insertion of heart           0106        36.64    $1,865.12      $503.07      $373.02
                            electrode.
   33212  T                Insertion of pulse           0090       117.54    $5,983.26    $2,133.88    $1,196.65
                            generator.
   33213  T                Insertion of pulse           0090       117.54    $5,983.26    $2,133.88    $1,196.65
                            generator.
   33214  T                Upgrade of pacemaker         0089       149.52    $7,611.17    $2,246.59    $1,522.23
                            system.
   33216  T                Revise eltrd pacing-         0106        36.64    $1,865.12      $503.07      $373.02
                            defib.
   33217  T                Revise eltrd pacing-         0106        36.64    $1,865.12      $503.07      $373.02
                            defib.
   33218  T                Revise eltrd pacing-         0106        36.64    $1,865.12      $503.07      $373.02
                            defib.
   33220  T                Revise eltrd pacing-         0106        36.64    $1,865.12      $503.07      $373.02
                            defib.
   33222  T                Revise pocket,               0026        12.62      $642.41      $277.92      $128.48
                            pacemaker.
   33223  T                Revise pocket,               0026        12.62      $642.41      $277.92      $128.48
                            pacing-defib.
   33233  T                Removal of pacemaker         0105        14.76      $751.34      $368.16      $150.27
                            system.
   33234  T                Removal of pacemaker         0105        14.76      $751.34      $368.16      $150.27
                            system.
   33235  T                Removal pacemaker            0105        14.76      $751.34      $368.16      $150.27
                            electrode.
   33236  C                Remove electrode/     ...........  ...........  ...........  ...........  ...........
                            thoracotomy.
   33237  C                Remove electrode/     ...........  ...........  ...........  ...........  ...........
                            thoracotomy.
   33238  C                Remove electrode/     ...........  ...........  ...........  ...........  ...........
                            thoracotomy.
   33240  T                Insert pulse                 0107       379.46   $19,316.03    $4,224.27    $3,863.21
                            generator.
   33241  T                Remove pulse                 0105        14.76      $751.34      $368.16      $150.27
                            generator.
   33243  C                Remove eltrd/         ...........  ...........  ...........  ...........  ...........
                            thoracotomy.
   33244  T                Remove eltrd,                0105        14.76      $751.34      $368.16      $150.27
                            transven.
   33245  C                Insert epic eltrd     ...........  ...........  ...........  ...........  ...........
                            pace-defib.
   33246  C                Insert epic eltrd/    ...........  ...........  ...........  ...........  ...........
                            generator.
   33249  T                Eltrd/insert pace-           0108       573.46   $29,191.41  ...........    $5,838.28
                            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           0710  ...........      $400.00  ...........       $80.00
                            ht record.
   33284  T                Remove pat-active ht         0109         6.27      $319.17      $130.86       $63.83
                            record.
   33300  C                Repair of heart       ...........  ...........  ...........  ...........  ...........
                            wound.
   33305  C                Repair of heart       ...........  ...........  ...........  ...........  ...........
                            wound.
   33310  C                Exploratory heart     ...........  ...........  ...........  ...........  ...........
                            surgery.
   33315  C                Exploratory heart     ...........  ...........  ...........  ...........  ...........
                            surgery.
   33320  C                Repair major blood    ...........  ...........  ...........  ...........  ...........
                            vessel(s).
   33321  C                Repair major vessel.  ...........  ...........  ...........  ...........  ...........
   33322  C                Repair major blood    ...........  ...........  ...........  ...........  ...........
                            vessel(s).
   33330  C                Insert major vessel   ...........  ...........  ...........  ...........  ...........
                            graft.
   33332  C                Insert major vessel   ...........  ...........  ...........  ...........  ...........
                            graft.
   33335  C                Insert major vessel   ...........  ...........  ...........  ...........  ...........
                            graft.
   33400  C                Repair of aortic      ...........  ...........  ...........  ...........  ...........
                            valve.
   33401  C                Valvuloplasty, open.  ...........  ...........  ...........  ...........  ...........
   33403  C                Valvuloplasty, w/cp   ...........  ...........  ...........  ...........  ...........
                            bypass.
   33404  C                Prepare heart-aorta   ...........  ...........  ...........  ...........  ...........
                            conduit.
   33405  C                Replacement of        ...........  ...........  ...........  ...........  ...........
                            aortic valve.
   33406  C                Replacement of        ...........  ...........  ...........  ...........  ...........
                            aortic valve.
   33410  C                Replacement of        ...........  ...........  ...........  ...........  ...........
                            aortic valve.
   33411  C                Replacement of        ...........  ...........  ...........  ...........  ...........
                            aortic valve.
   33412  C                Replacement of        ...........  ...........  ...........  ...........  ...........
                            aortic valve.
   33413  C                Replacement of        ...........  ...........  ...........  ...........  ...........
                            aortic valve.
   33414  C                Repair of aortic      ...........  ...........  ...........  ...........  ...........
                            valve.
   33415  C                Revision,             ...........  ...........  ...........  ...........  ...........
                            subvalvular tissue.
   33416  C                Revise ventricle      ...........  ...........  ...........  ...........  ...........
                            muscle.
   33417  C                Repair of aortic      ...........  ...........  ...........  ...........  ...........
                            valve.
   33420  C                Revision of mitral    ...........  ...........  ...........  ...........  ...........
                            valve.
   33422  C                Revision of mitral    ...........  ...........  ...........  ...........  ...........
                            valve.
   33425  C                Repair of mitral      ...........  ...........  ...........  ...........  ...........
                            valve.
   33426  C                Repair of mitral      ...........  ...........  ...........  ...........  ...........
                            valve.
   33427  C                Repair of mitral      ...........  ...........  ...........  ...........  ...........
                            valve.
   33430  C                Replacement of        ...........  ...........  ...........  ...........  ...........
                            mitral valve.
   33460  C                Revision of           ...........  ...........  ...........  ...........  ...........
                            tricuspid valve.
   33463  C                Valvuloplasty,        ...........  ...........  ...........  ...........  ...........
                            tricuspid.
   33464  C                Valvuloplasty,        ...........  ...........  ...........  ...........  ...........
                            tricuspid.
   33465  C                Replace tricuspid     ...........  ...........  ...........  ...........  ...........
                            valve.
   33468  C                Revision of           ...........  ...........  ...........  ...........  ...........
                            tricuspid valve.
   33470  C                Revision of           ...........  ...........  ...........  ...........  ...........
                            pulmonary valve.
   33471  C                Valvotomy, pulmonary  ...........  ...........  ...........  ...........  ...........
                            valve.
   33472  C                Revision of           ...........  ...........  ...........  ...........  ...........
                            pulmonary valve.
   33474  C                Revision of           ...........  ...........  ...........  ...........  ...........
                            pulmonary valve.
   33475  C                Replacement,          ...........  ...........  ...........  ...........  ...........
                            pulmonary valve.
   33476  C                Revision of heart     ...........  ...........  ...........  ...........  ...........
                            chamber.
   33478  C                Revision of heart     ...........  ...........  ...........  ...........  ...........
                            chamber.

[[Page 59968]]

 
   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.
   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.

[[Page 59969]]

 
   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.
  *33967  C                Insert ia percut      ...........  ...........  ...........  ...........  ...........
                            device.
   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.
  *33979  C                Insert                ...........  ...........  ...........  ...........  ...........
                            intracorporeal
                            device.
  *33980  C                Remove                ...........  ...........  ...........  ...........  ...........
                            intracorporeal
                            device.
   33999  T                Cardiac surgery              0070         4.58      $233.14       $79.60       $46.63
                            procedure.
   34001  C                Removal of artery     ...........  ...........  ...........  ...........  ...........
                            clot.
   34051  C                Removal of artery     ...........  ...........  ...........  ...........  ...........
                            clot.
   34101  T                Removal of artery            0088        34.38    $1,750.08      $678.68      $350.02
                            clot.
   34111  T                Removal of arm               0088        34.38    $1,750.08      $678.68      $350.02
                            artery clot.
   34151  C                Removal of artery     ...........  ...........  ...........  ...........  ...........
                            clot.
   34201  T                Removal of artery            0088        34.38    $1,750.08      $678.68      $350.02
                            clot.
   34203  T                Removal of leg               0088        34.38    $1,750.08      $678.68      $350.02
                            artery clot.
   34401  C                Removal of vein clot  ...........  ...........  ...........  ...........  ...........
   34421  T                Removal of vein clot         0088        34.38    $1,750.08      $678.68      $350.02
   34451  C                Removal of vein clot  ...........  ...........  ...........  ...........  ...........
   34471  T                Removal of vein clot         0088        34.38    $1,750.08      $678.68      $350.02
   34490  T                Removal of vein clot         0088        34.38    $1,750.08      $678.68      $350.02
   34501  T                Repair valve,                0088        34.38    $1,750.08      $678.68      $350.02
                            femoral vein.
   34502  C                Reconstruct vena      ...........  ...........  ...........  ...........  ...........
                            cava.
   34510  T                Transposition of             0088        34.38    $1,750.08      $678.68      $350.02
                            vein valve.
   34520  T                Cross-over vein              0088        34.38    $1,750.08      $678.68      $350.02
                            graft.
   34530  T                Leg vein fusion.....         0088        34.38    $1,750.08      $678.68      $350.02
   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.

[[Page 59970]]

 
   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        14.16      $720.80      $277.34      $144.16
                            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        14.16      $720.80      $277.34      $144.16
                            lesion.
   35182  C                Repair blood vessel   ...........  ...........  ...........  ...........  ...........
                            lesion.
   35184  T                Repair blood vessel          0093        14.16      $720.80      $277.34      $144.16
                            lesion.
   35188  T                Repair blood vessel          0088        34.38    $1,750.08      $678.68      $350.02
                            lesion.
   35189  C                Repair blood vessel   ...........  ...........  ...........  ...........  ...........
                            lesion.
   35190  T                Repair blood vessel          0093        14.16      $720.80      $277.34      $144.16
                            lesion.
   35201  T                Repair blood vessel          0093        14.16      $720.80      $277.34      $144.16
                            lesion.
   35206  T                Repair blood vessel          0093        14.16      $720.80      $277.34      $144.16
                            lesion.
   35207  T                Repair blood vessel          0088        34.38    $1,750.08      $678.68      $350.02
                            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        14.16      $720.80      $277.34      $144.16
                            lesion.
   35231  T                Repair blood vessel          0093        14.16      $720.80      $277.34      $144.16
                            lesion.
   35236  T                Repair blood vessel          0093        14.16      $720.80      $277.34      $144.16
                            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        14.16      $720.80      $277.34      $144.16
                            lesion.
   35261  T                Repair blood vessel          0093        14.16      $720.80      $277.34      $144.16
                            lesion.
   35266  T                Repair blood vessel          0093        14.16      $720.80      $277.34      $144.16
                            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        14.16      $720.80      $277.34      $144.16
                            lesion.
   35301  C                Rechanneling of       ...........  ...........  ...........  ...........  ...........
                            artery.
   35311  C                Rechanneling of       ...........  ...........  ...........  ...........  ...........
                            artery.
   35321  T                Rechanneling of              0093        14.16      $720.80      $277.34      $144.16
                            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.
   35458  T                Repair arterial              0081        29.24    $1,488.43      $710.91      $297.69
                            blockage.
   35459  T                Repair arterial              0081        29.24    $1,488.43      $710.91      $297.69
                            blockage.

[[Page 59971]]

 
   35460  T                Repair venous                0081        29.24    $1,488.43      $710.91      $297.69
                            blockage.
   35470  T                Repair arterial              0081        29.24    $1,488.43      $710.91      $297.69
                            blockage.
   35471  T                Repair arterial              0081        29.24    $1,488.43      $710.91      $297.69
                            blockage.
   35472  T                Repair arterial              0081        29.24    $1,488.43      $710.91      $297.69
                            blockage.
   35473  T                Repair arterial              0081        29.24    $1,488.43      $710.91      $297.69
                            blockage.
   35474  T                Repair arterial              0081        29.24    $1,488.43      $710.91      $297.69
                            blockage.
   35475  T                Repair arterial              0081        29.24    $1,488.43      $710.91      $297.69
                            blockage.
   35476  T                Repair venous                0081        29.24    $1,488.43      $710.91      $297.69
                            blockage.
   35480  C                Atherectomy, open...  ...........  ...........  ...........  ...........  ...........
   35481  C                Atherectomy, open...  ...........  ...........  ...........  ...........  ...........
   35482  C                Atherectomy, open...  ...........  ...........  ...........  ...........  ...........
   35483  C                Atherectomy, open...  ...........  ...........  ...........  ...........  ...........
   35484  T                Atherectomy, open...         0081        29.24    $1,488.43      $710.91      $297.69
   35485  T                Atherectomy, open...         0081        29.24    $1,488.43      $710.91      $297.69
   35490  T                Atherectomy,                 0081        29.24    $1,488.43      $710.91      $297.69
                            percutaneous.
   35491  T                Atherectomy,                 0081        29.24    $1,488.43      $710.91      $297.69
                            percutaneous.
   35492  T                Atherectomy,                 0081        29.24    $1,488.43      $710.91      $297.69
                            percutaneous.
   35493  T                Atherectomy,                 0081        29.24    $1,488.43      $710.91      $297.69
                            percutaneous.
   35494  T                Atherectomy,                 0081        29.24    $1,488.43      $710.91      $297.69
                            percutaneous.
   35495  T                Atherectomy,                 0081        29.24    $1,488.43      $710.91      $297.69
                            percutaneous.
   35500  T                Harvest vein for             0081        29.24    $1,488.43      $710.91      $297.69
                            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.  ...........  ...........  ...........  ...........  ...........
   35645  C                Artery bypass graft.  ...........  ...........  ...........  ...........  ...........
   35646  C                Artery bypass graft.  ...........  ...........  ...........  ...........  ...........
  *35647  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.  ...........  ...........  ...........  ...........  ...........

[[Page 59972]]

 
   35681  C                Composite bypass      ...........  ...........  ...........  ...........  ...........
                            graft.
   35682  C                Composite bypass      ...........  ...........  ...........  ...........  ...........
                            graft.
   35683  C                Composite bypass      ...........  ...........  ...........  ...........  ...........
                            graft.
  *35685  T                Bypass graft patency/        0093        14.16      $720.80      $277.34      $144.16
                            patch.
  *35686  T                Bypass graft/av fist         0093        14.16      $720.80      $277.34      $144.16
                            patency.
   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        21.35    $1,086.80      $506.74      $217.36
                            artery/vein.
   35800  C                Explore neck vessels  ...........  ...........  ...........  ...........  ...........
   35820  C                Explore chest         ...........  ...........  ...........  ...........  ...........
                            vessels.
   35840  C                Explore abdominal     ...........  ...........  ...........  ...........  ...........
                            vessels.
   35860  T                Explore limb vessels         0093        14.16      $720.80      $277.34      $144.16
   35870  C                Repair vessel graft   ...........  ...........  ...........  ...........  ...........
                            defect.
   35875  T                Removal of clot in           0088        34.38    $1,750.08      $678.68      $350.02
                            graft.
   35876  T                Removal of clot in           0088        34.38    $1,750.08      $678.68      $350.02
                            graft.
   35879  T                Revise graft w/vein.         0088        34.38    $1,750.08      $678.68      $350.02
   35881  T                Revise graft w/vein.         0088        34.38    $1,750.08      $678.68      $350.02
   35901  C                Excision, graft,      ...........  ...........  ...........  ...........  ...........
                            neck.
   35903  T                Excision, graft,             0115        21.35    $1,086.80      $506.74      $217.36
                            extremity.
   35905  C                Excision, graft,      ...........  ...........  ...........  ...........  ...........
                            thorax.
   35907  C                Excision, graft,      ...........  ...........  ...........  ...........  ...........
                            abdomen.
   36000  N                Place needle in vein  ...........  ...........  ...........  ...........  ...........
  *36002  S                Pseudoaneurysm               0267         2.33      $118.61       $65.23       $23.72
                            injection trt.
   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        79.67    $4,055.52  ...........      $811.10
                            infusion pump.
   36261  T                Revision of infusion         0124        89.07    $4,534.02  ...........      $906.80
                            pump.
   36262  T                Removal of infusion          0109         6.27      $319.17      $130.86       $63.83
                            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         0.12        $6.11        $2.69        $1.22
                            vein.
   36425  T                Establish access to          0035         0.12        $6.11        $2.69        $1.22
                            vein.
   36430  S                Blood transfusion            0110         5.30      $269.79      $113.31       $53.96
                            service.
   36440  S                Blood transfusion            0110         5.30      $269.79      $113.31       $53.96
                            service.
   36450  S                Exchange transfusion         0110         5.30      $269.79      $113.31       $53.96
                            service.
   36455  S                Exchange transfusion         0110         5.30      $269.79      $113.31       $53.96
                            service.
   36460  S                Transfusion service,         0110         5.30      $269.79      $113.31       $53.96
                            fetal.
   36468  T                Injection(s), spider         0098         1.24       $63.12       $20.88       $12.62
                            veins.
   36469  T                Injection(s), spider         0098         1.24       $63.12       $20.88       $12.62
                            veins.
   36470  T                Injection therapy of         0098         1.24       $63.12       $20.88       $12.62
                            vein.
   36471  T                Injection therapy of         0098         1.24       $63.12       $20.88       $12.62
                            veins.
   36481  N                Insertion of          ...........  ...........  ...........  ...........  ...........
                            catheter, vein.
   36488  T                Insertion of                 0032        12.64      $643.43  ...........      $128.69
                            catheter, vein.
   36489  T                Insertion of                 0032        12.64      $643.43  ...........      $128.69
                            catheter, vein.
   36490  T                Insertion of                 0032        12.64      $643.43  ...........      $128.69
                            catheter, vein.
   36491  T                Insertion of                 0032        12.64      $643.43  ...........      $128.69
                            catheter, vein.

[[Page 59973]]

 
   36493  X                Repositioning of cvc         0187         4.22      $214.81  ...........       $42.96
   36500  N                Insertion of          ...........  ...........  ...........  ...........  ...........
                            catheter, vein.
   36510  C                Insertion of          ...........  ...........  ...........  ...........  ...........
                            catheter, vein.
   36520  S                Plasma and/or cell           0111        21.08    $1,073.06      $300.74      $214.61
                            exchange.
   36521  S                Apheresis w/ adsorp/         0112        36.25    $1,845.27      $608.94      $369.05
                            reinfuse.
   36522  S                Photopheresis.......         0112        36.25    $1,845.27      $608.94      $369.05
   36530  T                Insertion of                 0119        79.67    $4,055.52  ...........      $811.10
                            infusion pump.
   36531  T                Revision of infusion         0124        89.07    $4,534.02  ...........      $906.80
                            pump.
   36532  T                Removal of infusion          0109         6.27      $319.17      $130.86       $63.83
                            pump.
   36533  T                Insertion of access          0115        21.35    $1,086.80      $506.74      $217.36
                            device.
   36534  T                Revision of access           0109         6.27      $319.17      $130.86       $63.83
                            device.
   36535  T                Removal of access            0109         6.27      $319.17      $130.86       $63.83
                            device.
   36540  N                Collect blood venous  ...........  ...........  ...........  ...........  ...........
                            device.
   36550  T                Declot vascular              0972  ...........      $150.00  ...........       $30.00
                            device.
   36600  N                Withdrawal of         ...........  ...........  ...........  ...........  ...........
                            arterial blood.
   36620  N                Insertion catheter,   ...........  ...........  ...........  ...........  ...........
                            artery.
   36625  N                Insertion catheter,   ...........  ...........  ...........  ...........  ...........
                            artery.
   36640  T                Insertion catheter,          0032        12.64      $643.43  ...........      $128.69
                            artery.
   36660  C                Insertion catheter,   ...........  ...........  ...........  ...........  ...........
                            artery.
   36680  T                Insert needle, bone          0120         3.08      $156.78       $42.67       $31.36
                            cavity.
   36800  T                Insertion of cannula         0115        21.35    $1,086.80      $506.74      $217.36
   36810  T                Insertion of cannula         0115        21.35    $1,086.80      $506.74      $217.36
   36815  T                Insertion of cannula         0115        21.35    $1,086.80      $506.74      $217.36
   36819  T                Av fusion by basilic         0088        34.38    $1,750.08      $678.68      $350.02
                            vein.
  *36820  T                Av fusion/forearm            0088        34.38    $1,750.08      $678.68      $350.02
                            vein.
   36821  T                Av fusion direct any         0088        34.38    $1,750.08      $678.68      $350.02
                            site.
   36822  C                Insertion of          ...........  ...........  ...........  ...........  ...........
                            cannula(s).
   36823  C                Insertion of          ...........  ...........  ...........  ...........  ...........
                            cannula(s).
   36825  T                Artery-vein graft...         0088        34.38    $1,750.08      $678.68      $350.02
   36830  T                Artery-vein graft...         0088        34.38    $1,750.08      $678.68      $350.02
   36831  T                Av fistula excision,         0088        34.38    $1,750.08      $678.68      $350.02
                            open.
   36832  T                Av fistula revision,         0088        34.38    $1,750.08      $678.68      $350.02
                            open.
   36833  T                Av fistula revision.         0088        34.38    $1,750.08      $678.68      $350.02
   36834  T                Repair A-V aneurysm.         0088        34.38    $1,750.08      $678.68      $350.02
   36835  T                Artery to vein shunt         0115        21.35    $1,086.80      $506.74      $217.36
   36860  T                External cannula             0115        21.35    $1,086.80      $506.74      $217.36
                            declotting.
   36861  T                Cannula declotting..         0115        21.35    $1,086.80      $506.74      $217.36
   36870  T                Av fistula revision,         0093        14.16      $720.80      $277.34      $144.16
                            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         0685         9.16      $466.28      $205.16       $93.26
   37201  T                Transcatheter                0120         3.08      $156.78       $42.67       $31.36
                            therapy infuse.
   37202  T                Transcatheter                0120         3.08      $156.78       $42.67       $31.36
                            therapy infuse.
   37203  T                Transcatheter                0103        15.95      $811.92      $295.70      $162.38
                            retrieval.
   37204  T                Transcatheter                0103        15.95      $811.92      $295.70      $162.38
                            occlusion.
   37205  T                Transcatheter stent.         0229        67.22    $3,421.77      $996.86      $684.35
   37206  T                Transcatheter stent          0229        67.22    $3,421.77      $996.86      $684.35
                            add-on.
   37207  T                Transcatheter stent.         0229        67.22    $3,421.77      $996.86      $684.35
   37208  T                Transcatheter stent          0229        67.22    $3,421.77      $996.86      $684.35
                            add-on.
   37209  T                Exchange arterial            0103        15.95      $811.92      $295.70      $162.38
                            catheter.
   37250  T                Iv us first vessel           0103        15.95      $811.92      $295.70      $162.38
                            add-on.
   37251  T                Iv us each add               0103        15.95      $811.92      $295.70      $162.38
                            vessel add-on.
   37565  T                Ligation of neck             0093        14.16      $720.80      $277.34      $144.16
                            vein.
   37600  T                Ligation of neck             0093        14.16      $720.80      $277.34      $144.16
                            artery.
   37605  T                Ligation of neck             0091        20.34    $1,035.39      $348.23      $207.08
                            artery.
   37606  T                Ligation of neck             0091        20.34    $1,035.39      $348.23      $207.08
                            artery.
   37607  T                Ligation of a-v              0092        19.91    $1,013.50      $503.71      $202.70
                            fistula.
   37609  T                Temporal artery              0020         8.44      $429.63      $130.53       $85.93
                            procedure.
   37615  T                Ligation of neck             0091        20.34    $1,035.39      $348.23      $207.08
                            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        20.34    $1,035.39      $348.23      $207.08
                            vein.
   37650  T                Revision of major            0091        20.34    $1,035.39      $348.23      $207.08
                            vein.
   37660  C                Revision of major     ...........  ...........  ...........  ...........  ...........
                            vein.
   37700  T                Revise leg vein.....         0091        20.34    $1,035.39      $348.23      $207.08
   37720  T                Removal of leg vein.         0092        19.91    $1,013.50      $503.71      $202.70
   37730  T                Removal of leg veins         0092        19.91    $1,013.50      $503.71      $202.70
   37735  T                Removal of leg veins/        0092        19.91    $1,013.50      $503.71      $202.70
                            lesion.
   37760  T                Revision of leg              0091        20.34    $1,035.39      $348.23      $207.08
                            veins.
   37780  T                Revision of leg vein         0091        20.34    $1,035.39      $348.23      $207.08

[[Page 59974]]

 
   37785  T                Revise secondary             0091        20.34    $1,035.39      $348.23      $207.08
                            varicosity.
   37788  C                Revascularization,    ...........  ...........  ...........  ...........  ...........
                            penis.
   37790  T                Penile venous                0181        22.09    $1,124.47      $618.45      $224.89
                            occlusion.
   37799  T                Vascular surgery             0020         8.44      $429.63      $130.53       $85.93
                            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        37.63    $1,915.52      $996.07      $383.10
                            splenectomy.
   38129  T                Laparoscope proc,            0130        25.91    $1,318.92      $659.53      $263.78
                            spleen.
   38200  N                Injection for spleen  ...........  ...........  ...........  ...........  ...........
                            x-ray.
  *38220  T                Bone marrow                  0003         1.03       $52.43       $27.99       $10.49
                            aspiration.
  *38221  T                Bone marrow biopsy..         0003         1.03       $52.43       $27.99       $10.49
   38230  S                Bone marrow                  0123         8.56      $435.74  ...........       $87.15
                            collection.
   38231  S                Stem cell collection         0111        21.08    $1,073.06      $300.74      $214.61
   38240  S                Bone marrow/stem             0123         8.56      $435.74  ...........       $87.15
                            transplant.
   38241  S                Bone marrow/stem             0123         8.56      $435.74  ...........       $87.15
                            transplant.
   38300  T                Drainage, lymph node         0008        10.93      $556.38      $113.67      $111.28
                            lesion.
   38305  T                Drainage, lymph node         0008        10.93      $556.38      $113.67      $111.28
                            lesion.
   38308  T                Incision of lymph            0113        15.53      $790.54      $326.55      $158.11
                            channels.
   38380  C                Thoracic duct         ...........  ...........  ...........  ...........  ...........
                            procedure.
   38381  C                Thoracic duct         ...........  ...........  ...........  ...........  ...........
                            procedure.
   38382  C                Thoracic duct         ...........  ...........  ...........  ...........  ...........
                            procedure.
   38500  T                Biopsy/removal,              0113        15.53      $790.54      $326.55      $158.11
                            lymph nodes.
   38505  T                Needle biopsy, lymph         0005         4.03      $205.14       $90.26       $41.03
                            nodes.
   38510  T                Biopsy/removal,              0113        15.53      $790.54      $326.55      $158.11
                            lymph nodes.
   38520  T                Biopsy/removal,              0113        15.53      $790.54      $326.55      $158.11
                            lymph nodes.
   38525  T                Biopsy/removal,              0113        15.53      $790.54      $326.55      $158.11
                            lymph nodes.
   38530  T                Biopsy/removal,              0113        15.53      $790.54      $326.55      $158.11
                            lymph nodes.
   38542  T                Explore deep                 0114        29.28    $1,490.47      $493.78      $298.09
                            node(s), neck.
   38550  T                Removal, neck/armpit         0113        15.53      $790.54      $326.55      $158.11
                            lesion.
   38555  T                Removal, neck/armpit         0113        15.53      $790.54      $326.55      $158.11
                            lesion.
   38562  C                Removal, pelvic       ...........  ...........  ...........  ...........  ...........
                            lymph nodes.
   38564  C                Removal, abdomen      ...........  ...........  ...........  ...........  ...........
                            lymph nodes.
   38570  T                Laparoscopy, lymph           0131        37.63    $1,915.52      $996.07      $383.10
                            node biop.
   38571  T                Laparoscopy,                 0132        56.06    $2,853.68    $1,239.22      $570.74
                            lymphadenectomy.
   38572  T                Laparoscopy,                 0131        37.63    $1,915.52      $996.07      $383.10
                            lymphadenectomy.
   38589  T                Laparoscope proc,            0130        25.91    $1,318.92      $659.53      $263.78
                            lymphatic.
   38700  C                Removal of lymph      ...........  ...........  ...........  ...........  ...........
                            nodes, neck.
   38720  T                Removal of lymph             0113        15.53      $790.54      $326.55      $158.11
                            nodes, neck.
   38724  C                Removal of lymph      ...........  ...........  ...........  ...........  ...........
                            nodes, neck.
   38740  T                Remove armpit lymph          0114        29.28    $1,490.47      $493.78      $298.09
                            nodes.
   38745  T                Remove armpit lymph          0114        29.28    $1,490.47      $493.78      $298.09
                            nodes.
   38746  C                Remove thoracic       ...........  ...........  ...........  ...........  ...........
                            lymph nodes.
   38747  C                Remove abdominal      ...........  ...........  ...........  ...........  ...........
                            lymph nodes.
   38760  T                Remove groin lymph           0113        15.53      $790.54      $326.55      $158.11
                            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        10.93      $556.38      $113.67      $111.28
                            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        23.57    $1,199.81  ...........      $239.96
                            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.
   39599  C                Diaphragm surgery     ...........  ...........  ...........  ...........  ...........
                            procedure.
   40490  T                Biopsy of lip.......         0251         2.43      $123.70       $27.99       $24.74
   40500  T                Partial excision of          0253        12.33      $627.65      $284.00      $125.53
                            lip.
   40510  T                Partial excision of          0254        17.37      $884.20      $272.41      $176.84
                            lip.
   40520  T                Partial excision of          0253        12.33      $627.65      $284.00      $125.53
                            lip.

[[Page 59975]]

 
   40525  T                Reconstruct lip with         0254        17.37      $884.20      $272.41      $176.84
                            flap.
   40527  T                Reconstruct lip with         0254        17.37      $884.20      $272.41      $176.84
                            flap.
   40530  T                Partial removal of           0254        17.37      $884.20      $272.41      $176.84
                            lip.
   40650  T                Repair lip..........         0252         5.95      $302.88      $114.24       $60.58
   40652  T                Repair lip..........         0252         5.95      $302.88      $114.24       $60.58
   40654  T                Repair lip..........         0252         5.95      $302.88      $114.24       $60.58
   40700  T                Repair cleft lip/            0256        26.61    $1,354.56      $623.05      $270.91
                            nasal.
   40701  T                Repair cleft lip/            0256        26.61    $1,354.56      $623.05      $270.91
                            nasal.
   40702  T                Repair cleft lip/            0256        26.61    $1,354.56      $623.05      $270.91
                            nasal.
   40720  T                Repair cleft lip/            0256        26.61    $1,354.56      $623.05      $270.91
                            nasal.
   40761  T                Repair cleft lip/            0256        26.61    $1,354.56      $623.05      $270.91
                            nasal.
   40799  T                Lip surgery                  0253        12.33      $627.65      $284.00      $125.53
                            procedure.
   40800  T                Drainage of mouth            0251         2.43      $123.70       $27.99       $24.74
                            lesion.
   40801  T                Drainage of mouth            0252         5.95      $302.88      $114.24       $60.58
                            lesion.
   40804  X                Removal, foreign             0340         0.84       $42.76       $10.69        $8.55
                            body, mouth.
   40805  T                Removal, foreign             0252         5.95      $302.88      $114.24       $60.58
                            body, mouth.
   40806  T                Incision of lip fold         0251         2.43      $123.70       $27.99       $24.74
   40808  T                Biopsy of mouth              0251         2.43      $123.70       $27.99       $24.74
                            lesion.
   40810  T                Excision of mouth            0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   40812  T                Excise/repair mouth          0252         5.95      $302.88      $114.24       $60.58
                            lesion.
   40814  T                Excise/repair mouth          0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   40816  T                Excision of mouth            0254        17.37      $884.20      $272.41      $176.84
                            lesion.
   40818  T                Excise oral mucosa           0251         2.43      $123.70       $27.99       $24.74
                            for graft.
   40819  T                Excise lip or cheek          0252         5.95      $302.88      $114.24       $60.58
                            fold.
   40820  T                Treatment of mouth           0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   40830  T                Repair mouth                 0251         2.43      $123.70       $27.99       $24.74
                            laceration.
   40831  T                Repair mouth                 0252         5.95      $302.88      $114.24       $60.58
                            laceration.
   40840  T                Reconstruction of            0254        17.37      $884.20      $272.41      $176.84
                            mouth.
   40842  T                Reconstruction of            0254        17.37      $884.20      $272.41      $176.84
                            mouth.
   40843  T                Reconstruction of            0254        17.37      $884.20      $272.41      $176.84
                            mouth.
   40844  T                Reconstruction of            0256        26.61    $1,354.56      $623.05      $270.91
                            mouth.
   40845  T                Reconstruction of            0256        26.61    $1,354.56      $623.05      $270.91
                            mouth.
   40899  T                Mouth surgery                0252         5.95      $302.88      $114.24       $60.58
                            procedure.
   41000  T                Drainage of mouth            0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   41005  T                Drainage of mouth            0251         2.43      $123.70       $27.99       $24.74
                            lesion.
   41006  T                Drainage of mouth            0254        17.37      $884.20      $272.41      $176.84
                            lesion.
   41007  T                Drainage of mouth            0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   41008  T                Drainage of mouth            0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   41009  T                Drainage of mouth            0251         2.43      $123.70       $27.99       $24.74
                            lesion.
   41010  T                Incision of tongue           0253        12.33      $627.65      $284.00      $125.53
                            fold.
   41015  T                Drainage of mouth            0251         2.43      $123.70       $27.99       $24.74
                            lesion.
   41016  T                Drainage of mouth            0252         5.95      $302.88      $114.24       $60.58
                            lesion.
   41017  T                Drainage of mouth            0252         5.95      $302.88      $114.24       $60.58
                            lesion.
   41018  T                Drainage of mouth            0252         5.95      $302.88      $114.24       $60.58
                            lesion.
   41100  T                Biopsy of tongue....         0252         5.95      $302.88      $114.24       $60.58
   41105  T                Biopsy of tongue....         0253        12.33      $627.65      $284.00      $125.53
   41108  T                Biopsy of floor of           0252         5.95      $302.88      $114.24       $60.58
                            mouth.
   41110  T                Excision of tongue           0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   41112  T                Excision of tongue           0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   41113  T                Excision of tongue           0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   41114  T                Excision of tongue           0254        17.37      $884.20      $272.41      $176.84
                            lesion.
   41115  T                Excision of tongue           0252         5.95      $302.88      $114.24       $60.58
                            fold.
   41116  T                Excision of mouth            0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   41120  T                Partial removal of           0256        26.61    $1,354.56      $623.05      $270.91
                            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         2.43      $123.70       $27.99       $24.74
                            laceration.
   41251  T                Repair tongue                0252         5.95      $302.88      $114.24       $60.58
                            laceration.
   41252  T                Repair tongue                0252         5.95      $302.88      $114.24       $60.58
                            laceration.
   41500  T                Fixation of tongue..         0254        17.37      $884.20      $272.41      $176.84
   41510  T                Tongue to lip                0253        12.33      $627.65      $284.00      $125.53
                            surgery.
   41520  T                Reconstruction,              0252         5.95      $302.88      $114.24       $60.58
                            tongue fold.
   41599  T                Tongue and mouth             0251         2.43      $123.70       $27.99       $24.74
                            surgery.
   41800  T                Drainage of gum              0251         2.43      $123.70       $27.99       $24.74
                            lesion.
   41805  T                Removal foreign              0254        17.37      $884.20      $272.41      $176.84
                            body, gum.
   41806  T                Removal foreign              0253        12.33      $627.65      $284.00      $125.53
                            body, jawbone.
   41820  T                Excision, gum, each          0252         5.95      $302.88      $114.24       $60.58
                            quadrant.
   41821  T                Excision of gum flap         0252         5.95      $302.88      $114.24       $60.58
   41822  T                Excision of gum              0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   41823  T                Excision of gum              0254        17.37      $884.20      $272.41      $176.84
                            lesion.

[[Page 59976]]

 
   41825  T                Excision of gum              0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   41826  T                Excision of gum              0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   41827  T                Excision of gum              0254        17.37      $884.20      $272.41      $176.84
                            lesion.
   41828  T                Excision of gum              0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   41830  T                Removal of gum               0253        12.33      $627.65      $284.00      $125.53
                            tissue.
   41850  T                Treatment of gum             0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   41870  T                Gum graft...........         0254        17.37      $884.20      $272.41      $176.84
   41872  T                Repair gum..........         0253        12.33      $627.65      $284.00      $125.53
   41874  T                Repair tooth socket.         0254        17.37      $884.20      $272.41      $176.84
   41899  T                Dental surgery               0253        12.33      $627.65      $284.00      $125.53
                            procedure.
   42000  T                Drainage mouth roof          0251         2.43      $123.70       $27.99       $24.74
                            lesion.
   42100  T                Biopsy roof of mouth         0252         5.95      $302.88      $114.24       $60.58
   42104  T                Excision lesion,             0253        12.33      $627.65      $284.00      $125.53
                            mouth roof.
   42106  T                Excision lesion,             0253        12.33      $627.65      $284.00      $125.53
                            mouth roof.
   42107  T                Excision lesion,             0254        17.37      $884.20      $272.41      $176.84
                            mouth roof.
   42120  T                Remove palate/lesion         0256        26.61    $1,354.56      $623.05      $270.91
   42140  T                Excision of uvula...         0252         5.95      $302.88      $114.24       $60.58
   42145  T                Repair palate,               0254        17.37      $884.20      $272.41      $176.84
                            pharynx/uvula.
   42160  T                Treatment mouth roof         0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   42180  T                Repair palate.......         0251         2.43      $123.70       $27.99       $24.74
   42182  T                Repair palate.......         0256        26.61    $1,354.56      $623.05      $270.91
   42200  T                Reconstruct cleft            0256        26.61    $1,354.56      $623.05      $270.91
                            palate.
   42205  T                Reconstruct cleft            0256        26.61    $1,354.56      $623.05      $270.91
                            palate.
   42210  T                Reconstruct cleft            0256        26.61    $1,354.56      $623.05      $270.91
                            palate.
   42215  T                Reconstruct cleft            0256        26.61    $1,354.56      $623.05      $270.91
                            palate.
   42220  T                Reconstruct cleft            0256        26.61    $1,354.56      $623.05      $270.91
                            palate.
   42225  T                Reconstruct cleft            0256        26.61    $1,354.56      $623.05      $270.91
                            palate.
   42226  T                Lengthening of               0256        26.61    $1,354.56      $623.05      $270.91
                            palate.
   42227  T                Lengthening of               0256        26.61    $1,354.56      $623.05      $270.91
                            palate.
   42235  T                Repair palate.......         0253        12.33      $627.65      $284.00      $125.53
   42260  T                Repair nose to lip           0254        17.37      $884.20      $272.41      $176.84
                            fistula.
   42280  T                Preparation, palate          0251         2.43      $123.70       $27.99       $24.74
                            mold.
   42281  T                Insertion, palate            0253        12.33      $627.65      $284.00      $125.53
                            prosthesis.
   42299  T                Palate/uvula surgery         0251         2.43      $123.70       $27.99       $24.74
   42300  T                Drainage of salivary         0253        12.33      $627.65      $284.00      $125.53
                            gland.
   42305  T                Drainage of salivary         0253        12.33      $627.65      $284.00      $125.53
                            gland.
   42310  T                Drainage of salivary         0251         2.43      $123.70       $27.99       $24.74
                            gland.
   42320  T                Drainage of salivary         0251         2.43      $123.70       $27.99       $24.74
                            gland.
   42325  T                Create salivary cyst         0251         2.43      $123.70       $27.99       $24.74
                            drain.
   42326  T                Create salivary cyst         0252         5.95      $302.88      $114.24       $60.58
                            drain.
   42330  T                Removal of salivary          0252         5.95      $302.88      $114.24       $60.58
                            stone.
   42335  T                Removal of salivary          0253        12.33      $627.65      $284.00      $125.53
                            stone.
   42340  T                Removal of salivary          0253        12.33      $627.65      $284.00      $125.53
                            stone.
   42400  T                Biopsy of salivary           0004         2.47      $125.73       $32.57       $25.15
                            gland.
   42405  T                Biopsy of salivary           0253        12.33      $627.65      $284.00      $125.53
                            gland.
   42408  T                Excision of salivary         0253        12.33      $627.65      $284.00      $125.53
                            cyst.
   42409  T                Drainage of salivary         0253        12.33      $627.65      $284.00      $125.53
                            cyst.
   42410  T                Excise parotid gland/        0256        26.61    $1,354.56      $623.05      $270.91
                            lesion.
   42415  T                Excise parotid gland/        0256        26.61    $1,354.56      $623.05      $270.91
                            lesion.
   42420  T                Excise parotid gland/        0256        26.61    $1,354.56      $623.05      $270.91
                            lesion.
   42425  T                Excise parotid gland/        0256        26.61    $1,354.56      $623.05      $270.91
                            lesion.
   42426  C                Excise parotid gland/ ...........  ...........  ...........  ...........  ...........
                            lesion.
   42440  T                Excise submaxillary          0256        26.61    $1,354.56      $623.05      $270.91
                            gland.
   42450  T                Excise sublingual            0254        17.37      $884.20      $272.41      $176.84
                            gland.
   42500  T                Repair salivary duct         0254        17.37      $884.20      $272.41      $176.84
   42505  T                Repair salivary duct         0256        26.61    $1,354.56      $623.05      $270.91
   42507  T                Parotid duct                 0256        26.61    $1,354.56      $623.05      $270.91
                            diversion.
   42508  T                Parotid duct                 0256        26.61    $1,354.56      $623.05      $270.91
                            diversion.
   42509  T                Parotid duct                 0256        26.61    $1,354.56      $623.05      $270.91
                            diversion.
   42510  T                Parotid duct                 0256        26.61    $1,354.56      $623.05      $270.91
                            diversion.
   42550  N                Injection for         ...........  ...........  ...........  ...........  ...........
                            salivary x-ray.
   42600  T                Closure of salivary          0253        12.33      $627.65      $284.00      $125.53
                            fistula.
   42650  T                Dilation of salivary         0252         5.95      $302.88      $114.24       $60.58
                            duct.
   42660  T                Dilation of salivary         0252         5.95      $302.88      $114.24       $60.58
                            duct.
   42665  T                Ligation of salivary         0254        17.37      $884.20      $272.41      $176.84
                            duct.
   42699  T                Salivary surgery             0253        12.33      $627.65      $284.00      $125.53
                            procedure.
   42700  T                Drainage of tonsil           0251         2.43      $123.70       $27.99       $24.74
                            abscess.
   42720  T                Drainage of throat           0253        12.33      $627.65      $284.00      $125.53
                            abscess.
   42725  T                Drainage of throat           0256        26.61    $1,354.56      $623.05      $270.91
                            abscess.
   42800  T                Biopsy of throat....         0252         5.95      $302.88      $114.24       $60.58
   42802  T                Biopsy of throat....         0253        12.33      $627.65      $284.00      $125.53
   42804  T                Biopsy of upper nose/        0253        12.33      $627.65      $284.00      $125.53
                            throat.
   42806  T                Biopsy of upper nose/        0254        17.37      $884.20      $272.41      $176.84
                            throat.
   42808  T                Excise pharynx               0253        12.33      $627.65      $284.00      $125.53
                            lesion.
   42809  X                Remove pharynx               0340         0.84       $42.76       $10.69        $8.55
                            foreign body.

[[Page 59977]]

 
   42810  T                Excision of neck             0254        17.37      $884.20      $272.41      $176.84
                            cyst.
   42815  T                Excision of neck             0256        26.61    $1,354.56      $623.05      $270.91
                            cyst.
   42820  T                Remove tonsils and           0258        17.43      $887.26      $434.76      $177.45
                            adenoids.
   42821  T                Remove tonsils and           0258        17.43      $887.26      $434.76      $177.45
                            adenoids.
   42825  T                Removal of tonsils..         0258        17.43      $887.26      $434.76      $177.45
   42826  T                Removal of tonsils..         0258        17.43      $887.26      $434.76      $177.45
   42830  T                Removal of adenoids.         0258        17.43      $887.26      $434.76      $177.45
   42831  T                Removal of adenoids.         0258        17.43      $887.26      $434.76      $177.45
   42835  T                Removal of adenoids.         0258        17.43      $887.26      $434.76      $177.45
   42836  T                Removal of adenoids.         0258        17.43      $887.26      $434.76      $177.45
   42842  C                Extensive surgery of  ...........  ...........  ...........  ...........  ...........
                            throat.
   42844  T                Extensive surgery of         0256        26.61    $1,354.56      $623.05      $270.91
                            throat.
   42845  C                Extensive surgery of  ...........  ...........  ...........  ...........  ...........
                            throat.
   42860  T                Excision of tonsil           0258        17.43      $887.26      $434.76      $177.45
                            tags.
   42870  T                Excision of lingual          0258        17.43      $887.26      $434.76      $177.45
                            tonsil.
   42890  T                Partial removal of           0256        26.61    $1,354.56      $623.05      $270.91
                            pharynx.
   42892  T                Revision of                  0256        26.61    $1,354.56      $623.05      $270.91
                            pharyngeal walls.
   42894  C                Revision of           ...........  ...........  ...........  ...........  ...........
                            pharyngeal walls.
   42900  T                Repair throat wound.         0252         5.95      $302.88      $114.24       $60.58
   42950  T                Reconstruction of            0254        17.37      $884.20      $272.41      $176.84
                            throat.
   42953  C                Repair throat,        ...........  ...........  ...........  ...........  ...........
                            esophagus.
   42955  T                Surgical opening of          0254        17.37      $884.20      $272.41      $176.84
                            throat.
   42960  T                Control throat               0250         2.10      $106.90       $37.42       $21.38
                            bleeding.
   42961  C                Control throat        ...........  ...........  ...........  ...........  ...........
                            bleeding.
   42962  T                Control throat               0256        26.61    $1,354.56      $623.05      $270.91
                            bleeding.
   42970  T                Control nose/throat          0250         2.10      $106.90       $37.42       $21.38
                            bleeding.
   42971  C                Control nose/throat   ...........  ...........  ...........  ...........  ...........
                            bleeding.
   42972  T                Control nose/throat          0253        12.33      $627.65      $284.00      $125.53
                            bleeding.
   42999  T                Throat surgery               0252         5.95      $302.88      $114.24       $60.58
                            procedure.
   43020  T                Incision of                  0252         5.95      $302.88      $114.24       $60.58
                            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        17.37      $884.20      $272.41      $176.84
                            pouch.
   43135  C                Removal of esophagus  ...........  ...........  ...........  ...........  ...........
                            pouch.
   43200  T                Esophagus endoscopy.         0141         7.21      $367.02      $184.67       $73.40
   43202  T                Esophagus endoscopy,         0141         7.21      $367.02      $184.67       $73.40
                            biopsy.
   43204  T                Esophagus endoscopy          0141         7.21      $367.02      $184.67       $73.40
                            & inject.
   43205  T                Esophagus endoscopy/         0141         7.21      $367.02      $184.67       $73.40
                            ligation.
   43215  T                Esophagus endoscopy.         0141         7.21      $367.02      $184.67       $73.40
   43216  T                Esophagus endoscopy/         0141         7.21      $367.02      $184.67       $73.40
                            lesion.
   43217  T                Esophagus endoscopy.         0141         7.21      $367.02      $184.67       $73.40
   43219  T                Esophagus endoscopy.         0141         7.21      $367.02      $184.67       $73.40
   43220  T                Esoph endoscopy,             0141         7.21      $367.02      $184.67       $73.40
                            dilation.
   43226  T                Esoph endoscopy,             0141         7.21      $367.02      $184.67       $73.40
                            dilation.
   43227  T                Esoph endoscopy,             0141         7.21      $367.02      $184.67       $73.40
                            repair.
   43228  T                Esoph endoscopy,             0141         7.21      $367.02      $184.67       $73.40
                            ablation.
   43231  T                Esoph endoscopy w/us         0141         7.21      $367.02      $184.67       $73.40
                            exam.
   43232  T                Esoph endoscopy w/us         0141         7.21      $367.02      $184.67       $73.40
                            fn bx.
   43234  T                Upper GI endoscopy,          0141         7.21      $367.02      $184.67       $73.40
                            exam.
   43235  T                Uppr gi endoscopy,           0141         7.21      $367.02      $184.67       $73.40
                            diagnosis.
   43239  T                Upper GI endoscopy,          0141         7.21      $367.02      $184.67       $73.40
                            biopsy.
   43240  T                Esoph endoscope w/           0141         7.21      $367.02      $184.67       $73.40
                            drain cyst.
   43241  T                Upper GI endoscopy           0141         7.21      $367.02      $184.67       $73.40
                            with tube.
   43242  T                Uppr gi endoscopy w/         0141         7.21      $367.02      $184.67       $73.40
                            us fn bx.
   43243  T                Upper gi endoscopy &         0141         7.21      $367.02      $184.67       $73.40
                            inject.
   43244  T                Upper GI endoscopy/          0141         7.21      $367.02      $184.67       $73.40
                            ligation.
   43245  T                Operative upper GI           0141         7.21      $367.02      $184.67       $73.40
                            endoscopy.
   43246  T                Place gastrostomy            0141         7.21      $367.02      $184.67       $73.40
                            tube.
   43247  T                Operative upper GI           0141         7.21      $367.02      $184.67       $73.40
                            endoscopy.
   43248  T                Uppr gi endoscopy/           0141         7.21      $367.02      $184.67       $73.40
                            guide wire.
   43249  T                Esoph endoscopy,             0141         7.21      $367.02      $184.67       $73.40
                            dilation.
   43250  T                Upper GI endoscopy/          0141         7.21      $367.02      $184.67       $73.40
                            tumor.

[[Page 59978]]

 
   43251  T                Operative upper GI           0141         7.21      $367.02      $184.67       $73.40
                            endoscopy.
   43255  T                Operative upper GI           0141         7.21      $367.02      $184.67       $73.40
                            endoscopy.
   43256  T                Uppr gi endoscopy w          0141         7.21      $367.02      $184.67       $73.40
                            stent.
   43258  T                Operative upper GI           0141         7.21      $367.02      $184.67       $73.40
                            endoscopy.
   43259  T                Endoscopic                   0141         7.21      $367.02      $184.67       $73.40
                            ultrasound exam.
   43260  T                Endo                         0151        15.29      $778.32      $245.46      $155.66
                            cholangiopancreatog
                            raph.
   43261  T                Endo                         0151        15.29      $778.32      $245.46      $155.66
                            cholangiopancreatog
                            raph.
   43262  T                Endo                         0151        15.29      $778.32      $245.46      $155.66
                            cholangiopancreatog
                            raph.
   43263  T                Endo                         0151        15.29      $778.32      $245.46      $155.66
                            cholangiopancreatog
                            raph.
   43264  T                Endo                         0151        15.29      $778.32      $245.46      $155.66
                            cholangiopancreatog
                            raph.
   43265  T                Endo                         0151        15.29      $778.32      $245.46      $155.66
                            cholangiopancreatog
                            raph.
   43267  T                Endo                         0151        15.29      $778.32      $245.46      $155.66
                            cholangiopancreatog
                            raph.
   43268  T                Endo                         0151        15.29      $778.32      $245.46      $155.66
                            cholangiopancreatog
                            raph.
   43269  T                Endo                         0151        15.29      $778.32      $245.46      $155.66
                            cholangiopancreatog
                            raph.
   43271  T                Endo                         0151        15.29      $778.32      $245.46      $155.66
                            cholangiopancreatog
                            raph.
   43272  T                Endo                         0151        15.29      $778.32      $245.46      $155.66
                            cholangiopancreatog
                            raph.
   43280  T                Laparoscopy,                 0132        56.06    $2,853.68    $1,239.22      $570.74
                            fundoplasty.
   43289  T                Laparoscope proc,            0130        25.91    $1,318.92      $659.53      $263.78
                            esoph.
   43300  C                Repair of esophagus.  ...........  ...........  ...........  ...........  ...........
   43305  C                Repair esophagus and  ...........  ...........  ...........  ...........  ...........
                            fistula.
   43310  C                Repair of esophagus.  ...........  ...........  ...........  ...........  ...........
   43312  C                Repair esophagus and  ...........  ...........  ...........  ...........  ...........
                            fistula.
  *43313  C                Esophagoplasty        ...........  ...........  ...........  ...........  ...........
                            congential.
  *43314  C                Tracheo-              ...........  ...........  ...........  ...........  ...........
                            esophagoplasty cong.
   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         5.65      $287.61      $107.24       $57.52
   43453  T                Dilate esophagus....         0140         5.65      $287.61      $107.24       $57.52
   43456  T                Dilate esophagus....         0140         5.65      $287.61      $107.24       $57.52
   43458  T                Dilate esophagus....         0140         5.65      $287.61      $107.24       $57.52
   43460  C                Pressure treatment    ...........  ...........  ...........  ...........  ...........
                            esophagus.
   43496  C                Free jejunum flap,    ...........  ...........  ...........  ...........  ...........
                            microvasc.
   43499  T                Esophagus surgery            0140         5.65      $287.61      $107.24       $57.52
                            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         7.21      $367.02      $184.67       $73.40
   43605  C                Biopsy of stomach...  ...........  ...........  ...........  ...........  ...........
   43610  C                Excision of stomach   ...........  ...........  ...........  ...........  ...........
                            lesion.
   43611  C                Excision of stomach   ...........  ...........  ...........  ...........  ...........
                            lesion.
   43620  C                Removal of stomach..  ...........  ...........  ...........  ...........  ...........
   43621  C                Removal of stomach..  ...........  ...........  ...........  ...........  ...........
   43622  C                Removal of stomach..  ...........  ...........  ...........  ...........  ...........
   43631  C                Removal of stomach,   ...........  ...........  ...........  ...........  ...........
                            partial.
   43632  C                Removal of stomach,   ...........  ...........  ...........  ...........  ...........
                            partial.
   43633  C                Removal of stomach,   ...........  ...........  ...........  ...........  ...........
                            partial.
   43634  C                Removal of stomach,   ...........  ...........  ...........  ...........  ...........
                            partial.
   43635  C                Removal of stomach,   ...........  ...........  ...........  ...........  ...........
                            partial.
   43638  C                Removal of stomach,   ...........  ...........  ...........  ...........  ...........
                            partial.
   43639  C                Removal of stomach,   ...........  ...........  ...........  ...........  ...........
                            partial.
   43640  C                Vagotomy & pylorus    ...........  ...........  ...........  ...........  ...........
                            repair.
   43641  C                Vagotomy & pylorus    ...........  ...........  ...........  ...........  ...........
                            repair.
   43651  T                Laparoscopy, vagus           0132        56.06    $2,853.68    $1,239.22      $570.74
                            nerve.
   43652  T                Laparoscopy, vagus           0132        56.06    $2,853.68    $1,239.22      $570.74
                            nerve.
   43653  T                Laparoscopy,                 0131        37.63    $1,915.52      $996.07      $383.10
                            gastrostomy.

[[Page 59979]]

 
   43659  T                Laparoscope proc,            0130        25.91    $1,318.92      $659.53      $263.78
                            stom.
   43750  T                Place gastrostomy            0141         7.21      $367.02      $184.67       $73.40
                            tube.
   43752  E                Nasal/orogastric w/   ...........  ...........  ...........  ...........  ...........
                            stent.
   43760  T                Change gastrostomy           0121         2.54      $129.30       $52.53       $25.86
                            tube.
   43761  T                Reposition                   0121         2.54      $129.30       $52.53       $25.86
                            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         7.21      $367.02      $184.67       $73.40
                            tube.
   43831  T                Place gastrostomy            0141         7.21      $367.02      $184.67       $73.40
                            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         3.39      $172.56       $65.57       $34.51
                            opening.
   43880  C                Repair stomach-bowel  ...........  ...........  ...........  ...........  ...........
                            fistula.
   43999  T                Stomach surgery              0121         2.54      $129.30       $52.53       $25.86
                            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         7.21      $367.02      $184.67       $73.40
   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.
  *44126  C                Enterectomy w/taper,  ...........  ...........  ...........  ...........  ...........
                            cong.
  *44127  C                Enterectomy w/o       ...........  ...........  ...........  ...........  ...........
                            taper, cong.
  *44128  C                Enterectomy cong,     ...........  ...........  ...........  ...........  ...........
                            add-on.
   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        37.63    $1,915.52      $996.07      $383.10
                            enterolysis.
   44201  T                Laparoscopy,                 0131        37.63    $1,915.52      $996.07      $383.10
                            jejunostomy.
   44202  C                Laparo, resect        ...........  ...........  ...........  ...........  ...........
                            intestine.
  *44203  C                Lap resect s/         ...........  ...........  ...........  ...........  ...........
                            intestine, addl.
  *44204  C                Laparo partial        ...........  ...........  ...........  ...........  ...........
                            colectomy.
  *44205  C                Lap colectomy part w/ ...........  ...........  ...........  ...........  ...........
                            ileum.
   44209  T                Laparoscope proc,            0130        25.91    $1,318.92      $659.53      $263.78
                            intestine.
   44300  C                Open bowel to skin..  ...........  ...........  ...........  ...........  ...........
   44310  C                Ileostomy/            ...........  ...........  ...........  ...........  ...........
                            jejunostomy.
   44312  T                Revision of                  0026        12.62      $642.41      $277.92      $128.48
                            ileostomy.
   44314  C                Revision of           ...........  ...........  ...........  ...........  ...........
                            ileostomy.
   44316  C                Devise bowel pouch..  ...........  ...........  ...........  ...........  ...........
   44320  C                Colostomy...........  ...........  ...........  ...........  ...........  ...........

[[Page 59980]]

 
   44322  C                Colostomy with        ...........  ...........  ...........  ...........  ...........
                            biopsies.
   44340  T                Revision of                  0026        12.62      $642.41      $277.92      $128.48
                            colostomy.
   44345  C                Revision of           ...........  ...........  ...........  ...........  ...........
                            colostomy.
   44346  C                Revision of           ...........  ...........  ...........  ...........  ...........
                            colostomy.
   44360  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy.
   44361  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy/biopsy.
   44363  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy.
   44364  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy.
   44365  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy.
   44366  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy.
   44369  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy.
   44370  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy/stent.
   44372  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy.
   44373  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy.
   44376  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy.
   44377  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy/biopsy.
   44378  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy.
   44379  T                S bowel endoscope w/         0142         6.94      $353.27      $151.91       $70.65
                            stent.
   44380  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy.
   44382  T                Small bowel                  0142         6.94      $353.27      $151.91       $70.65
                            endoscopy.
   44383  T                Ileoscopy w/stent...         0142         6.94      $353.27      $151.91       $70.65
   44385  T                Endoscopy of bowel           0143         7.27      $370.07      $185.04       $74.01
                            pouch.
   44386  T                Endoscopy, bowel             0143         7.27      $370.07      $185.04       $74.01
                            pouch/biop.
   44388  T                Colon endoscopy.....         0143         7.27      $370.07      $185.04       $74.01
   44389  T                Colonoscopy with             0143         7.27      $370.07      $185.04       $74.01
                            biopsy.
   44390  T                Colonoscopy for              0143         7.27      $370.07      $185.04       $74.01
                            foreign body.
   44391  T                Colonoscopy for              0143         7.27      $370.07      $185.04       $74.01
                            bleeding.
   44392  T                Colonoscopy &                0143         7.27      $370.07      $185.04       $74.01
                            polypectomy.
   44393  T                Colonoscopy, lesion          0143         7.27      $370.07      $185.04       $74.01
                            removal.
   44394  T                Colonoscopy w/snare.         0143         7.27      $370.07      $185.04       $74.01
   44397  T                Colonoscopy w stent.         0143         7.27      $370.07      $185.04       $74.01
   44500  T                Intro,                       0121         2.54      $129.30       $52.53       $25.86
                            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         6.94      $353.27      $151.91       $70.65
                            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        25.91    $1,318.92      $659.53      $263.78
                            appendectomy.
   44979  T                Laparoscope proc,            0130        25.91    $1,318.92      $659.53      $263.78
                            app.
   45000  T                Drainage of pelvic           0149        13.53      $688.73      $293.06      $137.75
                            abscess.
   45005  T                Drainage of rectal           0148         2.40      $122.17       $43.59       $24.43
                            abscess.
   45020  T                Drainage of rectal           0149        13.53      $688.73      $293.06      $137.75
                            abscess.
   45100  T                Biopsy of rectum....         0149        13.53      $688.73      $293.06      $137.75
   45108  T                Removal of anorectal         0150        18.08      $920.34      $437.12      $184.07
                            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.

[[Page 59981]]

 
   45135  C                Excision of rectal    ...........  ...........  ...........  ...........  ...........
                            prolapse.
  *45136  C                Excise ileoanal       ...........  ...........  ...........  ...........  ...........
                            reservoir.
   45150  T                Excision of rectal           0150        18.08      $920.34      $437.12      $184.07
                            stricture.
   45160  T                Excision of rectal           0150        18.08      $920.34      $437.12      $184.07
                            lesion.
   45170  T                Excision of rectal           0150        18.08      $920.34      $437.12      $184.07
                            lesion.
   45190  T                Destruction, rectal          0150        18.08      $920.34      $437.12      $184.07
                            tumor.
   45300  T                Proctosigmoidoscopy          0146         2.73      $138.97       $63.93       $27.79
                            dx.
   45303  T                Proctosigmoidoscopy          0146         2.73      $138.97       $63.93       $27.79
                            dilate.
   45305  T                Protosigmoidoscopy w/        0146         2.73      $138.97       $63.93       $27.79
                            bx.
   45307  T                Protosigmoidoscopy           0146         2.73      $138.97       $63.93       $27.79
                            fb.
   45308  T                Protosigmoidoscopy           0147         5.71      $290.66      $136.61       $58.13
                            removal.
   45309  T                Protosigmoidoscopy           0147         5.71      $290.66      $136.61       $58.13
                            removal.
   45315  T                Protosigmoidoscopy           0147         5.71      $290.66      $136.61       $58.13
                            removal.
   45317  T                Protosigmoidoscopy           0146         2.73      $138.97       $63.93       $27.79
                            bleed.
   45320  T                Protosigmoidoscopy           0147         5.71      $290.66      $136.61       $58.13
                            ablate.
   45321  T                Protosigmoidoscopy           0147         5.71      $290.66      $136.61       $58.13
                            volvul.
   45327  T                Proctosigmoidoscopy          0147         5.71      $290.66      $136.61       $58.13
                            w/stent.
   45330  T                Diagnostic                   0146         2.73      $138.97       $63.93       $27.79
                            sigmoidoscopy.
   45331  T                Sigmoidoscopy and            0146         2.73      $138.97       $63.93       $27.79
                            biopsy.
   45332  T                Sigmoidoscopy w/fb           0146         2.73      $138.97       $63.93       $27.79
                            removal.
   45333  T                Sigmoidoscopy &              0147         5.71      $290.66      $136.61       $58.13
                            polypectomy.
   45334  T                Sigmoidoscopy for            0147         5.71      $290.66      $136.61       $58.13
                            bleeding.
   45337  T                Sigmoidoscopy &              0147         5.71      $290.66      $136.61       $58.13
                            decompress.
   45338  T                Sigmoidoscpy w/tumr          0147         5.71      $290.66      $136.61       $58.13
                            remove.
   45339  T                Sigmoidoscopy w/             0147         5.71      $290.66      $136.61       $58.13
                            ablate tumr.
   45341  T                Sigmoidoscopy w/             0147         5.71      $290.66      $136.61       $58.13
                            ultrasound.
   45342  T                Sigmoidoscopy w/us           0147         5.71      $290.66      $136.61       $58.13
                            guide bx.
   45345  T                Sigmodoscopy w/stent         0147         5.71      $290.66      $136.61       $58.13
   45355  T                Surgical colonoscopy         0143         7.27      $370.07      $185.04       $74.01
   45378  T                Diagnostic                   0143         7.27      $370.07      $185.04       $74.01
                            colonoscopy.
   45379  T                Colonoscopy w/fb             0143         7.27      $370.07      $185.04       $74.01
                            removal.
   45380  T                Colonoscopy and              0143         7.27      $370.07      $185.04       $74.01
                            biopsy.
   45382  T                Colonoscopy/control          0143         7.27      $370.07      $185.04       $74.01
                            bleeding.
   45383  T                Lesion removal               0143         7.27      $370.07      $185.04       $74.01
                            colonoscopy.
   45384  T                Lesion remove                0143         7.27      $370.07      $185.04       $74.01
                            colonoscopy.
   45385  T                Lesion removal               0143         7.27      $370.07      $185.04       $74.01
                            colonoscopy.
   45387  T                Colonoscopy w/stent.         0143         7.27      $370.07      $185.04       $74.01
   45500  T                Repair of rectum....         0150        18.08      $920.34      $437.12      $184.07
   45505  T                Repair of rectum....         0150        18.08      $920.34      $437.12      $184.07
   45520  T                Treatment of rectal          0098         1.24       $63.12       $20.88       $12.62
                            prolapse.
   45540  C                Correct rectal        ...........  ...........  ...........  ...........  ...........
                            prolapse.
   45541  C                Correct rectal        ...........  ...........  ...........  ...........  ...........
                            prolapse.
   45550  C                Repair rectum/remove  ...........  ...........  ...........  ...........  ...........
                            sigmoid.
   45560  T                Repair of rectocele.         0150        18.08      $920.34      $437.12      $184.07
   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         2.40      $122.17       $43.59       $24.43
                            prolapse.
   45905  T                Dilation of anal             0149        13.53      $688.73      $293.06      $137.75
                            sphincter.
   45910  T                Dilation of rectal           0149        13.53      $688.73      $293.06      $137.75
                            narrowing.
   45915  T                Remove rectal                0148         2.40      $122.17       $43.59       $24.43
                            obstruction.
   45999  T                Rectum surgery               0148         2.40      $122.17       $43.59       $24.43
                            procedure.
  *46020  T                Placement of seton..         0148         2.40      $122.17       $43.59       $24.43
   46030  N                Removal of rectal     ...........  ...........  ...........  ...........  ...........
                            marker.
   46040  T                Incision of rectal           0155         5.26      $267.76  ...........       $53.55
                            abscess.
   46045  T                Incision of rectal           0150        18.08      $920.34      $437.12      $184.07
                            abscess.
   46050  T                Incision of anal             0148         2.40      $122.17       $43.59       $24.43
                            abscess.
   46060  T                Incision of rectal           0150        18.08      $920.34      $437.12      $184.07
                            abscess.
   46070  T                Incision of anal             0155         5.26      $267.76  ...........       $53.55
                            septum.
   46080  T                Incision of anal             0149        13.53      $688.73      $293.06      $137.75
                            sphincter.
   46083  T                Incise external              0148         2.40      $122.17       $43.59       $24.43
                            hemorrhoid.
   46200  T                Removal of anal              0150        18.08      $920.34      $437.12      $184.07
                            fissure.
   46210  T                Removal of anal              0149        13.53      $688.73      $293.06      $137.75
                            crypt.
   46211  T                Removal of anal              0150        18.08      $920.34      $437.12      $184.07
                            crypts.
   46220  T                Removal of anal tab.         0149        13.53      $688.73      $293.06      $137.75
   46221  T                Ligation of                  0155         5.26      $267.76  ...........       $53.55
                            hemorrhoid(s).
   46230  T                Removal of anal tabs         0149        13.53      $688.73      $293.06      $137.75
   46250  T                Hemorrhoidectomy....         0150        18.08      $920.34      $437.12      $184.07
   46255  T                Hemorrhoidectomy....         0150        18.08      $920.34      $437.12      $184.07
   46257  T                Remove hemorrhoids &         0150        18.08      $920.34      $437.12      $184.07
                            fissure.
   46258  T                Remove hemorrhoids &         0150        18.08      $920.34      $437.12      $184.07
                            fistula.
   46260  T                Hemorrhoidectomy....         0150        18.08      $920.34      $437.12      $184.07

[[Page 59982]]

 
   46261  T                Remove hemorrhoids &         0150        18.08      $920.34      $437.12      $184.07
                            fissure.
   46262  T                Remove hemorrhoids &         0150        18.08      $920.34      $437.12      $184.07
                            fistula.
   46270  T                Removal of anal              0150        18.08      $920.34      $437.12      $184.07
                            fistula.
   46275  T                Removal of anal              0150        18.08      $920.34      $437.12      $184.07
                            fistula.
   46280  T                Removal of anal              0150        18.08      $920.34      $437.12      $184.07
                            fistula.
   46285  T                Removal of anal              0150        18.08      $920.34      $437.12      $184.07
                            fistula.
   46288  T                Repair anal fistula.         0150        18.08      $920.34      $437.12      $184.07
   46320  T                Removal of                   0155         5.26      $267.76  ...........       $53.55
                            hemorrhoid clot.
   46500  T                Injection into               0155         5.26      $267.76  ...........       $53.55
                            hemorrhoids.
   46600  N                Diagnostic anoscopy.  ...........  ...........  ...........  ...........  ...........
   46604  T                Anoscopy and                 0144         4.43      $225.50       $49.32       $45.10
                            dilation.
   46606  T                Anoscopy and biopsy.         0145        10.81      $550.27      $179.39      $110.05
   46608  T                Anoscopy/ remove for         0144         4.43      $225.50       $49.32       $45.10
                            body.
   46610  T                Anoscopy/remove              0145        10.81      $550.27      $179.39      $110.05
                            lesion.
   46611  T                Anoscopy............         0145        10.81      $550.27      $179.39      $110.05
   46612  T                Anoscopy/ remove             0145        10.81      $550.27      $179.39      $110.05
                            lesions.
   46614  T                Anoscopy/control             0145        10.81      $550.27      $179.39      $110.05
                            bleeding.
   46615  T                Anoscopy............         0145        10.81      $550.27      $179.39      $110.05
   46700  T                Repair of anal               0150        18.08      $920.34      $437.12      $184.07
                            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        18.08      $920.34      $437.12      $184.07
                            sphincter.
   46751  C                Repair of anal        ...........  ...........  ...........  ...........  ...........
                            sphincter.
   46753  T                Reconstruction of            0150        18.08      $920.34      $437.12      $184.07
                            anus.
   46754  T                Removal of suture            0149        13.53      $688.73      $293.06      $137.75
                            from anus.
   46760  T                Repair of anal               0150        18.08      $920.34      $437.12      $184.07
                            sphincter.
   46761  T                Repair of anal               0150        18.08      $920.34      $437.12      $184.07
                            sphincter.
   46762  T                Implant artificial           0150        18.08      $920.34      $437.12      $184.07
                            sphincter.
   46900  T                Destruction, anal            0016         3.02      $153.73       $64.57       $30.75
                            lesion(s).
   46910  T                Destruction, anal            0017         9.68      $492.75      $226.67       $98.55
                            lesion(s).
   46916  T                Cryosurgery, anal            0013         1.36       $69.23       $17.66       $13.85
                            lesion(s).
   46917  T                Laser surgery, anal          0695        15.78      $803.27      $369.50      $160.65
                            lesions.
   46922  T                Excision of anal             0695        15.78      $803.27      $369.50      $160.65
                            lesion(s).
   46924  T                Destruction, anal            0695        15.78      $803.27      $369.50      $160.65
                            lesion(s).
   46934  T                Destruction of               0155         5.26      $267.76  ...........       $53.55
                            hemorrhoids.
   46935  T                Destruction of               0155         5.26      $267.76  ...........       $53.55
                            hemorrhoids.
   46936  T                Destruction of               0149        13.53      $688.73      $293.06      $137.75
                            hemorrhoids.
   46937  T                Cryotherapy of               0149        13.53      $688.73      $293.06      $137.75
                            rectal lesion.
   46938  T                Cryotherapy of               0150        18.08      $920.34      $437.12      $184.07
                            rectal lesion.
   46940  T                Treatment of anal            0149        13.53      $688.73      $293.06      $137.75
                            fissure.
   46942  T                Treatment of anal            0149        13.53      $688.73      $293.06      $137.75
                            fissure.
   46945  T                Ligation of                  0155         5.26      $267.76  ...........       $53.55
                            hemorrhoids.
   46946  T                Ligation of                  0155         5.26      $267.76  ...........       $53.55
                            hemorrhoids.
   46999  T                Anus surgery                 0149        13.53      $688.73      $293.06      $137.75
                            procedure.
   47000  T                Needle biopsy of             0685         9.16      $466.28      $205.16       $93.26
                            liver.
   47001  C                Needle biopsy, liver  ...........  ...........  ...........  ...........  ...........
                            add-on.
   47010  C                Open drainage, liver  ...........  ...........  ...........  ...........  ...........
                            lesion.
   47011  T                Percut drain, liver          0005         4.03      $205.14       $90.26       $41.03
                            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..  ...........  ...........  ...........  ...........  ...........
  *47370  T                Laparo ablate liver          0130        25.91    $1,318.92      $659.53      $263.78
                            tumor rf.
  *47371  T                Laparo ablate liver          0130        25.91    $1,318.92      $659.53      $263.78
                            cryosug.
   47379  T                Laparoscope                  0130        25.91    $1,318.92      $659.53      $263.78
                            procedure, liver.
  *47380  C                Open ablate liver     ...........  ...........  ...........  ...........  ...........
                            tumor rf.

[[Page 59983]]

 
  *47381  C                Open ablate liver     ...........  ...........  ...........  ...........  ...........
                            tumor cryo.
  *47382  T                Percut ablate liver          0152        16.13      $821.08      $207.38      $164.22
                            rf.
   47399  T                Liver surgery                0005         4.03      $205.14       $90.26       $41.03
                            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.
   47505  N                Injection for liver   ...........  ...........  ...........  ...........  ...........
                            x-rays.
   47510  T                Insert catheter,             0152        16.13      $821.08      $207.38      $164.22
                            bile duct.
   47511  T                Insert bile duct             0152        16.13      $821.08      $207.38      $164.22
                            drain.
   47525  T                Change bile duct             0122         9.89      $503.44      $114.93      $100.69
                            catheter.
   47530  T                Revise/reinsert bile         0121         2.54      $129.30       $52.53       $25.86
                            tube.
   47550  C                Bile duct endoscopy   ...........  ...........  ...........  ...........  ...........
                            add-on.
   47552  T                Biliary endoscopy            0152        16.13      $821.08      $207.38      $164.22
                            thru skin.
   47553  T                Biliary endoscopy            0152        16.13      $821.08      $207.38      $164.22
                            thru skin.
   47554  T                Biliary endoscopy            0152        16.13      $821.08      $207.38      $164.22
                            thru skin.
   47555  T                Biliary endoscopy            0152        16.13      $821.08      $207.38      $164.22
                            thru skin.
   47556  T                Biliary endoscopy            0152        16.13      $821.08      $207.38      $164.22
                            thru skin.
   47560  T                Laparoscopy w/               0130        25.91    $1,318.92      $659.53      $263.78
                            cholangio.
   47561  T                Laparo w/cholangio/          0130        25.91    $1,318.92      $659.53      $263.78
                            biopsy.
   47562  T                Laparoscopic                 0131        37.63    $1,915.52      $996.07      $383.10
                            cholecystectomy.
   47563  T                Laparo                       0131        37.63    $1,915.52      $996.07      $383.10
                            cholecystectomy/
                            graph.
   47564  T                Laparo                       0131        37.63    $1,915.52      $996.07      $383.10
                            cholecystectomy/
                            explr.
   47570  C                Laparo                ...........  ...........  ...........  ...........  ...........
                            cholecystoenterosto
                            my.
   47579  T                Laparoscope proc,            0130        25.91    $1,318.92      $659.53      $263.78
                            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        16.13      $821.08      $207.38      $164.22
                            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         2.54      $129.30       $52.53       $25.86
                            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,               0685         9.16      $466.28      $205.16       $93.26
                            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  S                Drain pancreatic             0005         4.03      $205.14       $90.26       $41.03
                            pseudocyst.

[[Page 59984]]

 
   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         4.03      $205.14       $90.26       $41.03
                            procedure.
   49000  C                Exploration of        ...........  ...........  ...........  ...........  ...........
                            abdomen.
   49002  C                Reopening of abdomen  ...........  ...........  ...........  ...........  ...........
   49010  C                Exploration behind    ...........  ...........  ...........  ...........  ...........
                            abdomen.
   49020  C                Drain abdominal       ...........  ...........  ...........  ...........  ...........
                            abscess.
   49021  C                Drain abdominal       ...........  ...........  ...........  ...........  ...........
                            abscess.
   49040  C                Drain, open, abdom    ...........  ...........  ...........  ...........  ...........
                            abscess.
   49041  C                Drain, percut, abdom  ...........  ...........  ...........  ...........  ...........
                            abscess.
   49060  C                Drain, open, retrop   ...........  ...........  ...........  ...........  ...........
                            abscess.
   49061  C                Drain, percut,        ...........  ...........  ...........  ...........  ...........
                            retroper absc.
   49062  C                Drain to peritoneal   ...........  ...........  ...........  ...........  ...........
                            cavity.
   49080  T                Puncture, peritoneal         0070         4.58      $233.14       $79.60       $46.63
                            cavity.
   49081  T                Removal of abdominal         0070         4.58      $233.14       $79.60       $46.63
                            fluid.
   49085  T                Remove abdomen               0153        23.55    $1,198.79      $496.31      $239.76
                            foreign body.
   49180  T                Biopsy, abdominal            0685         9.16      $466.28      $205.16       $93.26
                            mass.
   49200  T                Removal of abdominal         0130        25.91    $1,318.92      $659.53      $263.78
                            lesion.
   49201  C                Removal of abdominal  ...........  ...........  ...........  ...........  ...........
                            lesion.
   49215  C                Excise sacral spine   ...........  ...........  ...........  ...........  ...........
                            tumor.
   49220  C                Multiple surgery,     ...........  ...........  ...........  ...........  ...........
                            abdomen.
   49250  T                Excision of                  0153        23.55    $1,198.79      $496.31      $239.76
                            umbilicus.
   49255  C                Removal of omentum..  ...........  ...........  ...........  ...........  ...........
   49320  T                Diag laparo separate         0130        25.91    $1,318.92      $659.53      $263.78
                            proc.
   49321  T                Laparoscopy, biopsy.         0130        25.91    $1,318.92      $659.53      $263.78
   49322  T                Laparoscopy,                 0130        25.91    $1,318.92      $659.53      $263.78
                            aspiration.
   49323  T                Laparo drain                 0130        25.91    $1,318.92      $659.53      $263.78
                            lymphocele.
   49329  T                Laparo proc, abdm/           0130        25.91    $1,318.92      $659.53      $263.78
                            per/oment.
   49400  N                Air injection into    ...........  ...........  ...........  ...........  ...........
                            abdomen.
   49420  T                Insert abdominal             0153        23.55    $1,198.79      $496.31      $239.76
                            drain.
   49421  T                Insert abdominal             0153        23.55    $1,198.79      $496.31      $239.76
                            drain.
   49422  T                Remove perm cannula/         0105        14.76      $751.34      $368.16      $150.27
                            catheter.
   49423  T                Exchange drainage            0153        23.55    $1,198.79      $496.31      $239.76
                            catheter.
   49424  N                Assess cyst,          ...........  ...........  ...........  ...........  ...........
                            contrast inject.
   49425  C                Insert abdomen-       ...........  ...........  ...........  ...........  ...........
                            venous drain.
   49426  T                Revise abdomen-              0153        23.55    $1,198.79      $496.31      $239.76
                            venous shunt.
   49427  N                Injection, abdominal  ...........  ...........  ...........  ...........  ...........
                            shunt.
   49428  C                Ligation of shunt...  ...........  ...........  ...........  ...........  ...........
   49429  T                Removal of shunt....         0105        14.76      $751.34      $368.16      $150.27
  *49491  T                Repairing hern               0154        31.40    $1,598.39      $556.98      $319.68
                            premie reduc.
  *49492  T                Rpr ing hern premie,         0154        31.40    $1,598.39      $556.98      $319.68
                            blocked.
   49495  T                Repair inguinal              0154        31.40    $1,598.39      $556.98      $319.68
                            hernia, init.
   49496  T                Repair inguinal              0154        31.40    $1,598.39      $556.98      $319.68
                            hernia, init.
   49500  T                Repair inguinal              0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49501  T                Repair inguinal              0154        31.40    $1,598.39      $556.98      $319.68
                            hernia, init.
   49505  T                Repair inguinal              0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49507  T                Repair inguinal              0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49520  T                Rerepair inguinal            0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49521  T                Repair inguinal              0154        31.40    $1,598.39      $556.98      $319.68
                            hernia, rec.
   49525  T                Repair inguinal              0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49540  T                Repair lumbar hernia         0154        31.40    $1,598.39      $556.98      $319.68
   49550  T                Repair femoral               0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49553  T                Repair femoral               0154        31.40    $1,598.39      $556.98      $319.68
                            hernia, init.
   49555  T                Repair femoral               0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49557  T                Repair femoral               0154        31.40    $1,598.39      $556.98      $319.68
                            hernia, recur.
   49560  T                Repair abdominal             0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49561  T                Repair incisional            0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49565  T                Rerepair abdominal           0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49566  T                Repair incisional            0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49568  T                Hernia repair w/mesh         0154        31.40    $1,598.39      $556.98      $319.68
   49570  T                Repair epigastric            0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49572  T                Repair epigastric            0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49580  T                Repair umbilical             0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49582  T                Repair umbilical             0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49585  T                Repair umbilical             0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49587  T                Repair umbilical             0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49590  T                Repair abdominal             0154        31.40    $1,598.39      $556.98      $319.68
                            hernia.
   49600  T                Repair umbilical             0154        31.40    $1,598.39      $556.98      $319.68
                            lesion.
   49605  C                Repair umbilical      ...........  ...........  ...........  ...........  ...........
                            lesion.
   49606  C                Repair umbilical      ...........  ...........  ...........  ...........  ...........
                            lesion.

[[Page 59985]]

 
   49610  C                Repair umbilical      ...........  ...........  ...........  ...........  ...........
                            lesion.
   49611  C                Repair umbilical      ...........  ...........  ...........  ...........  ...........
                            lesion.
   49650  T                Laparo hernia repair         0131        37.63    $1,915.52      $996.07      $383.10
                            initial.
   49651  T                Laparo hernia repair         0131        37.63    $1,915.52      $996.07      $383.10
                            recur.
   49659  T                Laparo proc, hernia          0131        37.63    $1,915.52      $996.07      $383.10
                            repair.
   49900  C                Repair of abdominal   ...........  ...........  ...........  ...........  ...........
                            wall.
   49905  C                Omental flap........  ...........  ...........  ...........  ...........  ...........
   49906  C                Free omental flap,    ...........  ...........  ...........  ...........  ...........
                            microvasc.
   49999  T                Abdomen surgery              0121         2.54      $129.30       $52.53       $25.86
                            procedure.
   50010  C                Exploration of        ...........  ...........  ...........  ...........  ...........
                            kidney.
   50020  C                Renal abscess, open   ...........  ...........  ...........  ...........  ...........
                            drain.
   50021  S                Renal abscess,               0005         4.03      $205.14       $90.26       $41.03
                            percut drain.
   50040  C                Drainage of kidney..  ...........  ...........  ...........  ...........  ...........
   50045  C                Exploration of        ...........  ...........  ...........  ...........  ...........
                            kidney.
   50060  C                Removal of kidney     ...........  ...........  ...........  ...........  ...........
                            stone.
   50065  C                Incision of kidney..  ...........  ...........  ...........  ...........  ...........
   50070  C                Incision of kidney..  ...........  ...........  ...........  ...........  ...........
   50075  C                Removal of kidney     ...........  ...........  ...........  ...........  ...........
                            stone.
   50080  T                Removal of kidney            0163        40.40    $2,056.52      $792.58      $411.30
                            stone.
   50081  T                Removal of kidney            0163        40.40    $2,056.52      $792.58      $411.30
                            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....         0685         9.16      $466.28      $205.16       $93.26
   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           0685         9.16      $466.28      $205.16       $93.26
                            lesion.
   50392  T                Insert kidney drain.         0161        13.72      $698.40      $249.36      $139.68
   50393  T                Insert ureteral tube         0161        13.72      $698.40      $249.36      $139.68
   50394  N                Injection for kidney  ...........  ...........  ...........  ...........  ...........
                            x-ray.
   50395  T                Create passage to            0161        13.72      $698.40      $249.36      $139.68
                            kidney.
   50396  T                Measure kidney               0164         1.01       $51.41       $15.42       $10.28
                            pressure.
   50398  T                Change kidney tube..         0122         9.89      $503.44      $114.93      $100.69
   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        25.91    $1,318.92      $659.53      $263.78
                            cyst.
   50544  T                Laparoscopy,                 0130        25.91    $1,318.92      $659.53      $263.78
                            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        25.91    $1,318.92      $659.53      $263.78
                            renal.
   50551  T                Kidney endoscopy....         0160         5.13      $261.14      $104.46       $52.23
   50553  T                Kidney endoscopy....         0161        13.72      $698.40      $249.36      $139.68
   50555  T                Kidney endoscopy &           0160         5.13      $261.14      $104.46       $52.23
                            biopsy.
   50557  T                Kidney endoscopy &           0162        25.09    $1,277.18      $427.49      $255.44
                            treatment.
   50559  T                Renal endoscopy/             0160         5.13      $261.14      $104.46       $52.23
                            radiotracer.
   50561  T                Kidney endoscopy &           0161        13.72      $698.40      $249.36      $139.68
                            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.

[[Page 59986]]

 
   50580  C                Kidney endoscopy &    ...........  ...........  ...........  ...........  ...........
                            treatment.
   50590  T                Fragmenting of               0169        39.62    $2,016.82    $1,109.25      $403.36
                            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         1.01       $51.41       $15.42       $10.28
                            pressure.
   50688  T                Change of ureter             0121         2.54      $129.30       $52.53       $25.86
                            tube.
   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        37.63    $1,915.52      $996.07      $383.10
                            ureterolithotomy.
   50947  T                Laparo new ureter/           0131        37.63    $1,915.52      $996.07      $383.10
                            bladder.
   50948  T                Laparo new ureter/           0131        37.63    $1,915.52      $996.07      $383.10
                            bladder.
   50949  T                Laparoscope proc,            0130        25.91    $1,318.92      $659.53      $263.78
                            ureter.
   50951  T                Endoscopy of ureter.         0160         5.13      $261.14      $104.46       $52.23
   50953  T                Endoscopy of ureter.         0160         5.13      $261.14      $104.46       $52.23
   50955  T                Ureter endoscopy &           0161        13.72      $698.40      $249.36      $139.68
                            biopsy.
   50957  T                Ureter endoscopy &           0161        13.72      $698.40      $249.36      $139.68
                            treatment.
   50959  T                Ureter endoscopy &           0161        13.72      $698.40      $249.36      $139.68
                            tracer.
   50961  T                Ureter endoscopy &           0161        13.72      $698.40      $249.36      $139.68
                            treatment.
   50970  T                Ureter endoscopy....         0160         5.13      $261.14      $104.46       $52.23
   50972  T                Ureter endoscopy &           0160         5.13      $261.14      $104.46       $52.23
                            catheter.
   50974  T                Ureter endoscopy &           0161        13.72      $698.40      $249.36      $139.68
                            biopsy.
   50976  T                Ureter endoscopy &           0161        13.72      $698.40      $249.36      $139.68
                            treatment.
   50978  T                Ureter endoscopy &           0161        13.72      $698.40      $249.36      $139.68
                            tracer.
   50980  T                Ureter endoscopy &           0161        13.72      $698.40      $249.36      $139.68
                            treatment.
   51000  T                Drainage of bladder.         0165         5.22      $265.72       $91.76       $53.14
   51005  T                Drainage of bladder.         0156         2.45      $124.71       $37.41       $24.94
   51010  T                Drainage of bladder.         0165         5.22      $265.72       $91.76       $53.14
   51020  T                Incise & treat               0162        25.09    $1,277.18      $427.49      $255.44
                            bladder.
   51030  T                Incise & treat               0162        25.09    $1,277.18      $427.49      $255.44
                            bladder.
   51040  T                Incise & drain               0162        25.09    $1,277.18      $427.49      $255.44
                            bladder.
   51045  T                Incise bladder/drain         0160         5.13      $261.14      $104.46       $52.23
                            ureter.
   51050  T                Removal of bladder           0162        25.09    $1,277.18      $427.49      $255.44
                            stone.
   51060  C                Removal of ureter     ...........  ...........  ...........  ...........  ...........
                            stone.
   51065  T                Removal of ureter            0162        25.09    $1,277.18      $427.49      $255.44
                            stone.
   51080  T                Drainage of bladder          0007         6.75      $343.60       $72.03       $68.72
                            abscess.
   51500  T                Removal of bladder           0154        31.40    $1,598.39      $556.98      $319.68
                            cyst.
   51520  T                Removal of bladder           0162        25.09    $1,277.18      $427.49      $255.44
                            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).

[[Page 59987]]

 
   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         2.45      $124.71       $37.41       $24.94
                            bladder.
   51705  T                Change of bladder            0121         2.54      $129.30       $52.53       $25.86
                            tube.
   51710  T                Change of bladder            0121         2.54      $129.30       $52.53       $25.86
                            tube.
   51715  T                Endoscopic injection/        0167        22.28    $1,134.14      $555.84      $226.83
                            implant.
   51720  T                Treatment of bladder         0156         2.45      $124.71       $37.41       $24.94
                            lesion.
   51725  T                Simple                       0165         5.22      $265.72       $91.76       $53.14
                            cystometrogram.
   51726  T                Complex                      0165         5.22      $265.72       $91.76       $53.14
                            cystometrogram.
   51736  T                Urine flow                   0164         1.01       $51.41       $15.42       $10.28
                            measurement.
   51741  T                Electro-                     0164         1.01       $51.41       $15.42       $10.28
                            uroflowmetry, first.
   51772  T                Urethra pressure             0165         5.22      $265.72       $91.76       $53.14
                            profile.
   51784  T                Anal/urinary muscle          0164         1.01       $51.41       $15.42       $10.28
                            study.
   51785  T                Anal/urinary muscle          0156         2.45      $124.71       $37.41       $24.94
                            study.
   51792  T                Urinary reflex study         0156         2.45      $124.71       $37.41       $24.94
   51795  T                Urine voiding                0165         5.22      $265.72       $91.76       $53.14
                            pressure study.
   51797  T                Intraabdominal               0165         5.22      $265.72       $91.76       $53.14
                            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        25.09    $1,277.18      $427.49      $255.44
                            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        37.63    $1,915.52      $996.07      $383.10
                            suspension.
   51992  T                Laparo sling                 0132        56.06    $2,853.68    $1,239.22      $570.74
                            operation.
   52000  T                Cystoscopy..........         0160         5.13      $261.14      $104.46       $52.23
  *52001  T                Cystoscopy, removal          0160         5.13      $261.14      $104.46       $52.23
                            of clots.
   52005  T                Cystoscopy & ureter          0161        13.72      $698.40      $249.36      $139.68
                            catheter.
   52007  T                Cystoscopy and               0161        13.72      $698.40      $249.36      $139.68
                            biopsy.
   52010  T                Cystoscopy & duct            0160         5.13      $261.14      $104.46       $52.23
                            catheter.
   52204  T                Cystoscopy..........         0161        13.72      $698.40      $249.36      $139.68
   52214  T                Cystoscopy and               0162        25.09    $1,277.18      $427.49      $255.44
                            treatment.
   52224  T                Cystoscopy and               0162        25.09    $1,277.18      $427.49      $255.44
                            treatment.
   52234  T                Cystoscopy and               0163        40.40    $2,056.52      $792.58      $411.30
                            treatment.
   52235  T                Cystoscopy and               0163        40.40    $2,056.52      $792.58      $411.30
                            treatment.
   52240  T                Cystoscopy and               0162        25.09    $1,277.18      $427.49      $255.44
                            treatment.
   52250  T                Cystoscopy and               0162        25.09    $1,277.18      $427.49      $255.44
                            radiotracer.
   52260  T                Cystoscopy and               0161        13.72      $698.40      $249.36      $139.68
                            treatment.
   52265  T                Cystoscopy and               0160         5.13      $261.14      $104.46       $52.23
                            treatment.
   52270  T                Cystoscopy & revise          0161        13.72      $698.40      $249.36      $139.68
                            urethra.
   52275  T                Cystoscopy & revise          0161        13.72      $698.40      $249.36      $139.68
                            urethra.
   52276  T                Cystoscopy and               0161        13.72      $698.40      $249.36      $139.68
                            treatment.
   52277  T                Cystoscopy and               0162        25.09    $1,277.18      $427.49      $255.44
                            treatment.
   52281  T                Cystoscopy and               0161        13.72      $698.40      $249.36      $139.68
                            treatment.
   52282  T                Cystoscopy, implant          0163        40.40    $2,056.52      $792.58      $411.30
                            stent.
   52283  T                Cystoscopy and               0161        13.72      $698.40      $249.36      $139.68
                            treatment.
   52285  T                Cystoscopy and               0161        13.72      $698.40      $249.36      $139.68
                            treatment.
   52290  T                Cystoscopy and               0161        13.72      $698.40      $249.36      $139.68
                            treatment.
   52300  T                Cystoscopy and               0161        13.72      $698.40      $249.36      $139.68
                            treatment.
   52301  T                Cystoscopy and               0161        13.72      $698.40      $249.36      $139.68
                            treatment.
   52305  T                Cystoscopy and               0161        13.72      $698.40      $249.36      $139.68
                            treatment.
   52310  T                Cystoscopy and               0160         5.13      $261.14      $104.46       $52.23
                            treatment.
   52315  T                Cystoscopy and               0161        13.72      $698.40      $249.36      $139.68
                            treatment.
   52317  T                Remove bladder stone         0162        25.09    $1,277.18      $427.49      $255.44
   52318  T                Remove bladder stone         0162        25.09    $1,277.18      $427.49      $255.44
   52320  T                Cystoscopy and               0162        25.09    $1,277.18      $427.49      $255.44
                            treatment.
   52325  T                Cystoscopy, stone            0162        25.09    $1,277.18      $427.49      $255.44
                            removal.
   52327  T                Cystoscopy, inject           0162        25.09    $1,277.18      $427.49      $255.44
                            material.

[[Page 59988]]

 
   52330  T                Cystoscopy and               0162        25.09    $1,277.18      $427.49      $255.44
                            treatment.
   52332  T                Cystoscopy and               0162        25.09    $1,277.18      $427.49      $255.44
                            treatment.
   52334  T                Create passage to            0162        25.09    $1,277.18      $427.49      $255.44
                            kidney.
   52341  T                Cysto w/ureter               0162        25.09    $1,277.18      $427.49      $255.44
                            stricture tx.
   52342  T                Cysto w/up stricture         0162        25.09    $1,277.18      $427.49      $255.44
                            tx.
   52343  T                Cysto w/renal                0162        25.09    $1,277.18      $427.49      $255.44
                            stricture tx.
   52344  T                Cysto/uretero, stone         0162        25.09    $1,277.18      $427.49      $255.44
                            remove.
   52345  T                Cysto/uretero w/up           0162        25.09    $1,277.18      $427.49      $255.44
                            stricture.
   52346  T                Cystouretero w/renal         0162        25.09    $1,277.18      $427.49      $255.44
                            strict.
  *52347  T                Cystoscopy, resect           0160         5.13      $261.14      $104.46       $52.23
                            ducts.
   52351  T                Cystouretro & or             0160         5.13      $261.14      $104.46       $52.23
                            pyeloscope.
   52352  T                Cystouretro w/stone          0162        25.09    $1,277.18      $427.49      $255.44
                            remove.
   52353  T                Cystouretero w/              0163        40.40    $2,056.52      $792.58      $411.30
                            lithotripsy.
   52354  T                Cystouretero w/              0162        25.09    $1,277.18      $427.49      $255.44
                            biopsy.
   52355  T                Cystouretero w/              0162        25.09    $1,277.18      $427.49      $255.44
                            excise tumor.
   52400  T                Cystouretero w/              0162        25.09    $1,277.18      $427.49      $255.44
                            congen repr.
   52450  T                Incision of prostate         0162        25.09    $1,277.18      $427.49      $255.44
   52500  T                Revision of bladder          0162        25.09    $1,277.18      $427.49      $255.44
                            neck.
   52510  T                Dilation prostatic           0161        13.72      $698.40      $249.36      $139.68
                            urethra.
   52601  T                Prostatectomy (TURP)         0163        40.40    $2,056.52      $792.58      $411.30
   52606  T                Control postop               0162        25.09    $1,277.18      $427.49      $255.44
                            bleeding.
   52612  T                Prostatectomy, first         0163        40.40    $2,056.52      $792.58      $411.30
                            stage.
   52614  T                Prostatectomy,               0163        40.40    $2,056.52      $792.58      $411.30
                            second stage.
   52620  T                Remove residual              0163        40.40    $2,056.52      $792.58      $411.30
                            prostate.
   52630  T                Remove prostate              0163        40.40    $2,056.52      $792.58      $411.30
                            regrowth.
   52640  T                Relieve bladder              0162        25.09    $1,277.18      $427.49      $255.44
                            contracture.
   52647  T                Laser surgery of             0163        40.40    $2,056.52      $792.58      $411.30
                            prostate.
   52648  T                Laser surgery of             0163        40.40    $2,056.52      $792.58      $411.30
                            prostate.
   52700  T                Drainage of prostate         0162        25.09    $1,277.18      $427.49      $255.44
                            abscess.
   53000  T                Incision of urethra.         0166        12.20      $621.03      $218.73      $124.21
   53010  T                Incision of urethra.         0166        12.20      $621.03      $218.73      $124.21
   53020  T                Incision of urethra.         0166        12.20      $621.03      $218.73      $124.21
   53025  T                Incision of urethra.         0166        12.20      $621.03      $218.73      $124.21
   53040  T                Drainage of urethra          0166        12.20      $621.03      $218.73      $124.21
                            abscess.
   53060  T                Drainage of urethra          0166        12.20      $621.03      $218.73      $124.21
                            abscess.
   53080  T                Drainage of urinary          0166        12.20      $621.03      $218.73      $124.21
                            leakage.
   53085  C                Drainage of urinary   ...........  ...........  ...........  ...........  ...........
                            leakage.
   53200  T                Biopsy of urethra...         0166        12.20      $621.03      $218.73      $124.21
   53210  T                Removal of urethra..         0168        18.42      $937.65      $403.19      $187.53
   53215  T                Removal of urethra..         0168        18.42      $937.65      $403.19      $187.53
   53220  T                Treatment of urethra         0168        18.42      $937.65      $403.19      $187.53
                            lesion.
   53230  T                Removal of urethra           0168        18.42      $937.65      $403.19      $187.53
                            lesion.
   53235  T                Removal of urethra           0168        18.42      $937.65      $403.19      $187.53
                            lesion.
   53240  T                Surgery for urethra          0168        18.42      $937.65      $403.19      $187.53
                            pouch.
   53250  T                Removal of urethra           0166        12.20      $621.03      $218.73      $124.21
                            gland.
   53260  T                Treatment of urethra         0166        12.20      $621.03      $218.73      $124.21
                            lesion.
   53265  T                Treatment of urethra         0166        12.20      $621.03      $218.73      $124.21
                            lesion.
   53270  T                Removal of urethra           0167        22.28    $1,134.14      $555.84      $226.83
                            gland.
   53275  T                Repair of urethra            0166        12.20      $621.03      $218.73      $124.21
                            defect.
   53400  T                Revise urethra,              0168        18.42      $937.65      $403.19      $187.53
                            stage 1.
   53405  T                Revise urethra,              0168        18.42      $937.65      $403.19      $187.53
                            stage 2.
   53410  T                Reconstruction of            0168        18.42      $937.65      $403.19      $187.53
                            urethra.
   53415  C                Reconstruction of     ...........  ...........  ...........  ...........  ...........
                            urethra.
   53420  T                Reconstruct urethra,         0168        18.42      $937.65      $403.19      $187.53
                            stage 1.
   53425  T                Reconstruct urethra,         0168        18.42      $937.65      $403.19      $187.53
                            stage 2.
   53430  T                Reconstruction of            0168        18.42      $937.65      $403.19      $187.53
                            urethra.
  *53431  T                Reconstruct urethra/         0168        18.42      $937.65      $403.19      $187.53
                            bladder.
   53440  T                Correct bladder              0179       139.33    $7,092.45    $2,340.51    $1,418.49
                            function.
   53442  T                Remove perineal              0166        12.20      $621.03      $218.73      $124.21
                            prosthesis.
   53443  D                Reconstruction of     ...........  ...........  ...........  ...........  ...........
                            urethra.
  *53444  T                Insert tandem cuff..         0179       139.33    $7,092.45    $2,340.51    $1,418.49
   53445  T                Correct urine flow           0179       139.33    $7,092.45    $2,340.51    $1,418.49
                            control.
  *53446  T                Remove uro sphincter         0168        18.42      $937.65      $403.19      $187.53
   53447  T                Remove artificial            0179       139.33    $7,092.45    $2,340.51    $1,418.49
                            sphincter.
  *53448  C                Remov/replc ur        ...........  ...........  ...........  ...........  ...........
                            sphinctr comp.
   53449  T                Correct artificial           0168        18.42      $937.65      $403.19      $187.53
                            sphincter.
   53450  T                Revision of urethra.         0168        18.42      $937.65      $403.19      $187.53
   53460  T                Revision of urethra.         0168        18.42      $937.65      $403.19      $187.53
   53502  T                Repair of urethra            0166        12.20      $621.03      $218.73      $124.21
                            injury.
   53505  T                Repair of urethra            0167        22.28    $1,134.14      $555.84      $226.83
                            injury.
   53510  T                Repair of urethra            0166        12.20      $621.03      $218.73      $124.21
                            injury.
   53515  T                Repair of urethra            0168        18.42      $937.65      $403.19      $187.53
                            injury.
   53520  T                Repair of urethra            0168        18.42      $937.65      $403.19      $187.53
                            defect.
   53600  T                Dilate urethra               0156         2.45      $124.71       $37.41       $24.94
                            stricture.
   53601  T                Dilate urethra               0164         1.01       $51.41       $15.42       $10.28
                            stricture.

[[Page 59989]]

 
   53605  T                Dilate urethra               0161        13.72      $698.40      $249.36      $139.68
                            stricture.
   53620  T                Dilate urethra               0165         5.22      $265.72       $91.76       $53.14
                            stricture.
   53621  T                Dilate urethra               0164         1.01       $51.41       $15.42       $10.28
                            stricture.
   53660  T                Dilation of urethra.         0164         1.01       $51.41       $15.42       $10.28
   53661  T                Dilation of urethra.         0164         1.01       $51.41       $15.42       $10.28
   53665  T                Dilation of urethra.         0166        12.20      $621.03      $218.73      $124.21
   53670  N                Insert urinary        ...........  ...........  ...........  ...........  ...........
                            catheter.
   53675  T                Insert urinary               0156         2.45      $124.71       $37.41       $24.94
                            catheter.
   53850  T                Prostatic microwave          0982  ...........    $2,750.00  ...........      $550.00
                            thermotx.
   53852  T                Prostatic rf                 0982  ...........    $2,750.00  ...........      $550.00
                            thermotx.
  *53853  T                Prostatic water              0977  ...........    $1,125.00  ...........      $225.00
                            thermother.
   53899  T                Urology surgery              0165         5.22      $265.72       $91.76       $53.14
                            procedure.
   54000  T                Slitting of prepuce.         0166        12.20      $621.03      $218.73      $124.21
   54001  T                Slitting of prepuce.         0166        12.20      $621.03      $218.73      $124.21
   54015  T                Drain penis lesion..         0006         2.18      $110.97       $33.95       $22.19
   54050  T                Destruction, penis           0013         1.36       $69.23       $17.66       $13.85
                            lesion(s).
   54055  T                Destruction, penis           0017         9.68      $492.75      $226.67       $98.55
                            lesion(s).
   54056  T                Cryosurgery, penis           0012         0.66       $33.60        $9.18        $6.72
                            lesion(s).
   54057  T                Laser surg, penis            0017         9.68      $492.75      $226.67       $98.55
                            lesion(s).
   54060  T                Excision of penis            0017         9.68      $492.75      $226.67       $98.55
                            lesion(s).
   54065  T                Destruction, penis           0695        15.78      $803.27      $369.50      $160.65
                            lesion(s).
   54100  T                Biopsy of penis.....         0020         8.44      $429.63      $130.53       $85.93
   54105  T                Biopsy of penis.....         0021        11.82      $601.69      $236.51      $120.34
   54110  T                Treatment of penis           0181        22.09    $1,124.47      $618.45      $224.89
                            lesion.
   54111  T                Treat penis lesion,          0181        22.09    $1,124.47      $618.45      $224.89
                            graft.
   54112  T                Treat penis lesion,          0181        22.09    $1,124.47      $618.45      $224.89
                            graft.
   54115  T                Treatment of penis           0008        10.93      $556.38      $113.67      $111.28
                            lesion.
   54120  T                Partial removal of           0181        22.09    $1,124.47      $618.45      $224.89
                            penis.
   54125  C                Removal of penis....  ...........  ...........  ...........  ...........  ...........
   54130  C                Remove penis & nodes  ...........  ...........  ...........  ...........  ...........
   54135  C                Remove penis & nodes  ...........  ...........  ...........  ...........  ...........
   54150  T                Circumcision........         0180        15.02      $764.58      $304.87      $152.92
   54152  T                Circumcision........         0180        15.02      $764.58      $304.87      $152.92
   54160  T                Circumcision........         0180        15.02      $764.58      $304.87      $152.92
   54161  T                Circumcision........         0180        15.02      $764.58      $304.87      $152.92
  *54162  T                Lysis penil                  0180        15.02      $764.58      $304.87      $152.92
                            circumcis lesion.
  *54163  T                Repair of                    0180        15.02      $764.58      $304.87      $152.92
                            circumcision.
  *54164  T                Frenulotomy of penis         0180        15.02      $764.58      $304.87      $152.92
   54200  T                Treatment of penis           0156         2.45      $124.71       $37.41       $24.94
                            lesion.
   54205  T                Treatment of penis           0181        22.09    $1,124.47      $618.45      $224.89
                            lesion.
   54220  T                Treatment of penis           0156         2.45      $124.71       $37.41       $24.94
                            lesion.
   54230  N                Prepare penis study.  ...........  ...........  ...........  ...........  ...........
   54231  T                Dynamic                      0165         5.22      $265.72       $91.76       $53.14
                            cavernosometry.
   54235  T                Penile injection....         0164         1.01       $51.41       $15.42       $10.28
   54240  T                Penis study.........         0164         1.01       $51.41       $15.42       $10.28
   54250  T                Penis study.........         0165         5.22      $265.72       $91.76       $53.14
   54300  T                Revision of penis...         0181        22.09    $1,124.47      $618.45      $224.89
   54304  T                Revision of penis...         0181        22.09    $1,124.47      $618.45      $224.89
   54308  T                Reconstruction of            0181        22.09    $1,124.47      $618.45      $224.89
                            urethra.
   54312  T                Reconstruction of            0181        22.09    $1,124.47      $618.45      $224.89
                            urethra.
   54316  T                Reconstruction of            0181        22.09    $1,124.47      $618.45      $224.89
                            urethra.
   54318  T                Reconstruction of            0181        22.09    $1,124.47      $618.45      $224.89
                            urethra.
   54322  T                Reconstruction of            0181        22.09    $1,124.47      $618.45      $224.89
                            urethra.
   54324  T                Reconstruction of            0181        22.09    $1,124.47      $618.45      $224.89
                            urethra.
   54326  T                Reconstruction of            0181        22.09    $1,124.47      $618.45      $224.89
                            urethra.
   54328  T                Revise penis/urethra         0181        22.09    $1,124.47      $618.45      $224.89
   54332  C                Revise penis/urethra  ...........  ...........  ...........  ...........  ...........
   54336  C                Revise penis/urethra  ...........  ...........  ...........  ...........  ...........
   54340  T                Secondary urethral           0181        22.09    $1,124.47      $618.45      $224.89
                            surgery.
   54344  T                Secondary urethral           0181        22.09    $1,124.47      $618.45      $224.89
                            surgery.
   54348  T                Secondary urethral           0181        22.09    $1,124.47      $618.45      $224.89
                            surgery.
   54352  T                Reconstruct urethra/         0181        22.09    $1,124.47      $618.45      $224.89
                            penis.
   54360  T                Penis plastic                0181        22.09    $1,124.47      $618.45      $224.89
                            surgery.
   54380  T                Repair penis........         0181        22.09    $1,124.47      $618.45      $224.89
   54385  T                Repair penis........         0181        22.09    $1,124.47      $618.45      $224.89
   54390  C                Repair penis and      ...........  ...........  ...........  ...........  ...........
                            bladder.
   54400  T                Insert semi-rigid            0182        87.54    $4,456.14    $1,492.28      $891.23
                            prosthesis.
   54401  T                Insert self-contd            0182        87.54    $4,456.14    $1,492.28      $891.23
                            prosthesis.
   54402  D                Remove penis                 0182        87.54    $4,456.14    $1,492.28      $891.23
                            prosthesis.
   54405  T                Insert multi-comp            0182        87.54    $4,456.14    $1,492.28      $891.23
                            prosthesis.
  *54406  T                Remove multi-comp            0181        22.09    $1,124.47      $618.45      $224.89
                            penis pros.
   54407  D                Remove multi-comp            0182        87.54    $4,456.14    $1,492.28      $891.23
                            prosthesis.
  *54408  T                Repair multi-comp            0181        22.09    $1,124.47      $618.45      $224.89
                            penis pros.
   54409  D                Revise penis                 0182        87.54    $4,456.14    $1,492.28      $891.23
                            prosthesis.
  *54410  T                Remove/replace penis         0182        87.54    $4,456.14    $1,492.28      $891.23
                            prosth.

[[Page 59990]]

 
  *54411  C                Remv/replc penis      ...........  ...........  ...........  ...........  ...........
                            pros, comp.
  *54415  T                Remove self-contd            0181        22.09    $1,124.47      $618.45      $224.89
                            penis pros.
  *54416  T                Remv/repl penis              0182        87.54    $4,456.14    $1,492.28      $891.23
                            contain pros.
  *54417  C                Remv/replc penis      ...........  ...........  ...........  ...........  ...........
                            pros, compl.
   54420  T                Revision of penis...         0181        22.09    $1,124.47      $618.45      $224.89
   54430  C                Revision of penis...  ...........  ...........  ...........  ...........  ...........
   54435  T                Revision of penis...         0181        22.09    $1,124.47      $618.45      $224.89
   54440  T                Repair of penis.....         0181        22.09    $1,124.47      $618.45      $224.89
   54450  T                Preputial stretching         0156         2.45      $124.71       $37.41       $24.94
   54500  T                Biopsy of testis....         0005         4.03      $205.14       $90.26       $41.03
   54505  T                Biopsy of testis....         0183        18.87      $960.56      $448.94      $192.11
   54510  D                Removal of testis            0183        18.87      $960.56      $448.94      $192.11
                            lesion.
   54512  T                Excise lesion testis         0183        18.87      $960.56      $448.94      $192.11
   54520  T                Removal of testis...         0183        18.87      $960.56      $448.94      $192.11
   54522  T                Orchiectomy, partial         0183        18.87      $960.56      $448.94      $192.11
   54530  T                Removal of testis...         0154        31.40    $1,598.39      $556.98      $319.68
   54535  C                Extensive testis      ...........  ...........  ...........  ...........  ...........
                            surgery.
   54550  T                Exploration for              0154        31.40    $1,598.39      $556.98      $319.68
                            testis.
   54560  C                Exploration for       ...........  ...........  ...........  ...........  ...........
                            testis.
   54600  T                Reduce testis                0183        18.87      $960.56      $448.94      $192.11
                            torsion.
   54620  T                Suspension of testis         0183        18.87      $960.56      $448.94      $192.11
   54640  T                Suspension of testis         0154        31.40    $1,598.39      $556.98      $319.68
   54650  C                Orchiopexy (Fowler-   ...........  ...........  ...........  ...........  ...........
                            Stephens).
   54660  T                Revision of testis..         0183        18.87      $960.56      $448.94      $192.11
   54670  T                Repair testis injury         0183        18.87      $960.56      $448.94      $192.11
   54680  T                Relocation of                0183        18.87      $960.56      $448.94      $192.11
                            testis(es).
   54690  T                Laparoscopy,                 0131        37.63    $1,915.52      $996.07      $383.10
                            orchiectomy.
   54692  T                Laparoscopy,                 0132        56.06    $2,853.68    $1,239.22      $570.74
                            orchiopexy.
   54699  T                Laparoscope proc,            0130        25.91    $1,318.92      $659.53      $263.78
                            testis.
   54700  T                Drainage of scrotum.         0183        18.87      $960.56      $448.94      $192.11
   54800  T                Biopsy of epididymis         0004         2.47      $125.73       $32.57       $25.15
   54820  T                Exploration of               0183        18.87      $960.56      $448.94      $192.11
                            epididymis.
   54830  T                Remove epididymis            0183        18.87      $960.56      $448.94      $192.11
                            lesion.
   54840  T                Remove epididymis            0183        18.87      $960.56      $448.94      $192.11
                            lesion.
   54860  T                Removal of                   0183        18.87      $960.56      $448.94      $192.11
                            epididymis.
   54861  T                Removal of                   0183        18.87      $960.56      $448.94      $192.11
                            epididymis.
   54900  T                Fusion of spermatic          0183        18.87      $960.56      $448.94      $192.11
                            ducts.
   54901  T                Fusion of spermatic          0183        18.87      $960.56      $448.94      $192.11
                            ducts.
   55000  T                Drainage of                  0004         2.47      $125.73       $32.57       $25.15
                            hydrocele.
   55040  T                Removal of hydrocele         0154        31.40    $1,598.39      $556.98      $319.68
   55041  T                Removal of                   0154        31.40    $1,598.39      $556.98      $319.68
                            hydroceles.
   55060  T                Repair of hydrocele.         0183        18.87      $960.56      $448.94      $192.11
   55100  T                Drainage of scrotum          0007         6.75      $343.60       $72.03       $68.72
                            abscess.
   55110  T                Explore scrotum.....         0183        18.87      $960.56      $448.94      $192.11
   55120  T                Removal of scrotum           0183        18.87      $960.56      $448.94      $192.11
                            lesion.
   55150  T                Removal of scrotum..         0183        18.87      $960.56      $448.94      $192.11
   55175  T                Revision of scrotum.         0183        18.87      $960.56      $448.94      $192.11
   55180  T                Revision of scrotum.         0183        18.87      $960.56      $448.94      $192.11
   55200  T                Incision of sperm            0183        18.87      $960.56      $448.94      $192.11
                            duct.
   55250  T                Removal of sperm             0183        18.87      $960.56      $448.94      $192.11
                            duct(s).
   55300  N                Prepare, sperm duct   ...........  ...........  ...........  ...........  ...........
                            x-ray.
   55400  T                Repair of sperm duct         0183        18.87      $960.56      $448.94      $192.11
   55450  T                Ligation of sperm            0183        18.87      $960.56      $448.94      $192.11
                            duct.
   55500  T                Removal of hydrocele         0183        18.87      $960.56      $448.94      $192.11
   55520  T                Removal of sperm             0183        18.87      $960.56      $448.94      $192.11
                            cord lesion.
   55530  T                Revise spermatic             0183        18.87      $960.56      $448.94      $192.11
                            cord veins.
   55535  T                Revise spermatic             0154        31.40    $1,598.39      $556.98      $319.68
                            cord veins.
   55540  T                Revise hernia &              0154        31.40    $1,598.39      $556.98      $319.68
                            sperm veins.
   55550  T                Laparo ligate                0131        37.63    $1,915.52      $996.07      $383.10
                            spermatic vein.
   55559  T                Laparo proc,                 0130        25.91    $1,318.92      $659.53      $263.78
                            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        18.87      $960.56      $448.94      $192.11
                            lesion.
   55700  T                Biopsy of prostate..         0184         4.83      $245.87      $122.94       $49.17
   55705  T                Biopsy of prostate..         0184         4.83      $245.87      $122.94       $49.17
   55720  T                Drainage of prostate         0162        25.09    $1,277.18      $427.49      $255.44
                            abscess.
   55725  T                Drainage of prostate         0162        25.09    $1,277.18      $427.49      $255.44
                            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.

[[Page 59991]]

 
   55842  C                Extensive prostate    ...........  ...........  ...........  ...........  ...........
                            surgery.
   55845  C                Extensive prostate    ...........  ...........  ...........  ...........  ...........
                            surgery.
   55859  T                Percut/needle                0163        40.40    $2,056.52      $792.58      $411.30
                            insert, pros.
   55860  T                Surgical exposure,           0165         5.22      $265.72       $91.76       $53.14
                            prostate.
   55862  C                Extensive prostate    ...........  ...........  ...........  ...........  ...........
                            surgery.
   55865  C                Extensive prostate    ...........  ...........  ...........  ...........  ...........
                            surgery.
   55870  T                Electroejaculation..         0197         2.40      $122.17       $49.55       $24.43
   55873  T                Cryoablate prostate.         0982  ...........    $2,750.00  ...........      $550.00
   55899  T                Genital surgery              0164         1.01       $51.41       $15.42       $10.28
                            procedure.
   55970  E                Sex transformation,   ...........  ...........  ...........  ...........  ...........
                            M to F.
   55980  E                Sex transformation,   ...........  ...........  ...........  ...........  ...........
                            F to M.
   56405  T                I & D of vulva/              0192         2.50      $127.26       $35.33       $25.45
                            perineum.
   56420  T                Drainage of gland            0192         2.50      $127.26       $35.33       $25.45
                            abscess.
   56440  T                Surgery for vulva            0194        15.86      $807.34      $395.60      $161.47
                            lesion.
   56441  T                Lysis of labial              0193        11.16      $568.09      $171.13      $113.62
                            lesion(s).
   56501  T                Destruction, vulva           0017         9.68      $492.75      $226.67       $98.55
                            lesion(s).
   56515  T                Destruction, vulva           0695        15.78      $803.27      $369.50      $160.65
                            lesion(s).
   56605  T                Biopsy of vulva/             0019         4.22      $214.81       $78.91       $42.96
                            perineum.
   56606  T                Biopsy of vulva/             0019         4.22      $214.81       $78.91       $42.96
                            perineum.
   56620  T                Partial removal of           0195        20.62    $1,049.64      $483.80      $209.93
                            vulva.
   56625  T                Complete removal of          0195        20.62    $1,049.64      $483.80      $209.93
                            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        15.86      $807.34      $395.60      $161.47
                            hymen.
   56720  T                Incision of hymen...         0193        11.16      $568.09      $171.13      $113.62
   56740  T                Remove vagina gland          0194        15.86      $807.34      $395.60      $161.47
                            lesion.
   56800  T                Repair of vagina....         0194        15.86      $807.34      $395.60      $161.47
   56805  T                Repair clitoris.....         0194        15.86      $807.34      $395.60      $161.47
   56810  T                Repair of perineum..         0194        15.86      $807.34      $395.60      $161.47
   57000  T                Exploration of               0194        15.86      $807.34      $395.60      $161.47
                            vagina.
   57010  T                Drainage of pelvic           0194        15.86      $807.34      $395.60      $161.47
                            abscess.
   57020  T                Drainage of pelvic           0193        11.16      $568.09      $171.13      $113.62
                            fluid.
   57022  T                I &d vaginal                 0007         6.75      $343.60       $72.03       $68.72
                            hematoma, ob.
   57023  T                I &d vag hematoma,           0007         6.75      $343.60       $72.03       $68.72
                            trauma.
   57061  T                Destruction vagina           0194        15.86      $807.34      $395.60      $161.47
                            lesion(s).
   57065  T                Destruction vagina           0194        15.86      $807.34      $395.60      $161.47
                            lesion(s).
   57100  T                Biopsy of vagina....         0193        11.16      $568.09      $171.13      $113.62
   57105  T                Biopsy of vagina....         0194        15.86      $807.34      $395.60      $161.47
   57106  T                Remove vagina wall,          0194        15.86      $807.34      $395.60      $161.47
                            partial.
   57107  T                Remove vagina                0195        20.62    $1,049.64      $483.80      $209.93
                            tissue, part.
   57109  T                Vaginectomy partial          0202        63.54    $3,234.44    $1,487.84      $646.89
                            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        15.86      $807.34      $395.60      $161.47
   57130  T                Remove vagina lesion         0194        15.86      $807.34      $395.60      $161.47
   57135  T                Remove vagina lesion         0194        15.86      $807.34      $395.60      $161.47
   57150  T                Treat vagina                 0191         0.23       $11.71        $3.40        $2.34
                            infection.
  *57155  T                Insert uteri tandems/        0192         2.50      $127.26       $35.33       $25.45
                            ovoids.
   57160  T                Insert pessary/other         0188         0.80       $40.72       $11.81        $8.14
                            device.
   57170  T                Fitting of diaphragm/        0191         0.23       $11.71        $3.40        $2.34
                            cap.
   57180  T                Treat vaginal                0192         2.50      $127.26       $35.33       $25.45
                            bleeding.
   57200  T                Repair of vagina....         0194        15.86      $807.34      $395.60      $161.47
   57210  T                Repair vagina/               0194        15.86      $807.34      $395.60      $161.47
                            perineum.
   57220  T                Revision of urethra.         0195        20.62    $1,049.64      $483.80      $209.93
   57230  T                Repair of urethral           0194        15.86      $807.34      $395.60      $161.47
                            lesion.
   57240  T                Repair bladder &             0195        20.62    $1,049.64      $483.80      $209.93
                            vagina.
   57250  T                Repair rectum &              0195        20.62    $1,049.64      $483.80      $209.93
                            vagina.
   57260  T                Repair of vagina....         0195        20.62    $1,049.64      $483.80      $209.93
   57265  T                Extensive repair of          0195        20.62    $1,049.64      $483.80      $209.93
                            vagina.
   57268  T                Repair of bowel              0195        20.62    $1,049.64      $483.80      $209.93
                            bulge.
   57270  C                Repair of bowel       ...........  ...........  ...........  ...........  ...........
                            pouch.
   57280  C                Suspension of vagina  ...........  ...........  ...........  ...........  ...........
   57282  C                Repair of vaginal     ...........  ...........  ...........  ...........  ...........
                            prolapse.
   57284  T                Repair paravaginal           0195        20.62    $1,049.64      $483.80      $209.93
                            defect.
   57287  T                Revise/remove sling          0202        63.54    $3,234.44    $1,487.84      $646.89
                            repair.
   57288  T                Repair bladder               0202        63.54    $3,234.44    $1,487.84      $646.89
                            defect.
   57289  T                Repair bladder &             0195        20.62    $1,049.64      $483.80      $209.93
                            vagina.
   57291  T                Construction of              0195        20.62    $1,049.64      $483.80      $209.93
                            vagina.
   57292  C                Construct vagina      ...........  ...........  ...........  ...........  ...........
                            with graft.

[[Page 59992]]

 
   57300  T                Repair rectum-vagina         0195        20.62    $1,049.64      $483.80      $209.93
                            fistula.
   57305  C                Repair rectum-vagina  ...........  ...........  ...........  ...........  ...........
                            fistula.
   57307  C                Fistula repair &      ...........  ...........  ...........  ...........  ...........
                            colostomy.
   57308  C                Fistula repair,       ...........  ...........  ...........  ...........  ...........
                            transperine.
   57310  T                Repair                       0195        20.62    $1,049.64      $483.80      $209.93
                            urethrovaginal
                            lesion.
   57311  C                Repair                ...........  ...........  ...........  ...........  ...........
                            urethrovaginal
                            lesion.
   57320  T                Repair bladder-              0195        20.62    $1,049.64      $483.80      $209.93
                            vagina lesion.
   57330  T                Repair bladder-              0195        20.62    $1,049.64      $483.80      $209.93
                            vagina lesion.
   57335  C                Repair vagina.......  ...........  ...........  ...........  ...........  ...........
   57400  T                Dilation of vagina..         0194        15.86      $807.34      $395.60      $161.47
   57410  T                Pelvic examination..         0194        15.86      $807.34      $395.60      $161.47
   57415  T                Remove vaginal               0194        15.86      $807.34      $395.60      $161.47
                            foreign body.
   57452  T                Examination of               0189         1.26       $64.14       $17.96       $12.83
                            vagina.
   57454  T                Vagina examination &         0192         2.50      $127.26       $35.33       $25.45
                            biopsy.
   57460  T                Cervix excision.....         0193        11.16      $568.09      $171.13      $113.62
   57500  T                Biopsy of cervix....         0192         2.50      $127.26       $35.33       $25.45
   57505  T                Endocervical                 0192         2.50      $127.26       $35.33       $25.45
                            curettage.
   57510  T                Cauterization of             0193        11.16      $568.09      $171.13      $113.62
                            cervix.
   57511  T                Cryocautery of               0189         1.26       $64.14       $17.96       $12.83
                            cervix.
   57513  T                Laser surgery of             0193        11.16      $568.09      $171.13      $113.62
                            cervix.
   57520  T                Conization of cervix         0194        15.86      $807.34      $395.60      $161.47
   57522  T                Conization of cervix         0195        20.62    $1,049.64      $483.80      $209.93
   57530  T                Removal of cervix...         0195        20.62    $1,049.64      $483.80      $209.93
   57531  C                Removal of cervix,    ...........  ...........  ...........  ...........  ...........
                            radical.
   57540  C                Removal of residual   ...........  ...........  ...........  ...........  ...........
                            cervix.
   57545  C                Remove cervix/repair  ...........  ...........  ...........  ...........  ...........
                            pelvis.
   57550  T                Removal of residual          0195        20.62    $1,049.64      $483.80      $209.93
                            cervix.
   57555  T                Remove cervix/repair         0195        20.62    $1,049.64      $483.80      $209.93
                            vagina.
   57556  T                Remove cervix,               0195        20.62    $1,049.64      $483.80      $209.93
                            repair bowel.
   57700  T                Revision of cervix..         0194        15.86      $807.34      $395.60      $161.47
   57720  T                Revision of cervix..         0194        15.86      $807.34      $395.60      $161.47
   57800  T                Dilation of cervical         0192         2.50      $127.26       $35.33       $25.45
                            canal.
   57820  T                D & c of residual            0196        13.48      $686.19      $336.23      $137.24
                            cervix.
   58100  T                Biopsy of uterus             0188         0.80       $40.72       $11.81        $8.14
                            lining.
   58120  T                Dilation and                 0196        13.48      $686.19      $336.23      $137.24
                            curettage.
   58140  C                Removal of uterus     ...........  ...........  ...........  ...........  ...........
                            lesion.
   58145  T                Removal of uterus            0195        20.62    $1,049.64      $483.80      $209.93
                            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         1.26       $64.14       $17.96       $12.83
                            device.
   58321  T                Artificial                   0197         2.40      $122.17       $49.55       $24.43
                            insemination.
   58322  T                Artificial                   0197         2.40      $122.17       $49.55       $24.43
                            insemination.
   58323  T                Sperm washing.......         0197         2.40      $122.17       $49.55       $24.43
   58340  N                Catheter for          ...........  ...........  ...........  ...........  ...........
                            hysterography.
   58345  T                Reopen fallopian             0194        15.86      $807.34      $395.60      $161.47
                            tube.
  *58346  T                Insert heyman uteri          0192         2.50      $127.26       $35.33       $25.45
                            capsule.
   58350  T                Reopen fallopian             0194        15.86      $807.34      $395.60      $161.47
                            tube.
   58353  T                Endometr ablate,             0193        11.16      $568.09      $171.13      $113.62
                            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        56.06    $2,853.68    $1,239.22      $570.74
                            hysterectomy.
   58551  T                Laparoscopy, remove          0131        37.63    $1,915.52      $996.07      $383.10
                            myoma.
   58555  T                Hysteroscopy, dx,            0194        15.86      $807.34      $395.60      $161.47
                            sep proc.
   58558  T                Hysteroscopy, biopsy         0190        16.91      $860.79      $421.79      $172.16
   58559  T                Hysteroscopy, lysis.         0190        16.91      $860.79      $421.79      $172.16
   58560  T                Hysteroscopy, resect         0190        16.91      $860.79      $421.79      $172.16
                            septum.
   58561  T                Hysteroscopy, remove         0190        16.91      $860.79      $421.79      $172.16
                            myoma.
   58562  T                Hysteroscopy, remove         0190        16.91      $860.79      $421.79      $172.16
                            fb.
   58563  T                Hysteroscopy,                0190        16.91      $860.79      $421.79      $172.16
                            ablation.
   58578  T                Laparo proc, uterus.         0190        16.91      $860.79      $421.79      $172.16

[[Page 59993]]

 
   58579  T                Hysteroscope                 0190        16.91      $860.79      $421.79      $172.16
                            procedure.
   58600  T                Division of                  0194        15.86      $807.34      $395.60      $161.47
                            fallopian tube.
   58605  C                Division of           ...........  ...........  ...........  ...........  ...........
                            fallopian tube.
   58611  C                Ligate oviduct(s)     ...........  ...........  ...........  ...........  ...........
                            add-on.
   58615  T                Occlude fallopian            0194        15.86      $807.34      $395.60      $161.47
                            tube(s).
   58660  T                Laparoscopy, lysis..         0131        37.63    $1,915.52      $996.07      $383.10
   58661  T                Laparoscopy, remove          0131        37.63    $1,915.52      $996.07      $383.10
                            adnexa.
   58662  T                Laparoscopy, excise          0131        37.63    $1,915.52      $996.07      $383.10
                            lesions.
   58670  T                Laparoscopy, tubal           0131        37.63    $1,915.52      $996.07      $383.10
                            cautery.
   58671  T                Laparoscopy, tubal           0131        37.63    $1,915.52      $996.07      $383.10
                            block.
   58672  T                Laparoscopy,                 0131        37.63    $1,915.52      $996.07      $383.10
                            fimbrioplasty.
   58673  T                Laparoscopy,                 0131        37.63    $1,915.52      $996.07      $383.10
                            salpingostomy.
   58679  T                Laparo proc, oviduct-        0130        25.91    $1,318.92      $659.53      $263.78
                            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        20.62    $1,049.64      $483.80      $209.93
                            cyst(s).
   58805  C                Drainage of ovarian   ...........  ...........  ...........  ...........  ...........
                            cyst(s).
   58820  T                Drain ovary abscess,         0195        20.62    $1,049.64      $483.80      $209.93
                            open.
   58822  C                Drain ovary abscess,  ...........  ...........  ...........  ...........  ...........
                            percut.
   58823  T                Drain pelvic                 0193        11.16      $568.09      $171.13      $113.62
                            abscess, percut.
   58825  C                Transposition,        ...........  ...........  ...........  ...........  ...........
                            ovary(s).
   58900  T                Biopsy of ovary(s)..         0195        20.62    $1,049.64      $483.80      $209.93
   58920  T                Partial removal of           0202        63.54    $3,234.44    $1,487.84      $646.89
                            ovary(s).
   58925  T                Removal of ovarian           0202        63.54    $3,234.44    $1,487.84      $646.89
                            cyst(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.
  *58953  C                Tah, rad dissect for  ...........  ...........  ...........  ...........  ...........
                            debulk.
  *58954  C                Tah rad debulk/lymph  ...........  ...........  ...........  ...........  ...........
                            remove.
   58960  C                Exploration of        ...........  ...........  ...........  ...........  ...........
                            abdomen.
   58970  T                Retrieval of oocyte.         0194        15.86      $807.34      $395.60      $161.47
   58974  T                Transfer of embryo..         0197         2.40      $122.17       $49.55       $24.43
   58976  T                Transfer of embryo..         0197         2.40      $122.17       $49.55       $24.43
   58999  T                Genital surgery              0019         4.22      $214.81       $78.91       $42.96
                            procedure.
   59000  T                Amniocentesis.......         0198         1.31       $66.68       $32.67       $13.34
  *59001  T                Amniocentesis,               0198         1.31       $66.68       $32.67       $13.34
                            therapeutic.
   59012  T                Fetal cord                   0198         1.31       $66.68       $32.67       $13.34
                            puncture,prenatal.
   59015  T                Chorion biopsy......         0198         1.31       $66.68       $32.67       $13.34
   59020  T                Fetal contract               0198         1.31       $66.68       $32.67       $13.34
                            stress test.
   59025  T                Fetal non-stress             0198         1.31       $66.68       $32.67       $13.34
                            test.
   59030  T                Fetal scalp blood            0198         1.31       $66.68       $32.67       $13.34
                            sample.
   59050  T                Fetal monitor w/             0198         1.31       $66.68       $32.67       $13.34
                            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        37.63    $1,915.52      $996.07      $383.10
                            pregnancy.
   59151  T                Treat ectopic                0131        37.63    $1,915.52      $996.07      $383.10
                            pregnancy.
   59160  T                D & c after delivery         0196        13.48      $686.19      $336.23      $137.24
   59200  T                Insert cervical              0189         1.26       $64.14       $17.96       $12.83
                            dilator.
   59300  T                Episiotomy or                0193        11.16      $568.09      $171.13      $113.62
                            vaginal repair.
   59320  T                Revision of cervix..         0194        15.86      $807.34      $395.60      $161.47
   59325  C                Revision of cervix..  ...........  ...........  ...........  ...........  ...........
   59350  C                Repair of uterus....  ...........  ...........  ...........  ...........  ...........
   59400  E                Obstetrical care....  ...........  ...........  ...........  ...........  ...........
   59409  T                Obstetrical care....         0199         5.09      $259.10       $72.55       $51.82
   59410  E                Obstetrical care....  ...........  ...........  ...........  ...........  ...........
   59412  T                Antepartum                   0199         5.09      $259.10       $72.55       $51.82
                            manipulation.
   59414  T                Deliver placenta....         0199         5.09      $259.10       $72.55       $51.82
   59425  E                Antepartum care only  ...........  ...........  ...........  ...........  ...........
   59426  E                Antepartum care only  ...........  ...........  ...........  ...........  ...........
   59430  E                Care after delivery.  ...........  ...........  ...........  ...........  ...........
   59510  E                Cesarean delivery...  ...........  ...........  ...........  ...........  ...........
   59514  C                Cesarean delivery     ...........  ...........  ...........  ...........  ...........
                            only.

[[Page 59994]]

 
   59515  E                Cesarean delivery...  ...........  ...........  ...........  ...........  ...........
   59525  C                Remove uterus after   ...........  ...........  ...........  ...........  ...........
                            cesarean.
   59610  E                Vbac delivery.......  ...........  ...........  ...........  ...........  ...........
   59612  T                Vbac delivery only..         0199         5.09      $259.10       $72.55       $51.82
   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        14.33      $729.45      $329.65      $145.89
                            miscarriage.
   59820  T                Care of miscarriage.         0201        14.33      $729.45      $329.65      $145.89
   59821  T                Treatment of                 0201        14.33      $729.45      $329.65      $145.89
                            miscarriage.
   59830  C                Treat uterus          ...........  ...........  ...........  ...........  ...........
                            infection.
   59840  T                Abortion............         0200        11.34      $577.25      $305.94      $115.45
   59841  T                Abortion............         0200        11.34      $577.25      $305.94      $115.45
   59850  C                Abortion............  ...........  ...........  ...........  ...........  ...........
   59851  C                Abortion............  ...........  ...........  ...........  ...........  ...........
   59852  C                Abortion............  ...........  ...........  ...........  ...........  ...........
   59855  C                Abortion............  ...........  ...........  ...........  ...........  ...........
   59856  C                Abortion............  ...........  ...........  ...........  ...........  ...........
   59857  C                Abortion............  ...........  ...........  ...........  ...........  ...........
   59866  T                Abortion (mpr)......         0198         1.31       $66.68       $32.67       $13.34
   59870  T                Evacuate mole of             0201        14.33      $729.45      $329.65      $145.89
                            uterus.
   59871  T                Remove cerclage              0194        15.86      $807.34      $395.60      $161.47
                            suture.
   59898  T                Laparo proc, ob care/        0130        25.91    $1,318.92      $659.53      $263.78
                            deliver.
   59899  T                Maternity care               0198         1.31       $66.68       $32.67       $13.34
                            procedure.
   60000  T                Drain thyroid/tongue         0252         5.95      $302.88      $114.24       $60.58
                            cyst.
   60001  T                Aspirate/inject              0004         2.47      $125.73       $32.57       $25.15
                            thyriod cyst.
   60100  T                Biopsy of thyroid...         0004         2.47      $125.73       $32.57       $25.15
   60200  T                Remove thyroid               0114        29.28    $1,490.47      $493.78      $298.09
                            lesion.
   60210  T                Partial thyroid              0114        29.28    $1,490.47      $493.78      $298.09
                            excision.
   60212  T                Parital thyroid              0114        29.28    $1,490.47      $493.78      $298.09
                            excision.
   60220  T                Partial removal of           0114        29.28    $1,490.47      $493.78      $298.09
                            thyroid.
   60225  T                Partial removal of           0114        29.28    $1,490.47      $493.78      $298.09
                            thyroid.
   60240  T                Removal of thyroid..         0114        29.28    $1,490.47      $493.78      $298.09
   60252  T                Removal of thyroid..         0256        26.61    $1,354.56      $623.05      $270.91
   60254  C                Extensive thyroid     ...........  ...........  ...........  ...........  ...........
                            surgery.
   60260  T                Repeat thyroid               0256        26.61    $1,354.56      $623.05      $270.91
                            surgery.
   60270  C                Removal of thyroid..  ...........  ...........  ...........  ...........  ...........
   60271  C                Removal of thyroid..  ...........  ...........  ...........  ...........  ...........
   60280  T                Remove thyroid duct          0114        29.28    $1,490.47      $493.78      $298.09
                            lesion.
   60281  T                Remove thyroid duct          0114        29.28    $1,490.47      $493.78      $298.09
                            lesion.
   60500  T                Explore parathyroid          0256        26.61    $1,354.56      $623.05      $270.91
                            glands.
   60502  C                Re-explore            ...........  ...........  ...........  ...........  ...........
                            parathyroids.
   60505  C                Explore parathyroid   ...........  ...........  ...........  ...........  ...........
                            glands.
   60512  T                Autotransplant               0021        11.82      $601.69      $236.51      $120.34
                            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        25.91    $1,318.92      $659.53      $263.78
                            endocrine.
   60699  T                Endocrine surgery            0004         2.47      $125.73       $32.57       $25.15
                            procedure.
   61000  T                Remove cranial               0212         3.77      $191.91       $88.78       $38.38
                            cavity fluid.
   61001  T                Remove cranial               0212         3.77      $191.91       $88.78       $38.38
                            cavity fluid.
   61020  T                Remove brain cavity          0212         3.77      $191.91       $88.78       $38.38
                            fluid.
   61026  T                Injection into brain         0212         3.77      $191.91       $88.78       $38.38
                            canal.
   61050  T                Remove brain canal           0212         3.77      $191.91       $88.78       $38.38
                            fluid.
   61055  T                Injection into brain         0212         3.77      $191.91       $88.78       $38.38
                            canal.
   61070  T                Brain canal shunt            0212         3.77      $191.91       $88.78       $38.38
                            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        28.48    $1,449.75      $453.41      $289.95
                            device.
   61250  C                Pierce skull &        ...........  ...........  ...........  ...........  ...........
                            explore.
   61253  C                Pierce skull &        ...........  ...........  ...........  ...........  ...........
                            explore.

[[Page 59995]]

 
   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        26.61    $1,354.56      $623.05      $270.91
                            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.
   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.

[[Page 59996]]

 
   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  T                Occlusion/                   0081        29.24    $1,488.43      $710.91      $297.69
                            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.
   61790  T                Treat trigeminal             0220        13.60      $692.29      $325.38      $138.46
                            nerve.
   61791  T                Treat trigeminal             0204         2.24      $114.02       $43.33       $22.80
                            tract.
   61793  S                Focus radiation beam         0302        11.16      $568.09      $216.55      $113.62
   61795  S                Brain surgery using          0302        11.16      $568.09      $216.55      $113.62
                            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                0687        42.34    $2,155.28  ...........      $431.06
                            neuroelectrode.
   61885  T                Implant neurostim            0222       302.53   $15,399.99  ...........    $3,080.00
                            one array.
   61886  T                Implant neurostim            0222       302.53   $15,399.99  ...........    $3,080.00
                            arrays.
   61888  T                Revise/remove                0688       145.27    $7,394.82  ...........    $1,478.96
                            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         2.54      $129.30       $52.53       $25.86
                            catheter.
   62200  C                Establish brain       ...........  ...........  ...........  ...........  ...........
                            cavity shunt.
   62201  C                Establish brain       ...........  ...........  ...........  ...........  ...........
                            cavity shunt.
   62220  C                Establish brain       ...........  ...........  ...........  ...........  ...........
                            cavity shunt.

[[Page 59997]]

 
   62223  C                Establish brain       ...........  ...........  ...........  ...........  ...........
                            cavity shunt.
   62225  T                Replace/irrigate             0121         2.54      $129.30       $52.53       $25.86
                            catheter.
   62230  T                Replace/revise brain         0224        28.48    $1,449.75      $453.41      $289.95
                            shunt.
   62252  S                Csf shunt reprogram.         0691         3.17      $161.37       $88.75       $32.27
   62256  C                Remove brain cavity   ...........  ...........  ...........  ...........  ...........
                            shunt.
   62258  C                Replace brain cavity  ...........  ...........  ...........  ...........  ...........
                            shunt.
   62263  T                Lysis epidural               0203        15.79      $803.77      $369.73      $160.75
                            adhesions.
   62268  T                Drain spinal cord            0212         3.77      $191.91       $88.78       $38.38
                            cyst.
   62269  T                Needle biopsy,               0005         4.03      $205.14       $90.26       $41.03
                            spinal cord.
   62270  T                Spinal fluid tap,            0206         3.59      $182.75       $74.93       $36.55
                            diagnostic.
   62272  T                Drain spinal fluid..         0206         3.59      $182.75       $74.93       $36.55
   62273  T                Treat epidural spine         0206         3.59      $182.75       $74.93       $36.55
                            lesion.
   62280  T                Treat spinal cord            0207         5.36      $272.85      $122.78       $54.57
                            lesion.
   62281  T                Treat spinal cord            0207         5.36      $272.85      $122.78       $54.57
                            lesion.
   62282  T                Treat spinal canal           0207         5.36      $272.85      $122.78       $54.57
                            lesion.
   62284  N                Injection for         ...........  ...........  ...........  ...........  ...........
                            myelogram.
   62287  T                Percutaneous                 0220        13.60      $692.29      $325.38      $138.46
                            diskectomy.
   62290  N                Inject for spine      ...........  ...........  ...........  ...........  ...........
                            disk x-ray.
   62291  N                Inject for spine      ...........  ...........  ...........  ...........  ...........
                            disk x-ray.
   62292  T                Injection into disk          0212         3.77      $191.91       $88.78       $38.38
                            lesion.
   62294  T                Injection into               0212         3.77      $191.91       $88.78       $38.38
                            spinal artery.
   62310  T                Inject spine c/t....         0206         3.59      $182.75       $74.93       $36.55
   62311  T                Inject spine l/s             0206         3.59      $182.75       $74.93       $36.55
                            (cd).
   62318  T                Inject spine w/cath,         0206         3.59      $182.75       $74.93       $36.55
                            c/t.
   62319  T                Inject spine w/cath          0206         3.59      $182.75       $74.93       $36.55
                            l/s (cd).
   62350  T                Implant spinal canal         0223        75.39    $3,837.65  ...........      $767.53
                            cath.
   62351  C                Implant spinal canal  ...........  ...........  ...........  ...........  ...........
                            cath.
   62355  T                Remove spinal canal          0105        14.76      $751.34      $368.16      $150.27
                            catheter.
   62360  T                Insert spine                 0226        75.81    $3,859.03  ...........      $771.81
                            infusion device.
   62361  T                Implant spine                0227       139.55    $7,103.65  ...........    $1,420.73
                            infusion pump.
   62362  T                Implant spine                0227       139.55    $7,103.65  ...........    $1,420.73
                            infusion pump.
   62365  T                Remove spine                 0105        14.76      $751.34      $368.16      $150.27
                            infusion device.
   62367  S                Analyze spine                0691         3.17      $161.37       $88.75       $32.27
                            infusion pump.
   62368  S                Analyze spine                0691         3.17      $161.37       $88.75       $32.27
                            infusion pump.
   63001  T                Removal of spinal            0208        29.12    $1,482.32  ...........      $296.46
                            lamina.
   63003  T                Removal of spinal            0208        29.12    $1,482.32  ...........      $296.46
                            lamina.
   63005  T                Removal of spinal            0208        29.12    $1,482.32  ...........      $296.46
                            lamina.
   63011  T                Removal of spinal            0208        29.12    $1,482.32  ...........      $296.46
                            lamina.
   63012  T                Removal of spinal            0208        29.12    $1,482.32  ...........      $296.46
                            lamina.
   63015  T                Removal of spinal            0208        29.12    $1,482.32  ...........      $296.46
                            lamina.
   63016  T                Removal of spinal            0208        29.12    $1,482.32  ...........      $296.46
                            lamina.
   63017  T                Removal of spinal            0208        29.12    $1,482.32  ...........      $296.46
                            lamina.
   63020  T                Neck spine disk              0208        29.12    $1,482.32  ...........      $296.46
                            surgery.
   63030  T                Low back disk                0208        29.12    $1,482.32  ...........      $296.46
                            surgery.
   63035  T                Spinal disk surgery          0208        29.12    $1,482.32  ...........      $296.46
                            add-on.
   63040  T                Laminotomy, single           0208        29.12    $1,482.32  ...........      $296.46
                            cervical.
   63042  T                Laminotomy, single           0208        29.12    $1,482.32  ...........      $296.46
                            lumbar.
   63043  C                Laminotomy, addl      ...........  ...........  ...........  ...........  ...........
                            cervical.
   63044  C                Laminotomy, addl      ...........  ...........  ...........  ...........  ...........
                            lumbar.
   63045  T                Removal of spinal            0208        29.12    $1,482.32  ...........      $296.46
                            lamina.
   63046  T                Removal of spinal            0208        29.12    $1,482.32  ...........      $296.46
                            lamina.
   63047  T                Removal of spinal            0208        29.12    $1,482.32  ...........      $296.46
                            lamina.
   63048  T                Remove spinal lamina         0208        29.12    $1,482.32  ...........      $296.46
                            add-on.
   63055  T                Decompress spinal            0208        29.12    $1,482.32  ...........      $296.46
                            cord.
   63056  T                Decompress spinal            0208        29.12    $1,482.32  ...........      $296.46
                            cord.
   63057  T                Decompress spine             0208        29.12    $1,482.32  ...........      $296.46
                            cord add-on.
   63064  T                Decompress spinal            0208        29.12    $1,482.32  ...........      $296.46
                            cord.
   63066  T                Decompress spine             0208        29.12    $1,482.32  ...........      $296.46
                            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.

[[Page 59998]]

 
   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.
   63600  T                Remove spinal cord           0220        13.60      $692.29      $325.38      $138.46
                            lesion.
   63610  T                Stimulation of               0220        13.60      $692.29      $325.38      $138.46
                            spinal cord.
   63615  T                Remove lesion of             0220        13.60      $692.29      $325.38      $138.46
                            spinal cord.
   63650  T                Implant                      0225       267.56   $13,619.87  ...........    $2,723.97
                            neuroelectrodes.
   63655  T                Implant                      0225       267.56   $13,619.87  ...........    $2,723.97
                            neuroelectrodes.
   63660  T                Revise/remove                0687        42.34    $2,155.28  ...........      $431.06
                            neuroelectrode.
   63685  T                Implant                      0222       302.53   $15,399.99  ...........    $3,080.00
                            neuroreceiver.
   63688  T                Revise/remove                0688       145.27    $7,394.82  ...........    $1,478.96
                            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        53.77    $2,737.11      $696.46      $547.42
   63744  T                Revision of spinal           0228        53.77    $2,737.11      $696.46      $547.42
                            shunt.
   63746  T                Removal of spinal            0109         6.27      $319.17      $130.86       $63.83
                            shunt.
   64400  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64402  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64405  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64408  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64410  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64412  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64413  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64415  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64417  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64418  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64420  T                Injection for nerve          0207         5.36      $272.85      $122.78       $54.57
                            block.
   64421  T                Injection for nerve          0207         5.36      $272.85      $122.78       $54.57
                            block.
   64425  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64430  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.

[[Page 59999]]

 
   64435  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64445  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64450  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64470  T                Inj paravertebral c/         0207         5.36      $272.85      $122.78       $54.57
                            t.
   64472  T                Inj paravertebral c/         0207         5.36      $272.85      $122.78       $54.57
                            t add-on.
   64475  T                Inj paravertebral l/         0207         5.36      $272.85      $122.78       $54.57
                            s.
   64476  T                Inj paravertebral l/         0207         5.36      $272.85      $122.78       $54.57
                            s add-on.
   64479  T                Inj foramen epidural         0207         5.36      $272.85      $122.78       $54.57
                            c/t.
   64480  T                Inj foramen epidural         0207         5.36      $272.85      $122.78       $54.57
                            add-on.
   64483  T                Inj foramen epidural         0207         5.36      $272.85      $122.78       $54.57
                            l/s.
   64484  T                Inj foramen epidural         0207         5.36      $272.85      $122.78       $54.57
                            add-on.
   64505  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64508  T                Injection for nerve          0204         2.24      $114.02       $43.33       $22.80
                            block.
   64510  T                Injection for nerve          0207         5.36      $272.85      $122.78       $54.57
                            block.
   64520  T                Injection for nerve          0207         5.36      $272.85      $122.78       $54.57
                            block.
   64530  T                Injection for nerve          0207         5.36      $272.85      $122.78       $54.57
                            block.
   64550  A                Apply                 ...........  ...........  ...........  ...........  ...........
                            neurostimulator.
   64553  T                Implant                      0225       267.56   $13,619.87  ...........    $2,723.97
                            neuroelectrodes.
   64555  T                Implant                      0225       267.56   $13,619.87  ...........    $2,723.97
                            neuroelectrodes.
   64560  T                Implant                      0225       267.56   $13,619.87  ...........    $2,723.97
                            neuroelectrodes.
  *64561  T                Implant                      0225       267.56   $13,619.87  ...........    $2,723.97
                            neuroelectrodes.
   64565  T                Implant                      0225       267.56   $13,619.87  ...........    $2,723.97
                            neuroelectrodes.
   64573  T                Implant                      0225       267.56   $13,619.87  ...........    $2,723.97
                            neuroelectrodes.
   64575  T                Implant                      0225       267.56   $13,619.87  ...........    $2,723.97
                            neuroelectrodes.
   64577  T                Implant                      0225       267.56   $13,619.87  ...........    $2,723.97
                            neuroelectrodes.
   64580  T                Implant                      0225       267.56   $13,619.87  ...........    $2,723.97
                            neuroelectrodes.
  *64581  T                Implant                      0225       267.56   $13,619.87  ...........    $2,723.97
                            neuroelectrodes.
   64585  T                Revise/remove                0687        42.34    $2,155.28  ...........      $431.06
                            neuroelectrode.
   64590  T                Implant                      0222       302.53   $15,399.99  ...........    $3,080.00
                            neuroreceiver.
   64595  T                Revise/remove                0688       145.27    $7,394.82  ...........    $1,478.96
                            neuroreceiver.
   64600  T                Injection treatment          0203        15.79      $803.77      $369.73      $160.75
                            of nerve.
   64605  T                Injection treatment          0203        15.79      $803.77      $369.73      $160.75
                            of nerve.
   64610  T                Injection treatment          0203        15.79      $803.77      $369.73      $160.75
                            of nerve.
   64612  T                Destroy nerve, face          0204         2.24      $114.02       $43.33       $22.80
                            muscle.
   64613  T                Destroy nerve, spine         0204         2.24      $114.02       $43.33       $22.80
                            muscle.
   64614  T                Destroy nerve,               0206         3.59      $182.75       $74.93       $36.55
                            extrem musc.
   64620  T                Injection treatment          0203        15.79      $803.77      $369.73      $160.75
                            of nerve.
   64622  T                Destr paravertebrl           0203        15.79      $803.77      $369.73      $160.75
                            nerve l/s.
   64623  T                Destr paravertebral          0203        15.79      $803.77      $369.73      $160.75
                            n add-on.
   64626  T                Destr paravertebrl           0203        15.79      $803.77      $369.73      $160.75
                            nerve c/t.
   64627  T                Destr paravertebral          0203        15.79      $803.77      $369.73      $160.75
                            n add-on.
   64630  T                Injection treatment          0207         5.36      $272.85      $122.78       $54.57
                            of nerve.
   64640  T                Injection treatment          0207         5.36      $272.85      $122.78       $54.57
                            of nerve.
   64680  T                Injection treatment          0203        15.79      $803.77      $369.73      $160.75
                            of nerve.
   64702  T                Revise finger/toe            0220        13.60      $692.29      $325.38      $138.46
                            nerve.
   64704  T                Revise hand/foot             0220        13.60      $692.29      $325.38      $138.46
                            nerve.
   64708  T                Revise arm/leg nerve         0220        13.60      $692.29      $325.38      $138.46
   64712  T                Revision of sciatic          0220        13.60      $692.29      $325.38      $138.46
                            nerve.
   64713  T                Revision of arm              0220        13.60      $692.29      $325.38      $138.46
                            nerve(s).
   64714  T                Revise low back              0220        13.60      $692.29      $325.38      $138.46
                            nerve(s).
   64716  T                Revision of cranial          0220        13.60      $692.29      $325.38      $138.46
                            nerve.
   64718  T                Revise ulnar nerve           0220        13.60      $692.29      $325.38      $138.46
                            at elbow.
   64719  T                Revise ulnar nerve           0220        13.60      $692.29      $325.38      $138.46
                            at wrist.
   64721  T                Carpal tunnel                0220        13.60      $692.29      $325.38      $138.46
                            surgery.
   64722  T                Relieve pressure on          0220        13.60      $692.29      $325.38      $138.46
                            nerve(s).
   64726  T                Release foot/toe             0220        13.60      $692.29      $325.38      $138.46
                            nerve.
   64727  T                Internal nerve               0220        13.60      $692.29      $325.38      $138.46
                            revision.
   64732  T                Incision of brow             0220        13.60      $692.29      $325.38      $138.46
                            nerve.
   64734  T                Incision of cheek            0220        13.60      $692.29      $325.38      $138.46
                            nerve.
   64736  T                Incision of chin             0220        13.60      $692.29      $325.38      $138.46
                            nerve.
   64738  T                Incision of jaw              0220        13.60      $692.29      $325.38      $138.46
                            nerve.
   64740  T                Incision of tongue           0220        13.60      $692.29      $325.38      $138.46
                            nerve.
   64742  T                Incision of facial           0220        13.60      $692.29      $325.38      $138.46
                            nerve.
   64744  T                Incise nerve, back           0220        13.60      $692.29      $325.38      $138.46
                            of head.
   64746  T                Incise diaphragm             0220        13.60      $692.29      $325.38      $138.46
                            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        13.60      $692.29      $325.38      $138.46
                            nerve.
   64763  C                Incise hip/thigh      ...........  ...........  ...........  ...........  ...........
                            nerve.
   64766  C                Incise hip/thigh      ...........  ...........  ...........  ...........  ...........
                            nerve.
   64771  T                Sever cranial nerve.         0220        13.60      $692.29      $325.38      $138.46
   64772  T                Incision of spinal           0220        13.60      $692.29      $325.38      $138.46
                            nerve.
   64774  T                Remove skin nerve            0220        13.60      $692.29      $325.38      $138.46
                            lesion.
   64776  T                Remove digit nerve           0220        13.60      $692.29      $325.38      $138.46
                            lesion.

[[Page 60000]]

 
   64778  T                Digit nerve surgery          0220        13.60      $692.29      $325.38      $138.46
                            add-on.
   64782  T                Remove limb nerve            0220        13.60      $692.29      $325.38      $138.46
                            lesion.
   64783  T                Limb nerve surgery           0220        13.60      $692.29      $325.38      $138.46
                            add-on.
   64784  T                Remove nerve lesion.         0220        13.60      $692.29      $325.38      $138.46
   64786  T                Remove sciatic nerve         0221        21.43    $1,090.87      $463.62      $218.17
                            lesion.
   64787  T                Implant nerve end...         0220        13.60      $692.29      $325.38      $138.46
   64788  T                Remove skin nerve            0220        13.60      $692.29      $325.38      $138.46
                            lesion.
   64790  T                Removal of nerve             0220        13.60      $692.29      $325.38      $138.46
                            lesion.
   64792  T                Removal of nerve             0221        21.43    $1,090.87      $463.62      $218.17
                            lesion.
   64795  T                Biopsy of nerve.....         0220        13.60      $692.29      $325.38      $138.46
   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.
  *64821  T                Remove sympathetic           0054        19.83    $1,009.43      $472.33      $201.89
                            nerves.
  *64822  T                Remove sympathetic           0054        19.83    $1,009.43      $472.33      $201.89
                            nerves.
  *64823  T                Remove sympathetic           0054        19.83    $1,009.43      $472.33      $201.89
                            nerves.
   64831  T                Repair of digit              0221        21.43    $1,090.87      $463.62      $218.17
                            nerve.
   64832  T                Repair nerve add-on.         0221        21.43    $1,090.87      $463.62      $218.17
   64834  T                Repair of hand or            0221        21.43    $1,090.87      $463.62      $218.17
                            foot nerve.
   64835  T                Repair of hand or            0221        21.43    $1,090.87      $463.62      $218.17
                            foot nerve.
   64836  T                Repair of hand or            0221        21.43    $1,090.87      $463.62      $218.17
                            foot nerve.
   64837  T                Repair nerve add-on.         0221        21.43    $1,090.87      $463.62      $218.17
   64840  T                Repair of leg nerve.         0221        21.43    $1,090.87      $463.62      $218.17
   64856  T                Repair/transpose             0221        21.43    $1,090.87      $463.62      $218.17
                            nerve.
   64857  T                Repair arm/leg nerve         0221        21.43    $1,090.87      $463.62      $218.17
   64858  T                Repair sciatic nerve         0221        21.43    $1,090.87      $463.62      $218.17
   64859  T                Nerve surgery.......         0221        21.43    $1,090.87      $463.62      $218.17
   64861  T                Repair of arm nerves         0221        21.43    $1,090.87      $463.62      $218.17
   64862  T                Repair of low back           0221        21.43    $1,090.87      $463.62      $218.17
                            nerves.
   64864  T                Repair of facial             0221        21.43    $1,090.87      $463.62      $218.17
                            nerve.
   64865  T                Repair of facial             0221        21.43    $1,090.87      $463.62      $218.17
                            nerve.
   64866  C                Fusion of facial/     ...........  ...........  ...........  ...........  ...........
                            other nerve.
   64868  C                Fusion of facial/     ...........  ...........  ...........  ...........  ...........
                            other nerve.
   64870  T                Fusion of facial/            0221        21.43    $1,090.87      $463.62      $218.17
                            other nerve.
   64872  T                Subsequent repair of         0221        21.43    $1,090.87      $463.62      $218.17
                            nerve.
   64874  T                Repair & revise              0221        21.43    $1,090.87      $463.62      $218.17
                            nerve add-on.
   64876  T                Repair nerve/shorten         0221        21.43    $1,090.87      $463.62      $218.17
                            bone.
   64885  T                Nerve graft, head or         0221        21.43    $1,090.87      $463.62      $218.17
                            neck.
   64886  T                Nerve graft, head or         0221        21.43    $1,090.87      $463.62      $218.17
                            neck.
   64890  T                Nerve graft, hand or         0221        21.43    $1,090.87      $463.62      $218.17
                            foot.
   64891  T                Nerve graft, hand or         0221        21.43    $1,090.87      $463.62      $218.17
                            foot.
   64892  T                Nerve graft, arm or          0221        21.43    $1,090.87      $463.62      $218.17
                            leg.
   64893  T                Nerve graft, arm or          0221        21.43    $1,090.87      $463.62      $218.17
                            leg.
   64895  T                Nerve graft, hand or         0221        21.43    $1,090.87      $463.62      $218.17
                            foot.
   64896  T                Nerve graft, hand or         0221        21.43    $1,090.87      $463.62      $218.17
                            foot.
   64897  T                Nerve graft, arm or          0221        21.43    $1,090.87      $463.62      $218.17
                            leg.
   64898  T                Nerve graft, arm or          0221        21.43    $1,090.87      $463.62      $218.17
                            leg.
   64901  T                Nerve graft add-on..         0221        21.43    $1,090.87      $463.62      $218.17
   64902  T                Nerve graft add-on..         0221        21.43    $1,090.87      $463.62      $218.17
   64905  T                Nerve pedicle                0221        21.43    $1,090.87      $463.62      $218.17
                            transfer.
   64907  T                Nerve pedicle                0221        21.43    $1,090.87      $463.62      $218.17
                            transfer.
   64999  T                Nervous system               0204         2.24      $114.02       $43.33       $22.80
                            surgery.
   65091  T                Revise eye..........         0242        23.72    $1,207.44      $597.36      $241.49
   65093  T                Revise eye with              0241        18.12      $922.38      $384.47      $184.48
                            implant.
   65101  T                Removal of eye......         0242        23.72    $1,207.44      $597.36      $241.49
   65103  T                Remove eye/insert            0242        23.72    $1,207.44      $597.36      $241.49
                            implant.
   65105  T                Remove eye/attach            0242        23.72    $1,207.44      $597.36      $241.49
                            implant.
   65110  T                Removal of eye......         0242        23.72    $1,207.44      $597.36      $241.49
   65112  T                Remove eye/revise            0242        23.72    $1,207.44      $597.36      $241.49
                            socket.
   65114  T                Remove eye/revise            0242        23.72    $1,207.44      $597.36      $241.49
                            socket.
   65125  T                Revise ocular                0240        13.83      $704.00      $315.34      $140.80
                            implant.
   65130  T                Insert ocular                0241        18.12      $922.38      $384.47      $184.48
                            implant.
   65135  T                Insert ocular                0241        18.12      $922.38      $384.47      $184.48
                            implant.
   65140  T                Attach ocular                0242        23.72    $1,207.44      $597.36      $241.49
                            implant.
   65150  T                Revise ocular                0241        18.12      $922.38      $384.47      $184.48
                            implant.
   65155  T                Reinsert ocular              0242        23.72    $1,207.44      $597.36      $241.49
                            implant.
   65175  T                Removal of ocular            0240        13.83      $704.00      $315.34      $140.80
                            implant.
   65205  S                Remove foreign body          0231         2.03      $103.34       $46.50       $20.67
                            from eye.
   65210  S                Remove foreign body          0231         2.03      $103.34       $46.50       $20.67
                            from eye.
   65220  S                Remove foreign body          0231         2.03      $103.34       $46.50       $20.67
                            from eye.
   65222  S                Remove foreign body          0231         2.03      $103.34       $46.50       $20.67
                            from eye.
   65235  T                Remove foreign body          0233        10.83      $551.29      $264.62      $110.26
                            from eye.
   65260  T                Remove foreign body          0237        36.32    $1,848.83  ...........      $369.77
                            from eye.

[[Page 60001]]

 
   65265  T                Remove foreign body          0236        16.21      $825.15  ...........      $165.03
                            from eye.
   65270  T                Repair of eye wound.         0240        13.83      $704.00      $315.34      $140.80
   65272  T                Repair of eye wound.         0233        10.83      $551.29      $264.62      $110.26
   65273  C                Repair of eye wound.  ...........  ...........  ...........  ...........  ...........
   65275  T                Repair of eye wound.         0233        10.83      $551.29      $264.62      $110.26
   65280  T                Repair of eye wound.         0234        19.08      $971.25      $466.20      $194.25
   65285  T                Repair of eye wound.         0234        19.08      $971.25      $466.20      $194.25
   65286  T                Repair of eye wound.         0233        10.83      $551.29      $264.62      $110.26
   65290  T                Repair of eye socket         0243        17.70      $901.00      $429.78      $180.20
                            wound.
   65400  T                Removal of eye               0233        10.83      $551.29      $264.62      $110.26
                            lesion.
   65410  T                Biopsy of cornea....         0233        10.83      $551.29      $264.62      $110.26
   65420  T                Removal of eye               0233        10.83      $551.29      $264.62      $110.26
                            lesion.
   65426  T                Removal of eye               0234        19.08      $971.25      $466.20      $194.25
                            lesion.
   65430  S                Corneal smear.......         0230         0.61       $31.05       $14.28        $6.21
   65435  T                Curette/treat cornea         0239         5.80      $295.24      $115.14       $59.05
   65436  T                Curette/treat cornea         0233        10.83      $551.29      $264.62      $110.26
   65450  S                Treatment of corneal         0231         2.03      $103.34       $46.50       $20.67
                            lesion.
   65600  T                Revision of cornea..         0240        13.83      $704.00      $315.34      $140.80
   65710  T                Corneal transplant..         0244        38.46    $1,957.77      $851.42      $391.55
   65730  T                Corneal transplant..         0244        38.46    $1,957.77      $851.42      $391.55
   65750  T                Corneal transplant..         0244        38.46    $1,957.77      $851.42      $391.55
   65755  T                Corneal transplant..         0244        38.46    $1,957.77      $851.42      $391.55
   65760  E                Revision of cornea..  ...........  ...........  ...........  ...........  ...........
   65765  E                Revision of cornea..  ...........  ...........  ...........  ...........  ...........
   65767  E                Corneal tissue        ...........  ...........  ...........  ...........  ...........
                            transplant.
   65770  T                Revise cornea with           0244        38.46    $1,957.77      $851.42      $391.55
                            implant.
   65771  E                Radial keratotomy...  ...........  ...........  ...........  ...........  ...........
   65772  T                Correction of                0233        10.83      $551.29      $264.62      $110.26
                            astigmatism.
   65775  T                Correction of                0233        10.83      $551.29      $264.62      $110.26
                            astigmatism.
   65800  T                Drainage of eye.....         0233        10.83      $551.29      $264.62      $110.26
   65805  T                Drainage of eye.....         0233        10.83      $551.29      $264.62      $110.26
   65810  T                Drainage of eye.....         0233        10.83      $551.29      $264.62      $110.26
   65815  T                Drainage of eye.....         0234        19.08      $971.25      $466.20      $194.25
   65820  T                Relieve inner eye            0232         3.50      $178.16       $78.39       $35.63
                            pressure.
   65850  T                Incision of eye.....         0234        19.08      $971.25      $466.20      $194.25
   65855  T                Laser surgery of eye         0248        29.51    $1,502.18  ...........      $300.44
   65860  T                Incise inner eye             0247         4.03      $205.14       $94.36       $41.03
                            adhesions.
   65865  T                Incise inner eye             0233        10.83      $551.29      $264.62      $110.26
                            adhesions.
   65870  T                Incise inner eye             0234        19.08      $971.25      $466.20      $194.25
                            adhesions.
   65875  T                Incise inner eye             0234        19.08      $971.25      $466.20      $194.25
                            adhesions.
   65880  T                Incise inner eye             0233        10.83      $551.29      $264.62      $110.26
                            adhesions.
   65900  T                Remove eye lesion...         0233        10.83      $551.29      $264.62      $110.26
   65920  T                Remove implant from          0233        10.83      $551.29      $264.62      $110.26
                            eye.
   65930  T                Remove blood clot            0234        19.08      $971.25      $466.20      $194.25
                            from eye.
   66020  T                Injection treatment          0233        10.83      $551.29      $264.62      $110.26
                            of eye.
   66030  T                Injection treatment          0233        10.83      $551.29      $264.62      $110.26
                            of eye.
   66130  T                Remove eye lesion...         0234        19.08      $971.25      $466.20      $194.25
   66150  T                Glaucoma surgery....         0233        10.83      $551.29      $264.62      $110.26
   66155  T                Glaucoma surgery....         0234        19.08      $971.25      $466.20      $194.25
   66160  T                Glaucoma surgery....         0234        19.08      $971.25      $466.20      $194.25
   66165  T                Glaucoma surgery....         0234        19.08      $971.25      $466.20      $194.25
   66170  T                Glaucoma surgery....         0234        19.08      $971.25      $466.20      $194.25
   66172  T                Incision of eye.....         0234        19.08      $971.25      $466.20      $194.25
   66180  T                Implant eye shunt...         0234        19.08      $971.25      $466.20      $194.25
   66185  T                Revise eye shunt....         0234        19.08      $971.25      $466.20      $194.25
   66220  T                Repair eye lesion...         0236        16.21      $825.15  ...........      $165.03
   66225  T                Repair/graft eye             0234        19.08      $971.25      $466.20      $194.25
                            lesion.
   66250  T                Follow-up surgery of         0233        10.83      $551.29      $264.62      $110.26
                            eye.
   66500  T                Incision of iris....         0232         3.50      $178.16       $78.39       $35.63
   66505  T                Incision of iris....         0232         3.50      $178.16       $78.39       $35.63
   66600  T                Remove iris and              0233        10.83      $551.29      $264.62      $110.26
                            lesion.
   66605  T                Removal of iris.....         0234        19.08      $971.25      $466.20      $194.25
   66625  T                Removal of iris.....         0233        10.83      $551.29      $264.62      $110.26
   66630  T                Removal of iris.....         0233        10.83      $551.29      $264.62      $110.26
   66635  T                Removal of iris.....         0234        19.08      $971.25      $466.20      $194.25
   66680  T                Repair iris &                0234        19.08      $971.25      $466.20      $194.25
                            ciliary body.
   66682  T                Repair iris &                0234        19.08      $971.25      $466.20      $194.25
                            ciliary body.
   66700  T                Destruction, ciliary         0233        10.83      $551.29      $264.62      $110.26
                            body.
   66710  T                Destruction, ciliary         0233        10.83      $551.29      $264.62      $110.26
                            body.
   66720  T                Destruction, ciliary         0233        10.83      $551.29      $264.62      $110.26
                            body.
   66740  T                Destruction, ciliary         0233        10.83      $551.29      $264.62      $110.26
                            body.
   66761  T                Revision of iris....         0248        29.51    $1,502.18  ...........      $300.44
   66762  T                Revision of iris....         0247         4.03      $205.14       $94.36       $41.03
   66770  T                Removal of inner eye         0247         4.03      $205.14       $94.36       $41.03
                            lesion.
   66820  T                Incision, secondary          0232         3.50      $178.16       $78.39       $35.63
                            cataract.

[[Page 60002]]

 
   66821  T                After cataract laser         0248        29.51    $1,502.18  ...........      $300.44
                            surgery.
   66825  T                Reposition                   0234        19.08      $971.25      $466.20      $194.25
                            intraocular lens.
   66830  T                Removal of lens              0232         3.50      $178.16       $78.39       $35.63
                            lesion.
   66840  T                Removal of lens              0245        10.44      $531.44      $249.78      $106.29
                            material.
   66850  T                Removal of lens              0249        21.80    $1,109.71      $521.56      $221.94
                            material.
   66852  T                Removal of lens              0249        21.80    $1,109.71      $521.56      $221.94
                            material.
   66920  T                Extraction of lens..         0249        21.80    $1,109.71      $521.56      $221.94
   66930  T                Extraction of lens..         0249        21.80    $1,109.71      $521.56      $221.94
   66940  T                Extraction of lens..         0245        10.44      $531.44      $249.78      $106.29
   66982  T                Cataract surgery,            0246        21.20    $1,079.16      $507.21      $215.83
                            complex.
   66983  T                Cataract surg w/iol,         0246        21.20    $1,079.16      $507.21      $215.83
                            1 stage.
   66984  T                Cataract surg w/iol,         0246        21.20    $1,079.16      $507.21      $215.83
                            i stage.
   66985  T                Insert lens                  0246        21.20    $1,079.16      $507.21      $215.83
                            prosthesis.
   66986  T                Exchange lens                0246        21.20    $1,079.16      $507.21      $215.83
                            prosthesis.
   66999  T                Eye surgery                  0247         4.03      $205.14       $94.36       $41.03
                            procedure.
   67005  T                Partial removal of           0237        36.32    $1,848.83  ...........      $369.77
                            eye fluid.
   67010  T                Partial removal of           0237        36.32    $1,848.83  ...........      $369.77
                            eye fluid.
   67015  T                Release of eye fluid         0237        36.32    $1,848.83  ...........      $369.77
   67025  T                Replace eye fluid...         0236        16.21      $825.15  ...........      $165.03
   67027  T                Implant eye drug             0237        36.32    $1,848.83  ...........      $369.77
                            system.
   67028  T                Injection eye drug..         0235         5.57      $283.54       $78.91       $56.71
   67030  T                Incise inner eye             0236        16.21      $825.15  ...........      $165.03
                            strands.
   67031  T                Laser surgery, eye           0247         4.03      $205.14       $94.36       $41.03
                            strands.
   67036  T                Removal of inner eye         0237        36.32    $1,848.83  ...........      $369.77
                            fluid.
   67038  T                Strip retinal                0237        36.32    $1,848.83  ...........      $369.77
                            membrane.
   67039  T                Laser treatment of           0237        36.32    $1,848.83  ...........      $369.77
                            retina.
   67040  T                Laser treatment of           0237        36.32    $1,848.83  ...........      $369.77
                            retina.
   67101  T                Repair detached              0235         5.57      $283.54       $78.91       $56.71
                            retina.
   67105  T                Repair detached              0247         4.03      $205.14       $94.36       $41.03
                            retina.
   67107  T                Repair detached              0237        36.32    $1,848.83  ...........      $369.77
                            retina.
   67108  T                Repair detached              0237        36.32    $1,848.83  ...........      $369.77
                            retina.
   67110  T                Repair detached              0235         5.57      $283.54       $78.91       $56.71
                            retina.
   67112  T                Rerepair detached            0237        36.32    $1,848.83  ...........      $369.77
                            retina.
   67115  T                Release encircling           0236        16.21      $825.15  ...........      $165.03
                            material.
   67120  T                Remove eye implant           0236        16.21      $825.15  ...........      $165.03
                            material.
   67121  T                Remove eye implant           0237        36.32    $1,848.83  ...........      $369.77
                            material.
   67141  T                Treatment of retina.         0235         5.57      $283.54       $78.91       $56.71
   67145  T                Treatment of retina.         0247         4.03      $205.14       $94.36       $41.03
   67208  S                Treatment of retinal         0231         2.03      $103.34       $46.50       $20.67
                            lesion.
   67210  T                Treatment of retinal         0247         4.03      $205.14       $94.36       $41.03
                            lesion.
   67218  T                Treatment of retinal         0237        36.32    $1,848.83  ...........      $369.77
                            lesion.
   67220  T                Treatment of choroid         0235         5.57      $283.54       $78.91       $56.71
                            lesion.
   67221  T                Ocular photodynamic          0235         5.57      $283.54       $78.91       $56.71
                            ther.
  *67225  T                Eye photodynamic             0235         5.57      $283.54       $78.91       $56.71
                            ther add-on.
   67227  T                Treatment of retinal         0235         5.57      $283.54       $78.91       $56.71
                            lesion.
   67228  T                Treatment of retinal         0248        29.51    $1,502.18  ...........      $300.44
                            lesion.
   67250  T                Reinforce eye wall..         0240        13.83      $704.00      $315.34      $140.80
   67255  T                Reinforce/graft eye          0237        36.32    $1,848.83  ...........      $369.77
                            wall.
   67299  T                Eye surgery                  0248        29.51    $1,502.18  ...........      $300.44
                            procedure.
   67311  T                Revise eye muscle...         0243        17.70      $901.00      $429.78      $180.20
   67312  T                Revise two eye               0243        17.70      $901.00      $429.78      $180.20
                            muscles.
   67314  T                Revise eye muscle...         0243        17.70      $901.00      $429.78      $180.20
   67316  T                Revise two eye               0243        17.70      $901.00      $429.78      $180.20
                            muscles.
   67318  T                Revise eye muscle(s)         0243        17.70      $901.00      $429.78      $180.20
   67320  T                Revise eye muscle(s)         0243        17.70      $901.00      $429.78      $180.20
                            add-on.
   67331  T                Eye surgery follow-          0243        17.70      $901.00      $429.78      $180.20
                            up add-on.
   67332  T                Rerevise eye muscles         0243        17.70      $901.00      $429.78      $180.20
                            add-on.
   67334  T                Revise eye muscle w/         0243        17.70      $901.00      $429.78      $180.20
                            suture.
   67335  T                Eye suture during            0243        17.70      $901.00      $429.78      $180.20
                            surgery.
   67340  T                Revise eye muscle            0243        17.70      $901.00      $429.78      $180.20
                            add-on.
   67343  T                Release eye tissue..         0243        17.70      $901.00      $429.78      $180.20
   67345  T                Destroy nerve of eye         0238         3.01      $153.22       $58.96       $30.64
                            muscle.
   67350  T                Biopsy eye muscle...         0699         6.46      $328.84      $147.98       $65.77
   67399  T                Eye muscle surgery           0243        17.70      $901.00      $429.78      $180.20
                            procedure.
   67400  T                Explore/biopsy eye           0241        18.12      $922.38      $384.47      $184.48
                            socket.
   67405  T                Explore/drain eye            0241        18.12      $922.38      $384.47      $184.48
                            socket.
   67412  T                Explore/treat eye            0241        18.12      $922.38      $384.47      $184.48
                            socket.
   67413  T                Explore/treat eye            0241        18.12      $922.38      $384.47      $184.48
                            socket.
   67414  T                Explr/decompress eye         0242        23.72    $1,207.44      $597.36      $241.49
                            socket.
   67415  T                Aspiration, orbital          0239         5.80      $295.24      $115.14       $59.05
                            contents.
   67420  T                Explore/treat eye            0242        23.72    $1,207.44      $597.36      $241.49
                            socket.
   67430  T                Explore/treat eye            0242        23.72    $1,207.44      $597.36      $241.49
                            socket.
   67440  T                Explore/drain eye            0242        23.72    $1,207.44      $597.36      $241.49
                            socket.
   67445  T                Explr/decompress eye         0242        23.72    $1,207.44      $597.36      $241.49
                            socket.
   67450  T                Explore/biopsy eye           0242        23.72    $1,207.44      $597.36      $241.49
                            socket.

[[Page 60003]]

 
   67500  S                Inject/treat eye             0231         2.03      $103.34       $46.50       $20.67
                            socket.
   67505  T                Inject/treat eye             0238         3.01      $153.22       $58.96       $30.64
                            socket.
   67515  T                Inject/treat eye             0239         5.80      $295.24      $115.14       $59.05
                            socket.
   67550  T                Insert eye socket            0242        23.72    $1,207.44      $597.36      $241.49
                            implant.
   67560  T                Revise eye socket            0241        18.12      $922.38      $384.47      $184.48
                            implant.
   67570  T                Decompress optic             0242        23.72    $1,207.44      $597.36      $241.49
                            nerve.
   67599  T                Orbit surgery                0239         5.80      $295.24      $115.14       $59.05
                            procedure.
   67700  T                Drainage of eyelid           0238         3.01      $153.22       $58.96       $30.64
                            abscess.
   67710  T                Incision of eyelid..         0239         5.80      $295.24      $115.14       $59.05
   67715  T                Incision of eyelid           0240        13.83      $704.00      $315.34      $140.80
                            fold.
   67800  T                Remove eyelid lesion         0238         3.01      $153.22       $58.96       $30.64
   67801  T                Remove eyelid                0239         5.80      $295.24      $115.14       $59.05
                            lesions.
   67805  T                Remove eyelid                0238         3.01      $153.22       $58.96       $30.64
                            lesions.
   67808  T                Remove eyelid                0240        13.83      $704.00      $315.34      $140.80
                            lesion(s).
   67810  T                Biopsy of eyelid....         0238         3.01      $153.22       $58.96       $30.64
   67820  S                Revise eyelashes....         0698         1.03       $52.43       $19.92       $10.49
   67825  T                Revise eyelashes....         0238         3.01      $153.22       $58.96       $30.64
   67830  T                Revise eyelashes....         0239         5.80      $295.24      $115.14       $59.05
   67835  T                Revise eyelashes....         0240        13.83      $704.00      $315.34      $140.80
   67840  T                Remove eyelid lesion         0239         5.80      $295.24      $115.14       $59.05
   67850  T                Treat eyelid lesion.         0239         5.80      $295.24      $115.14       $59.05
   67875  T                Closure of eyelid by         0239         5.80      $295.24      $115.14       $59.05
                            suture.
   67880  T                Revision of eyelid..         0233        10.83      $551.29      $264.62      $110.26
   67882  T                Revision of eyelid..         0240        13.83      $704.00      $315.34      $140.80
   67900  T                Repair brow defect..         0240        13.83      $704.00      $315.34      $140.80
   67901  T                Repair eyelid defect         0240        13.83      $704.00      $315.34      $140.80
   67902  T                Repair eyelid defect         0240        13.83      $704.00      $315.34      $140.80
   67903  T                Repair eyelid defect         0240        13.83      $704.00      $315.34      $140.80
   67904  T                Repair eyelid defect         0240        13.83      $704.00      $315.34      $140.80
   67906  T                Repair eyelid defect         0240        13.83      $704.00      $315.34      $140.80
   67908  T                Repair eyelid defect         0240        13.83      $704.00      $315.34      $140.80
   67909  T                Revise eyelid defect         0240        13.83      $704.00      $315.34      $140.80
   67911  T                Revise eyelid defect         0240        13.83      $704.00      $315.34      $140.80
   67914  T                Repair eyelid defect         0240        13.83      $704.00      $315.34      $140.80
   67915  T                Repair eyelid defect         0239         5.80      $295.24      $115.14       $59.05
   67916  T                Repair eyelid defect         0240        13.83      $704.00      $315.34      $140.80
   67917  T                Repair eyelid defect         0240        13.83      $704.00      $315.34      $140.80
   67921  T                Repair eyelid defect         0240        13.83      $704.00      $315.34      $140.80
   67922  T                Repair eyelid defect         0239         5.80      $295.24      $115.14       $59.05
   67923  T                Repair eyelid defect         0240        13.83      $704.00      $315.34      $140.80
   67924  T                Repair eyelid defect         0240        13.83      $704.00      $315.34      $140.80
   67930  T                Repair eyelid wound.         0240        13.83      $704.00      $315.34      $140.80
   67935  T                Repair eyelid wound.         0240        13.83      $704.00      $315.34      $140.80
   67938  S                Remove eyelid                0698         1.03       $52.43       $19.92       $10.49
                            foreign body.
   67950  T                Revision of eyelid..         0240        13.83      $704.00      $315.34      $140.80
   67961  T                Revision of eyelid..         0240        13.83      $704.00      $315.34      $140.80
   67966  T                Revision of eyelid..         0240        13.83      $704.00      $315.34      $140.80
   67971  T                Reconstruction of            0241        18.12      $922.38      $384.47      $184.48
                            eyelid.
   67973  T                Reconstruction of            0241        18.12      $922.38      $384.47      $184.48
                            eyelid.
   67974  T                Reconstruction of            0241        18.12      $922.38      $384.47      $184.48
                            eyelid.
   67975  T                Reconstruction of            0240        13.83      $704.00      $315.34      $140.80
                            eyelid.
   67999  T                Revision of eyelid..         0240        13.83      $704.00      $315.34      $140.80
   68020  T                Incise/drain eyelid          0240        13.83      $704.00      $315.34      $140.80
                            lining.
   68040  S                Treatment of eyelid          0698         1.03       $52.43       $19.92       $10.49
                            lesions.
   68100  T                Biopsy of eyelid             0233        10.83      $551.29      $264.62      $110.26
                            lining.
   68110  T                Remove eyelid lining         0699         6.46      $328.84      $147.98       $65.77
                            lesion.
   68115  T                Remove eyelid lining         0239         5.80      $295.24      $115.14       $59.05
                            lesion.
   68130  T                Remove eyelid lining         0233        10.83      $551.29      $264.62      $110.26
                            lesion.
   68135  T                Remove eyelid lining         0239         5.80      $295.24      $115.14       $59.05
                            lesion.
   68200  S                Treat eyelid by              0698         1.03       $52.43       $19.92       $10.49
                            injection.
   68320  T                Revise/graft eyelid          0240        13.83      $704.00      $315.34      $140.80
                            lining.
   68325  T                Revise/graft eyelid          0242        23.72    $1,207.44      $597.36      $241.49
                            lining.
   68326  T                Revise/graft eyelid          0241        18.12      $922.38      $384.47      $184.48
                            lining.
   68328  T                Revise/graft eyelid          0241        18.12      $922.38      $384.47      $184.48
                            lining.
   68330  T                Revise eyelid lining         0233        10.83      $551.29      $264.62      $110.26
   68335  T                Revise/graft eyelid          0241        18.12      $922.38      $384.47      $184.48
                            lining.
   68340  T                Separate eyelid              0240        13.83      $704.00      $315.34      $140.80
                            adhesions.
   68360  T                Revise eyelid lining         0234        19.08      $971.25      $466.20      $194.25
   68362  T                Revise eyelid lining         0234        19.08      $971.25      $466.20      $194.25
   68399  T                Eyelid lining                0239         5.80      $295.24      $115.14       $59.05
                            surgery.
   68400  T                Incise/drain tear            0238         3.01      $153.22       $58.96       $30.64
                            gland.
   68420  T                Incise/drain tear            0240        13.83      $704.00      $315.34      $140.80
                            sac.
   68440  T                Incise tear duct             0238         3.01      $153.22       $58.96       $30.64
                            opening.
   68500  T                Removal of tear              0241        18.12      $922.38      $384.47      $184.48
                            gland.
   68505  T                Partial removal,             0241        18.12      $922.38      $384.47      $184.48
                            tear gland.

[[Page 60004]]

 
   68510  T                Biopsy of tear gland         0240        13.83      $704.00      $315.34      $140.80
   68520  T                Removal of tear sac.         0241        18.12      $922.38      $384.47      $184.48
   68525  T                Biopsy of tear sac..         0240        13.83      $704.00      $315.34      $140.80
   68530  T                Clearance of tear            0240        13.83      $704.00      $315.34      $140.80
                            duct.
   68540  T                Remove tear gland            0241        18.12      $922.38      $384.47      $184.48
                            lesion.
   68550  T                Remove tear gland            0242        23.72    $1,207.44      $597.36      $241.49
                            lesion.
   68700  T                Repair tear ducts...         0241        18.12      $922.38      $384.47      $184.48
   68705  T                Revise tear duct             0238         3.01      $153.22       $58.96       $30.64
                            opening.
   68720  T                Create tear sac              0242        23.72    $1,207.44      $597.36      $241.49
                            drain.
   68745  T                Create tear duct             0241        18.12      $922.38      $384.47      $184.48
                            drain.
   68750  T                Create tear duct             0242        23.72    $1,207.44      $597.36      $241.49
                            drain.
   68760  S                Close tear duct              0698         1.03       $52.43       $19.92       $10.49
                            opening.
   68761  S                Close tear duct              0231         2.03      $103.34       $46.50       $20.67
                            opening.
   68770  T                Close tear system            0240        13.83      $704.00      $315.34      $140.80
                            fistula.
   68801  S                Dilate tear duct             0231         2.03      $103.34       $46.50       $20.67
                            opening.
   68810  T                Probe nasolacrimal           0699         6.46      $328.84      $147.98       $65.77
                            duct.
   68811  T                Probe nasolacrimal           0240        13.83      $704.00      $315.34      $140.80
                            duct.
   68815  T                Probe nasolacrimal           0240        13.83      $704.00      $315.34      $140.80
                            duct.
   68840  T                Explore/irrigate             0699         6.46      $328.84      $147.98       $65.77
                            tear ducts.
   68850  N                Injection for tear    ...........  ...........  ...........  ...........  ...........
                            sac x-ray.
   68899  T                Tear duct system             0699         6.46      $328.84      $147.98       $65.77
                            surgery.
   69000  T                Drain external ear           0006         2.18      $110.97       $33.95       $22.19
                            lesion.
   69005  T                Drain external ear           0007         6.75      $343.60       $72.03       $68.72
                            lesion.
   69020  T                Drain outer ear              0006         2.18      $110.97       $33.95       $22.19
                            canal lesion.
   69090  E                Pierce earlobes.....  ...........  ...........  ...........  ...........  ...........
   69100  T                Biopsy of external           0019         4.22      $214.81       $78.91       $42.96
                            ear.
   69105  T                Biopsy of external           0253        12.33      $627.65      $284.00      $125.53
                            ear canal.
   69110  T                Remove external ear,         0020         8.44      $429.63      $130.53       $85.93
                            partial.
   69120  T                Removal of external          0254        17.37      $884.20      $272.41      $176.84
                            ear.
   69140  T                Remove ear canal             0254        17.37      $884.20      $272.41      $176.84
                            lesion(s).
   69145  T                Remove ear canal             0020         8.44      $429.63      $130.53       $85.93
                            lesion(s).
   69150  C                Extensive ear canal   ...........  ...........  ...........  ...........  ...........
                            surgery.
   69155  C                Extensive ear/neck    ...........  ...........  ...........  ...........  ...........
                            surgery.
   69200  X                Clear outer ear              0340         0.84       $42.76       $10.69        $8.55
                            canal.
   69205  T                Clear outer ear              0022        13.91      $708.07      $292.94      $141.61
                            canal.
   69210  X                Remove impacted ear          0340         0.84       $42.76       $10.69        $8.55
                            wax.
   69220  T                Clean out mastoid            0012         0.66       $33.60        $9.18        $6.72
                            cavity.
   69222  T                Clean out mastoid            0253        12.33      $627.65      $284.00      $125.53
                            cavity.
   69300  T                Revise external ear.         0254        17.37      $884.20      $272.41      $176.84
   69310  T                Rebuild outer ear            0256        26.61    $1,354.56      $623.05      $270.91
                            canal.
   69320  T                Rebuild outer ear            0256        26.61    $1,354.56      $623.05      $270.91
                            canal.
   69399  T                Outer ear surgery            0251         2.43      $123.70       $27.99       $24.74
                            procedure.
   69400  T                Inflate middle ear           0251         2.43      $123.70       $27.99       $24.74
                            canal.
   69401  N                Inflate middle ear    ...........  ...........  ...........  ...........  ...........
                            canal.
   69405  T                Catheterize middle           0252         5.95      $302.88      $114.24       $60.58
                            ear canal.
   69410  T                Inset middle ear             0252         5.95      $302.88      $114.24       $60.58
                            (baffle).
   69420  T                Incision of eardrum.         0251         2.43      $123.70       $27.99       $24.74
   69421  T                Incision of eardrum.         0253        12.33      $627.65      $284.00      $125.53
   69424  T                Remove ventilating           0252         5.95      $302.88      $114.24       $60.58
                            tube.
   69433  T                Create eardrum               0252         5.95      $302.88      $114.24       $60.58
                            opening.
   69436  T                Create eardrum               0253        12.33      $627.65      $284.00      $125.53
                            opening.
   69440  T                Exploration of               0254        17.37      $884.20      $272.41      $176.84
                            middle ear.
   69450  T                Eardrum revision....         0256        26.61    $1,354.56      $623.05      $270.91
   69501  T                Mastoidectomy.......         0256        26.61    $1,354.56      $623.05      $270.91
   69502  C                Mastoidectomy.......  ...........  ...........  ...........  ...........  ...........
   69505  T                Remove mastoid               0256        26.61    $1,354.56      $623.05      $270.91
                            structures.
   69511  T                Extensive mastoid            0256        26.61    $1,354.56      $623.05      $270.91
                            surgery.
   69530  T                Extensive mastoid            0256        26.61    $1,354.56      $623.05      $270.91
                            surgery.
   69535  C                Remove part of        ...........  ...........  ...........  ...........  ...........
                            temporal bone.
   69540  T                Remove ear lesion...         0253        12.33      $627.65      $284.00      $125.53
   69550  T                Remove ear lesion...         0256        26.61    $1,354.56      $623.05      $270.91
   69552  T                Remove ear lesion...         0256        26.61    $1,354.56      $623.05      $270.91
   69554  C                Remove ear lesion...  ...........  ...........  ...........  ...........  ...........
   69601  T                Mastoid surgery              0256        26.61    $1,354.56      $623.05      $270.91
                            revision.
   69602  T                Mastoid surgery              0256        26.61    $1,354.56      $623.05      $270.91
                            revision.
   69603  T                Mastoid surgery              0256        26.61    $1,354.56      $623.05      $270.91
                            revision.
   69604  T                Mastoid surgery              0256        26.61    $1,354.56      $623.05      $270.91
                            revision.
   69605  T                Mastoid surgery              0256        26.61    $1,354.56      $623.05      $270.91
                            revision.
   69610  T                Repair of eardrum...         0254        17.37      $884.20      $272.41      $176.84
   69620  T                Repair of eardrum...         0254        17.37      $884.20      $272.41      $176.84
   69631  T                Repair eardrum               0256        26.61    $1,354.56      $623.05      $270.91
                            structures.
   69632  T                Rebuild eardrum              0256        26.61    $1,354.56      $623.05      $270.91
                            structures.
   69633  T                Rebuild eardrum              0256        26.61    $1,354.56      $623.05      $270.91
                            structures.
   69635  T                Repair eardrum               0256        26.61    $1,354.56      $623.05      $270.91
                            structures.
   69636  T                Rebuild eardrum              0256        26.61    $1,354.56      $623.05      $270.91
                            structures.

[[Page 60005]]

 
   69637  T                Rebuild eardrum              0256        26.61    $1,354.56      $623.05      $270.91
                            structures.
   69641  T                Revise middle ear &          0256        26.61    $1,354.56      $623.05      $270.91
                            mastoid.
   69642  T                Revise middle ear &          0256        26.61    $1,354.56      $623.05      $270.91
                            mastoid.
   69643  T                Revise middle ear &          0256        26.61    $1,354.56      $623.05      $270.91
                            mastoid.
   69644  T                Revise middle ear &          0256        26.61    $1,354.56      $623.05      $270.91
                            mastoid.
   69645  T                Revise middle ear &          0256        26.61    $1,354.56      $623.05      $270.91
                            mastoid.
   69646  T                Revise middle ear &          0256        26.61    $1,354.56      $623.05      $270.91
                            mastoid.
   69650  T                Release middle ear           0254        17.37      $884.20      $272.41      $176.84
                            bone.
   69660  T                Revise middle ear            0256        26.61    $1,354.56      $623.05      $270.91
                            bone.
   69661  T                Revise middle ear            0256        26.61    $1,354.56      $623.05      $270.91
                            bone.
   69662  T                Revise middle ear            0256        26.61    $1,354.56      $623.05      $270.91
                            bone.
   69666  T                Repair middle ear            0256        26.61    $1,354.56      $623.05      $270.91
                            structures.
   69667  T                Repair middle ear            0256        26.61    $1,354.56      $623.05      $270.91
                            structures.
   69670  T                Remove mastoid air           0256        26.61    $1,354.56      $623.05      $270.91
                            cells.
   69676  T                Remove middle ear            0256        26.61    $1,354.56      $623.05      $270.91
                            nerve.
   69700  T                Close mastoid                0256        26.61    $1,354.56      $623.05      $270.91
                            fistula.
   69710  E                Implant/replace       ...........  ...........  ...........  ...........  ...........
                            hearing aid.
   69711  T                Remove/repair                0256        26.61    $1,354.56      $623.05      $270.91
                            hearing aid.
   69714  T                Implant temple bone          0256        26.61    $1,354.56      $623.05      $270.91
                            w/stimul.
   69715  T                Temple bne implnt w/         0256        26.61    $1,354.56      $623.05      $270.91
                            stimulat.
   69717  T                Temple bone implant          0256        26.61    $1,354.56      $623.05      $270.91
                            revision.
   69718  T                Revise temple bone           0256        26.61    $1,354.56      $623.05      $270.91
                            implant.
   69720  T                Release facial nerve         0256        26.61    $1,354.56      $623.05      $270.91
   69725  T                Release facial nerve         0256        26.61    $1,354.56      $623.05      $270.91
   69740  T                Repair facial nerve.         0256        26.61    $1,354.56      $623.05      $270.91
   69745  T                Repair facial nerve.         0256        26.61    $1,354.56      $623.05      $270.91
   69799  T                Middle ear surgery           0253        12.33      $627.65      $284.00      $125.53
                            procedure.
   69801  T                Incise inner ear....         0256        26.61    $1,354.56      $623.05      $270.91
   69802  T                Incise inner ear....         0256        26.61    $1,354.56      $623.05      $270.91
   69805  T                Explore inner ear...         0256        26.61    $1,354.56      $623.05      $270.91
   69806  T                Explore inner ear...         0256        26.61    $1,354.56      $623.05      $270.91
   69820  T                Establish inner ear          0256        26.61    $1,354.56      $623.05      $270.91
                            window.
   69840  T                Revise inner ear             0256        26.61    $1,354.56      $623.05      $270.91
                            window.
   69905  T                Remove inner ear....         0256        26.61    $1,354.56      $623.05      $270.91
   69910  T                Remove inner ear &           0256        26.61    $1,354.56      $623.05      $270.91
                            mastoid.
   69915  T                Incise inner ear             0256        26.61    $1,354.56      $623.05      $270.91
                            nerve.
   69930  T                Implant cochlear             0259       376.56   $19,168.41    $8,798.30    $3,833.68
                            device.
   69949  T                Inner ear surgery            0253        12.33      $627.65      $284.00      $125.53
                            procedure.
   69950  C                Incise inner ear      ...........  ...........  ...........  ...........  ...........
                            nerve.
   69955  T                Release facial nerve         0256        26.61    $1,354.56      $623.05      $270.91
   69960  T                Release inner ear            0256        26.61    $1,354.56      $623.05      $270.91
                            canal.
   69970  C                Remove inner ear      ...........  ...........  ...........  ...........  ...........
                            lesion.
   69979  T                Temporal bone                0251         2.43      $123.70       $27.99       $24.74
                            surgery.
   69990  N                Microsurgery add-on.  ...........  ...........  ...........  ...........  ...........
   70010  S                Contrast x-ray of            0274         5.24      $266.74      $128.12       $53.35
                            brain.
   70015  S                Contrast x-ray of            0274         5.24      $266.74      $128.12       $53.35
                            brain.
   70030  X                X-ray eye for                0260         0.70       $35.63       $19.59        $7.13
                            foreign body.
   70100  X                X-ray exam of jaw...         0260         0.70       $35.63       $19.59        $7.13
   70110  X                X-ray exam of jaw...         0260         0.70       $35.63       $19.59        $7.13
   70120  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            mastoids.
   70130  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            mastoids.
   70134  X                X-ray exam of middle         0261         1.21       $61.59       $33.87       $12.32
                            ear.
   70140  X                X-ray exam of facial         0260         0.70       $35.63       $19.59        $7.13
                            bones.
   70150  X                X-ray exam of facial         0260         0.70       $35.63       $19.59        $7.13
                            bones.
   70160  X                X-ray exam of nasal          0260         0.70       $35.63       $19.59        $7.13
                            bones.
   70170  X                X-ray exam of tear           0263         1.61       $81.96       $44.26       $16.39
                            duct.
   70190  X                X-ray exam of eye            0260         0.70       $35.63       $19.59        $7.13
                            sockets.
   70200  X                X-ray exam of eye            0260         0.70       $35.63       $19.59        $7.13
                            sockets.
   70210  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            sinuses.
   70220  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            sinuses.
   70240  X                X-ray exam,                  0260         0.70       $35.63       $19.59        $7.13
                            pituitary saddle.
   70250  X                X-ray exam of skull.         0260         0.70       $35.63       $19.59        $7.13
   70260  X                X-ray exam of skull.         0261         1.21       $61.59       $33.87       $12.32
   70300  X                X-ray exam of teeth.         0262         0.65       $33.09       $10.90        $6.62
   70310  X                X-ray exam of teeth.         0262         0.65       $33.09       $10.90        $6.62
   70320  X                Full mouth x-ray of          0262         0.65       $33.09       $10.90        $6.62
                            teeth.
   70328  X                X-ray exam of jaw            0260         0.70       $35.63       $19.59        $7.13
                            joint.
   70330  X                X-ray exam of jaw            0260         0.70       $35.63       $19.59        $7.13
                            joints.
   70332  S                X-ray exam of jaw            0275         2.59      $131.84       $68.56       $26.37
                            joint.
   70336  S                Magnetic image, jaw          0335         5.39      $274.37      $150.90       $54.87
                            joint.
   70350  X                X-ray head for               0260         0.70       $35.63       $19.59        $7.13
                            orthodontia.
   70355  X                Panoramic x-ray of           0260         0.70       $35.63       $19.59        $7.13
                            jaws.
   70360  X                X-ray exam of neck..         0260         0.70       $35.63       $19.59        $7.13
   70370  X                Throat x-ray &               0272         1.38       $70.25       $38.63       $14.05
                            fluoroscopy.
   70371  X                Speech evaluation,           0272         1.38       $70.25       $38.63       $14.05
                            complex.

[[Page 60006]]

 
   70373  X                Contrast x-ray of            0263         1.61       $81.96       $44.26       $16.39
                            larynx.
   70380  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            salivary gland.
   70390  X                X-ray exam of                0263         1.61       $81.96       $44.26       $16.39
                            salivary duct.
   70450  S                Ct head/brain w/o            0332         3.24      $164.93       $90.71       $32.99
                            dye.
   70460  S                Ct head/brain w/dye.         0283         4.48      $228.05      $125.42       $45.61
   70470  S                Ct head/brain w/o&w          0333         5.22      $265.72      $146.14       $53.14
                            dye.
   70480  S                Ct orbit/ear/fossa w/        0332         3.24      $164.93       $90.71       $32.99
                            o dye.
   70481  S                Ct orbit/ear/fossa w/        0283         4.48      $228.05      $125.42       $45.61
                            dye.
   70482  S                Ct orbit/ear/fossa w/        0333         5.22      $265.72      $146.14       $53.14
                            o&w dye.
   70486  S                Ct maxillofacial w/o         0332         3.24      $164.93       $90.71       $32.99
                            dye.
   70487  S                Ct maxillofacial w/          0283         4.48      $228.05      $125.42       $45.61
                            dye.
   70488  S                Ct maxillofacial w/          0333         5.22      $265.72      $146.14       $53.14
                            o&w dye.
   70490  S                Ct soft tissue neck          0332         3.24      $164.93       $90.71       $32.99
                            w/o dye.
   70491  S                Ct soft tissue neck          0283         4.48      $228.05      $125.42       $45.61
                            w/dye.
   70492  S                Ct sft tsue nck w/o          0333         5.22      $265.72      $146.14       $53.14
                            & w/dye.
   70496  S                Ct angiography, head         0333         5.22      $265.72      $146.14       $53.14
   70498  S                Ct angiography, neck         0333         5.22      $265.72      $146.14       $53.14
   70540  S                Mri orbit/face/neck          0336         6.29      $320.19      $176.10       $64.04
                            w/o dye.
   70542  S                Mri orbit/face/neck          0284         7.15      $363.96      $200.17       $72.79
                            w/dye.
   70543  S                Mri orbt/fac/nck w/          0337         8.54      $434.72      $239.09       $86.94
                            o&w dye.
   70544  S                Mr angiography head          0336         6.29      $320.19      $176.10       $64.04
                            w/o dye.
   70545  S                Mr angiography head          0284         7.15      $363.96      $200.17       $72.79
                            w/dye.
   70546  S                Mr angiograph head w/        0337         8.54      $434.72      $239.09       $86.94
                            o&w dye.
   70547  S                Mr angiography neck          0336         6.29      $320.19      $176.10       $64.04
                            w/o dye.
   70548  S                Mr angiography neck          0284         7.15      $363.96      $200.17       $72.79
                            w/dye.
   70549  S                Mr angiograph neck w/        0337         8.54      $434.72      $239.09       $86.94
                            o&w dye.
   70551  S                Mri brain w/o dye...         0336         6.29      $320.19      $176.10       $64.04
   70552  S                Mri brain w/dye.....         0284         7.15      $363.96      $200.17       $72.79
   70553  S                Mri brain w/o&w dye.         0337         8.54      $434.72      $239.09       $86.94
   71010  X                Chest x-ray.........         0260         0.70       $35.63       $19.59        $7.13
   71015  X                Chest x-ray.........         0260         0.70       $35.63       $19.59        $7.13
   71020  X                Chest x-ray.........         0260         0.70       $35.63       $19.59        $7.13
   71021  X                Chest x-ray.........         0260         0.70       $35.63       $19.59        $7.13
   71022  X                Chest x-ray.........         0260         0.70       $35.63       $19.59        $7.13
   71023  X                Chest x-ray and              0272         1.38       $70.25       $38.63       $14.05
                            fluoroscopy.
   71030  X                Chest x-ray.........         0260         0.70       $35.63       $19.59        $7.13
   71034  X                Chest x-ray and              0272         1.38       $70.25       $38.63       $14.05
                            fluoroscopy.
   71035  X                Chest x-ray.........         0260         0.70       $35.63       $19.59        $7.13
   71040  X                Contrast x-ray of            0263         1.61       $81.96       $44.26       $16.39
                            bronchi.
   71060  X                Contrast x-ray of            0263         1.61       $81.96       $44.26       $16.39
                            bronchi.
   71090  X                X-ray & pacemaker            0272         1.38       $70.25       $38.63       $14.05
                            insertion.
   71100  X                X-ray exam of ribs..         0260         0.70       $35.63       $19.59        $7.13
   71101  X                X-ray exam of ribs/          0260         0.70       $35.63       $19.59        $7.13
                            chest.
   71110  X                X-ray exam of ribs..         0260         0.70       $35.63       $19.59        $7.13
   71111  X                X-ray exam of ribs/          0261         1.21       $61.59       $33.87       $12.32
                            chest.
   71120  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            breastbone.
   71130  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            breastbone.
   71250  S                Ct thorax w/o dye...         0332         3.24      $164.93       $90.71       $32.99
   71260  S                Ct thorax w/dye.....         0283         4.48      $228.05      $125.42       $45.61
   71270  S                Ct thorax w/o&w dye.         0333         5.22      $265.72      $146.14       $53.14
   71275  S                Ct angiography,              0333         5.22      $265.72      $146.14       $53.14
                            chest.
   71550  S                Mri chest w/o dye...         0336         6.29      $320.19      $176.10       $64.04
   71551  S                Mri chest w/dye.....         0284         7.15      $363.96      $200.17       $72.79
   71552  S                Mri chest w/o&w dye.         0337         8.54      $434.72      $239.09       $86.94
   71555  E                Mri angio chest w or  ...........  ...........  ...........  ...........  ...........
                            w/o dye.
   72010  X                X-ray exam of spine.         0261         1.21       $61.59       $33.87       $12.32
   72020  X                X-ray exam of spine.         0260         0.70       $35.63       $19.59        $7.13
   72040  X                X-ray exam of neck           0260         0.70       $35.63       $19.59        $7.13
                            spine.
   72050  X                X-ray exam of neck           0261         1.21       $61.59       $33.87       $12.32
                            spine.
   72052  X                X-ray exam of neck           0261         1.21       $61.59       $33.87       $12.32
                            spine.
   72069  X                X-ray exam of trunk          0260         0.70       $35.63       $19.59        $7.13
                            spine.
   72070  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            thoracic spine.
   72072  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            thoracic spine.
   72074  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            thoracic spine.
   72080  X                X-ray exam of trunk          0260         0.70       $35.63       $19.59        $7.13
                            spine.
   72090  X                X-ray exam of trunk          0261         1.21       $61.59       $33.87       $12.32
                            spine.
   72100  X                X-ray exam of lower          0260         0.70       $35.63       $19.59        $7.13
                            spine.
   72110  X                X-ray exam of lower          0261         1.21       $61.59       $33.87       $12.32
                            spine.
   72114  X                X-ray exam of lower          0261         1.21       $61.59       $33.87       $12.32
                            spine.
   72120  X                X-ray exam of lower          0260         0.70       $35.63       $19.59        $7.13
                            spine.
   72125  S                Ct neck spine w/o            0332         3.24      $164.93       $90.71       $32.99
                            dye.
   72126  S                Ct neck spine w/dye.         0283         4.48      $228.05      $125.42       $45.61
   72127  S                Ct neck spine w/o&w          0333         5.22      $265.72      $146.14       $53.14
                            dye.
   72128  S                Ct chest spine w/o           0332         3.24      $164.93       $90.71       $32.99
                            dye.
   72129  S                Ct chest spine w/dye         0283         4.48      $228.05      $125.42       $45.61

[[Page 60007]]

 
   72130  S                Ct chest spine w/o&w         0333         5.22      $265.72      $146.14       $53.14
                            dye.
   72131  S                Ct lumbar spine w/o          0332         3.24      $164.93       $90.71       $32.99
                            dye.
   72132  S                Ct lumbar spine w/           0283         4.48      $228.05      $125.42       $45.61
                            dye.
   72133  S                Ct lumbar spine w/           0333         5.22      $265.72      $146.14       $53.14
                            o&w dye.
   72141  S                Mri neck spine w/o           0336         6.29      $320.19      $176.10       $64.04
                            dye.
   72142  S                Mri neck spine w/dye         0284         7.15      $363.96      $200.17       $72.79
   72146  S                Mri chest spine w/o          0336         6.29      $320.19      $176.10       $64.04
                            dye.
   72147  S                Mri chest spine w/           0284         7.15      $363.96      $200.17       $72.79
                            dye.
   72148  S                Mri lumbar spine w/o         0336         6.29      $320.19      $176.10       $64.04
                            dye.
   72149  S                Mri lumbar spine w/          0284         7.15      $363.96      $200.17       $72.79
                            dye.
   72156  S                Mri neck spine w/o&w         0337         8.54      $434.72      $239.09       $86.94
                            dye.
   72157  S                Mri chest spine w/           0337         8.54      $434.72      $239.09       $86.94
                            o&w dye.
   72158  S                Mri lumbar spine w/          0337         8.54      $434.72      $239.09       $86.94
                            o&w dye.
   72159  E                Mr angio spine w/o&w  ...........  ...........  ...........  ...........  ...........
                            dye.
   72170  X                X-ray exam of pelvis         0260         0.70       $35.63       $19.59        $7.13
   72190  X                X-ray exam of pelvis         0260         0.70       $35.63       $19.59        $7.13
   72191  S                Ct angiograph pelv w/        0333         5.22      $265.72      $146.14       $53.14
                            o&w dye.
   72192  S                Ct pelvis w/o dye...         0332         3.24      $164.93       $90.71       $32.99
   72193  S                Ct pelvis w/dye.....         0283         4.48      $228.05      $125.42       $45.61
   72194  S                Ct pelvis w/o&w dye.         0333         5.22      $265.72      $146.14       $53.14
   72195  S                Mri pelvis w/o dye..         0336         6.29      $320.19      $176.10       $64.04
   72196  S                Mri pelvis w/dye....         0284         7.15      $363.96      $200.17       $72.79
   72197  S                Mri pelvis w/o & w           0337         8.54      $434.72      $239.09       $86.94
                            dye.
   72198  E                Mr angio pelvis w/    ...........  ...........  ...........  ...........  ...........
                            o&w dye.
   72200  X                X-ray exam                   0260         0.70       $35.63       $19.59        $7.13
                            sacroiliac joints.
   72202  X                X-ray exam                   0260         0.70       $35.63       $19.59        $7.13
                            sacroiliac joints.
   72220  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            tailbone.
   72240  S                Contrast x-ray of            0274         5.24      $266.74      $128.12       $53.35
                            neck spine.
   72255  S                Contrast x-ray,              0274         5.24      $266.74      $128.12       $53.35
                            thorax spine.
   72265  S                Contrast x-ray,              0274         5.24      $266.74      $128.12       $53.35
                            lower spine.
   72270  S                Contrast x-ray of            0274         5.24      $266.74      $128.12       $53.35
                            spine.
   72275  S                Epidurography.......         0274         5.24      $266.74      $128.12       $53.35
   72285  S                X-ray c/t spine disk         0274         5.24      $266.74      $128.12       $53.35
   72295  S                X-ray of lower spine         0274         5.24      $266.74      $128.12       $53.35
                            disk.
   73000  X                X-ray exam of collar         0260         0.70       $35.63       $19.59        $7.13
                            bone.
   73010  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            shoulder blade.
   73020  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            shoulder.
   73030  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            shoulder.
   73040  S                Contrast x-ray of            0275         2.59      $131.84       $68.56       $26.37
                            shoulder.
   73050  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            shoulders.
   73060  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            humerus.
   73070  X                X-ray exam of elbow.         0260         0.70       $35.63       $19.59        $7.13
   73080  X                X-ray exam of elbow.         0260         0.70       $35.63       $19.59        $7.13
   73085  S                Contrast x-ray of            0275         2.59      $131.84       $68.56       $26.37
                            elbow.
   73090  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            forearm.
   73092  X                X-ray exam of arm,           0260         0.70       $35.63       $19.59        $7.13
                            infant.
   73100  X                X-ray exam of wrist.         0260         0.70       $35.63       $19.59        $7.13
   73110  X                X-ray exam of wrist.         0260         0.70       $35.63       $19.59        $7.13
   73115  S                Contrast x-ray of            0275         2.59      $131.84       $68.56       $26.37
                            wrist.
   73120  X                X-ray exam of hand..         0260         0.70       $35.63       $19.59        $7.13
   73130  X                X-ray exam of hand..         0260         0.70       $35.63       $19.59        $7.13
   73140  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            finger(s).
   73200  S                Ct upper extremity w/        0332         3.24      $164.93       $90.71       $32.99
                            o dye.
   73201  S                Ct upper extremity w/        0283         4.48      $228.05      $125.42       $45.61
                            dye.
   73202  S                Ct uppr extremity w/         0333         5.22      $265.72      $146.14       $53.14
                            o&w dye.
   73206  S                Ct angio upr extrm w/        0333         5.22      $265.72      $146.14       $53.14
                            o&w dye.
   73218  S                Mri upper extremity          0336         6.29      $320.19      $176.10       $64.04
                            w/o dye.
   73219  S                Mri upper extremity          0284         7.15      $363.96      $200.17       $72.79
                            w/dye.
   73220  S                Mri uppr extremity w/        0337         8.54      $434.72      $239.09       $86.94
                            o&w dye.
   73221  S                Mri joint upr extrem         0336         6.29      $320.19      $176.10       $64.04
                            w/o dye.
   73222  S                Mri joint upr extrem         0284         7.15      $363.96      $200.17       $72.79
                            w/ dye.
   73223  S                Mri joint upr extr w/        0337         8.54      $434.72      $239.09       $86.94
                            o&w dye.
   73225  E                Mr angio upr extr w/  ...........  ...........  ...........  ...........  ...........
                            o&w dye.
   73500  X                X-ray exam of hip...         0260         0.70       $35.63       $19.59        $7.13
   73510  X                X-ray exam of hip...         0260         0.70       $35.63       $19.59        $7.13
   73520  X                X-ray exam of hips..         0260         0.70       $35.63       $19.59        $7.13
   73525  S                Contrast x-ray of            0275         2.59      $131.84       $68.56       $26.37
                            hip.
   73530  X                X-ray exam of hip...         0261         1.21       $61.59       $33.87       $12.32
   73540  X                X-ray exam of pelvis         0260         0.70       $35.63       $19.59        $7.13
                            & hips.
   73542  S                X-ray exam,                  0275         2.59      $131.84       $68.56       $26.37
                            sacroiliac joint.
   73550  X                X-ray exam of thigh.         0260         0.70       $35.63       $19.59        $7.13
   73560  X                X-ray exam of knee,          0260         0.70       $35.63       $19.59        $7.13
                            1 or 2.
   73562  X                X-ray exam of knee,          0260         0.70       $35.63       $19.59        $7.13
                            3.
   73564  X                X-ray exam, knee, 4          0260         0.70       $35.63       $19.59        $7.13
                            or more.
   73565  X                X-ray exam of knees.         0260         0.70       $35.63       $19.59        $7.13

[[Page 60008]]

 
   73580  S                Contrast x-ray of            0275         2.59      $131.84       $68.56       $26.37
                            knee joint.
   73590  X                X-ray exam of lower          0260         0.70       $35.63       $19.59        $7.13
                            leg.
   73592  X                X-ray exam of leg,           0261         1.21       $61.59       $33.87       $12.32
                            infant.
   73600  X                X-ray exam of ankle.         0260         0.70       $35.63       $19.59        $7.13
   73610  X                X-ray exam of ankle.         0260         0.70       $35.63       $19.59        $7.13
   73615  S                Contrast x-ray of            0275         2.59      $131.84       $68.56       $26.37
                            ankle.
   73620  X                X-ray exam of foot..         0260         0.70       $35.63       $19.59        $7.13
   73630  X                X-ray exam of foot..         0260         0.70       $35.63       $19.59        $7.13
   73650  X                X-ray exam of heel..         0260         0.70       $35.63       $19.59        $7.13
   73660  X                X-ray exam of toe(s)         0260         0.70       $35.63       $19.59        $7.13
   73700  S                Ct lower extremity w/        0332         3.24      $164.93       $90.71       $32.99
                            o dye.
   73701  S                Ct lower extremity w/        0283         4.48      $228.05      $125.42       $45.61
                            dye.
   73702  S                Ct lwr extremity w/          0333         5.22      $265.72      $146.14       $53.14
                            o&w dye.
   73706  S                Ct angio lwr extr w/         0333         5.22      $265.72      $146.14       $53.14
                            o&w dye.
   73718  S                Mri lower extremity          0336         6.29      $320.19      $176.10       $64.04
                            w/o dye.
   73719  S                Mri lower extremity          0284         7.15      $363.96      $200.17       $72.79
                            w/dye.
   73720  S                Mri lwr extremity w/         0337         8.54      $434.72      $239.09       $86.94
                            o&w dye.
   73721  S                Mri joint of lwr             0336         6.29      $320.19      $176.10       $64.04
                            extre w/o d.
   73722  S                Mri joint of lwr             0284         7.15      $363.96      $200.17       $72.79
                            extr w/dye.
   73723  S                Mri joint lwr extr w/        0337         8.54      $434.72      $239.09       $86.94
                            o&w dye.
   73725  E                Mr ang lwr ext w or   ...........  ...........  ...........  ...........  ...........
                            w/o dye.
   74000  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            abdomen.
   74010  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            abdomen.
   74020  X                X-ray exam of                0260         0.70       $35.63       $19.59        $7.13
                            abdomen.
   74022  X                X-ray exam series,           0261         1.21       $61.59       $33.87       $12.32
                            abdomen.
   74150  S                Ct abdomen w/o dye..         0332         3.24      $164.93       $90.71       $32.99
   74160  S                Ct abdomen w/dye....         0283         4.48      $228.05      $125.42       $45.61
   74170  S                Ct abdomen w/o&w dye         0333         5.22      $265.72      $146.14       $53.14
   74175  S                Ct angio abdom w/o&w         0333         5.22      $265.72      $146.14       $53.14
                            dye.
   74181  S                Mri abdomen w/o dye.         0336         6.29      $320.19      $176.10       $64.04
   74182  S                Mri abdomen w/dye...         0284         7.15      $363.96      $200.17       $72.79
   74183  S                Mri abdomen w/o&w            0337         8.54      $434.72      $239.09       $86.94
                            dye.
   74185  E                Mri angio, abdom w    ...........  ...........  ...........  ...........  ...........
                            or w/o dy.
   74190  X                X-ray exam of                0263         1.61       $81.96       $44.26       $16.39
                            peritoneum.
   74210  S                Contrst x-ray exam           0276         1.48       $75.34       $41.43       $15.07
                            of throat.
   74220  S                Contrast x-ray,              0276         1.48       $75.34       $41.43       $15.07
                            esophagus.
   74230  S                Cinema x-ray, throat/        0276         1.48       $75.34       $41.43       $15.07
                            esoph.
   74235  S                Remove esophagus             0296         3.39      $172.56       $94.90       $34.51
                            obstruction.
   74240  S                X-ray exam, upper gi         0276         1.48       $75.34       $41.43       $15.07
                            tract.
   74241  S                X-ray exam, upper gi         0276         1.48       $75.34       $41.43       $15.07
                            tract.
   74245  S                X-ray exam, upper gi         0277         2.16      $109.95       $60.47       $21.99
                            tract.
   74246  S                Contrst x-ray uppr           0276         1.48       $75.34       $41.43       $15.07
                            gi tract.
   74247  S                Contrst x-ray uppr           0276         1.48       $75.34       $41.43       $15.07
                            gi tract.
   74249  S                Contrst x-ray uppr           0277         2.16      $109.95       $60.47       $21.99
                            gi tract.
   74250  S                X-ray exam of small          0276         1.48       $75.34       $41.43       $15.07
                            bowel.
   74251  S                X-ray exam of small          0277         2.16      $109.95       $60.47       $21.99
                            bowel.
   74260  S                X-ray exam of small          0277         2.16      $109.95       $60.47       $21.99
                            bowel.
   74270  S                Contrast x-ray exam          0276         1.48       $75.34       $41.43       $15.07
                            of colon.
   74280  S                Contrast x-ray exam          0277         2.16      $109.95       $60.47       $21.99
                            of colon.
   74283  S                Contrast x-ray exam          0276         1.48       $75.34       $41.43       $15.07
                            of colon.
   74290  S                Contrast x-ray,              0276         1.48       $75.34       $41.43       $15.07
                            gallbladder.
   74291  S                Contrast x-rays,             0276         1.48       $75.34       $41.43       $15.07
                            gallbladder.
   74300  X                X-ray bile ducts/            0263         1.61       $81.96       $44.26       $16.39
                            pancreas.
   74301  X                X-rays at surgery            0263         1.61       $81.96       $44.26       $16.39
                            add-on.
   74305  X                X-ray bile ducts/            0263         1.61       $81.96       $44.26       $16.39
                            pancreas.
   74320  X                Contrast x-ray of            0264         3.71      $188.85      $103.86       $37.77
                            bile ducts.
   74327  S                X-ray bile stone             0296         3.39      $172.56       $94.90       $34.51
                            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         1.38       $70.25       $38.63       $14.05
                            tube.
   74350  X                X-ray guide, stomach         0187         4.22      $214.81  ...........       $42.96
                            tube.
   74355  X                X-ray guide,                 0187         4.22      $214.81  ...........       $42.96
                            intestinal tube.
   74360  S                X-ray guide, GI              0296         3.39      $172.56       $94.90       $34.51
                            dilation.
   74363  S                X-ray, bile duct             0297         7.07      $359.89      $172.51       $71.98
                            dilation.
   74400  S                Contrst x-ray,               0278         2.34      $119.12       $65.51       $23.82
                            urinary tract.
   74410  S                Contrst x-ray,               0278         2.34      $119.12       $65.51       $23.82
                            urinary tract.
   74415  S                Contrst x-ray,               0278         2.34      $119.12       $65.51       $23.82
                            urinary tract.
   74420  S                Contrst x-ray,               0278         2.34      $119.12       $65.51       $23.82
                            urinary tract.
   74425  S                Contrst x-ray,               0278         2.34      $119.12       $65.51       $23.82
                            urinary tract.
   74430  S                Contrast x-ray,              0278         2.34      $119.12       $65.51       $23.82
                            bladder.
   74440  S                X-ray, male genital          0278         2.34      $119.12       $65.51       $23.82
                            tract.
   74445  S                X-ray exam of penis.         0278         2.34      $119.12       $65.51       $23.82
   74450  S                X-ray, urethra/              0278         2.34      $119.12       $65.51       $23.82
                            bladder.
   74455  S                X-ray, urethra/              0278         2.34      $119.12       $65.51       $23.82
                            bladder.

[[Page 60009]]

 
   74470  X                X-ray exam of kidney         0264         3.71      $188.85      $103.86       $37.77
                            lesion.
   74475  S                X-ray control, cath          0297         7.07      $359.89      $172.51       $71.98
                            insert.
   74480  S                X-ray control, cath          0297         7.07      $359.89      $172.51       $71.98
                            insert.
   74485  S                X-ray guide, GU              0296         3.39      $172.56       $94.90       $34.51
                            dilation.
   74710  X                X-ray measurement of         0260         0.70       $35.63       $19.59        $7.13
                            pelvis.
   74740  X                X-ray, female                0264         3.71      $188.85      $103.86       $37.77
                            genital tract.
   74742  X                X-ray, fallopian             0187         4.22      $214.81  ...........       $42.96
                            tube.
   74775  S                X-ray exam of                0278         2.34      $119.12       $65.51       $23.82
                            perineum.
   75552  S                Heart mri for morph          0336         6.29      $320.19      $176.10       $64.04
                            w/o dye.
   75553  S                Heart mri for morph          0284         7.15      $363.96      $200.17       $72.79
                            w/dye.
   75554  S                Cardiac MRI/function         0335         5.39      $274.37      $150.90       $54.87
   75555  S                Cardiac MRI/limited          0335         5.39      $274.37      $150.90       $54.87
                            study.
   75556  E                Cardiac MRI/flow      ...........  ...........  ...........  ...........  ...........
                            mapping.
   75600  S                Contrast x-ray exam          0280        13.54      $689.24      $351.51      $137.85
                            of aorta.
   75605  S                Contrast x-ray exam          0280        13.54      $689.24      $351.51      $137.85
                            of aorta.
   75625  S                Contrast x-ray exam          0280        13.54      $689.24      $351.51      $137.85
                            of aorta.
   75630  S                X-ray aorta, leg             0280        13.54      $689.24      $351.51      $137.85
                            arteries.
   75635  S                Ct angio abdominal           0333         5.22      $265.72      $146.14       $53.14
                            arteries.
   75650  S                Artery x-rays, head          0280        13.54      $689.24      $351.51      $137.85
                            & neck.
   75658  S                Artery x-rays, arm..         0280        13.54      $689.24      $351.51      $137.85
   75660  S                Artery x-rays, head          0279         7.72      $392.98      $174.57       $78.60
                            & neck.
   75662  S                Artery x-rays, head          0279         7.72      $392.98      $174.57       $78.60
                            & neck.
   75665  S                Artery x-rays, head          0280        13.54      $689.24      $351.51      $137.85
                            & neck.
   75671  S                Artery x-rays, head          0280        13.54      $689.24      $351.51      $137.85
                            & neck.
   75676  S                Artery x-rays, neck.         0280        13.54      $689.24      $351.51      $137.85
   75680  S                Artery x-rays, neck.         0280        13.54      $689.24      $351.51      $137.85
   75685  S                Artery x-rays, spine         0279         7.72      $392.98      $174.57       $78.60
   75705  S                Artery x-rays, spine         0279         7.72      $392.98      $174.57       $78.60
   75710  S                Artery x-rays, arm/          0280        13.54      $689.24      $351.51      $137.85
                            leg.
   75716  S                Artery x-rays, arms/         0280        13.54      $689.24      $351.51      $137.85
                            legs.
   75722  S                Artery x-rays,               0280        13.54      $689.24      $351.51      $137.85
                            kidney.
   75724  S                Artery x-rays,               0280        13.54      $689.24      $351.51      $137.85
                            kidneys.
   75726  S                Artery x-rays,               0280        13.54      $689.24      $351.51      $137.85
                            abdomen.
   75731  S                Artery x-rays,               0280        13.54      $689.24      $351.51      $137.85
                            adrenal gland.
   75733  S                Artery x-rays,               0280        13.54      $689.24      $351.51      $137.85
                            adrenals.
   75736  S                Artery x-rays,               0280        13.54      $689.24      $351.51      $137.85
                            pelvis.
   75741  S                Artery x-rays, lung.         0279         7.72      $392.98      $174.57       $78.60
   75743  S                Artery x-rays, lungs         0280        13.54      $689.24      $351.51      $137.85
   75746  S                Artery x-rays, lung.         0279         7.72      $392.98      $174.57       $78.60
   75756  S                Artery x-rays, chest         0279         7.72      $392.98      $174.57       $78.60
   75774  S                Artery x-ray, each           0279         7.72      $392.98      $174.57       $78.60
                            vessel.
   75790  S                Visualize A-V shunt.         0281         4.32      $219.91      $114.35       $43.98
   75801  X                Lymph vessel x-ray,          0264         3.71      $188.85      $103.86       $37.77
                            arm/leg.
   75803  X                Lymph vessel x-              0264         3.71      $188.85      $103.86       $37.77
                            ray,arms/legs.
   75805  X                Lymph vessel x-ray,          0264         3.71      $188.85      $103.86       $37.77
                            trunk.
   75807  X                Lymph vessel x-ray,          0264         3.71      $188.85      $103.86       $37.77
                            trunk.
   75809  X                Nonvascular shunt, x-        0263         1.61       $81.96       $44.26       $16.39
                            ray.
   75810  S                Vein x-ray, spleen/          0279         7.72      $392.98      $174.57       $78.60
                            liver.
   75820  S                Vein x-ray, arm/leg.         0281         4.32      $219.91      $114.35       $43.98
   75822  S                Vein x-ray, arms/            0281         4.32      $219.91      $114.35       $43.98
                            legs.
   75825  S                Vein x-ray, trunk...         0279         7.72      $392.98      $174.57       $78.60
   75827  S                Vein x-ray, chest...         0279         7.72      $392.98      $174.57       $78.60
   75831  S                Vein x-ray, kidney..         0287         4.06      $206.67       $90.93       $41.33
   75833  S                Vein x-ray, kidneys.         0279         7.72      $392.98      $174.57       $78.60
   75840  S                Vein x-ray, adrenal          0287         4.06      $206.67       $90.93       $41.33
                            gland.
   75842  S                Vein x-ray, adrenal          0287         4.06      $206.67       $90.93       $41.33
                            glands.
   75860  S                Vein x-ray, neck....         0287         4.06      $206.67       $90.93       $41.33
   75870  S                Vein x-ray, skull...         0287         4.06      $206.67       $90.93       $41.33
   75872  S                Vein x-ray, skull...         0287         4.06      $206.67       $90.93       $41.33
   75880  S                Vein x-ray, eye              0287         4.06      $206.67       $90.93       $41.33
                            socket.
   75885  S                Vein x-ray, liver...         0279         7.72      $392.98      $174.57       $78.60
   75887  S                Vein x-ray, liver...         0280        13.54      $689.24      $351.51      $137.85
   75889  S                Vein x-ray, liver...         0279         7.72      $392.98      $174.57       $78.60
   75891  S                Vein x-ray, liver...         0279         7.72      $392.98      $174.57       $78.60
   75893  N                Venous sampling by    ...........  ...........  ...........  ...........  ...........
                            catheter.
   75894  S                X-rays, transcath            0297         7.07      $359.89      $172.51       $71.98
                            therapy.
   75896  S                X-rays, transcath            0297         7.07      $359.89      $172.51       $71.98
                            therapy.
   75898  X                Follow-up angiogram.         0264         3.71      $188.85      $103.86       $37.77
   75900  C                Arterial catheter     ...........  ...........  ...........  ...........  ...........
                            exchange.
   75940  X                X-ray placement,             0187         4.22      $214.81  ...........       $42.96
                            vein filter.
   75945  S                Intravascular us....         0267         2.33      $118.61       $65.23       $23.72
   75946  S                Intravascular us add-        0267         2.33      $118.61       $65.23       $23.72
                            on.
   75952  C                Endovasc repair       ...........  ...........  ...........  ...........  ...........
                            abdom aorta.
   75953  C                Abdom aneurysm        ...........  ...........  ...........  ...........  ...........
                            endovas rpr.
   75960  S                Transcatheter intro,         0280        13.54      $689.24      $351.51      $137.85
                            stent.

[[Page 60010]]

 
   75961  S                Retrieval, broken            0280        13.54      $689.24      $351.51      $137.85
                            catheter.
   75962  S                Repair arterial              0280        13.54      $689.24      $351.51      $137.85
                            blockage.
   75964  S                Repair artery                0280        13.54      $689.24      $351.51      $137.85
                            blockage, each.
   75966  S                Repair arterial              0280        13.54      $689.24      $351.51      $137.85
                            blockage.
   75968  S                Repair artery                0280        13.54      $689.24      $351.51      $137.85
                            blockage, each.
   75970  S                Vascular biopsy.....         0280        13.54      $689.24      $351.51      $137.85
   75978  S                Repair venous                0280        13.54      $689.24      $351.51      $137.85
                            blockage.
   75980  S                Contrast xray exam           0297         7.07      $359.89      $172.51       $71.98
                            bile duct.
   75982  S                Contrast xray exam           0297         7.07      $359.89      $172.51       $71.98
                            bile duct.
   75984  S                Xray control                 0296         3.39      $172.56       $94.90       $34.51
                            catheter change.
   75989  N                Abscess drainage      ...........  ...........  ...........  ...........  ...........
                            under x-ray.
   75992  S                Atherectomy, x-ray           0280        13.54      $689.24      $351.51      $137.85
                            exam.
   75993  S                Atherectomy, x-ray           0280        13.54      $689.24      $351.51      $137.85
                            exam.
   75994  S                Atherectomy, x-ray           0280        13.54      $689.24      $351.51      $137.85
                            exam.
   75995  S                Atherectomy, x-ray           0280        13.54      $689.24      $351.51      $137.85
                            exam.
   75996  S                Atherectomy, x-ray           0280        13.54      $689.24      $351.51      $137.85
                            exam.
   76000  X                Fluoroscope                  0272         1.38       $70.25       $38.63       $14.05
                            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         1.21       $61.59       $33.87       $12.32
   76010  X                X-ray, nose to               0260         0.70       $35.63       $19.59        $7.13
                            rectum.
   76012  S                Percut                       0274         5.24      $266.74      $128.12       $53.35
                            vertebroplasty
                            fluor.
   76013  S                Percut                       0274         5.24      $266.74      $128.12       $53.35
                            vertebroplasty, ct.
   76020  X                X-rays for bone age.         0261         1.21       $61.59       $33.87       $12.32
   76040  X                X-rays, bone                 0260         0.70       $35.63       $19.59        $7.13
                            evaluation.
   76061  X                X-rays, bone survey.         0261         1.21       $61.59       $33.87       $12.32
   76062  X                X-rays, bone survey.         0261         1.21       $61.59       $33.87       $12.32
   76065  X                X-rays, bone                 0261         1.21       $61.59       $33.87       $12.32
                            evaluation.
   76066  X                Joint(s) survey,             0260         0.70       $35.63       $19.59        $7.13
                            single film.
   76070  E                CT scan, bone         ...........  ...........  ...........  ...........  ...........
                            density study.
   76075  S                Dual energy x-ray            0707  ...........       $75.00  ...........       $15.00
                            study.
   76076  S                Dual energy x-ray            0707  ...........       $75.00  ...........       $15.00
                            study.
   76078  X                Photodensitometry...         0261         1.21       $61.59       $33.87       $12.32
   76080  X                X-ray exam of                0263         1.61       $81.96       $44.26       $16.39
                            fistula.
  *76085  A                Computer mammogram    ...........  ...........  ...........  ...........  ...........
                            add-on.
   76086  X                X-ray of mammary             0263         1.61       $81.96       $44.26       $16.39
                            duct.
   76088  X                X-ray of mammary             0263         1.61       $81.96       $44.26       $16.39
                            ducts.
   76090  S                Mammogram, one               0271         0.60       $30.54       $16.79        $6.11
                            breast.
   76091  S                Mammogram, both              0271         0.60       $30.54       $16.79        $6.11
                            breasts.
   76092  A                Mammogram, screening  ...........  ...........  ...........  ...........  ...........
   76093  E                Magnetic image,       ...........  ...........  ...........  ...........  ...........
                            breast.
   76094  E                Magnetic image, both  ...........  ...........  ...........  ...........  ...........
                            breasts.
   76095  X                Stereotactic breast          0187         4.22      $214.81  ...........       $42.96
                            biopsy.
   76096  X                X-ray of needle              0289         1.63       $82.97       $44.80       $16.59
                            wire, breast.
   76098  X                X-ray exam, breast           0260         0.70       $35.63       $19.59        $7.13
                            specimen.
   76100  X                X-ray exam of body           0261         1.21       $61.59       $33.87       $12.32
                            section.
   76101  X                Complex body section         0263         1.61       $81.96       $44.26       $16.39
                            x-ray.
   76102  X                Complex body section         0264         3.71      $188.85      $103.86       $37.77
                            x-rays.
   76120  X                Cinematic x-rays....         0261         1.21       $61.59       $33.87       $12.32
   76125  X                Cinematic x-rays add-        0261         1.21       $61.59       $33.87       $12.32
                            on.
   76140  E                X-ray consultation..  ...........  ...........  ...........  ...........  ...........
   76150  X                X-ray exam, dry              0260         0.70       $35.63       $19.59        $7.13
                            process.
   76350  N                Special x-ray         ...........  ...........  ...........  ...........  ...........
                            contrast study.
   76355  S                CAT scan for                 0283         4.48      $228.05      $125.42       $45.61
                            localization.
   76360  S                CAT scan for needle          0283         4.48      $228.05      $125.42       $45.61
                            biopsy.
  *76362  N                Cat scan for tissue   ...........  ...........  ...........  ...........  ...........
                            ablation.
   76370  S                CAT scan for therapy         0282         1.58       $80.43       $44.23       $16.09
                            guide.
   76375  S                3d/holograph                 0282         1.58       $80.43       $44.23       $16.09
                            reconstr add-on.
   76380  S                CAT scan follow-up           0282         1.58       $80.43       $44.23       $16.09
                            study.
   76390  E                Mr spectroscopy.....  ...........  ...........  ...........  ...........  ...........
   76393  N                Mr guidance for       ...........  ...........  ...........  ...........  ...........
                            needle place.
  *76394  N                Mri for tissue        ...........  ...........  ...........  ...........  ...........
                            ablation.
   76400  S                Magnetic image, bone         0335         5.39      $274.37      $150.90       $54.87
                            marrow.
  *76490  N                Us for tissue         ...........  ...........  ...........  ...........  ...........
                            ablation.
   76499  X                Radiographic                 0260         0.70       $35.63       $19.59        $7.13
                            procedure.
   76506  S                Echo exam of head...         0266         1.54       $78.39       $43.11       $15.68
   76511  S                Echo exam of eye....         0266         1.54       $78.39       $43.11       $15.68
   76512  S                Echo exam of eye....         0266         1.54       $78.39       $43.11       $15.68
   76513  S                Echo exam of eye,            0265         0.95       $48.36       $26.59        $9.67
                            water bath.
   76516  S                Echo exam of eye....         0266         1.54       $78.39       $43.11       $15.68
   76519  S                Echo exam of eye....         0266         1.54       $78.39       $43.11       $15.68
   76529  S                Echo exam of eye....         0265         0.95       $48.36       $26.59        $9.67
   76536  S                Echo exam of head            0266         1.54       $78.39       $43.11       $15.68
                            and neck.
   76604  S                Echo exam of chest..         0266         1.54       $78.39       $43.11       $15.68

[[Page 60011]]

 
   76645  S                Echo exam of                 0265         0.95       $48.36       $26.59        $9.67
                            breast(s).
   76700  S                Echo exam of abdomen         0266         1.54       $78.39       $43.11       $15.68
   76705  S                Echo exam of abdomen         0266         1.54       $78.39       $43.11       $15.68
   76770  S                Echo exam abdomen            0266         1.54       $78.39       $43.11       $15.68
                            back wall.
   76775  S                Echo exam abdomen            0266         1.54       $78.39       $43.11       $15.68
                            back wall.
   76778  S                Echo exam kidney             0266         1.54       $78.39       $43.11       $15.68
                            transplant.
   76800  S                Echo exam spinal             0266         1.54       $78.39       $43.11       $15.68
                            canal.
   76805  S                Echo exam of                 0266         1.54       $78.39       $43.11       $15.68
                            pregnant uterus.
   76810  S                Echo exam of                 0265         0.95       $48.36       $26.59        $9.67
                            pregnant uterus.
   76815  S                Echo exam of                 0265         0.95       $48.36       $26.59        $9.67
                            pregnant uterus.
   76816  S                Echo exam follow-up/         0265         0.95       $48.36       $26.59        $9.67
                            repeat.
   76818  S                Fetl biophys profil          0266         1.54       $78.39       $43.11       $15.68
                            w/stress.
   76819  S                Fetl biophys profil          0266         1.54       $78.39       $43.11       $15.68
                            w/o strs.
   76825  S                Echo exam of fetal           0269         3.85      $195.98      $101.91       $39.20
                            heart.
   76826  S                Echo exam of fetal           0697         2.08      $105.88       $55.06       $21.18
                            heart.
   76827  S                Echo exam of fetal           0269         3.85      $195.98      $101.91       $39.20
                            heart.
   76828  S                Echo exam of fetal           0697         2.08      $105.88       $55.06       $21.18
                            heart.
   76830  S                Echo exam,                   0266         1.54       $78.39       $43.11       $15.68
                            transvaginal.
   76831  S                Echo exam, uterus...         0266         1.54       $78.39       $43.11       $15.68
   76856  S                Echo exam of pelvis.         0266         1.54       $78.39       $43.11       $15.68
   76857  S                Echo exam of pelvis.         0265         0.95       $48.36       $26.59        $9.67
   76870  S                Echo exam of scrotum         0266         1.54       $78.39       $43.11       $15.68
   76872  S                Echo exam,                   0266         1.54       $78.39       $43.11       $15.68
                            transrectal.
   76873  N                Echograp trans r,     ...........  ...........  ...........  ...........  ...........
                            pros study.
   76880  S                Echo exam of                 0266         1.54       $78.39       $43.11       $15.68
                            extremity.
   76885  S                Echo exam, infant            0266         1.54       $78.39       $43.11       $15.68
                            hips.
   76886  S                Echo exam, infant            0266         1.54       $78.39       $43.11       $15.68
                            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         0.95       $48.36       $26.59        $9.67
                            follow-up.
   76975  S                GI endoscopic                0266         1.54       $78.39       $43.11       $15.68
                            ultrasound.
   76977  S                Us bone density              0265         0.95       $48.36       $26.59        $9.67
                            measure.
   76986  S                Ultrasound guide             0266         1.54       $78.39       $43.11       $15.68
                            intraoper.
   76999  S                Echo examination             0266         1.54       $78.39       $43.11       $15.68
                            procedure.
   77261  E                Radiation therapy     ...........  ...........  ...........  ...........  ...........
                            planning.
   77262  E                Radiation therapy     ...........  ...........  ...........  ...........  ...........
                            planning.
   77263  E                Radiation therapy     ...........  ...........  ...........  ...........  ...........
                            planning.
   77280  X                Set radiation                0304         1.63       $82.97       $41.52       $16.59
                            therapy field.
   77285  X                Set radiation                0305         3.71      $188.85       $90.65       $37.77
                            therapy field.
   77290  X                Set radiation                0305         3.71      $188.85       $90.65       $37.77
                            therapy field.
   77295  X                Set radiation                0310        14.51      $738.62      $339.05      $147.72
                            therapy field.
   77299  E                Radiation therapy     ...........  ...........  ...........  ...........  ...........
                            planning.
   77300  X                Radiation therapy            0304         1.63       $82.97       $41.52       $16.59
                            dose plan.
  *77301  S                Radioltherapy dos            0712  ...........      $875.00  ...........      $175.00
                            plan, imrt.
   77305  X                Radiation therapy            0304         1.63       $82.97       $41.52       $16.59
                            dose plan.
   77310  X                Radiation therapy            0304         1.63       $82.97       $41.52       $16.59
                            dose plan.
   77315  X                Radiation therapy            0305         3.71      $188.85       $90.65       $37.77
                            dose plan.
   77321  X                Radiation therapy            0305         3.71      $188.85       $90.65       $37.77
                            port plan.
   77326  X                Radiation therapy            0305         3.71      $188.85       $90.65       $37.77
                            dose plan.
   77327  X                Radiation therapy            0305         3.71      $188.85       $90.65       $37.77
                            dose plan.
   77328  X                Radiation therapy            0305         3.71      $188.85       $90.65       $37.77
                            dose plan.
   77331  X                Special radiation            0304         1.63       $82.97       $41.52       $16.59
                            dosimetry.
   77332  X                Radiation treatment          0303         3.00      $152.71       $69.28       $30.54
                            aid(s).
   77333  X                Radiation treatment          0303         3.00      $152.71       $69.28       $30.54
                            aid(s).
   77334  X                Radiation treatment          0303         3.00      $152.71       $69.28       $30.54
                            aid(s).
   77336  X                Radiation physics            0304         1.63       $82.97       $41.52       $16.59
                            consult.
   77370  X                Radiation physics            0305         3.71      $188.85       $90.65       $37.77
                            consult.
   77399  X                External radiation           0304         1.63       $82.97       $41.52       $16.59
                            dosimetry.
   77401  S                Radiation treatment          0300         2.07      $105.37       $47.72       $21.07
                            delivery.
   77402  S                Radiation treatment          0300         2.07      $105.37       $47.72       $21.07
                            delivery.
   77403  S                Radiation treatment          0300         2.07      $105.37       $47.72       $21.07
                            delivery.
   77404  S                Radiation treatment          0300         2.07      $105.37       $47.72       $21.07
                            delivery.
   77406  S                Radiation treatment          0300         2.07      $105.37       $47.72       $21.07
                            delivery.
   77407  S                Radiation treatment          0300         2.07      $105.37       $47.72       $21.07
                            delivery.
   77408  S                Radiation treatment          0300         2.07      $105.37       $47.72       $21.07
                            delivery.
   77409  S                Radiation treatment          0300         2.07      $105.37       $47.72       $21.07
                            delivery.
   77411  S                Radiation treatment          0300         2.07      $105.37       $47.72       $21.07
                            delivery.

[[Page 60012]]

 
   77412  S                Radiation treatment          0300         2.07      $105.37       $47.72       $21.07
                            delivery.
   77413  S                Radiation treatment          0300         2.07      $105.37       $47.72       $21.07
                            delivery.
   77414  S                Radiation treatment          0300         2.07      $105.37       $47.72       $21.07
                            delivery.
   77416  S                Radiation treatment          0300         2.07      $105.37       $47.72       $21.07
                            delivery.
   77417  X                Radiology port               0260         0.70       $35.63       $19.59        $7.13
                            film(s).
  *77418  S                Radiation tx                 0710  ...........      $400.00  ...........       $80.00
                            delivery, imrt.
   77427  E                Radiation tx          ...........  ...........  ...........  ...........  ...........
                            management, x5.
   77431  E                Radiation therapy     ...........  ...........  ...........  ...........  ...........
                            management.
   77432  E                Stereotactic          ...........  ...........  ...........  ...........  ...........
                            radiation trmt.
   77470  S                Special radiation            0299         0.21       $10.69        $4.06        $2.14
                            treatment.
   77499  E                Radiation therapy     ...........  ...........  ...........  ...........  ...........
                            management.
   77520  S                Proton trmt, simple          0710  ...........      $400.00  ...........       $80.00
                            w/o comp.
   77522  S                Proton trmt, simple          0710  ...........      $400.00  ...........       $80.00
                            w/comp.
   77523  S                Proton trmt,                 0712  ...........      $875.00  ...........      $175.00
                            intermediate.
   77525  S                Proton treatment,            0712  ...........      $875.00  ...........      $175.00
                            complex.
   77600  S                Hyperthermia                 0314         3.90      $198.53      $101.25       $39.71
                            treatment.
   77605  S                Hyperthermia                 0314         3.90      $198.53      $101.25       $39.71
                            treatment.
   77610  S                Hyperthermia                 0314         3.90      $198.53      $101.25       $39.71
                            treatment.
   77615  S                Hyperthermia                 0314         3.90      $198.53      $101.25       $39.71
                            treatment.
   77620  S                Hyperthermia                 0314         3.90      $198.53      $101.25       $39.71
                            treatment.
   77750  S                Infuse radioactive           0301         5.15      $262.16       $52.53       $52.43
                            materials.
   77761  S                Apply intrcav radiat         0312        32.40    $1,649.29  ...........      $329.86
                            simple.
   77762  S                Apply intrcav radiat         0312        32.40    $1,649.29  ...........      $329.86
                            interm.
   77763  S                Apply intrcav radiat         0312        32.40    $1,649.29  ...........      $329.86
                            compl.
   77776  S                Apply interstit              0312        32.40    $1,649.29  ...........      $329.86
                            radiat simpl.
   77777  S                Apply interstit              0312        32.40    $1,649.29  ...........      $329.86
                            radiat inter.
   77778  S                Apply iterstit               0312        32.40    $1,649.29  ...........      $329.86
                            radiat compl.
   77781  S                High intensity               0313        14.84      $755.42      $164.02      $151.08
                            brachytherapy.
   77782  S                High intensity               0313        14.84      $755.42      $164.02      $151.08
                            brachytherapy.
   77783  S                High intensity               0313        14.84      $755.42      $164.02      $151.08
                            brachytherapy.
   77784  S                High intensity               0313        14.84      $755.42      $164.02      $151.08
                            brachytherapy.
   77789  S                Apply surface                0300         2.07      $105.37       $47.72       $21.07
                            radiation.
   77790  N                Radiation handling..  ...........  ...........  ...........  ...........  ...........
   77799  S                Radium/radioisotope          0313        14.84      $755.42      $164.02      $151.08
                            therapy.
   78000  S                Thyroid, single              0290         1.75       $89.08       $48.99       $17.82
                            uptake.
   78001  S                Thyroid, multiple            0290         1.75       $89.08       $48.99       $17.82
                            uptakes.
   78003  S                Thyroid suppress/            0290         1.75       $89.08       $48.99       $17.82
                            stimul.
   78006  S                Thyroid imaging with         0291         3.50      $178.16       $90.20       $35.63
                            uptake.
   78007  S                Thyroid image, mult          0291         3.50      $178.16       $90.20       $35.63
                            uptakes.
   78010  S                Thyroid imaging.....         0290         1.75       $89.08       $48.99       $17.82
   78011  S                Thyroid imaging with         0290         1.75       $89.08       $48.99       $17.82
                            flow.
   78015  S                Thyroid met imaging.         0291         3.50      $178.16       $90.20       $35.63
   78016  S                Thyroid met imaging/         0291         3.50      $178.16       $90.20       $35.63
                            studies.
   78018  S                Thyroid met imaging,         0292         4.20      $213.80      $117.59       $42.76
                            body.
   78020  S                Thyroid met uptake..         0291         3.50      $178.16       $90.20       $35.63
   78070  S                Parathyroid nuclear          0291         3.50      $178.16       $90.20       $35.63
                            imaging.
   78075  S                Adrenal nuclear              0292         4.20      $213.80      $117.59       $42.76
                            imaging.
   78099  S                Endocrine nuclear            0290         1.75       $89.08       $48.99       $17.82
                            procedure.
   78102  S                Bone marrow imaging,         0291         3.50      $178.16       $90.20       $35.63
                            ltd.
   78103  S                Bone marrow imaging,         0292         4.20      $213.80      $117.59       $42.76
                            mult.
   78104  S                Bone marrow imaging,         0291         3.50      $178.16       $90.20       $35.63
                            body.
   78110  S                Plasma volume,               0291         3.50      $178.16       $90.20       $35.63
                            single.
   78111  S                Plasma volume,               0291         3.50      $178.16       $90.20       $35.63
                            multiple.
   78120  S                Red cell mass,               0291         3.50      $178.16       $90.20       $35.63
                            single.
   78121  S                Red cell mass,               0291         3.50      $178.16       $90.20       $35.63
                            multiple.
   78122  S                Blood volume........         0292         4.20      $213.80      $117.59       $42.76
   78130  S                Red cell survival            0291         3.50      $178.16       $90.20       $35.63
                            study.
   78135  S                Red cell survival            0292         4.20      $213.80      $117.59       $42.76
                            kinetics.
   78140  S                Red cell                     0291         3.50      $178.16       $90.20       $35.63
                            sequestration.
   78160  S                Plasma iron turnover         0291         3.50      $178.16       $90.20       $35.63
   78162  S                Iron absorption exam         0291         3.50      $178.16       $90.20       $35.63
   78170  S                Red cell iron                0291         3.50      $178.16       $90.20       $35.63
                            utilization.
   78172  S                Total body iron              0291         3.50      $178.16       $90.20       $35.63
                            estimation.
   78185  S                Spleen imaging......         0291         3.50      $178.16       $90.20       $35.63
   78190  S                Platelet survival,           0291         3.50      $178.16       $90.20       $35.63
                            kinetics.
   78191  S                Platelet survival...         0291         3.50      $178.16       $90.20       $35.63
   78195  S                Lymph system imaging         0291         3.50      $178.16       $90.20       $35.63
   78199  S                Blood/lymph nuclear          0290         1.75       $89.08       $48.99       $17.82
                            exam.
   78201  S                Liver imaging.......         0291         3.50      $178.16       $90.20       $35.63
   78202  S                Liver imaging with           0291         3.50      $178.16       $90.20       $35.63
                            flow.
   78205  S                Liver imaging (3D)..         0292         4.20      $213.80      $117.59       $42.76
   78206  S                Liver image (3d) w/          0292         4.20      $213.80      $117.59       $42.76
                            flow.
   78215  S                Liver and spleen             0291         3.50      $178.16       $90.20       $35.63
                            imaging.
   78216  S                Liver & spleen image/        0291         3.50      $178.16       $90.20       $35.63
                            flow.
   78220  S                Liver function study         0291         3.50      $178.16       $90.20       $35.63

[[Page 60013]]

 
   78223  S                Hepatobiliary                0292         4.20      $213.80      $117.59       $42.76
                            imaging.
   78230  S                Salivary gland               0291         3.50      $178.16       $90.20       $35.63
                            imaging.
   78231  S                Serial salivary              0291         3.50      $178.16       $90.20       $35.63
                            imaging.
   78232  S                Salivary gland               0291         3.50      $178.16       $90.20       $35.63
                            function exam.
   78258  S                Esophageal motility          0291         3.50      $178.16       $90.20       $35.63
                            study.
   78261  S                Gastric mucosa               0291         3.50      $178.16       $90.20       $35.63
                            imaging.
   78262  S                Gastroesophageal             0291         3.50      $178.16       $90.20       $35.63
                            reflux exam.
   78264  S                Gastric emptying             0291         3.50      $178.16       $90.20       $35.63
                            study.
   78267  A                Breath tst attain/    ...........  ...........  ...........  ...........  ...........
                            anal c-14.
   78268  A                Breath test           ...........  ...........  ...........  ...........  ...........
                            analysis, c-14.
   78270  S                Vit B-12 absorption          0290         1.75       $89.08       $48.99       $17.82
                            exam.
   78271  S                Vit B-12 absorp              0290         1.75       $89.08       $48.99       $17.82
                            exam, IF.
   78272  S                Vit B-12 absorp,             0291         3.50      $178.16       $90.20       $35.63
                            combined.
   78278  S                Acute GI blood loss          0291         3.50      $178.16       $90.20       $35.63
                            imaging.
   78282  S                GI protein loss exam         0290         1.75       $89.08       $48.99       $17.82
   78290  S                Meckel's divert exam         0291         3.50      $178.16       $90.20       $35.63
   78291  S                Leveen/shunt patency         0291         3.50      $178.16       $90.20       $35.63
                            exam.
   78299  S                GI nuclear procedure         0290         1.75       $89.08       $48.99       $17.82
   78300  S                Bone imaging,                0291         3.50      $178.16       $90.20       $35.63
                            limited area.
   78305  S                Bone imaging,                0291         3.50      $178.16       $90.20       $35.63
                            multiple areas.
   78306  S                Bone imaging, whole          0291         3.50      $178.16       $90.20       $35.63
                            body.
   78315  S                Bone imaging, 3              0292         4.20      $213.80      $117.59       $42.76
                            phase.
   78320  S                Bone imaging (3D)...         0292         4.20      $213.80      $117.59       $42.76
   78350  X                Bone mineral, single         0261         1.21       $61.59       $33.87       $12.32
                            photon.
   78351  E                Bone mineral, dual    ...........  ...........  ...........  ...........  ...........
                            photon.
   78399  S                Musculoskeletal              0290         1.75       $89.08       $48.99       $17.82
                            nuclear exam.
   78414  S                Non-imaging heart            0292         4.20      $213.80      $117.59       $42.76
                            function.
   78428  S                Cardiac shunt                0292         4.20      $213.80      $117.59       $42.76
                            imaging.
   78445  S                Vascular flow                0291         3.50      $178.16       $90.20       $35.63
                            imaging.
   78455  S                Venous thrombosis            0291         3.50      $178.16       $90.20       $35.63
                            study.
   78456  S                Acute venous                 0291         3.50      $178.16       $90.20       $35.63
                            thrombus image.
   78457  S                Venous thrombosis            0291         3.50      $178.16       $90.20       $35.63
                            imaging.
   78458  S                Ven thrombosis               0291         3.50      $178.16       $90.20       $35.63
                            images, bilat.
   78459  E                Heart muscle imaging  ...........  ...........  ...........  ...........  ...........
                            (PET).
   78460  S                Heart muscle blood,          0286         5.41      $275.39      $151.46       $55.08
                            single.
   78461  S                Heart muscle blood,          0286         5.41      $275.39      $151.46       $55.08
                            multiple.
   78464  S                Heart image (3d),            0286         5.41      $275.39      $151.46       $55.08
                            single.
   78465  S                Heart image (3d),            0286         5.41      $275.39      $151.46       $55.08
                            multiple.
   78466  S                Heart infarct image.         0291         3.50      $178.16       $90.20       $35.63
   78468  S                Heart infarct image          0292         4.20      $213.80      $117.59       $42.76
                            (ef).
   78469  S                Heart infarct image          0292         4.20      $213.80      $117.59       $42.76
                            (3D).
   78472  S                Gated heart, planar,         0286         5.41      $275.39      $151.46       $55.08
                            single.
   78473  S                Gated heart,                 0286         5.41      $275.39      $151.46       $55.08
                            multiple.
   78478  S                Heart wall motion            0286         5.41      $275.39      $151.46       $55.08
                            add-on.
   78480  S                Heart function add-          0286         5.41      $275.39      $151.46       $55.08
                            on.
   78481  S                Heart first pass,            0286         5.41      $275.39      $151.46       $55.08
                            single.
   78483  S                Heart first pass,            0286         5.41      $275.39      $151.46       $55.08
                            multiple.
   78491  E                Heart image (pet),    ...........  ...........  ...........  ...........  ...........
                            single.
   78492  E                Heart image (pet),    ...........  ...........  ...........  ...........  ...........
                            multiple.
   78494  S                Heart image, spect..         0296         3.39      $172.56       $94.90       $34.51
   78496  S                Heart first pass add-        0296         3.39      $172.56       $94.90       $34.51
                            on.
   78499  S                Cardiovascular               0291         3.50      $178.16       $90.20       $35.63
                            nuclear exam.
   78580  S                Lung perfusion               0291         3.50      $178.16       $90.20       $35.63
                            imaging.
   78584  S                Lung V/Q image               0292         4.20      $213.80      $117.59       $42.76
                            single breath.
   78585  S                Lung V/Q imaging....         0292         4.20      $213.80      $117.59       $42.76
   78586  S                Aerosol lung image,          0292         4.20      $213.80      $117.59       $42.76
                            single.
   78587  S                Aerosol lung image,          0291         3.50      $178.16       $90.20       $35.63
                            multiple.
   78588  S                Perfusion lung image         0292         4.20      $213.80      $117.59       $42.76
   78591  S                Vent image, 1                0291         3.50      $178.16       $90.20       $35.63
                            breath, 1 proj.
   78593  S                Vent image, 1 proj,          0292         4.20      $213.80      $117.59       $42.76
                            gas.
   78594  S                Vent image, mult             0292         4.20      $213.80      $117.59       $42.76
                            proj, gas.
   78596  S                Lung differential            0292         4.20      $213.80      $117.59       $42.76
                            function.
   78599  S                Respiratory nuclear          0291         3.50      $178.16       $90.20       $35.63
                            exam.
   78600  S                Brain imaging, ltd           0292         4.20      $213.80      $117.59       $42.76
                            static.
   78601  S                Brain imaging, ltd w/        0291         3.50      $178.16       $90.20       $35.63
                             flow.
   78605  S                Brain imaging,               0291         3.50      $178.16       $90.20       $35.63
                            complete.
   78606  S                Brain imaging, compl         0292         4.20      $213.80      $117.59       $42.76
                            w/flow.
   78607  S                Brain imaging (3D)..         0292         4.20      $213.80      $117.59       $42.76
   78608  E                Brain imaging (PET).  ...........  ...........  ...........  ...........  ...........
   78609  E                Brain imaging (PET).  ...........  ...........  ...........  ...........  ...........
   78610  S                Brain flow imaging           0291         3.50      $178.16       $90.20       $35.63
                            only.
   78615  S                Cerebral blood flow          0291         3.50      $178.16       $90.20       $35.63
                            imaging.
   78630  S                Cerebrospinal fluid          0292         4.20      $213.80      $117.59       $42.76
                            scan.
   78635  S                CSF ventriculography         0292         4.20      $213.80      $117.59       $42.76
   78645  S                CSF shunt evaluation         0291         3.50      $178.16       $90.20       $35.63

[[Page 60014]]

 
   78647  S                Cerebrospinal fluid          0292         4.20      $213.80      $117.59       $42.76
                            scan.
   78650  S                CSF leakage imaging.         0292         4.20      $213.80      $117.59       $42.76
   78660  S                Nuclear exam of tear         0291         3.50      $178.16       $90.20       $35.63
                            flow.
   78699  S                Nervous system               0291         3.50      $178.16       $90.20       $35.63
                            nuclear exam.
   78700  S                Kidney imaging,              0291         3.50      $178.16       $90.20       $35.63
                            static.
   78701  S                Kidney imaging with          0291         3.50      $178.16       $90.20       $35.63
                            flow.
   78704  S                Imaging renogram....         0291         3.50      $178.16       $90.20       $35.63
   78707  S                Kidney flow/function         0292         4.20      $213.80      $117.59       $42.76
                            image.
   78708  S                Kidney flow/function         0292         4.20      $213.80      $117.59       $42.76
                            image.
   78709  S                Kidney flow/function         0292         4.20      $213.80      $117.59       $42.76
                            image.
   78710  S                Kidney imaging (3D).         0291         3.50      $178.16       $90.20       $35.63
   78715  S                Renal vascular flow          0291         3.50      $178.16       $90.20       $35.63
                            exam.
   78725  S                Kidney function              0291         3.50      $178.16       $90.20       $35.63
                            study.
   78730  S                Urinary bladder              0291         3.50      $178.16       $90.20       $35.63
                            retention.
   78740  S                Ureteral reflux              0291         3.50      $178.16       $90.20       $35.63
                            study.
   78760  S                Testicular imaging..         0291         3.50      $178.16       $90.20       $35.63
   78761  S                Testicular imaging/          0291         3.50      $178.16       $90.20       $35.63
                            flow.
   78799  S                Genitourinary                0292         4.20      $213.80      $117.59       $42.76
                            nuclear exam.
   78800  S                Tumor imaging,               0291         3.50      $178.16       $90.20       $35.63
                            limited area.
   78801  S                Tumor imaging, mult          0292         4.20      $213.80      $117.59       $42.76
                            areas.
   78802  S                Tumor imaging, whole         0292         4.20      $213.80      $117.59       $42.76
                            body.
   78803  S                Tumor imaging (3D)..         0292         4.20      $213.80      $117.59       $42.76
   78805  S                Abscess imaging, ltd         0292         4.20      $213.80      $117.59       $42.76
                            area.
   78806  S                Abscess imaging,             0292         4.20      $213.80      $117.59       $42.76
                            whole body.
   78807  S                Nuclear localization/        0292         4.20      $213.80      $117.59       $42.76
                            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         3.50      $178.16       $90.20       $35.63
                            exam.
   79000  S                Init hyperthyroid            0294         5.01      $255.03      $140.26       $51.01
                            therapy.
   79001  S                Repeat hyperthyroid          0294         5.01      $255.03      $140.26       $51.01
                            therapy.
   79020  S                Thyroid ablation....         0294         5.01      $255.03      $140.26       $51.01
   79030  S                Thyroid ablation,            0294         5.01      $255.03      $140.26       $51.01
                            carcinoma.
   79035  S                Thyroid metastatic           0294         5.01      $255.03      $140.26       $51.01
                            therapy.
   79100  S                Hematopoetic nuclear         0294         5.01      $255.03      $140.26       $51.01
                            therapy.
   79200  S                Intracavitary                0295        12.10      $615.94      $338.76      $123.19
                            nuclear trmt.
   79300  S                Interstitial nuclear         0294         5.01      $255.03      $140.26       $51.01
                            therapy.
   79400  S                Nonhemato nuclear            0295        12.10      $615.94      $338.76      $123.19
                            therapy.
   79420  S                Intravascular                0295        12.10      $615.94      $338.76      $123.19
                            nuclear ther.
   79440  S                Nuclear joint                0294         5.01      $255.03      $140.26       $51.01
                            therapy.
   79900  N                Provide ther          ...........  ...........  ...........  ...........  ...........
                            radiopharm(s).
   79999  S                Nuclear medicine             0294         5.01      $255.03      $140.26       $51.01
                            therapy.
   80048  A                Basic metabolic       ...........  ...........  ...........  ...........  ...........
                            panel.
   80050  A                General health panel  ...........  ...........  ...........  ...........  ...........
   80051  A                Electrolyte panel...  ...........  ...........  ...........  ...........  ...........
   80053  A                Comprehen metabolic   ...........  ...........  ...........  ...........  ...........
                            panel.
   80055  A                Obstetric panel.....  ...........  ...........  ...........  ...........  ...........
   80061  A                Lipid panel.........  ...........  ...........  ...........  ...........  ...........
   80069  A                Renal function panel  ...........  ...........  ...........  ...........  ...........
   80072  D                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....  ...........  ...........  ...........  ...........  ...........

[[Page 60015]]

 
   80182  A                Assay of              ...........  ...........  ...........  ...........  ...........
                            nortriptyline.
   80184  A                Assay of              ...........  ...........  ...........  ...........  ...........
                            phenobarbital.
   80185  A                Assay of phenytoin,   ...........  ...........  ...........  ...........  ...........
                            total.
   80186  A                Assay of phenytoin,   ...........  ...........  ...........  ...........  ...........
                            free.
   80188  A                Assay of primidone..  ...........  ...........  ...........  ...........  ...........
   80190  A                Assay of              ...........  ...........  ...........  ...........  ...........
                            procainamide.
   80192  A                Assay of              ...........  ...........  ...........  ...........  ...........
                            procainamide.
   80194  A                Assay of quinidine..  ...........  ...........  ...........  ...........  ...........
   80196  A                Assay of salicylate.  ...........  ...........  ...........  ...........  ...........
   80197  A                Assay of tacrolimus.  ...........  ...........  ...........  ...........  ...........
   80198  A                Assay of              ...........  ...........  ...........  ...........  ...........
                            theophylline.
   80200  A                Assay of tobramycin.  ...........  ...........  ...........  ...........  ...........
   80201  A                Assay of topiramate.  ...........  ...........  ...........  ...........  ...........
   80202  A                Assay of vancomycin.  ...........  ...........  ...........  ...........  ...........
   80299  A                Quantitative assay,   ...........  ...........  ...........  ...........  ...........
                            drug.
   80400  A                Acth stimulation      ...........  ...........  ...........  ...........  ...........
                            panel.
   80402  A                Acth stimulation      ...........  ...........  ...........  ...........  ...........
                            panel.
   80406  A                Acth stimulation      ...........  ...........  ...........  ...........  ...........
                            panel.
   80408  A                Aldosterone           ...........  ...........  ...........  ...........  ...........
                            suppression eval.
   80410  A                Calcitonin stimul     ...........  ...........  ...........  ...........  ...........
                            panel.
   80412  A                CRH stimulation       ...........  ...........  ...........  ...........  ...........
                            panel.
   80414  A                Testosterone          ...........  ...........  ...........  ...........  ...........
                            response.
   80415  A                Estradiol response    ...........  ...........  ...........  ...........  ...........
                            panel.
   80416  A                Renin stimulation     ...........  ...........  ...........  ...........  ...........
                            panel.
   80417  A                Renin stimulation     ...........  ...........  ...........  ...........  ...........
                            panel.
   80418  A                Pituitary evaluation  ...........  ...........  ...........  ...........  ...........
                            panel.
   80420  A                Dexamethasone panel.  ...........  ...........  ...........  ...........  ...........
   80422  A                Glucagon tolerance    ...........  ...........  ...........  ...........  ...........
                            panel.
   80424  A                Glucagon tolerance    ...........  ...........  ...........  ...........  ...........
                            panel.
   80426  A                Gonadotropin hormone  ...........  ...........  ...........  ...........  ...........
                            panel.
   80428  A                Growth hormone panel  ...........  ...........  ...........  ...........  ...........
   80430  A                Growth hormone panel  ...........  ...........  ...........  ...........  ...........
   80432  A                Insulin suppression   ...........  ...........  ...........  ...........  ...........
                            panel.
   80434  A                Insulin tolerance     ...........  ...........  ...........  ...........  ...........
                            panel.
   80435  A                Insulin tolerance     ...........  ...........  ...........  ...........  ...........
                            panel.
   80436  A                Metyrapone panel....  ...........  ...........  ...........  ...........  ...........
   80438  A                TRH stimulation       ...........  ...........  ...........  ...........  ...........
                            panel.
   80439  A                TRH stimulation       ...........  ...........  ...........  ...........  ...........
                            panel.
   80440  A                TRH stimulation       ...........  ...........  ...........  ...........  ...........
                            panel.
   80500  X                Lab pathology                0343         0.39       $19.85       $10.72        $3.97
                            consultation.
   80502  X                Lab pathology                0342         0.21       $10.69        $5.87        $2.14
                            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..........  ...........  ...........  ...........  ...........  ...........
   81007  A                Urine screen for      ...........  ...........  ...........  ...........  ...........
                            bacteria.
   81015  A                Microscopic exam of   ...........  ...........  ...........  ...........  ...........
                            urine.
   81020  A                Urinalysis, glass     ...........  ...........  ...........  ...........  ...........
                            test.
   81025  A                Urine pregnancy test  ...........  ...........  ...........  ...........  ...........
   81050  A                Urinalysis, volume    ...........  ...........  ...........  ...........  ...........
                            measure.
   81099  A                Urinalysis test       ...........  ...........  ...........  ...........  ...........
                            procedure.
   82000  A                Assay of blood        ...........  ...........  ...........  ...........  ...........
                            acetaldehyde.
   82003  A                Assay of              ...........  ...........  ...........  ...........  ...........
                            acetaminophen.
   82009  A                Test for acetone/     ...........  ...........  ...........  ...........  ...........
                            ketones.
   82010  A                Acetone assay.......  ...........  ...........  ...........  ...........  ...........
   82013  A                Acetylcholinesterase  ...........  ...........  ...........  ...........  ...........
                            assay.
   82016  A                Acylcarnitines, qual  ...........  ...........  ...........  ...........  ...........
   82017  A                Acylcarnitines,       ...........  ...........  ...........  ...........  ...........
                            quant.
   82024  A                Assay of acth.......  ...........  ...........  ...........  ...........  ...........
   82030  A                Assay of adp & amp..  ...........  ...........  ...........  ...........  ...........
   82040  A                Assay of serum        ...........  ...........  ...........  ...........  ...........
                            albumin.
   82042  A                Assay of urine        ...........  ...........  ...........  ...........  ...........
                            albumin.
   82043  A                Microalbumin,         ...........  ...........  ...........  ...........  ...........
                            quantitative.
   82044  A                Microalbumin,         ...........  ...........  ...........  ...........  ...........
                            semiquant.
   82055  A                Assay of ethanol....  ...........  ...........  ...........  ...........  ...........
   82075  A                Assay of breath       ...........  ...........  ...........  ...........  ...........
                            ethanol.
   82085  A                Assay of aldolase...  ...........  ...........  ...........  ...........  ...........
   82088  A                Assay of aldosterone  ...........  ...........  ...........  ...........  ...........
   82101  A                Assay of urine        ...........  ...........  ...........  ...........  ...........
                            alkaloids.
   82103  A                Alpha-1-antitrypsin,  ...........  ...........  ...........  ...........  ...........
                            total.
   82104  A                Alpha-1-antitrypsin,  ...........  ...........  ...........  ...........  ...........
                            pheno.
   82105  A                Alpha-fetoprotein,    ...........  ...........  ...........  ...........  ...........
                            serum.
   82106  A                Alpha-fetoprotein,    ...........  ...........  ...........  ...........  ...........
                            amniotic.
   82108  A                Assay of aluminum...  ...........  ...........  ...........  ...........  ...........

[[Page 60016]]

 
   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.
  *82274  A                Assay test for        ...........  ...........  ...........  ...........  ...........
                            blood, fecal.
   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.
   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....  ...........  ...........  ...........  ...........  ...........

[[Page 60017]]

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

[[Page 60018]]

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

[[Page 60019]]

 
   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.
   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....  ...........  ...........  ...........  ...........  ...........
  *83950  A                Oncorprotein, her-2/  ...........  ...........  ...........  ...........  ...........
                            neu.
   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.

[[Page 60020]]

 
   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.
   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.

[[Page 60021]]

 
   84485  A                Assay duodenal fluid  ...........  ...........  ...........  ...........  ...........
                            trypsin.
   84488  A                Test feces for        ...........  ...........  ...........  ...........  ...........
                            trypsin.
   84490  A                Assay of feces for    ...........  ...........  ...........  ...........  ...........
                            trypsin.
   84510  A                Assay of tyrosine...  ...........  ...........  ...........  ...........  ...........
   84512  A                Assay of troponin,    ...........  ...........  ...........  ...........  ...........
                            qual.
   84520  A                Assay of urea         ...........  ...........  ...........  ...........  ...........
                            nitrogen.
   84525  A                Urea nitrogen semi-   ...........  ...........  ...........  ...........  ...........
                            quant.
   84540  A                Assay of urine/urea-  ...........  ...........  ...........  ...........  ...........
                            n.
   84545  A                Urea-N clearance      ...........  ...........  ...........  ...........  ...........
                            test.
   84550  A                Assay of blood/uric   ...........  ...........  ...........  ...........  ...........
                            acid.
   84560  A                Assay of urine/uric   ...........  ...........  ...........  ...........  ...........
                            acid.
   84577  A                Assay of feces/       ...........  ...........  ...........  ...........  ...........
                            urobilinogen.
   84578  A                Test urine            ...........  ...........  ...........  ...........  ...........
                            urobilinogen.
   84580  A                Assay of urine        ...........  ...........  ...........  ...........  ...........
                            urobilinogen.
   84583  A                Assay of urine        ...........  ...........  ...........  ...........  ...........
                            urobilinogen.
   84585  A                Assay of urine vma..  ...........  ...........  ...........  ...........  ...........
   84586  A                Assay of vip........  ...........  ...........  ...........  ...........  ...........
   84588  A                Assay of vasopressin  ...........  ...........  ...........  ...........  ...........
   84590  A                Assay of vitamin a..  ...........  ...........  ...........  ...........  ...........
   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  A                Clinical chemistry    ...........  ...........  ...........  ...........  ...........
                            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.
   85060  X                Blood smear                  0342         0.21       $10.69        $5.87        $2.14
                            interpretation.
   85095  D                Bone marrow                  0003         1.03       $52.43       $27.99       $10.49
                            aspiration.
   85097  X                Bone marrow                  0344         0.56       $28.51       $15.68        $5.70
                            interpretation.
   85102  D                Bone marrow biopsy..         0003         1.03       $52.43       $27.99       $10.49
   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.

[[Page 60022]]

 
   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  D                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.
   85652  A                Rbc sed rate,         ...........  ...........  ...........  ...........  ...........
                            automated.
   85660  A                RBC sickle cell test  ...........  ...........  ...........  ...........  ...........
   85670  A                Thrombin time,        ...........  ...........  ...........  ...........  ...........
                            plasma.
   85675  A                Thrombin time, titer  ...........  ...........  ...........  ...........  ...........
   85705  A                Thromboplastin        ...........  ...........  ...........  ...........  ...........
                            inhibition.
   85730  A                Thromboplastin time,  ...........  ...........  ...........  ...........  ...........
                            partial.
   85732  A                Thromboplastin time,  ...........  ...........  ...........  ...........  ...........
                            partial.
   85810  A                Blood viscosity       ...........  ...........  ...........  ...........  ...........
                            examination.
   85999  A                Hematology procedure  ...........  ...........  ...........  ...........  ...........
   86000  A                Agglutinins, febrile  ...........  ...........  ...........  ...........  ...........
   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         0.39       $19.85       $10.72        $3.97
                            service.
   86078  X                Physician blood bank         0344         0.56       $28.51       $15.68        $5.70
                            service.
   86079  X                Physician blood bank         0344         0.56       $28.51       $15.68        $5.70
                            service.
   86140  A                C-reactive protein..  ...........  ...........  ...........  ...........  ...........
  *86141  A                C-reactive protein,   ...........  ...........  ...........  ...........  ...........
                            hs.
   86146  A                Glycoprotein          ...........  ...........  ...........  ...........  ...........
                            antibody.
   86147  A                Cardiolipin antibody  ...........  ...........  ...........  ...........  ...........

[[Page 60023]]

 
   86148  A                Phospholipid          ...........  ...........  ...........  ...........  ...........
                            antibody.
   86155  A                Chemotaxis assay....  ...........  ...........  ...........  ...........  ...........
   86156  A                Cold agglutinin,      ...........  ...........  ...........  ...........  ...........
                            screen.
   86157  A                Cold agglutinin,      ...........  ...........  ...........  ...........  ...........
                            titer.
   86160  A                Complement, antigen.  ...........  ...........  ...........  ...........  ...........
   86161  A                Complement/function   ...........  ...........  ...........  ...........  ...........
                            activity.
   86162  A                Complement, total     ...........  ...........  ...........  ...........  ...........
                            (CH50).
   86171  A                Complement fixation,  ...........  ...........  ...........  ...........  ...........
                            each.
   86185  A                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.
  *86336  A                Inhibin A...........  ...........  ...........  ...........  ...........  ...........
   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  A                T cell, absolute      ...........  ...........  ...........  ...........  ...........
                            count.
   86376  A                Microsomal antibody.  ...........  ...........  ...........  ...........  ...........
   86378  A                Migration inhibitory  ...........  ...........  ...........  ...........  ...........
                            factor.
   86382  A                Neutralization test,  ...........  ...........  ...........  ...........  ...........
                            viral.
   86384  A                Nitroblue             ...........  ...........  ...........  ...........  ...........
                            tetrazolium dye.
   86403  A                Particle              ...........  ...........  ...........  ...........  ...........
                            agglutination test.
   86406  A                Particle              ...........  ...........  ...........  ...........  ...........
                            agglutination test.
   86430  A                Rheumatoid factor     ...........  ...........  ...........  ...........  ...........
                            test.
   86431  A                Rheumatoid factor,    ...........  ...........  ...........  ...........  ...........
                            quant.
   86485  X                Skin test, candida..         0341         0.10        $5.09        $2.79        $1.02
   86490  X                Coccidioidomycosis           0341         0.10        $5.09        $2.79        $1.02
                            skin test.
   86510  X                Histoplasmosis skin          0341         0.10        $5.09        $2.79        $1.02
                            test.
   86580  X                TB intradermal test.         0341         0.10        $5.09        $2.79        $1.02
   86585  X                TB tine test........         0341         0.10        $5.09        $2.79        $1.02
   86586  X                Skin test, unlisted.         0341         0.10        $5.09        $2.79        $1.02
   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....  ...........  ...........  ...........  ...........  ...........

[[Page 60024]]

 
   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  D                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......  ...........  ...........  ...........  ...........  ...........
   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.

[[Page 60025]]

 
   86806  A                Lymphocytotoxicity    ...........  ...........  ...........  ...........  ...........
                            assay.
   86807  A                Cytotoxic antibody    ...........  ...........  ...........  ...........  ...........
                            screening.
   86808  A                Cytotoxic antibody    ...........  ...........  ...........  ...........  ...........
                            screening.
   86812  A                HLA typing, A, B, or  ...........  ...........  ...........  ...........  ...........
                            C.
   86813  A                HLA typing, A, B, or  ...........  ...........  ...........  ...........  ...........
                            C.
   86816  A                HLA typing, DR/DQ...  ...........  ...........  ...........  ...........  ...........
   86817  A                HLA typing, DR/DQ...  ...........  ...........  ...........  ...........  ...........
   86821  A                Lymphocyte culture,   ...........  ...........  ...........  ...........  ...........
                            mixed.
   86822  A                Lymphocyte culture,   ...........  ...........  ...........  ...........  ...........
                            primed.
   86849  A                Immunology procedure  ...........  ...........  ...........  ...........  ...........
   86850  X                RBC antibody screen.         0345         0.26       $13.24        $5.37        $2.65
   86860  X                RBC antibody elution         0345         0.26       $13.24        $5.37        $2.65
   86870  X                RBC antibody                 0346         0.77       $39.20       $12.03        $7.84
                            identification.
   86880  X                Coombs test.........         0341         0.10        $5.09        $2.79        $1.02
   86885  X                Coombs test.........         0341         0.10        $5.09        $2.79        $1.02
   86886  X                Coombs test.........         0341         0.10        $5.09        $2.79        $1.02
   86890  X                Autologous blood             0346         0.77       $39.20       $12.03        $7.84
                            process.
   86891  X                Autologous blood, op         0345         0.26       $13.24        $5.37        $2.65
                            salvage.
   86900  X                Blood typing, ABO...         0341         0.10        $5.09        $2.79        $1.02
   86901  X                Blood typing, Rh (D)         0345         0.26       $13.24        $5.37        $2.65
   86903  X                Blood typing,                0345         0.26       $13.24        $5.37        $2.65
                            antigen screen.
   86904  X                Blood typing,                0345         0.26       $13.24        $5.37        $2.65
                            patient serum.
   86905  X                Blood typing, RBC            0345         0.26       $13.24        $5.37        $2.65
                            antigens.
   86906  X                Blood typing, Rh             0345         0.26       $13.24        $5.37        $2.65
                            phenotype.
   86910  E                Blood typing,         ...........  ...........  ...........  ...........  ...........
                            paternity test.
   86911  E                Blood typing,         ...........  ...........  ...........  ...........  ...........
                            antigen system.
   86915  X                Bone marrow/stem             0346         0.77       $39.20       $12.03        $7.84
                            cell prep.
   86920  X                Compatibility test..         0346         0.77       $39.20       $12.03        $7.84
   86921  X                Compatibility test..         0345         0.26       $13.24        $5.37        $2.65
   86922  X                Compatibility test..         0346         0.77       $39.20       $12.03        $7.84
   86927  X                Plasma, fresh frozen         0346         0.77       $39.20       $12.03        $7.84
   86930  X                Frozen blood prep...         0347         1.56       $79.41       $20.13       $15.88
   86931  X                Frozen blood thaw...         0347         1.56       $79.41       $20.13       $15.88
   86932  X                Frozen blood freeze/         0346         0.77       $39.20       $12.03        $7.84
                            thaw.
   86940  A                Hemolysins/           ...........  ...........  ...........  ...........  ...........
                            agglutinins, auto.
   86941  A                Hemolysins/           ...........  ...........  ...........  ...........  ...........
                            agglutinins.
   86945  X                Blood product/               0345         0.26       $13.24        $5.37        $2.65
                            irradiation.
   86950  X                Leukacyte                    0347         1.56       $79.41       $20.13       $15.88
                            transfusion.
   86965  X                Pooling blood                0347         1.56       $79.41       $20.13       $15.88
                            platelets.
   86970  X                RBC pretreatment....         0345         0.26       $13.24        $5.37        $2.65
   86971  X                RBC pretreatment....         0345         0.26       $13.24        $5.37        $2.65
   86972  X                RBC pretreatment....         0345         0.26       $13.24        $5.37        $2.65
   86975  X                RBC pretreatment,            0345         0.26       $13.24        $5.37        $2.65
                            serum.
   86976  X                RBC pretreatment,            0345         0.26       $13.24        $5.37        $2.65
                            serum.
   86977  X                RBC pretreatment,            0345         0.26       $13.24        $5.37        $2.65
                            serum.
   86978  X                RBC pretreatment,            0345         0.26       $13.24        $5.37        $2.65
                            serum.
   86985  X                Split blood or               0347         1.56       $79.41       $20.13       $15.88
                            products.
   86999  X                Transfusion                  0346         0.77       $39.20       $12.03        $7.84
                            procedure.
   87001  A                Small animal          ...........  ...........  ...........  ...........  ...........
                            inoculation.
   87003  A                Small animal          ...........  ...........  ...........  ...........  ...........
                            inoculation.
   87015  A                Specimen              ...........  ...........  ...........  ...........  ...........
                            concentration.
   87040  A                Blood culture for     ...........  ...........  ...........  ...........  ...........
                            bacteria.
   87045  A                Stool culture,        ...........  ...........  ...........  ...........  ...........
                            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.

[[Page 60026]]

 
   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.
  *87198  A                Cytomegalovirus       ...........  ...........  ...........  ...........  ...........
                            antibody dfa.
  *87199  A                Enterovirus           ...........  ...........  ...........  ...........  ...........
                            antibody, dfa.
   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.  ...........  ...........  ...........  ...........  ...........
   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.

[[Page 60027]]

 
   87470  A                Bartonella, dna, dir  ...........  ...........  ...........  ...........  ...........
                            probe.
   87471  A                Bartonella, dna, amp  ...........  ...........  ...........  ...........  ...........
                            probe.
   87472  A                Bartonella, dna,      ...........  ...........  ...........  ...........  ...........
                            quant.
   87475  A                Lyme dis, dna, dir    ...........  ...........  ...........  ...........  ...........
                            probe.
   87476  A                Lyme dis, dna, amp    ...........  ...........  ...........  ...........  ...........
                            probe.
   87477  A                Lyme dis, dna, quant  ...........  ...........  ...........  ...........  ...........
   87480  A                Candida, dna, dir     ...........  ...........  ...........  ...........  ...........
                            probe.
   87481  A                Candida, dna, amp     ...........  ...........  ...........  ...........  ...........
                            probe.
   87482  A                Candida, dna, quant.  ...........  ...........  ...........  ...........  ...........
   87485  A                Chylmd pneum, dna,    ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87486  A                Chylmd pneum, dna,    ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87487  A                Chylmd pneum, dna,    ...........  ...........  ...........  ...........  ...........
                            quant.
   87490  A                Chylmd trach, dna,    ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87491  A                Chylmd trach, dna,    ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87492  A                Chylmd trach, dna,    ...........  ...........  ...........  ...........  ...........
                            quant.
   87495  A                Cytomeg, dna, dir     ...........  ...........  ...........  ...........  ...........
                            probe.
   87496  A                Cytomeg, dna, amp     ...........  ...........  ...........  ...........  ...........
                            probe.
   87497  A                Cytomeg, dna, quant.  ...........  ...........  ...........  ...........  ...........
   87510  A                Gardner vag, dna,     ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87511  A                Gardner vag, dna,     ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87512  A                Gardner vag, dna,     ...........  ...........  ...........  ...........  ...........
                            quant.
   87515  A                Hepatitis b, dna,     ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87516  A                Hepatitis b , dna,    ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87517  A                Hepatitis b , dna,    ...........  ...........  ...........  ...........  ...........
                            quant.
   87520  A                Hepatitis c , rna,    ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87521  A                Hepatitis c , rna,    ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87522  A                Hepatitis c, rna,     ...........  ...........  ...........  ...........  ...........
                            quant.
   87525  A                Hepatitis g , dna,    ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87526  A                Hepatitis g, dna,     ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87527  A                Hepatitis g, dna,     ...........  ...........  ...........  ...........  ...........
                            quant.
   87528  A                Hsv, dna, dir probe.  ...........  ...........  ...........  ...........  ...........
   87529  A                Hsv, dna, amp probe.  ...........  ...........  ...........  ...........  ...........
   87530  A                Hsv, dna, quant.....  ...........  ...........  ...........  ...........  ...........
   87531  A                Hhv-6, dna, dir       ...........  ...........  ...........  ...........  ...........
                            probe.
   87532  A                Hhv-6, dna, amp       ...........  ...........  ...........  ...........  ...........
                            probe.
   87533  A                Hhv-6, dna, quant...  ...........  ...........  ...........  ...........  ...........
   87534  A                Hiv-1, dna, dir       ...........  ...........  ...........  ...........  ...........
                            probe.
   87535  A                Hiv-1, dna, amp       ...........  ...........  ...........  ...........  ...........
                            probe.
   87536  A                Hiv-1, dna, quant...  ...........  ...........  ...........  ...........  ...........
   87537  A                Hiv-2, dna, dir       ...........  ...........  ...........  ...........  ...........
                            probe.
   87538  A                Hiv-2, dna, amp       ...........  ...........  ...........  ...........  ...........
                            probe.
   87539  A                Hiv-2, dna, quant...  ...........  ...........  ...........  ...........  ...........
   87540  A                Legion pneumo, dna,   ...........  ...........  ...........  ...........  ...........
                            dir prob.
   87541  A                Legion pneumo, dna,   ...........  ...........  ...........  ...........  ...........
                            amp prob.
   87542  A                Legion pneumo, dna,   ...........  ...........  ...........  ...........  ...........
                            quant.
   87550  A                Mycobacteria, dna,    ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87551  A                Mycobacteria, dna,    ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87552  A                Mycobacteria, dna,    ...........  ...........  ...........  ...........  ...........
                            quant.
   87555  A                M.tuberculo, dna,     ...........  ...........  ...........  ...........  ...........
                            dir probe.
   87556  A                M.tuberculo, dna,     ...........  ...........  ...........  ...........  ...........
                            amp probe.
   87557  A                M.tuberculo, dna,     ...........  ...........  ...........  ...........  ...........
                            quant.
   87560  A                M.avium-intra, dna,   ...........  ...........  ...........  ...........  ...........
                            dir prob.
   87561  A                M.avium-intra, dna,   ...........  ...........  ...........  ...........  ...........
                            amp prob.
   87562  A                M.avium-intra, dna,   ...........  ...........  ...........  ...........  ...........
                            quant.
   87580  A                M.pneumon, dna, dir   ...........  ...........  ...........  ...........  ...........
                            probe.
   87581  A                M.pneumon, dna, amp   ...........  ...........  ...........  ...........  ...........
                            probe.
   87582  A                M.pneumon, dna,       ...........  ...........  ...........  ...........  ...........
                            quant.
   87590  A                N.gonorrhoeae, dna,   ...........  ...........  ...........  ...........  ...........
                            dir prob.
   87591  A                N.gonorrhoeae, dna,   ...........  ...........  ...........  ...........  ...........
                            amp prob.
   87592  A                N.gonorrhoeae, dna,   ...........  ...........  ...........  ...........  ...........
                            quant.
   87620  A                Hpv, dna, dir probe.  ...........  ...........  ...........  ...........  ...........
   87621  A                Hpv, dna, amp probe.  ...........  ...........  ...........  ...........  ...........
   87622  A                Hpv, dna, quant.....  ...........  ...........  ...........  ...........  ...........
   87650  A                Strep a, dna, dir     ...........  ...........  ...........  ...........  ...........
                            probe.
   87651  A                Strep a, dna, amp     ...........  ...........  ...........  ...........  ...........
                            probe.
   87652  A                Strep a, dna, quant.  ...........  ...........  ...........  ...........  ...........
   87797  A                Detect agent nos,     ...........  ...........  ...........  ...........  ...........
                            dna, dir.
   87798  A                Detect agent nos,     ...........  ...........  ...........  ...........  ...........
                            dna, amp.
   87799  A                Detect agent nos,     ...........  ...........  ...........  ...........  ...........
                            dna, quant.
   87800  A                Detect agnt mult,     ...........  ...........  ...........  ...........  ...........
                            dna, direc.
   87801  A                Detect agnt mult,     ...........  ...........  ...........  ...........  ...........
                            dna, ampli.
  *87802  A                Strep b assay w/      ...........  ...........  ...........  ...........  ...........
                            optic.
  *87803  A                Clostridium toxin a   ...........  ...........  ...........  ...........  ...........
                            w/optic.
  *87804  A                Influenza assay w/    ...........  ...........  ...........  ...........  ...........
                            optic.
   87810  A                Chylmd trach assay w/ ...........  ...........  ...........  ...........  ...........
                            optic.

[[Page 60028]]

 
   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.
  *87902  A                Genotype, dna,        ...........  ...........  ...........  ...........  ...........
                            hepatitis C.
   87903  A                Phenotype, dna hiv w/ ...........  ...........  ...........  ...........  ...........
                            culture.
   87904  A                Phenotype, dna hiv w/ ...........  ...........  ...........  ...........  ...........
                            clt add.
   87999  A                Microbiology          ...........  ...........  ...........  ...........  ...........
                            procedure.
   88000  E                Autopsy (necropsy),   ...........  ...........  ...........  ...........  ...........
                            gross.
   88005  E                Autopsy (necropsy),   ...........  ...........  ...........  ...........  ...........
                            gross.
   88007  E                Autopsy (necropsy),   ...........  ...........  ...........  ...........  ...........
                            gross.
   88012  E                Autopsy (necropsy),   ...........  ...........  ...........  ...........  ...........
                            gross.
   88014  E                Autopsy (necropsy),   ...........  ...........  ...........  ...........  ...........
                            gross.
   88016  E                Autopsy (necropsy),   ...........  ...........  ...........  ...........  ...........
                            gross.
   88020  E                Autopsy (necropsy),   ...........  ...........  ...........  ...........  ...........
                            complete.
   88025  E                Autopsy (necropsy),   ...........  ...........  ...........  ...........  ...........
                            complete.
   88027  E                Autopsy (necropsy),   ...........  ...........  ...........  ...........  ...........
                            complete.
   88028  E                Autopsy (necropsy),   ...........  ...........  ...........  ...........  ...........
                            complete.
   88029  E                Autopsy (necropsy),   ...........  ...........  ...........  ...........  ...........
                            complete.
   88036  E                Limited autopsy.....  ...........  ...........  ...........  ...........  ...........
   88037  E                Limited autopsy.....  ...........  ...........  ...........  ...........  ...........
   88040  E                Forensic autopsy      ...........  ...........  ...........  ...........  ...........
                            (necropsy).
   88045  E                Coroner's autopsy     ...........  ...........  ...........  ...........  ...........
                            (necropsy).
   88099  E                Necropsy (autopsy)    ...........  ...........  ...........  ...........  ...........
                            procedure.
   88104  X                Cytopathology,               0343         0.39       $19.85       $10.72        $3.97
                            fluids.
   88106  X                Cytopathology,               0343         0.39       $19.85       $10.72        $3.97
                            fluids.
   88107  X                Cytopathology,               0343         0.39       $19.85       $10.72        $3.97
                            fluids.
   88108  X                Cytopath,                    0343         0.39       $19.85       $10.72        $3.97
                            concentrate tech.
   88125  X                Forensic                     0342         0.21       $10.69        $5.87        $2.14
                            cytopathology.
   88130  A                Sex chromatin         ...........  ...........  ...........  ...........  ...........
                            identification.
   88140  A                Sex chromatin         ...........  ...........  ...........  ...........  ...........
                            identification.
   88141  N                Cytopath, c/v,        ...........  ...........  ...........  ...........  ...........
                            interpret.
   88142  A                Cytopath, c/v, thin   ...........  ...........  ...........  ...........  ...........
                            layer.
   88143  A                Cytopath c/v thin     ...........  ...........  ...........  ...........  ...........
                            layer redo.
   88144  A                Cytopath, c/v thin    ...........  ...........  ...........  ...........  ...........
                            lyr redo.
   88145  A                Cytopath, c/v thin    ...........  ...........  ...........  ...........  ...........
                            lyr sel.
   88147  A                Cytopath, c/v,        ...........  ...........  ...........  ...........  ...........
                            automated.
   88148  A                Cytopath, c/v, auto   ...........  ...........  ...........  ...........  ...........
                            rescreen.
   88150  A                Cytopath, c/v,        ...........  ...........  ...........  ...........  ...........
                            manual.
   88152  A                Cytopath, c/v, auto   ...........  ...........  ...........  ...........  ...........
                            redo.
   88153  A                Cytopath, c/v, redo.  ...........  ...........  ...........  ...........  ...........
   88154  A                Cytopath, c/v,        ...........  ...........  ...........  ...........  ...........
                            select.
   88155  A                Cytopath, c/v, index  ...........  ...........  ...........  ...........  ...........
                            add-on.
   88160  X                Cytopath smear,              0342         0.21       $10.69        $5.87        $2.14
                            other source.
   88161  X                Cytopath smear,              0343         0.39       $19.85       $10.72        $3.97
                            other source.
   88162  X                Cytopath smear,              0343         0.39       $19.85       $10.72        $3.97
                            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  D                Fine needle                  0002         0.42       $21.38       $11.75        $4.28
                            aspiration.
   88171  D                Fine needle                  0004         2.47      $125.73       $32.57       $25.15
                            aspiration.
   88172  X                Cytopathology eval           0343         0.39       $19.85       $10.72        $3.97
                            of fna.
   88173  X                Cytopath eval, fna,          0343         0.39       $19.85       $10.72        $3.97
                            report.
   88180  X                Cell marker study...         0344         0.56       $28.51       $15.68        $5.70
   88182  X                Cell marker study...         0344         0.56       $28.51       $15.68        $5.70
   88199  A                Cytopathology         ...........  ...........  ...........  ...........  ...........
                            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...  ...........  ...........  ...........  ...........  ...........

[[Page 60029]]

 
   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         0.21       $10.69        $5.87        $2.14
   88300  X                Surgical path, gross         0342         0.21       $10.69        $5.87        $2.14
   88302  X                Tissue exam by               0342         0.21       $10.69        $5.87        $2.14
                            pathologist.
   88304  X                Tissue exam by               0343         0.39       $19.85       $10.72        $3.97
                            pathologist.
   88305  X                Tissue exam by               0343         0.39       $19.85       $10.72        $3.97
                            pathologist.
   88307  X                Tissue exam by               0344         0.56       $28.51       $15.68        $5.70
                            pathologist.
   88309  X                Tissue exam by               0344         0.56       $28.51       $15.68        $5.70
                            pathologist.
   88311  X                Decalcify tissue....         0342         0.21       $10.69        $5.87        $2.14
   88312  X                Special stains......         0342         0.21       $10.69        $5.87        $2.14
   88313  X                Special stains......         0342         0.21       $10.69        $5.87        $2.14
   88314  X                Histochemical stain.         0342         0.21       $10.69        $5.87        $2.14
   88318  X                Chemical                     0342         0.21       $10.69        $5.87        $2.14
                            histochemistry.
   88319  X                Enzyme                       0342         0.21       $10.69        $5.87        $2.14
                            histochemistry.
   88321  X                Microslide                   0342         0.21       $10.69        $5.87        $2.14
                            consultation.
   88323  X                Microslide                   0343         0.39       $19.85       $10.72        $3.97
                            consultation.
   88325  X                Comprehensive review         0343         0.39       $19.85       $10.72        $3.97
                            of data.
   88329  X                Path consult introp.         0342         0.21       $10.69        $5.87        $2.14
   88331  X                Path consult                 0343         0.39       $19.85       $10.72        $3.97
                            intraop, 1 bloc.
   88332  X                Path consult                 0342         0.21       $10.69        $5.87        $2.14
                            intraop, addl.
   88342  X                Immunocytochemistry.         0344         0.56       $28.51       $15.68        $5.70
   88346  X                Immunofluorescent            0343         0.39       $19.85       $10.72        $3.97
                            study.
   88347  X                Immunofluorescent            0344         0.56       $28.51       $15.68        $5.70
                            study.
   88348  X                Electron microscopy.         0344         0.56       $28.51       $15.68        $5.70
   88349  X                Scanning electron            0344         0.56       $28.51       $15.68        $5.70
                            microscopy.
   88355  X                Analysis, skeletal           0344         0.56       $28.51       $15.68        $5.70
                            muscle.
   88356  X                Analysis, nerve.....         0344         0.56       $28.51       $15.68        $5.70
   88358  X                Analysis, tumor.....         0344         0.56       $28.51       $15.68        $5.70
   88362  X                Nerve teasing                0343         0.39       $19.85       $10.72        $3.97
                            preparations.
   88365  X                Tissue hybridization         0344         0.56       $28.51       $15.68        $5.70
   88371  A                Protein, western      ...........  ...........  ...........  ...........  ...........
                            blot tissue.
   88372  A                Protein analysis w/   ...........  ...........  ...........  ...........  ...........
                            probe.
  *88380  A                Microdissection.....  ...........  ...........  ...........  ...........  ...........
   88399  A                Surgical pathology    ...........  ...........  ...........  ...........  ...........
                            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            0360         1.35       $68.72       $34.36       $13.74
                            contents.
   89105  X                Sample intestinal            0360         1.35       $68.72       $34.36       $13.74
                            contents.
   89125  A                Specimen fat stain..  ...........  ...........  ...........  ...........  ...........
   89130  X                Sample stomach               0360         1.35       $68.72       $34.36       $13.74
                            contents.
   89132  X                Sample stomach               0360         1.35       $68.72       $34.36       $13.74
                            contents.
   89135  X                Sample stomach               0360         1.35       $68.72       $34.36       $13.74
                            contents.
   89136  X                Sample stomach               0360         1.35       $68.72       $34.36       $13.74
                            contents.
   89140  X                Sample stomach               0360         1.35       $68.72       $34.36       $13.74
                            contents.
   89141  X                Sample stomach               0360         1.35       $68.72       $34.36       $13.74
                            contents.
   89160  A                Exam feces for meat   ...........  ...........  ...........  ...........  ...........
                            fibers.
   89190  A                Nasal smear for       ...........  ...........  ...........  ...........  ...........
                            eosinophils.
   89250  X                Fertilization of             0348         0.77       $39.20  ...........        $7.84
                            oocyte.
   89251  X                Culture oocyte w/            0348         0.77       $39.20  ...........        $7.84
                            embryos.
   89252  X                Assist oocyte                0348         0.77       $39.20  ...........        $7.84
                            fertilization.
   89253  X                Embryo hatching.....         0348         0.77       $39.20  ...........        $7.84
   89254  X                Oocyte                       0348         0.77       $39.20  ...........        $7.84
                            identification.
   89255  X                Prepare embryo for           0348         0.77       $39.20  ...........        $7.84
                            transfer.
   89256  X                Prepare                      0348         0.77       $39.20  ...........        $7.84
                            cryopreserved
                            embryo.
   89257  X                Sperm identification         0348         0.77       $39.20  ...........        $7.84
   89258  X                Cryopreservation,            0348         0.77       $39.20  ...........        $7.84
                            embryo.
   89259  X                Cryopreservation,            0348         0.77       $39.20  ...........        $7.84
                            sperm.
   89260  X                Sperm isolation,             0348         0.77       $39.20  ...........        $7.84
                            simple.
   89261  X                Sperm isolation,             0348         0.77       $39.20  ...........        $7.84
                            complex.
   89264  X                Identify sperm               0348         0.77       $39.20  ...........        $7.84
                            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.

[[Page 60030]]

 
   89330  A                Evaluation, cervical  ...........  ...........  ...........  ...........  ...........
                            mucus.
   89350  X                Sputum specimen              0344         0.56       $28.51       $15.68        $5.70
                            collection.
   89355  A                Exam feces for        ...........  ...........  ...........  ...........  ...........
                            starch.
   89360  X                Collect sweat for            0344         0.56       $28.51       $15.68        $5.70
                            test.
   89365  A                Water load test.....  ...........  ...........  ...........  ...........  ...........
   89399  A                Pathology lab         ...........  ...........  ...........  ...........  ...........
                            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         1.11       $56.50  ...........       $11.30
   90371  K                Hep b ig, im........         0356         1.11       $56.50  ...........       $11.30
   90375  K                Rabies ig, im/sc....         0356         1.11       $56.50  ...........       $11.30
   90376  K                Rabies ig, heat              0356         1.11       $56.50  ...........       $11.30
                            treated.
   90378  K                Rsv ig, im, 50 mg...         0356         1.11       $56.50  ...........       $11.30
   90379  K                Rsv ig, iv..........         0356         1.11       $56.50  ...........       $11.30
   90384  E                Rh ig, full-dose, im  ...........  ...........  ...........  ...........  ...........
   90385  K                Rh ig, minidose, im.         0356         1.11       $56.50  ...........       $11.30
   90386  E                Rh ig, iv...........  ...........  ...........  ...........  ...........  ...........
   90389  K                Tetanus ig, im......         0356         1.11       $56.50  ...........       $11.30
   90393  K                Vaccina ig, im......         0356         1.11       $56.50  ...........       $11.30
   90396  K                Varicella-zoster ig,         0356         1.11       $56.50  ...........       $11.30
                            im.
   90399  E                Immune globulin.....  ...........  ...........  ...........  ...........  ...........
   90471  N                Immunization admin..  ...........  ...........  ...........  ...........  ...........
   90472  N                Immunization admin,   ...........  ...........  ...........  ...........  ...........
                            each add.
  *90473  E                Immune admin oral/    ...........  ...........  ...........  ...........  ...........
                            nasal.
  *90474  E                Immune admin oral/    ...........  ...........  ...........  ...........  ...........
                            nasal addl.
   90476  K                Adenovirus vaccine,          0356         1.11       $56.50  ...........       $11.30
                            type 4.
   90477  K                Adenovirus vaccine,          0356         1.11       $56.50  ...........       $11.30
                            type 7.
   90581  K                Anthrax vaccine, sc.         0356         1.11       $56.50  ...........       $11.30
   90585  K                Bcg vaccine, percut.         0356         1.11       $56.50  ...........       $11.30
   90586  K                Bcg vaccine,                 0356         1.11       $56.50  ...........       $11.30
                            intravesical.
   90632  K                Hep a vaccine, adult         0356         1.11       $56.50  ...........       $11.30
                            im.
   90633  K                Hep a vacc, ped/             0356         1.11       $56.50  ...........       $11.30
                            adol, 2 dose.
   90634  K                Hep a vacc, ped/             0356         1.11       $56.50  ...........       $11.30
                            adol, 3 dose.
   90636  K                Hep a/hep b vacc,            0355         0.19        $9.67  ...........        $1.93
                            adult im.
   90645  K                Hib vaccine, hboc,           0355         0.19        $9.67  ...........        $1.93
                            im.
   90646  K                Hib vaccine, prp-d,          0355         0.19        $9.67  ...........        $1.93
                            im.
   90647  K                Hib vaccine, prp-            0355         0.19        $9.67  ...........        $1.93
                            omp, im.
   90648  K                Hib vaccine, prp-t,          0355         0.19        $9.67  ...........        $1.93
                            im.
   90657  K                Flu vaccine, 6-35            0354         0.10        $5.09  ...........  ...........
                            mo, im.
   90658  K                Flu vaccine, 3 yrs,          0354         0.10        $5.09  ...........  ...........
                            im.
   90659  K                Flu vaccine, whole,          0354         0.10        $5.09  ...........  ...........
                            im.
   90660  E                Flu vaccine, nasal..  ...........  ...........  ...........  ...........  ...........
   90665  K                Lyme disease                 0356         1.11       $56.50  ...........       $11.30
                            vaccine, im.
   90669  E                Pneumococcal vacc,    ...........  ...........  ...........  ...........  ...........
                            ped5.
   90675  K                Rabies vaccine, im..         0356         1.11       $56.50  ...........       $11.30
   90676  K                Rabies vaccine, id..         0356         1.11       $56.50  ...........       $11.30
   90680  K                Rotovirus vaccine,           0356         1.11       $56.50  ...........       $11.30
                            oral.
   90690  K                Typhoid vaccine,             0356         1.11       $56.50  ...........       $11.30
                            oral.
   90691  K                Typhoid vaccine, im.         0356         1.11       $56.50  ...........       $11.30
   90692  K                Typhoid vaccine, h-          0355         0.19        $9.67  ...........        $1.93
                            p, sc/id.
   90693  K                Typhoid vaccine,             0356         1.11       $56.50  ...........       $11.30
                            akd, sc.
   90700  K                Dtap vaccine, im....         0355         0.19        $9.67  ...........        $1.93
   90701  K                Dtp vaccine, im.....         0355         0.19        $9.67  ...........        $1.93
   90702  K                Dt vaccine  7, im...         0355         0.19        $9.67  ...........        $1.93
   90703  K                Tetanus vaccine, im.         0355         0.19        $9.67  ...........        $1.93
   90704  K                Mumps vaccine, sc...         0355         0.19        $9.67  ...........        $1.93
   90705  K                Measles vaccine, sc.         0356         1.11       $56.50  ...........       $11.30
   90706  K                Rubella vaccine, sc.         0355         0.19        $9.67  ...........        $1.93
   90707  K                Mmr vaccine, sc.....         0356         1.11       $56.50  ...........       $11.30
   90708  K                Measles-rubella              0356         1.11       $56.50  ...........       $11.30
                            vaccine, sc.
   90709  K                Rubella & mumps              0356         1.11       $56.50  ...........       $11.30
                            vaccine, sc.
   90710  K                Mmrv vaccine, sc....         0356         1.11       $56.50  ...........       $11.30
   90712  K                Oral poliovirus              0355         0.19        $9.67  ...........        $1.93
                            vaccine.
   90713  K                Poliovirus, ipv, sc.         0355         0.19        $9.67  ...........        $1.93
   90716  K                Chicken pox vaccine,         0355         0.19        $9.67  ...........        $1.93
                            sc.
   90717  K                Yellow fever                 0356         1.11       $56.50  ...........       $11.30
                            vaccine, sc.
   90718  K                Td vaccine > 7, im..         0355         0.19        $9.67  ...........        $1.93
   90719  K                Diphtheria vaccine,          0356         1.11       $56.50  ...........       $11.30
                            im.
   90720  K                Dtp/hib vaccine, im.         0355         0.19        $9.67  ...........        $1.93
   90721  K                Dtap/hib vaccine, im         0355         0.19        $9.67  ...........        $1.93
   90723  K                Dtap-hep b-ipv               0356         1.11       $56.50  ...........       $11.30
                            vaccine, im.
   90725  K                Cholera vaccine,             0355         0.19        $9.67  ...........        $1.93
                            injectable.

[[Page 60031]]

 
   90727  K                Plague vaccine, im..         0355         0.19        $9.67  ...........        $1.93
   90732  K                Pneumococcal vacc,           0354         0.10        $5.09  ...........  ...........
                            adult/ill.
   90733  K                Meningococcal                0356         1.11       $56.50  ...........       $11.30
                            vaccine, sc.
   90735  K                Encephalitis                 0356         1.11       $56.50  ...........       $11.30
                            vaccine, sc.
   90740  K                Hepb vacc, ill pat 3         0356         1.11       $56.50  ...........       $11.30
                            dose im.
   90743  K                Hep b vacc, adol, 2          0356         1.11       $56.50  ...........       $11.30
                            dose, im.
   90744  K                Hepb vacc ped/adol 3         0356         1.11       $56.50  ...........       $11.30
                            dose im.
   90746  K                Hep b vaccine,               0356         1.11       $56.50  ...........       $11.30
                            adult, im.
   90747  K                Hepb vacc, ill pat 4         0356         1.11       $56.50  ...........       $11.30
                            dose im.
   90748  K                Hep b/hib vaccine,           0355         0.19        $9.67  ...........        $1.93
                            im.
   90749  K                Vaccine toxoid......         0355         0.19        $9.67  ...........        $1.93
   90780  E                IV infusion therapy,  ...........  ...........  ...........  ...........  ...........
                            1 hour.
   90781  E                IV infusion,          ...........  ...........  ...........  ...........  ...........
                            additional hour.
   90782  X                Injection, sc/im....         0352         0.41       $20.87  ...........        $4.17
   90783  X                Injection, ia.......         0359         1.79       $91.12  ...........       $18.22
   90784  X                Injection, iv.......         0359         1.79       $91.12  ...........       $18.22
   90788  X                Injection of                 0359         1.79       $91.12  ...........       $18.22
                            antibiotic.
   90799  X                Ther/prophylactic/dx         0352         0.41       $20.87  ...........        $4.17
                            inject.
   90801  S                Psy dx interview....         0323         1.73       $88.06       $21.13       $17.61
   90802  S                Intac psy dx                 0323         1.73       $88.06       $21.13       $17.61
                            interview.
   90804  S                Psytx, office, 20-30         0322         1.15       $58.54       $12.29       $11.71
                            min.
   90805  S                Psytx, off, 20-30            0322         1.15       $58.54       $12.29       $11.71
                            min w/e&m.
   90806  S                Psytx, off, 45-50            0323         1.73       $88.06       $21.13       $17.61
                            min.
   90807  S                Psytx, off, 45-50            0323         1.73       $88.06       $21.13       $17.61
                            min w/e&m.
   90808  S                Psytx, office, 75-80         0323         1.73       $88.06       $21.13       $17.61
                            min.
   90809  S                Psytx, off, 75-80, w/        0323         1.73       $88.06       $21.13       $17.61
                            e&m.
   90810  S                Intac psytx, off, 20-        0322         1.15       $58.54       $12.29       $11.71
                            30 min.
   90811  S                Intac psytx, 20-30,          0322         1.15       $58.54       $12.29       $11.71
                            w/e&m.
   90812  S                Intac psytx, off, 45-        0323         1.73       $88.06       $21.13       $17.61
                            50 min.
   90813  S                Intac psytx, 45-50           0323         1.73       $88.06       $21.13       $17.61
                            min w/e&m.
   90814  S                Intac psytx, off, 75-        0323         1.73       $88.06       $21.13       $17.61
                            80 min.
   90815  S                Intac psytx, 75-80 w/        0323         1.73       $88.06       $21.13       $17.61
                            e&m.
   90816  S                Psytx, hosp, 20-30           0322         1.15       $58.54       $12.29       $11.71
                            min.
   90817  S                Psytx, hosp, 20-30           0322         1.15       $58.54       $12.29       $11.71
                            min w/e&m.
   90818  S                Psytx, hosp, 45-50           0323         1.73       $88.06       $21.13       $17.61
                            min.
   90819  S                Psytx, hosp, 45-50           0323         1.73       $88.06       $21.13       $17.61
                            min w/e&m.
   90821  S                Psytx, hosp, 75-80           0323         1.73       $88.06       $21.13       $17.61
                            min.
   90822  S                Psytx, hosp, 75-80           0323         1.73       $88.06       $21.13       $17.61
                            min w/e&m.
   90823  S                Intac psytx, hosp,           0322         1.15       $58.54       $12.29       $11.71
                            20-30 min.
   90824  S                Intac psytx, hsp 20-         0322         1.15       $58.54       $12.29       $11.71
                            30 w/e&m.
   90826  S                Intac psytx, hosp,           0323         1.73       $88.06       $21.13       $17.61
                            45-50 min.
   90827  S                Intac psytx, hsp 45-         0323         1.73       $88.06       $21.13       $17.61
                            50 w/e&m.
   90828  S                Intac psytx, hosp,           0323         1.73       $88.06       $21.13       $17.61
                            75-80 min.
   90829  S                Intac psytx, hsp 75-         0323         1.73       $88.06       $21.13       $17.61
                            80 w/e&m.
   90845  S                Psychoanalysis......         0323         1.73       $88.06       $21.13       $17.61
   90846  S                Family psytx w/o             0324         2.69      $136.93       $20.19       $27.39
                            patient.
   90847  S                Family psytx w/              0324         2.69      $136.93       $20.19       $27.39
                            patient.
   90849  S                Multiple family              0325         1.38       $70.25       $18.27       $14.05
                            group psytx.
   90853  S                Group psychotherapy.         0325         1.38       $70.25       $18.27       $14.05
   90857  S                Intac group psytx...         0325         1.38       $70.25       $18.27       $14.05
   90862  X                Medication                   0374         0.89       $45.30        $9.97        $9.06
                            management.
   90865  S                Narcosynthesis......         0323         1.73       $88.06       $21.13       $17.61
   90870  S                Electroconvulsive            0320         3.88      $197.51       $80.06       $39.50
                            therapy.
   90871  S                Electroconvulsive            0320         3.88      $197.51       $80.06       $39.50
                            therapy.
   90875  E                Psychophysiological   ...........  ...........  ...........  ...........  ...........
                            therapy.
   90876  E                Psychophysiological   ...........  ...........  ...........  ...........  ...........
                            therapy.
   90880  S                Hypnotherapy........         0323         1.73       $88.06       $21.13       $17.61
   90882  E                Environmental         ...........  ...........  ...........  ...........  ...........
                            manipulation.
   90885  N                Psy evaluation of     ...........  ...........  ...........  ...........  ...........
                            records.
   90887  N                Consultation with     ...........  ...........  ...........  ...........  ...........
                            family.
   90889  N                Preparation of        ...........  ...........  ...........  ...........  ...........
                            report.
   90899  S                Psychiatric service/         0322         1.15       $58.54       $12.29       $11.71
                            therapy.
   90901  S                Biofeedback train,           0321         0.93       $47.34       $21.78        $9.47
                            any meth.
   90911  S                Biofeedback peri/uro/        0321         0.93       $47.34       $21.78        $9.47
                            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         0.28       $14.25        $3.14        $2.85
                            evaluation.
   90937  E                Hemodialysis,         ...........  ...........  ...........  ...........  ...........
                            repeated eval.
  *90939  N                Hemodialysis study,   ...........  ...........  ...........  ...........  ...........
                            transcut.

[[Page 60032]]

 
   90940  N                Hemodialysis access   ...........  ...........  ...........  ...........  ...........
                            study.
   90945  S                Dialysis, one                0170         0.28       $14.25        $3.14        $2.85
                            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         3.25      $165.44       $82.72       $33.09
                            intubation.
   91010  X                Esophagus motility           0361         3.25      $165.44       $82.72       $33.09
                            study.
   91011  X                Esophagus motility           0361         3.25      $165.44       $82.72       $33.09
                            study.
   91012  X                Esophagus motility           0361         3.25      $165.44       $82.72       $33.09
                            study.
   91020  X                Gastric motility....         0361         3.25      $165.44       $82.72       $33.09
   91030  X                Acid perfusion of            0361         3.25      $165.44       $82.72       $33.09
                            esophagus.
   91032  X                Esophagus, acid              0361         3.25      $165.44       $82.72       $33.09
                            reflux test.
   91033  X                Prolonged acid               0361         3.25      $165.44       $82.72       $33.09
                            reflux test.
   91052  X                Gastric analysis             0361         3.25      $165.44       $82.72       $33.09
                            test.
   91055  X                Gastric intubation           0360         1.35       $68.72       $34.36       $13.74
                            for smear.
   91060  X                Gastric saline load          0360         1.35       $68.72       $34.36       $13.74
                            test.
   91065  X                Breath hydrogen test         0360         1.35       $68.72       $34.36       $13.74
   91100  X                Pass intestine               0360         1.35       $68.72       $34.36       $13.74
                            bleeding tube.
   91105  X                Gastric intubation           0361         3.25      $165.44       $82.72       $33.09
                            treatment.
   91122  T                Anal pressure record         0156         2.45      $124.71       $37.41       $24.94
  *91123  N                Irrigate fecal        ...........  ...........  ...........  ...........  ...........
                            impaction.
   91132  X                Electrogastrography.         0360         1.35       $68.72       $34.36       $13.74
   91133  X                Electrogastrography          0360         1.35       $68.72       $34.36       $13.74
                            w/test.
   91299  X                Gastroenterology             0360         1.35       $68.72       $34.36       $13.74
                            procedure.
   92002  V                Eye exam, new                0601         0.95       $48.36  ...........        $9.67
                            patient.
   92004  V                Eye exam, new                0602         1.38       $70.25  ...........       $14.05
                            patient.
   92012  V                Eye exam established         0600         0.86       $43.78  ...........        $8.76
                            pat.
   92014  V                Eye exam & treatment         0602         1.38       $70.25  ...........       $14.05
   92015  E                Refraction..........  ...........  ...........  ...........  ...........  ...........
   92018  T                New eye exam &               0699         6.46      $328.84      $147.98       $65.77
                            treatment.
   92019  S                Eye exam & treatment         0698         1.03       $52.43       $19.92       $10.49
   92020  S                Special eye                  0230         0.61       $31.05       $14.28        $6.21
                            evaluation.
   92060  S                Special eye                  0230         0.61       $31.05       $14.28        $6.21
                            evaluation.
   92065  S                Orthoptic/pleoptic           0230         0.61       $31.05       $14.28        $6.21
                            training.
   92070  N                Fitting of contact    ...........  ...........  ...........  ...........  ...........
                            lens.
   92081  S                Visual field                 0230         0.61       $31.05       $14.28        $6.21
                            examination(s).
   92082  S                Visual field                 0698         1.03       $52.43       $19.92       $10.49
                            examination(s).
   92083  S                Visual field                 0698         1.03       $52.43       $19.92       $10.49
                            examination(s).
   92100  N                Serial tonometry      ...........  ...........  ...........  ...........  ...........
                            exam(s).
   92120  S                Tonography & eye             0230         0.61       $31.05       $14.28        $6.21
                            evaluation.
   92130  S                Water provocation            0698         1.03       $52.43       $19.92       $10.49
                            tonography.
   92135  S                Opthalmic dx imaging         0230         0.61       $31.05       $14.28        $6.21
  *92136  S                Ophthalmic biometry.         0230         0.61       $31.05       $14.28        $6.21
   92140  S                Glaucoma provocative         0231         2.03      $103.34       $46.50       $20.67
                            tests.
   92225  S                Special eye exam,            0698         1.03       $52.43       $19.92       $10.49
                            initial.
   92226  S                Special eye exam,            0231         2.03      $103.34       $46.50       $20.67
                            subsequent.
   92230  T                Eye exam with photos         0699         6.46      $328.84      $147.98       $65.77
   92235  S                Eye exam with photos         0231         2.03      $103.34       $46.50       $20.67
   92240  S                Icg angiography.....         0231         2.03      $103.34       $46.50       $20.67
   92250  S                Eye exam with photos         0230         0.61       $31.05       $14.28        $6.21
   92260  S                Ophthalmoscopy/              0230         0.61       $31.05       $14.28        $6.21
                            dynamometry.
   92265  S                Eye muscle                   0231         2.03      $103.34       $46.50       $20.67
                            evaluation.
   92270  S                Electro-oculography.         0698         1.03       $52.43       $19.92       $10.49
   92275  S                Electroretinography.         0216         2.61      $132.86       $59.79       $26.57
   92283  S                Color vision                 0230         0.61       $31.05       $14.28        $6.21
                            examination.
   92284  S                Dark adaptation eye          0231         2.03      $103.34       $46.50       $20.67
                            exam.
   92285  S                Eye photography.....         0230         0.61       $31.05       $14.28        $6.21
   92286  S                Internal eye                 0698         1.03       $52.43       $19.92       $10.49
                            photography.
   92287  S                Internal eye                 0231         2.03      $103.34       $46.50       $20.67
                            photography.
   92310  E                Contact lens fitting  ...........  ...........  ...........  ...........  ...........
   92311  X                Contact lens fitting         0362         0.86       $43.78        $9.63        $8.76
   92312  X                Contact lens fitting         0362         0.86       $43.78        $9.63        $8.76
   92313  X                Contact lens fitting         0362         0.86       $43.78        $9.63        $8.76
   92314  E                Prescription of       ...........  ...........  ...........  ...........  ...........
                            contact lens.
   92315  X                Prescription of              0362         0.86       $43.78        $9.63        $8.76
                            contact lens.
   92316  X                Prescription of              0362         0.86       $43.78        $9.63        $8.76
                            contact lens.
   92317  X                Prescription of              0362         0.86       $43.78        $9.63        $8.76
                            contact lens.
   92325  X                Modification of              0362         0.86       $43.78        $9.63        $8.76
                            contact lens.
   92326  X                Replacement of               0362         0.86       $43.78        $9.63        $8.76
                            contact lens.
   92330  S                Fitting of                   0230         0.61       $31.05       $14.28        $6.21
                            artificial eye.
   92335  N                Fitting of            ...........  ...........  ...........  ...........  ...........
                            artificial eye.
   92340  E                Fitting of            ...........  ...........  ...........  ...........  ...........
                            spectacles.
   92341  E                Fitting of            ...........  ...........  ...........  ...........  ...........
                            spectacles.

[[Page 60033]]

 
   92342  E                Fitting of            ...........  ...........  ...........  ...........  ...........
                            spectacles.
   92352  X                Special spectacles           0362         0.86       $43.78        $9.63        $8.76
                            fitting.
   92353  X                Special spectacles           0362         0.86       $43.78        $9.63        $8.76
                            fitting.
   92354  X                Special spectacles           0362         0.86       $43.78        $9.63        $8.76
                            fitting.
   92355  X                Special spectacles           0362         0.86       $43.78        $9.63        $8.76
                            fitting.
   92358  X                Eye prosthesis               0362         0.86       $43.78        $9.63        $8.76
                            service.
   92370  E                Repair & adjust       ...........  ...........  ...........  ...........  ...........
                            spectacles.
   92371  X                Repair & adjust              0362         0.86       $43.78        $9.63        $8.76
                            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         0.61       $31.05       $14.28        $6.21
                            procedure.
   92502  T                Ear and throat               0251         2.43      $123.70       $27.99       $24.74
                            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         1.03       $52.43       $14.22       $10.49
   92512  X                Nasal function               0363         1.73       $88.06       $32.58       $17.61
                            studies.
   92516  X                Facial nerve                 0363         1.73       $88.06       $32.58       $17.61
                            function test.
   92520  X                Laryngeal function           0363         1.73       $88.06       $32.58       $17.61
                            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         1.73       $88.06       $32.58       $17.61
                            nystagmus test.
   92542  X                Positional nystagmus         0363         1.73       $88.06       $32.58       $17.61
                            test.
   92543  X                Caloric vestibular           0363         1.73       $88.06       $32.58       $17.61
                            test.
   92544  X                Optokinetic                  0363         1.73       $88.06       $32.58       $17.61
                            nystagmus test.
   92545  X                Oscillating tracking         0363         1.73       $88.06       $32.58       $17.61
                            test.
   92546  X                Sinusoidal                   0363         1.73       $88.06       $32.58       $17.61
                            rotational test.
   92547  X                Supplemental                 0363         1.73       $88.06       $32.58       $17.61
                            electrical test.
   92548  X                Posturography.......         0363         1.73       $88.06       $32.58       $17.61
   92551  E                Pure tone hearing     ...........  ...........  ...........  ...........  ...........
                            test, air.
   92552  X                Pure tone                    0364         0.58       $29.52       $11.51        $5.90
                            audiometry, air.
   92553  X                Audiometry, air &            0365         1.31       $66.68       $20.00       $13.34
                            bone.
   92555  X                Speech threshold             0364         0.58       $29.52       $11.51        $5.90
                            audiometry.
   92556  X                Speech audiometry,           0364         0.58       $29.52       $11.51        $5.90
                            complete.
   92557  X                Comprehensive                0365         1.31       $66.68       $20.00       $13.34
                            hearing test.
   92559  E                Group audiometric     ...........  ...........  ...........  ...........  ...........
                            testing.
   92560  E                Bekesy audiometry,    ...........  ...........  ...........  ...........  ...........
                            screen.
   92561  X                Bekesy audiometry,           0365         1.31       $66.68       $20.00       $13.34
                            diagnosis.
   92562  X                Loudness balance             0364         0.58       $29.52       $11.51        $5.90
                            test.
   92563  X                Tone decay hearing           0364         0.58       $29.52       $11.51        $5.90
                            test.
   92564  X                Sisi hearing test...         0364         0.58       $29.52       $11.51        $5.90
   92565  X                Stenger test, pure           0364         0.58       $29.52       $11.51        $5.90
                            tone.
   92567  X                Tympanometry........         0364         0.58       $29.52       $11.51        $5.90
   92568  X                Acoustic reflex              0364         0.58       $29.52       $11.51        $5.90
                            testing.
   92569  X                Acoustic reflex              0364         0.58       $29.52       $11.51        $5.90
                            decay test.
   92571  X                Filtered speech              0364         0.58       $29.52       $11.51        $5.90
                            hearing test.
   92572  X                Staggered spondaic           0364         0.58       $29.52       $11.51        $5.90
                            word test.
   92573  X                Lombard test........         0364         0.58       $29.52       $11.51        $5.90
   92575  X                Sensorineural acuity         0365         1.31       $66.68       $20.00       $13.34
                            test.
   92576  X                Synthetic sentence           0364         0.58       $29.52       $11.51        $5.90
                            test.
   92577  X                Stenger test, speech         0365         1.31       $66.68       $20.00       $13.34
   92579  X                Visual audiometry            0365         1.31       $66.68       $20.00       $13.34
                            (vra).
   92582  X                Conditioning play            0365         1.31       $66.68       $20.00       $13.34
                            audiometry.
   92583  X                Select picture               0364         0.58       $29.52       $11.51        $5.90
                            audiometry.
   92584  X                Electrocochleography         0363         1.73       $88.06       $32.58       $17.61
   92585  S                Auditor evoke                0216         2.61      $132.86       $59.79       $26.57
                            potent, compre.
   92586  S                Auditor evoke                0707  ...........       $75.00  ...........       $15.00
                            potent, limit.
   92587  X                Evoked auditory test         0363         1.73       $88.06       $32.58       $17.61
   92588  X                Evoked auditory test         0363         1.73       $88.06       $32.58       $17.61
   92589  X                Auditory function            0364         0.58       $29.52       $11.51        $5.90
                            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.

[[Page 60034]]

 
   92595  E                Electro hearng aid    ...........  ...........  ...........  ...........  ...........
                            tst, both.
   92596  X                Ear protector                0365         1.31       $66.68       $20.00       $13.34
                            evaluation.
   92599  X                ENT procedure/               0364         0.58       $29.52       $11.51        $5.90
                            service.
   92950  S                Heart/lung                   0094         6.08      $309.50      $105.29       $61.90
                            resuscitation cpr.
   92953  S                Temporary external           0094         6.08      $309.50      $105.29       $61.90
                            pacing.
   92960  S                Cardioversion                0094         6.08      $309.50      $105.29       $61.90
                            electric, ext.
   92961  S                Cardioversion,               0094         6.08      $309.50      $105.29       $61.90
                            electric, int.
   92970  C                Cardioassist,         ...........  ...........  ...........  ...........  ...........
                            internal.
   92971  C                Cardioassist,         ...........  ...........  ...........  ...........  ...........
                            external.
  *92973  T                Percut coronary              0973  ...........      $250.00  ...........       $50.00
                            thrombectomy.
  *92974  T                Cath place, cardio           0981  ...........    $2,250.00  ...........      $450.00
                            brachytx.
   92975  C                Dissolve clot, heart  ...........  ...........  ...........  ...........  ...........
                            vessel.
   92977  T                Dissolve clot, heart         0120         3.08      $156.78       $42.67       $31.36
                            vessel.
   92978  S                Intravasc us, heart          0267         2.33      $118.61       $65.23       $23.72
                            add-on.
   92979  S                Intravasc us, heart          0267         2.33      $118.61       $65.23       $23.72
                            add-on.
   92980  T                Insert intracoronary         0104        87.98    $4,478.53  ...........      $895.71
                            stent.
   92981  T                Insert intracoronary         0104        87.98    $4,478.53  ...........      $895.71
                            stent.
   92982  T                Coronary artery              0083        59.49    $3,028.28      $794.30      $605.66
                            dilation.
   92984  T                Coronary artery              0083        59.49    $3,028.28      $794.30      $605.66
                            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        92.00    $4,683.17    $1,351.74      $936.63
   92996  T                Coronary atherectomy         0082        92.00    $4,683.17    $1,351.74      $936.63
                            add-on.
   92997  C                Pul art balloon       ...........  ...........  ...........  ...........  ...........
                            repr, percut.
   92998  C                Pul art balloon       ...........  ...........  ...........  ...........  ...........
                            repr, percut.
   93000  E                Electrocardiogram,    ...........  ...........  ...........  ...........  ...........
                            complete.
   93005  S                Electrocardiogram,           0099         0.35       $17.82        $9.80        $3.56
                            tracing.
   93010  A                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         1.47       $74.83       $41.15       $14.97
                            stress test.
   93018  E                Cardiovascular        ...........  ...........  ...........  ...........  ...........
                            stress test.
   93024  X                Cardiac drug stress          0100         1.47       $74.83       $41.15       $14.97
                            test.
  *93025  X                Microvolt t-wave             0100         1.47       $74.83       $41.15       $14.97
                            assess.
   93040  E                Rhythm ECG with       ...........  ...........  ...........  ...........  ...........
                            report.
   93041  S                Rhythm ECG, tracing.         0099         0.35       $17.82        $9.80        $3.56
   93042  E                Rhythm ECG, report..  ...........  ...........  ...........  ...........  ...........
   93224  E                ECG monitor/report,   ...........  ...........  ...........  ...........  ...........
                            24 hrs.
   93225  X                ECG monitor/record,          0100         1.47       $74.83       $41.15       $14.97
                            24 hrs.
   93226  X                ECG monitor/report,          0100         1.47       $74.83       $41.15       $14.97
                            24 hrs.
   93227  E                ECG monitor/review,   ...........  ...........  ...........  ...........  ...........
                            24 hrs.
   93230  E                ECG monitor/report,   ...........  ...........  ...........  ...........  ...........
                            24 hrs.
   93231  X                Ecg monitor/record,          0100         1.47       $74.83       $41.15       $14.97
                            24 hrs.
   93232  X                ECG monitor/report,          0100         1.47       $74.83       $41.15       $14.97
                            24 hrs.
   93233  E                ECG monitor/review,   ...........  ...........  ...........  ...........  ...........
                            24 hrs.
   93235  E                ECG monitor/report,   ...........  ...........  ...........  ...........  ...........
                            24 hrs.
   93236  X                ECG monitor/report,          0100         1.47       $74.83       $41.15       $14.97
                            24 hrs.
   93237  E                ECG monitor/review,   ...........  ...........  ...........  ...........  ...........
                            24 hrs.
   93268  E                ECG record/review...  ...........  ...........  ...........  ...........  ...........
   93270  X                ECG recording.......         0097         0.84       $42.76       $23.51        $8.55
   93271  X                Ecg/monitoring and           0097         0.84       $42.76       $23.51        $8.55
                            analysis.
   93272  E                Ecg/review,           ...........  ...........  ...........  ...........  ...........
                            interpret only.
   93278  S                ECG/signal-averaged.         0099         0.35       $17.82        $9.80        $3.56
   93303  S                Echo transthoracic..         0269         3.85      $195.98      $101.91       $39.20
   93304  S                Echo transthoracic..         0697         2.08      $105.88       $55.06       $21.18
   93307  S                Echo exam of heart..         0269         3.85      $195.98      $101.91       $39.20
   93308  S                Echo exam of heart..         0697         2.08      $105.88       $55.06       $21.18
   93312  S                Echo transesophageal         0270         5.30      $269.79      $145.69       $53.96
   93313  S                Echo transesophageal         0270         5.30      $269.79      $145.69       $53.96
   93314  N                Echo transesophageal  ...........  ...........  ...........  ...........  ...........
   93315  S                Echo transesophageal         0270         5.30      $269.79      $145.69       $53.96
   93316  S                Echo transesophageal         0270         5.30      $269.79      $145.69       $53.96
   93317  N                Echo transesophageal  ...........  ...........  ...........  ...........  ...........
   93318  S                Echo transesophageal         0270         5.30      $269.79      $145.69       $53.96
                            intraop.
   93320  S                Doppler echo exam,           0269         3.85      $195.98      $101.91       $39.20
                            heart.
   93321  S                Doppler echo exam,           0697         2.08      $105.88       $55.06       $21.18
                            heart.
   93325  S                Doppler color flow           0697         2.08      $105.88       $55.06       $21.18
                            add-on.
   93350  S                Echo transthoracic..         0269         3.85      $195.98      $101.91       $39.20
   93501  T                Right heart                  0080        34.73    $1,767.90      $838.92      $353.58
                            catheterization.
   93503  T                Insert/place heart           0103        15.95      $811.92      $295.70      $162.38
                            catheter.

[[Page 60035]]

 
   93505  T                Biopsy of heart              0103        15.95      $811.92      $295.70      $162.38
                            lining.
   93508  T                Cath placement,              0080        34.73    $1,767.90      $838.92      $353.58
                            angiography.
   93510  T                Left heart                   0080        34.73    $1,767.90      $838.92      $353.58
                            catheterization.
   93511  T                Left heart                   0080        34.73    $1,767.90      $838.92      $353.58
                            catheterization.
   93514  T                Left heart                   0080        34.73    $1,767.90      $838.92      $353.58
                            catheterization.
   93524  T                Left heart                   0080        34.73    $1,767.90      $838.92      $353.58
                            catheterization.
   93526  T                Rt & Lt heart                0080        34.73    $1,767.90      $838.92      $353.58
                            catheters.
   93527  T                Rt & Lt heart                0080        34.73    $1,767.90      $838.92      $353.58
                            catheters.
   93528  T                Rt & Lt heart                0080        34.73    $1,767.90      $838.92      $353.58
                            catheters.
   93529  T                Rt, Lt heart                 0080        34.73    $1,767.90      $838.92      $353.58
                            catheterization.
   93530  T                Rt heart cath,               0080        34.73    $1,767.90      $838.92      $353.58
                            congenital.
   93531  T                R & l heart cath,            0080        34.73    $1,767.90      $838.92      $353.58
                            congenital.
   93532  T                R & l heart cath,            0080        34.73    $1,767.90      $838.92      $353.58
                            congenital.
   93533  T                R & l heart cath,            0080        34.73    $1,767.90      $838.92      $353.58
                            congenital.
   93536  D                Insert circulation           0103        15.95      $811.92      $295.70      $162.38
                            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  T                Bundle of His                0087        52.46    $2,670.42  ...........      $534.08
                            recording.
   93602  T                Intra-atrial                 0087        52.46    $2,670.42  ...........      $534.08
                            recording.
   93603  T                Right ventricular            0087        52.46    $2,670.42  ...........      $534.08
                            recording.
   93607  D                Left ventricular             0087        52.46    $2,670.42  ...........      $534.08
                            recording.
   93609  T                Mapping of                   0087        52.46    $2,670.42  ...........      $534.08
                            tachycardia.
   93610  T                Intra-atrial pacing.         0087        52.46    $2,670.42  ...........      $534.08
   93612  T                Intraventricular             0087        52.46    $2,670.42  ...........      $534.08
                            pacing.
  *93613  T                Electrophys map, 3d,         0087        52.46    $2,670.42  ...........      $534.08
                            add-on.
   93615  T                Esophageal recording         0087        52.46    $2,670.42  ...........      $534.08
   93616  T                Esophageal recording         0087        52.46    $2,670.42  ...........      $534.08
   93618  T                Heart rhythm pacing.         0087        52.46    $2,670.42  ...........      $534.08
   93619  T                Electrophysiology            0085        38.69    $1,969.48      $654.48      $393.90
                            evaluation.
   93620  T                Electrophysiology            0085        38.69    $1,969.48      $654.48      $393.90
                            evaluation.
   93621  T                Electrophysiology            0085        38.69    $1,969.48      $654.48      $393.90
                            evaluation.
   93622  T                Electrophysiology            0085        38.69    $1,969.48      $654.48      $393.90
                            evaluation.
   93623  T                Stimulation, pacing          0087        52.46    $2,670.42  ...........      $534.08
                            heart.
   93624  T                Electrophysiologic           0087        52.46    $2,670.42  ...........      $534.08
                            study.
   93631  T                Heart pacing,                0087        52.46    $2,670.42  ...........      $534.08
                            mapping.
   93640  S                Evaluation heart             0084       199.65   $10,162.98  ...........    $2,032.60
                            device.
   93641  S                Electrophysiology            0084       199.65   $10,162.98  ...........    $2,032.60
                            evaluation.
   93642  S                Electrophysiology            0084       199.65   $10,162.98  ...........    $2,032.60
                            evaluation.
   93650  T                Ablate heart                 0086        72.72    $3,701.74    $1,265.37      $740.35
                            dysrhythm focus.
   93651  T                Ablate heart                 0086        72.72    $3,701.74    $1,265.37      $740.35
                            dysrhythm focus.
   93652  T                Ablate heart                 0086        72.72    $3,701.74    $1,265.37      $740.35
                            dysrhythm focus.
   93660  S                Tilt table                   0101         3.74      $190.38      $104.70       $38.08
                            evaluation.
   93662  S                Intracardiac ecg             0270         5.30      $269.79      $145.69       $53.96
                            (ice).
   93668  E                Peripheral vascular   ...........  ...........  ...........  ...........  ...........
                            rehab.
  *93701  T                Bioimpedance,                0970  ...........       $25.00  ...........        $5.00
                            thoracic.
   93720  E                Total body            ...........  ...........  ...........  ...........  ...........
                            plethysmography.
   93721  S                Plethysmography              0096         1.71       $87.05       $47.87       $17.41
                            tracing.
   93722  E                Plethysmography       ...........  ...........  ...........  ...........  ...........
                            report.
   93724  S                Analyze pacemaker            0690         0.37       $18.83       $10.35        $3.77
                            system.
   93727  S                Analyze ilr system..         0690         0.37       $18.83       $10.35        $3.77
   93731  S                Analyze pacemaker            0690         0.37       $18.83       $10.35        $3.77
                            system.
   93732  S                Analyze pacemaker            0690         0.37       $18.83       $10.35        $3.77
                            system.
   93733  S                Telephone analy,             0690         0.37       $18.83       $10.35        $3.77
                            pacemaker.
   93734  S                Analyze pacemaker            0690         0.37       $18.83       $10.35        $3.77
                            system.
   93735  S                Analyze pacemaker            0690         0.37       $18.83       $10.35        $3.77
                            system.
   93736  S                Telephone analy,             0690         0.37       $18.83       $10.35        $3.77
                            pacemaker.
   93737  D                Analyze cardio/              0689         0.43       $21.89       $12.03        $4.38
                            defibrillator.
   93738  D                Analyze cardio/              0689         0.43       $21.89       $12.03        $4.38
                            defibrillator.
   93740  S                Temperature gradient         0096         1.71       $87.05       $47.87       $17.41
                            studies.
   93741  S                Analyze ht pace              0689         0.43       $21.89       $12.03        $4.38
                            device sngl.
   93742  S                Analyze ht pace              0689         0.43       $21.89       $12.03        $4.38
                            device sngl.
   93743  S                Analyze ht pace              0689         0.43       $21.89       $12.03        $4.38
                            device dual.
   93744  S                Analyze ht pace              0689         0.43       $21.89       $12.03        $4.38
                            device dual.
   93760  E                Cephalic thermogram.  ...........  ...........  ...........  ...........  ...........

[[Page 60036]]

 
   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         0.61       $31.05       $16.46        $6.21
   93798  S                Cardiac rehab/               0095         0.61       $31.05       $16.46        $6.21
                            monitor.
   93799  S                Cardiovascular               0096         1.71       $87.05       $47.87       $17.41
                            procedure.
   93875  S                Extracranial study..         0096         1.71       $87.05       $47.87       $17.41
   93880  S                Extracranial study..         0267         2.33      $118.61       $65.23       $23.72
   93882  S                Extracranial study..         0267         2.33      $118.61       $65.23       $23.72
   93886  S                Intracranial study..         0267         2.33      $118.61       $65.23       $23.72
   93888  S                Intracranial study..         0267         2.33      $118.61       $65.23       $23.72
   93922  S                Extremity study.....         0096         1.71       $87.05       $47.87       $17.41
   93923  S                Extremity study.....         0096         1.71       $87.05       $47.87       $17.41
   93924  S                Extremity study.....         0096         1.71       $87.05       $47.87       $17.41
   93925  S                Lower extremity              0267         2.33      $118.61       $65.23       $23.72
                            study.
   93926  S                Lower extremity              0267         2.33      $118.61       $65.23       $23.72
                            study.
   93930  S                Upper extremity              0267         2.33      $118.61       $65.23       $23.72
                            study.
   93931  S                Upper extremity              0267         2.33      $118.61       $65.23       $23.72
                            study.
   93965  S                Extremity study.....         0096         1.71       $87.05       $47.87       $17.41
   93970  S                Extremity study.....         0267         2.33      $118.61       $65.23       $23.72
   93971  S                Extremity study.....         0267         2.33      $118.61       $65.23       $23.72
   93975  S                Vascular study......         0267         2.33      $118.61       $65.23       $23.72
   93976  S                Vascular study......         0267         2.33      $118.61       $65.23       $23.72
   93978  S                Vascular study......         0267         2.33      $118.61       $65.23       $23.72
   93979  S                Vascular study......         0267         2.33      $118.61       $65.23       $23.72
   93980  S                Penile vascular              0267         2.33      $118.61       $65.23       $23.72
                            study.
   93981  S                Penile vascular              0267         2.33      $118.61       $65.23       $23.72
                            study.
   93990  S                Doppler flow testing         0267         2.33      $118.61       $65.23       $23.72
   94010  X                Breathing capacity           0367         0.70       $35.63       $17.82        $7.13
                            test.
   94014  X                Patient recorded             0367         0.70       $35.63       $17.82        $7.13
                            spirometry.
   94015  X                Patient recorded             0367         0.70       $35.63       $17.82        $7.13
                            spirometry.
   94016  X                Review patient               0369         3.49      $177.65       $58.50       $35.53
                            spirometry.
   94060  X                Evaluation of                0368         1.47       $74.83       $38.16       $14.97
                            wheezing.
   94070  X                Evaluation of                0368         1.47       $74.83       $38.16       $14.97
                            wheezing.
   94150  N                Vital capacity test.  ...........  ...........  ...........  ...........  ...........
   94200  X                Lung function test           0367         0.70       $35.63       $17.82        $7.13
                            (MBC/MVV).
   94240  X                Residual lung                0368         1.47       $74.83       $38.16       $14.97
                            capacity.
   94250  X                Expired gas                  0367         0.70       $35.63       $17.82        $7.13
                            collection.
   94260  X                Thoracic gas volume.         0368         1.47       $74.83       $38.16       $14.97
   94350  X                Lung nitrogen                0368         1.47       $74.83       $38.16       $14.97
                            washout curve.
   94360  X                Measure airflow              0368         1.47       $74.83       $38.16       $14.97
                            resistance.
   94370  X                Breath airway                0368         1.47       $74.83       $38.16       $14.97
                            closing volume.
   94375  X                Respiratory flow             0367         0.70       $35.63       $17.82        $7.13
                            volume loop.
   94400  X                CO2 breathing                0368         1.47       $74.83       $38.16       $14.97
                            response curve.
   94450  X                Hypoxia response             0367         0.70       $35.63       $17.82        $7.13
                            curve.
   94620  X                Pulmonary stress             0368         1.47       $74.83       $38.16       $14.97
                            test/simple.
   94621  X                Pulm stress test/            0369         3.49      $177.65       $58.50       $35.53
                            complex.
   94640  S                Airway inhalation            0077         0.39       $19.85       $10.91        $3.97
                            treatment.
   94642  S                Aerosol inhalation           0078         0.86       $43.78       $18.83        $8.76
                            treatment.
   94650  S                Pressure breathing           0077         0.39       $19.85       $10.91        $3.97
                            (IPPB).
   94651  S                Pressure breathing           0077         0.39       $19.85       $10.91        $3.97
                            (IPPB).
   94652  C                Pressure breathing    ...........  ...........  ...........  ...........  ...........
                            (IPPB).
   94656  S                Initial ventilator           0079         0.60       $30.54       $16.79        $6.11
                            mgmt.
   94657  S                Continued ventilator         0079         0.60       $30.54       $16.79        $6.11
                            mgmt.
   94660  S                Pos airway pressure,         0068         3.02      $153.73       $84.55       $30.75
                            CPAP.
   94662  S                Neg press                    0079         0.60       $30.54       $16.79        $6.11
                            ventilation, cnp.
   94664  S                Aerosol or vapor             0077         0.39       $19.85       $10.91        $3.97
                            inhalations.
   94665  S                Aerosol or vapor             0077         0.39       $19.85       $10.91        $3.97
                            inhalations.
   94667  S                Chest wall                   0077         0.39       $19.85       $10.91        $3.97
                            manipulation.
   94668  S                Chest wall                   0077         0.39       $19.85       $10.91        $3.97
                            manipulation.
   94680  X                Exhaled air                  0368         1.47       $74.83       $38.16       $14.97
                            analysis, o2.
   94681  X                Exhaled air                  0368         1.47       $74.83       $38.16       $14.97
                            analysis, o2/co2.
   94690  X                Exhaled air analysis         0367         0.70       $35.63       $17.82        $7.13
   94720  X                Monoxide diffusing           0367         0.70       $35.63       $17.82        $7.13
                            capacity.
   94725  X                Membrane diffusion           0368         1.47       $74.83       $38.16       $14.97
                            capacity.
   94750  X                Pulmonary compliance         0368         1.47       $74.83       $38.16       $14.97
                            study.
   94760  N                Measure blood oxygen  ...........  ...........  ...........  ...........  ...........
                            level.
   94761  N                Measure blood oxygen  ...........  ...........  ...........  ...........  ...........
                            level.
   94762  N                Measure blood oxygen  ...........  ...........  ...........  ...........  ...........
                            level.
   94770  X                Exhaled carbon               0367         0.70       $35.63       $17.82        $7.13
                            dioxide test.
   94772  X                Breath recording,            0369         3.49      $177.65       $58.50       $35.53
                            infant.
   94799  X                Pulmonary service/           0367         0.70       $35.63       $17.82        $7.13
                            procedure.

[[Page 60037]]

 
   95004  X                Allergy skin tests..         0370         0.80       $40.72       $11.81        $8.14
   95010  X                Sensitivity skin             0370         0.80       $40.72       $11.81        $8.14
                            tests.
   95015  X                Sensitivity skin             0370         0.80       $40.72       $11.81        $8.14
                            tests.
   95024  X                Allergy skin tests..         0370         0.80       $40.72       $11.81        $8.14
   95027  X                Skin end point               0370         0.80       $40.72       $11.81        $8.14
                            titration.
   95028  X                Allergy skin tests..         0370         0.80       $40.72       $11.81        $8.14
   95044  X                Allergy patch tests.         0370         0.80       $40.72       $11.81        $8.14
   95052  X                Photo patch test....         0370         0.80       $40.72       $11.81        $8.14
   95056  X                Photosensitivity             0370         0.80       $40.72       $11.81        $8.14
                            tests.
   95060  X                Eye allergy tests...         0370         0.80       $40.72       $11.81        $8.14
   95065  X                Nose allergy test...         0370         0.80       $40.72       $11.81        $8.14
   95070  X                Bronchial allergy            0369         3.49      $177.65       $58.50       $35.53
                            tests.
   95071  X                Bronchial allergy            0369         3.49      $177.65       $58.50       $35.53
                            tests.
   95075  X                Ingestion challenge          0361         3.25      $165.44       $82.72       $33.09
                            test.
   95078  X                Provocative testing.         0370         0.80       $40.72       $11.81        $8.14
   95115  X                Immunotherapy, one           0353         0.25       $12.73  ...........        $2.55
                            injection.
   95117  X                Immunotherapy                0353         0.25       $12.73  ...........        $2.55
                            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         0.70       $35.63  ...........        $7.13
                            services.
   95145  X                Antigen therapy              0371         0.70       $35.63  ...........        $7.13
                            services.
   95146  X                Antigen therapy              0371         0.70       $35.63  ...........        $7.13
                            services.
   95147  X                Antigen therapy              0371         0.70       $35.63  ...........        $7.13
                            services.
   95148  X                Antigen therapy              0371         0.70       $35.63  ...........        $7.13
                            services.
   95149  X                Antigen therapy              0371         0.70       $35.63  ...........        $7.13
                            services.
   95165  X                Antigen therapy              0371         0.70       $35.63  ...........        $7.13
                            services.
   95170  X                Antigen therapy              0371         0.70       $35.63  ...........        $7.13
                            services.
   95180  X                Rapid                        0370         0.80       $40.72       $11.81        $8.14
                            desensitization.
   95199  X                Allergy immunology           0370         0.80       $40.72       $11.81        $8.14
                            services.
  *95250  T                Glucose monitoring,          0972  ...........      $150.00  ...........       $30.00
                            cont.
   95805  S                Multiple sleep               0209        10.54      $536.53      $279.00      $107.31
                            latency test.
   95806  S                Sleep study,                 0213         2.65      $134.90       $70.15       $26.98
                            unattended.
   95807  S                Sleep study,                 0209        10.54      $536.53      $279.00      $107.31
                            attended.
   95808  S                Polysomnography, 1-3         0209        10.54      $536.53      $279.00      $107.31
   95810  S                Polysomnography, 4           0209        10.54      $536.53      $279.00      $107.31
                            or more.
   95811  S                Polysomnography w/           0209        10.54      $536.53      $279.00      $107.31
                            cpap.
   95812  S                Electroencephalogram         0213         2.65      $134.90       $70.15       $26.98
                            (EEG).
   95813  S                Electroencephalogram         0213         2.65      $134.90       $70.15       $26.98
                            (EEG).
   95816  S                Electroencephalogram         0214         2.10      $106.90       $53.45       $21.38
                            (EEG).
   95819  S                Electroencephalogram         0214         2.10      $106.90       $53.45       $21.38
                            (EEG).
   95822  S                Sleep                        0214         2.10      $106.90       $53.45       $21.38
                            electroencephalogra
                            m.
   95824  S                Electroencephalograp         0214         2.10      $106.90       $53.45       $21.38
                            hy.
   95827  S                Night                        0209        10.54      $536.53      $279.00      $107.31
                            electroencephalogra
                            m.
   95829  S                Surgery                      0214         2.10      $106.90       $53.45       $21.38
                            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         1.03       $52.43       $23.59       $10.49
   95858  S                Tensilon test &              0215         0.66       $33.60       $17.47        $6.72
                            myogram.
   95860  S                Muscle test, one             0218         1.03       $52.43       $23.59       $10.49
                            limb.
   95861  S                Muscle test, two             0218         1.03       $52.43       $23.59       $10.49
                            limbs.
   95863  S                Muscle test, 3 limbs         0218         1.03       $52.43       $23.59       $10.49
   95864  S                Muscle test, 4 limbs         0218         1.03       $52.43       $23.59       $10.49
   95867  S                Muscle test, head or         0218         1.03       $52.43       $23.59       $10.49
                            neck.
   95868  S                Muscle test, head or         0218         1.03       $52.43       $23.59       $10.49
                            neck.
   95869  S                Muscle test, thor            0215         0.66       $33.60       $17.47        $6.72
                            paraspinal.
   95870  S                Muscle test,                 0218         1.03       $52.43       $23.59       $10.49
                            nonparaspinal.
   95872  S                Muscle test, one             0215         0.66       $33.60       $17.47        $6.72
                            fiber.
   95875  S                Limb exercise test..         0215         0.66       $33.60       $17.47        $6.72
   95900  S                Motor nerve                  0218         1.03       $52.43       $23.59       $10.49
                            conduction test.
   95903  S                Motor nerve                  0218         1.03       $52.43       $23.59       $10.49
                            conduction test.
   95904  S                Sense/mixed n                0215         0.66       $33.60       $17.47        $6.72
                            conduction tst.
   95920  S                Intraop nerve test           0218         1.03       $52.43       $23.59       $10.49
                            add-on.
   95921  S                Autonomic nerv               0215         0.66       $33.60       $17.47        $6.72
                            function test.
   95922  S                Autonomic nerv               0215         0.66       $33.60       $17.47        $6.72
                            function test.
   95923  S                Autonomic nerv               0215         0.66       $33.60       $17.47        $6.72
                            function test.

[[Page 60038]]

 
   95925  S                Somatosensory                0216         2.61      $132.86       $59.79       $26.57
                            testing.
   95926  S                Somatosensory                0216         2.61      $132.86       $59.79       $26.57
                            testing.
   95927  S                Somatosensory                0216         2.61      $132.86       $59.79       $26.57
                            testing.
   95930  S                Visual evoked                0216         2.61      $132.86       $59.79       $26.57
                            potential test.
   95933  S                Blink reflex test...         0215         0.66       $33.60       $17.47        $6.72
   95934  S                H-reflex test.......         0215         0.66       $33.60       $17.47        $6.72
   95936  S                H-reflex test.......         0215         0.66       $33.60       $17.47        $6.72
   95937  S                Neuromuscular                0218         1.03       $52.43       $23.59       $10.49
                            junction test.
   95950  S                Ambulatory eeg               0213         2.65      $134.90       $70.15       $26.98
                            monitoring.
   95951  S                EEG monitoring/              0209        10.54      $536.53      $279.00      $107.31
                            videorecord.
   95953  S                EEG monitoring/              0209        10.54      $536.53      $279.00      $107.31
                            computer.
   95954  S                EEG monitoring/              0213         2.65      $134.90       $70.15       $26.98
                            giving drugs.
   95955  S                EEG during surgery..         0214         2.10      $106.90       $53.45       $21.38
   95956  N                Eeg monitoring,       ...........  ...........  ...........  ...........  ...........
                            cable/radio.
   95957  N                EEG digital analysis  ...........  ...........  ...........  ...........  ...........
   95958  S                EEG monitoring/              0213         2.65      $134.90       $70.15       $26.98
                            function test.
   95961  S                Electrode                    0216         2.61      $132.86       $59.79       $26.57
                            stimulation, brain.
   95962  S                Electrode stim,              0216         2.61      $132.86       $59.79       $26.57
                            brain add-on.
  *95965  T                Meg, spontaneous....         0972  ...........      $150.00  ...........       $30.00
  *95966  T                Meg, evoked, single.         0972  ...........      $150.00  ...........       $30.00
  *95967  T                Meg, evoked, each            0972  ...........      $150.00  ...........       $30.00
                            addl.
   95970  S                Analyze neurostim,           0692        14.34      $729.96      $401.47      $145.99
                            no prog.
   95971  S                Analyze neurostim,           0692        14.34      $729.96      $401.47      $145.99
                            simple.
   95972  S                Analyze neurostim,           0692        14.34      $729.96      $401.47      $145.99
                            complex.
   95973  S                Analyze neurostim,           0692        14.34      $729.96      $401.47      $145.99
                            complex.
   95974  S                Cranial neurostim,           0692        14.34      $729.96      $401.47      $145.99
                            complex.
   95975  S                Cranial neurostim,           0692        14.34      $729.96      $401.47      $145.99
                            complex.
   95999  N                Neurological          ...........  ...........  ...........  ...........  ...........
                            procedure.
  *96000  T                Motion analysis,             0972  ...........      $150.00  ...........       $30.00
                            video/3d.
  *96001  T                Motion test w/ft             0972  ...........      $150.00  ...........       $30.00
                            press meas.
  *96002  T                Dynamic surface emg.         0972  ...........      $150.00  ...........       $30.00
  *96003  T                Dynamic fine wire            0972  ...........      $150.00  ...........       $30.00
                            emg.
  *96004  E                Phys review of        ...........  ...........  ...........  ...........  ...........
                            motion tests.
   96100  X                Psychological                0373         1.00       $50.90       $14.25       $10.18
                            testing.
   96105  X                Assessment of                0373         1.00       $50.90       $14.25       $10.18
                            aphasia.
   96110  X                Developmental test,          0373         1.00       $50.90       $14.25       $10.18
                            lim.
   96111  X                Developmental test,          0373         1.00       $50.90       $14.25       $10.18
                            extend.
   96115  X                Neurobehavior status         0373         1.00       $50.90       $14.25       $10.18
                            exam.
   96117  X                Neuropsych test              0373         1.00       $50.90       $14.25       $10.18
                            battery.
  *96150  S                Assess hlth/behave,          0322         1.15       $58.54       $12.29       $11.71
                            init.
  *96151  S                Assess hlth/behave,          0322         1.15       $58.54       $12.29       $11.71
                            subseq.
  *96152  S                Intervene hlth/              0322         1.15       $58.54       $12.29       $11.71
                            behave, indiv.
  *96153  S                Intervene hlth/              0322         1.15       $58.54       $12.29       $11.71
                            behave, group.
  *96154  S                Interv hlth/behav,           0322         1.15       $58.54       $12.29       $11.71
                            fam w/pt.
  *96155  S                Interv hlth/behav            0322         1.15       $58.54       $12.29       $11.71
                            fam no pt.
   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         3.00      $152.71  ...........       $30.54
                            maintenance.
   96530  T                Pump refilling,              0125         3.00      $152.71  ...........       $30.54
                            maintenance.
   96542  E                Chemotherapy          ...........  ...........  ...........  ...........  ...........
                            injection.
   96545  E                Provide chemotherapy  ...........  ...........  ...........  ...........  ...........
                            agent.
   96549  E                Chemotherapy,         ...........  ...........  ...........  ...........  ...........
                            unspecified.
  *96567  T                Photodynamic tx,             0972  ...........      $150.00  ...........       $30.00
                            skin.
   96570  T                Photodynamic tx, 30          0973  ...........      $250.00  ...........       $50.00
                            min.
   96571  T                Photodynamic tx,             0973  ...........      $250.00  ...........       $50.00
                            addl 15 min.
   96900  S                Ultraviolet light            0001         0.43       $21.89        $7.88        $4.38
                            therapy.
   96902  N                Trichogram..........  ...........  ...........  ...........  ...........  ...........
   96910  S                Photochemotherapy            0001         0.43       $21.89        $7.88        $4.38
                            with UV-B.
   96912  S                Photochemotherapy            0001         0.43       $21.89        $7.88        $4.38
                            with UV-A.
   96913  S                Photochemotherapy,           0001         0.43       $21.89        $7.88        $4.38
                            UV-A or B.
   96999  S                Dermatological               0001         0.43       $21.89        $7.88        $4.38
                            procedure.
   97001  A                Pt evaluation.......  ...........  ...........  ...........  ...........  ...........
   97002  A                Pt re-evaluation....  ...........  ...........  ...........  ...........  ...........

[[Page 60039]]

 
   97003  A                Ot evaluation.......  ...........  ...........  ...........  ...........  ...........
   97004  A                Ot re-evaluation....  ...........  ...........  ...........  ...........  ...........
  *97005  E                Athletic train eval.  ...........  ...........  ...........  ...........  ...........
  *97006  E                Athletic train        ...........  ...........  ...........  ...........  ...........
                            reeval.
   97010  A                Hot or cold packs     ...........  ...........  ...........  ...........  ...........
                            therapy.
   97012  A                Mechanical traction   ...........  ...........  ...........  ...........  ...........
                            therapy.
   97014  A                Electric stimulation  ...........  ...........  ...........  ...........  ...........
                            therapy.
   97016  A                Vasopneumatic device  ...........  ...........  ...........  ...........  ...........
                            therapy.
   97018  A                Paraffin bath         ...........  ...........  ...........  ...........  ...........
                            therapy.
   97020  A                Microwave therapy...  ...........  ...........  ...........  ...........  ...........
   97022  A                Whirlpool therapy...  ...........  ...........  ...........  ...........  ...........
   97024  A                Diathermy treatment.  ...........  ...........  ...........  ...........  ...........
   97026  A                Infrared therapy....  ...........  ...........  ...........  ...........  ...........
   97028  A                Ultraviolet therapy.  ...........  ...........  ...........  ...........  ...........
   97032  A                Electrical            ...........  ...........  ...........  ...........  ...........
                            stimulation.
   97033  A                Electric current      ...........  ...........  ...........  ...........  ...........
                            therapy.
   97034  A                Contrast bath         ...........  ...........  ...........  ...........  ...........
                            therapy.
   97035  A                Ultrasound therapy..  ...........  ...........  ...........  ...........  ...........
   97036  A                Hydrotherapy........  ...........  ...........  ...........  ...........  ...........
   97039  A                Physical therapy      ...........  ...........  ...........  ...........  ...........
                            treatment.
   97110  A                Therapeutic           ...........  ...........  ...........  ...........  ...........
                            exercises.
   97112  A                Neuromuscular         ...........  ...........  ...........  ...........  ...........
                            reeducation.
   97113  A                Aquatic therapy/      ...........  ...........  ...........  ...........  ...........
                            exercises.
   97116  A                Gait training         ...........  ...........  ...........  ...........  ...........
                            therapy.
   97124  A                Massage therapy.....  ...........  ...........  ...........  ...........  ...........
   97139  A                Physical medicine     ...........  ...........  ...........  ...........  ...........
                            procedure.
   97140  A                Manual therapy......  ...........  ...........  ...........  ...........  ...........
   97150  A                Group therapeutic     ...........  ...........  ...........  ...........  ...........
                            procedures.
   97504  A                Orthotic training...  ...........  ...........  ...........  ...........  ...........
   97520  A                Prosthetic training.  ...........  ...........  ...........  ...........  ...........
   97530  A                Therapeutic           ...........  ...........  ...........  ...........  ...........
                            activities.
   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  A                Medical nutrition,    ...........  ...........  ...........  ...........  ...........
                            indiv, in.
   97803  A                Med nutrition,        ...........  ...........  ...........  ...........  ...........
                            indiv, subseq.
   97804  A                Medical nutrition,    ...........  ...........  ...........  ...........  ...........
                            group.
   98925  S                Osteopathic                  0060         0.23       $11.71  ...........        $2.34
                            manipulation.
   98926  S                Osteopathic                  0060         0.23       $11.71  ...........        $2.34
                            manipulation.
   98927  S                Osteopathic                  0060         0.23       $11.71  ...........        $2.34
                            manipulation.
   98928  S                Osteopathic                  0060         0.23       $11.71  ...........        $2.34
                            manipulation.
   98929  S                Osteopathic                  0060         0.23       $11.71  ...........        $2.34
                            manipulation.
   98940  S                Chiropractic                 0060         0.23       $11.71  ...........        $2.34
                            manipulation.
   98941  S                Chiropractic                 0060         0.23       $11.71  ...........        $2.34
                            manipulation.
   98942  S                Chiropractic                 0060         0.23       $11.71  ...........        $2.34
                            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  N                Group health          ...........  ...........  ...........  ...........  ...........
                            education.
   99080  E                Special reports or    ...........  ...........  ...........  ...........  ...........
                            forms.
   99082  E                Unusual physician     ...........  ...........  ...........  ...........  ...........
                            travel.
   99090  E                Computer data         ...........  ...........  ...........  ...........  ...........
                            analysis.
  *99091  E                Collect/review data   ...........  ...........  ...........  ...........  ...........
                            from pt.

[[Page 60040]]

 
   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         0.23       $11.71        $3.40        $2.34
                            child.
   99172  E                Ocular function       ...........  ...........  ...........  ...........  ...........
                            screen.
   99173  E                Visual acuity screen  ...........  ...........  ...........  ...........  ...........
   99175  N                Induction of          ...........  ...........  ...........  ...........  ...........
                            vomiting.
   99183  E                Hyperbaric oxygen     ...........  ...........  ...........  ...........  ...........
                            therapy.
   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         0.53       $26.98       $10.09        $5.40
   99199  E                Special service/proc/ ...........  ...........  ...........  ...........  ...........
                            report.
   99201  V                Office/outpatient            0600         0.86       $43.78  ...........        $8.76
                            visit, new.
   99202  V                Office/outpatient            0600         0.86       $43.78  ...........        $8.76
                            visit, new.
   99203  V                Office/outpatient            0601         0.95       $48.36  ...........        $9.67
                            visit, new.
   99204  V                Office/outpatient            0602         1.38       $70.25  ...........       $14.05
                            visit, new.
   99205  V                Office/outpatient            0602         1.38       $70.25  ...........       $14.05
                            visit, new.
   99211  V                Office/outpatient            0600         0.86       $43.78  ...........        $8.76
                            visit, est.
   99212  V                Office/outpatient            0600         0.86       $43.78  ...........        $8.76
                            visit, est.
   99213  V                Office/outpatient            0601         0.95       $48.36  ...........        $9.67
                            visit, est.
   99214  V                Office/outpatient            0602         1.38       $70.25  ...........       $14.05
                            visit, est.
   99215  V                Office/outpatient            0602         1.38       $70.25  ...........       $14.05
                            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         0.86       $43.78  ...........        $8.76
   99242  V                Office consultation.         0600         0.86       $43.78  ...........        $8.76
   99243  V                Office consultation.         0601         0.95       $48.36  ...........        $9.67
   99244  V                Office consultation.         0602         1.38       $70.25  ...........       $14.05
   99245  V                Office consultation.         0602         1.38       $70.25  ...........       $14.05
   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         0.86       $43.78  ...........        $8.76
                            consultation.
   99272  V                Confirmatory                 0600         0.86       $43.78  ...........        $8.76
                            consultation.
   99273  V                Confirmatory                 0601         0.95       $48.36  ...........        $9.67
                            consultation.
   99274  V                Confirmatory                 0602         1.38       $70.25  ...........       $14.05
                            consultation.
   99275  V                Confirmatory                 0602         1.38       $70.25  ...........       $14.05
                            consultation.
   99281  V                Emergency dept visit         0610         1.23       $62.61       $19.41       $12.52
   99282  V                Emergency dept visit         0610         1.23       $62.61       $19.41       $12.52
   99283  V                Emergency dept visit         0611         2.16      $109.95       $36.47       $21.99
   99284  V                Emergency dept visit         0612         3.49      $177.65       $54.14       $35.53
   99285  V                Emergency dept visit         0612         3.49      $177.65       $54.14       $35.53
   99288  E                Direct advanced life  ...........  ...........  ...........  ...........  ...........
                            support.
  *99289  N                Pt transport, 30-74   ...........  ...........  ...........  ...........  ...........
                            min.
  *99290  N                Pt transport, addl    ...........  ...........  ...........  ...........  ...........
                            30 min.
   99291  S                Critical care, first         0620         8.40      $427.59      $149.66       $85.52
                            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.

[[Page 60041]]

 
   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.
   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         6.08      $309.50      $105.29       $61.90
                            resuscitation.
   99450  E                Life/disability       ...........  ...........  ...........  ...........  ...........
                            evaluation.
   99455  E                Disability            ...........  ...........  ...........  ...........  ...........
                            examination.
   99456  E                Disability            ...........  ...........  ...........  ...........  ...........
                            examination.
   99499  E                Unlisted e&m service  ...........  ...........  ...........  ...........  ...........
  *99500  E                Home visit, prenatal  ...........  ...........  ...........  ...........  ...........
  *99501  E                Home visit,           ...........  ...........  ...........  ...........  ...........
                            postnatal.
  *99502  E                Home visit, nb care.  ...........  ...........  ...........  ...........  ...........
  *99503  E                Home visit, resp      ...........  ...........  ...........  ...........  ...........
                            therapy.

[[Page 60042]]

 
  *99504  E                Home visit mech       ...........  ...........  ...........  ...........  ...........
                            ventilator.
  *99505  E                Home visit, stoma     ...........  ...........  ...........  ...........  ...........
                            care.
  *99506  E                Home visit, im        ...........  ...........  ...........  ...........  ...........
                            injection.
  *99507  E                Home visit, cath      ...........  ...........  ...........  ...........  ...........
                            maintain.
  *99508  E                Home visit, sleep     ...........  ...........  ...........  ...........  ...........
                            studies.
  *99509  E                Home visit day life   ...........  ...........  ...........  ...........  ...........
                            activity.
  *99510  E                Home visit, sing/m/   ...........  ...........  ...........  ...........  ...........
                            fam couns.
  *99511  E                Home visit, fecal/    ...........  ...........  ...........  ...........  ...........
                            enema mgmt.
  *99512  E                Home visit,           ...........  ...........  ...........  ...........  ...........
                            hemodialysis.
  *99539  E                Home visit, nos.....  ...........  ...........  ...........  ...........  ...........
  *99551  E                Home infus, pain      ...........  ...........  ...........  ...........  ...........
                            mgmt, iv/sc.
  *99552  E                Hm infus pain mgmt,   ...........  ...........  ...........  ...........  ...........
                            epid/ith.
  *99553  E                Home infuse,          ...........  ...........  ...........  ...........  ...........
                            tocolytic tx.
  *99554  E                Home infus, hormone/  ...........  ...........  ...........  ...........  ...........
                            platelet.
  *99555  E                Home infuse,          ...........  ...........  ...........  ...........  ...........
                            chemotheraphy.
  *99556  E                Home infus, antibio/  ...........  ...........  ...........  ...........  ...........
                            fung/vir.
  *99557  E                Home infuse,          ...........  ...........  ...........  ...........  ...........
                            anticoagulant.
  *99558  E                Home infuse,          ...........  ...........  ...........  ...........  ...........
                            immunotherapy.
  *99559  E                Home infus, periton   ...........  ...........  ...........  ...........  ...........
                            dialysis.
  *99560  E                Home infus, entero    ...........  ...........  ...........  ...........  ...........
                            nutrition.
  *99561  E                Home infuse,          ...........  ...........  ...........  ...........  ...........
                            hydration tx.
  *99562  E                Home infus, parent    ...........  ...........  ...........  ...........  ...........
                            nutrition.
  *99563  E                Home admin,           ...........  ...........  ...........  ...........  ...........
                            pentamidine.
  *99564  E                Hme infus,            ...........  ...........  ...........  ...........  ...........
                            antihemophil agnt.
  *99565  E                Home infus,           ...........  ...........  ...........  ...........  ...........
                            proteinase inhib.
  *99566  E                Home infuse, iv       ...........  ...........  ...........  ...........  ...........
                            therapy.
  *99567  E                Home infuse, sympath  ...........  ...........  ...........  ...........  ...........
                            agent.
  *99568  E                Home infus, misc      ...........  ...........  ...........  ...........  ...........
                            drug, daily.
  *99569  E                Home infuse, each     ...........  ...........  ...........  ...........  ...........
                            addl tx.
   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.
   A0380  A                Basic life support    ...........  ...........  ...........  ...........  ...........
                            mileage.
   A0382  A                Basic support         ...........  ...........  ...........  ...........  ...........
                            routine suppls.
   A0384  A                Bls defibrillation    ...........  ...........  ...........  ...........  ...........
                            supplies.
   A0390  A                Advanced life         ...........  ...........  ...........  ...........  ...........
                            support mileage.
   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.

[[Page 60043]]

 
   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.
  *A4257  A                Replace Lensshield    ...........  ...........  ...........  ...........  ...........
                            Cartridge.
   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  E                Sacral nerve stim     ...........  ...........  ...........  ...........  ...........
                            test lead.
   A4300  E                Cath impl vasc        ...........  ...........  ...........  ...........  ...........
                            access portal.
   A4301  E                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.
   A4327  A                Fem urinary collect   ...........  ...........  ...........  ...........  ...........
                            dev cup.
   A4328  A                Fem urinary collect   ...........  ...........  ...........  ...........  ...........
                            pouch.
   A4329  D                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.
  *A4360  A                Adult incontinence    ...........  ...........  ...........  ...........  ...........
                            garment.
   A4361  A                Ostomy face plate...  ...........  ...........  ...........  ...........  ...........

[[Page 60044]]

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

[[Page 60045]]

 
   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  ...........    $1,591.25  ...........      $227.80
                            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  D                Supp esrd centrifuge  ...........  ...........  ...........  ...........  ...........
  *A4651  A                Calibrated microcap   ...........  ...........  ...........  ...........  ...........
                            tube.
  *A4652  A                Microcapillary tube   ...........  ...........  ...........  ...........  ...........
                            sealant.
   A4655  D                Esrd syringe/needle.  ...........  ...........  ...........  ...........  ...........
  *A4656  A                Dialysis needle.....  ...........  ...........  ...........  ...........  ...........
  *A4657  A                Dialysis syringe w/   ...........  ...........  ...........  ...........  ...........
                            wo 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  D                Standard dialysate    ...........  ...........  ...........  ...........  ...........
                            solution.
   A4705  D                Bicarb dialysate      ...........  ...........  ...........  ...........  ...........
                            solution.
  *A4706  A                Bicarbonate conc sol  ...........  ...........  ...........  ...........  ...........
                            per gal.
  *A4707  A                Bicarbonate conc pow  ...........  ...........  ...........  ...........  ...........
                            per pac.
  *A4708  A                Acetate conc sol per  ...........  ...........  ...........  ...........  ...........
                            gallon.
  *A4709  A                Acid conc sol per     ...........  ...........  ...........  ...........  ...........
                            gallon.
   A4712  A                Sterile water.......  ...........  ...........  ...........  ...........  ...........
   A4714  A                Treated water for     ...........  ...........  ...........  ...........  ...........
                            dialysis.
  *A4719  A                oY seto tubing......  ...........  ...........  ...........  ...........  ...........
  *A4720  A                Dialysat sol fld vol  ...........  ...........  ...........  ...........  ...........
                            > 249cc.
  *A4721  A                Dialysat sol fld vol  ...........  ...........  ...........  ...........  ...........
                            > 999cc.
  *A4722  A                Dialys sol fld vol >  ...........  ...........  ...........  ...........  ...........
                            1999cc.
  *A4723  A                Dialys sol fld vol >  ...........  ...........  ...........  ...........  ...........
                            2999cc.
  *A4724  A                Dialys sol fld vol >  ...........  ...........  ...........  ...........  ...........
                            3999cc.
  *A4725  A                Dialys sol fld vol >  ...........  ...........  ...........  ...........  ...........
                            4999cc.
  *A4726  A                Dialys sol fld vol >  ...........  ...........  ...........  ...........  ...........
                            5999cc.
   A4730  A                Fistula cannulation   ...........  ...........  ...........  ...........  ...........
                            set dial.
   A4735  D                Local/topical         ...........  ...........  ...........  ...........  ...........
                            anesthetics.
  *A4736  A                Topical anesthetic,   ...........  ...........  ...........  ...........  ...........
                            per gram.
  *A4737  A                Inj anesthetic per    ...........  ...........  ...........  ...........  ...........
                            10 ml.
   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.
  *A4766  A                Dialysate conc sol    ...........  ...........  ...........  ...........  ...........
                            add 10 ml.
   A4770  A                Blood testing         ...........  ...........  ...........  ...........  ...........
                            supplies.
   A4771  A                Blood clotting time   ...........  ...........  ...........  ...........  ...........
                            tube.
   A4772  A                Dextrostick/glucose   ...........  ...........  ...........  ...........  ...........
                            strips.
   A4773  A                Hemostix............  ...........  ...........  ...........  ...........  ...........
   A4774  A                Ammonia test paper..  ...........  ...........  ...........  ...........  ...........
   A4780  D                Esrd sterilizing      ...........  ...........  ...........  ...........  ...........
                            agent.
   A4790  D                Esrd cleansing        ...........  ...........  ...........  ...........  ...........
                            agents.
   A4800  D                Heparin/antidote      ...........  ...........  ...........  ...........  ...........
                            dialysis.
  *A4801  A                Heparin per 1000      ...........  ...........  ...........  ...........  ...........
                            units.
  *A4802  A                Protamine sulfate     ...........  ...........  ...........  ...........  ...........
                            per 50 mg.
   A4820  D                Supplies              ...........  ...........  ...........  ...........  ...........
                            hemodialysis kit.

[[Page 60046]]

 
   A4850  D                Rubber tipped         ...........  ...........  ...........  ...........  ...........
                            hemostats.
   A4860  A                Disposable catheter   ...........  ...........  ...........  ...........  ...........
                            caps.
   A4870  A                Plumbing/electrical   ...........  ...........  ...........  ...........  ...........
                            work.
   A4880  D                Water storage tanks.  ...........  ...........  ...........  ...........  ...........
   A4890  A                Contracts/repair/     ...........  ...........  ...........  ...........  ...........
                            maintenance.
   A4900  D                Capd supply kit.....  ...........  ...........  ...........  ...........  ...........
   A4901  D                Ccpd supply kit.....  ...........  ...........  ...........  ...........  ...........
   A4905  D                Ipd supply kit......  ...........  ...........  ...........  ...........  ...........
   A4910  D                Esrd nonmedical       ...........  ...........  ...........  ...........  ...........
                            supplies.
  *A4911  A                Drain bag/bottle....  ...........  ...........  ...........  ...........  ...........
   A4912  D                Gomco drain bottle..  ...........  ...........  ...........  ...........  ...........
   A4913  A                Esrd supply.........  ...........  ...........  ...........  ...........  ...........
   A4914  D                Preparation kit.....  ...........  ...........  ...........  ...........  ...........
   A4918  A                Venous pressure       ...........  ...........  ...........  ...........  ...........
                            clamp.
   A4919  D                Supp dialysis         ...........  ...........  ...........  ...........  ...........
                            dialyzer holde.
   A4920  D                Harvard pressure      ...........  ...........  ...........  ...........  ...........
                            clamp.
   A4921  D                Measuring cylinder..  ...........  ...........  ...........  ...........  ...........
   A4927  A                Gloves..............  ...........  ...........  ...........  ...........  ...........
  *A4928  A                Surgical mask.......  ...........  ...........  ...........  ...........  ...........
  *A4929  A                Tourniquet for        ...........  ...........  ...........  ...........  ...........
                            dialysis, ea.
   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  D                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  D                Urinary pouch w/      ...........  ...........  ...........  ...........  ...........
                            faceplate.
   A5075  D                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  D                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  ...........  ...........  ...........  ...........  ...........
  *A5509  A                Direct heat form      ...........  ...........  ...........  ...........  ...........
                            shoe insert.
  *A5510  A                Compression form      ...........  ...........  ...........  ...........  ...........
                            shoe insert.
  *A5511  A                Custom fab molded     ...........  ...........  ...........  ...........  ...........
                            shoe inser.
  *A6000  A                Wound warming wound   ...........  ...........  ...........  ...........  ...........
                            cover.
  *A6010  A                Collagen based wound  ...........  ...........  ...........  ...........  ...........
                            filler.
   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.

[[Page 60047]]

 
   A6202  A                Compos drsg >48 no    ...........  ...........  ...........  ...........  ...........
                            border.
   A6203  A                Composite drsg = 16   ...........  ...........  ...........  ...........  ...........
                            sq in.
   A6204  A                Composite drsg        ...........  ...........  ...........  ...........  ...........
                            >16=48 sq in.
   A6205  A                Composite drsg > 48   ...........  ...........  ...........  ...........  ...........
                            sq in.
   A6206  A                Contact layer = 16    ...........  ...........  ...........  ...........  ...........
                            sq in.
   A6207  A                Contact layer >16=    ...........  ...........  ...........  ...........  ...........
                            48 sq in.
   A6208  A                Contact layer > 48    ...........  ...........  ...........  ...........  ...........
                            sq in.
   A6209  A                Foam drsg =16 sq in   ...........  ...........  ...........  ...........  ...........
                            w/o bdr.
   A6210  A                Foam drg >16=48 sq    ...........  ...........  ...........  ...........  ...........
                            in w/o b.
   A6211  A                Foam drg > 48 sq in   ...........  ...........  ...........  ...........  ...........
                            w/o brdr.
   A6212  A                Foam drg =16 sq in w/ ...........  ...........  ...........  ...........  ...........
                            border.
   A6213  A                Foam drg >16=48 sq    ...........  ...........  ...........  ...........  ...........
                            in w/bdr.
   A6214  A                Foam drg > 48 sq in   ...........  ...........  ...........  ...........  ...........
                            w/border.
   A6215  A                Foam dressing wound   ...........  ...........  ...........  ...........  ...........
                            filler.
   A6216  A                Non-sterile gauze=16  ...........  ...........  ...........  ...........  ...........
                            sq in.
   A6217  A                Non-sterile           ...........  ...........  ...........  ...........  ...........
                            gauze>16=48 sq.
   A6218  A                Non-sterile gauze >   ...........  ...........  ...........  ...........  ...........
                            48 sq in.
   A6219  A                Gauze = 16 sq in w/   ...........  ...........  ...........  ...........  ...........
                            border.
   A6220  A                Gauze >16 =48 sq in   ...........  ...........  ...........  ...........  ...........
                            w/bordr.
   A6221  A                Gauze > 48 sq in w/   ...........  ...........  ...........  ...........  ...........
                            border.
   A6222  A                Gauze =16 in no w/    ...........  ...........  ...........  ...........  ...........
                            sal w/o b.
   A6223  A                Gauze >16=48 no w/    ...........  ...........  ...........  ...........  ...........
                            sal w/o b.
   A6224  A                Gauze > 48 in no w/   ...........  ...........  ...........  ...........  ...........
                            sal w/o b.
   A6228  A                Gauze = 16 sq in      ...........  ...........  ...........  ...........  ...........
                            water/sal.
   A6229  A                Gauze >16=48 sq in    ...........  ...........  ...........  ...........  ...........
                            watr/sal.
   A6230  A                Gauze > 48 sq in      ...........  ...........  ...........  ...........  ...........
                            water/salne.
   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.

[[Page 60048]]

 
   A7009  A                Nebulizer reservoir   ...........  ...........  ...........  ...........  ...........
                            bottle.
   A7010  A                Disposable            ...........  ...........  ...........  ...........  ...........
                            corrugated tubing.
   A7011  A                Nondispos corrugated  ...........  ...........  ...........  ...........  ...........
                            tubing.
   A7012  A                Nebulizer water       ...........  ...........  ...........  ...........  ...........
                            collec devic.
   A7013  A                Disposable            ...........  ...........  ...........  ...........  ...........
                            compressor filter.
   A7014  A                Compressor nondispos  ...........  ...........  ...........  ...........  ...........
                            filter.
   A7015  A                Aerosol mask used w   ...........  ...........  ...........  ...........  ...........
                            nebulize.
   A7016  A                Nebulizer dome &      ...........  ...........  ...........  ...........  ...........
                            mouthpiece.
   A7017  A                Nebulizer not used w  ...........  ...........  ...........  ...........  ...........
                            oxygen.
   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  D                Podiatrist non-       ...........  ...........  ...........  ...........  ...........
                            covered servi.
   A9170  D                Chiropractor non-     ...........  ...........  ...........  ...........  ...........
                            covered ser.
   A9190  D                Misc/expe personal    ...........  ...........  ...........  ...........  ...........
                            comfort i.
   A9270  E                Non-covered item or   ...........  ...........  ...........  ...........  ...........
                            service.
   A9300  E                Exercise equipment..  ...........  ...........  ...........  ...........  ...........
   A9500  G                Technetium TC 99m            1600  ...........      $121.70  ...........       $17.42
                            sestamibi.
   A9502  G                Technetium tc99m             0705  ...........      $114.00  ...........       $16.32
                            tetrofosmin, per
                            unit dose.
   A9503  G                Technetium TC 99m            1601  ...........       $42.18  ...........        $5.42
                            medronate.
   A9504  G                Technetium tc 99m            1602  ...........      $475.00  ...........       $68.00
                            apcitide.
   A9505  G                Thallous chloride TL         1603  ...........       $78.16  ...........        $7.08
                            201/mci.
   A9507  G                Indium/111 capromab          1604  ...........    $2,192.13  ...........      $313.82
                            pendetid, per dose.
   A9508  G                Iobenguane sulfate I-        1045  ...........      $495.65  ...........       $70.96
                            -31 per 0.5 mCi.
   A9510  G                Technetium TC99m             1205  ...........       $79.17  ...........       $11.33
                            Disofenin.
  *A9511  G                Technetium TC 99m            1095  ...........       $38.00  ...........        $5.44
                            depreotide.
   A9600  G                Strontium-89                 0701  ...........      $963.42  ...........      $137.92
                            chloride per mCi.
   A9605  G                Samarium sm153               0702  ...........    $1,020.00  ...........      $146.02
                            lexidronamm 50 mCi.
   A9700  G                Echocardiography             9016  ...........      $118.75  ...........       $17.00
                            contrast per study
                            [per 3 ml].
   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  D                Gastrostomy/          ...........  ...........  ...........  ...........  ...........
                            jejunostomy tubi.
   B4085  D                Gastrostomy tube w/   ...........  ...........  ...........  ...........  ...........
                            ring each.
  *B4086  A                Gastrostomy/          ...........  ...........  ...........  ...........  ...........
                            jejunostomy tube.
   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.

[[Page 60049]]

 
   B5200  A                Parenteral sol stres- ...........  ...........  ...........  ...........  ...........
                            brnch c.
   B9000  A                Enter infusion pump   ...........  ...........  ...........  ...........  ...........
                            w/o alrm.
   B9002  A                Enteral infusion      ...........  ...........  ...........  ...........  ...........
                            pump w/ ala.
   B9004  A                Parenteral infus      ...........  ...........  ...........  ...........  ...........
                            pump portab.
   B9006  A                Parenteral infus      ...........  ...........  ...........  ...........  ...........
                            pump statio.
   B9998  A                Enteral supp not      ...........  ...........  ...........  ...........  ...........
                            otherwise c.
   B9999  A                Parenteral supp not   ...........  ...........  ...........  ...........  ...........
                            othrws c.
   C1010  K                Blood, L/R, CMV-neg.         1010         2.72      $138.46  ...........       $27.69
   C1011  K                Platelets, HLA-m, L/         1011        11.21      $570.63  ...........      $114.13
                            R, unit.
   C1012  K                Platelet conc, L/R,          1012         1.81       $92.14  ...........       $18.43
                            irrad.
   C1013  K                Platelet conc, L/R,          1013         1.11       $56.50  ...........       $11.30
                            unit.
   C1014  K                Platelet,aph/pher, L/        1014         8.45      $430.14  ...........       $86.03
                            R, unit.
   C1016  K                Blood,l/r,froz/degly/        1016         6.76      $344.11  ...........       $68.82
                            washed.
   C1017  K                Plt, aph/pher,l/             1017         8.82      $448.97  ...........       $89.79
                            r,cmv-neg.
   C1018  K                Blood, L/R,                  1018         2.96      $150.68  ...........       $30.14
                            irradiated.
   C1019  D                Plt, APH,PHER, L/R,          1019         9.11      $463.74  ...........       $92.75
                            IRRAD.
   C1050  D                Prosorba Column.....         0976  ...........      $875.00  ...........      $175.00
  *C1058  G                TC 99M oxidronate,           1058  ...........       $36.74  ...........        $5.26
                            per vial.
  *C1064  G                I-131 cap, each add          1064  ...........        $5.86  ...........         $.75
                            mCi.
  *C1065  G                I-131 sol, each add          1065  ...........       $15.81  ...........        $2.03
                            mCi.
  *C1066  G                IN 111 satumomab             1066  ...........    $1,591.25  ...........      $227.80
                            pendetide.
   C1079  G                Co 57/58 0.5 uCi....         1079  ...........      $253.84  ...........       $36.34
   C1087  G                I-123 per 100 uCi...         1087  ...........         $.65  ...........         $.06
   C1088  T                Laser optic tr sys..         0980  ...........    $1,875.00  ...........      $375.00
   C1090  D                IN 111 chloride, per  ...........  ...........  ...........  ...........  ...........
                            mCi.
   C1091  G                IN111                        1091  ...........      $427.50  ...........       $61.20
                            oxyquinoline,per0.5
                            mCi.
   C1092  G                IN 111 pentetate,            1092  ...........      $256.50  ...........       $23.22
                            per 0.5 mCi.
   C1094  G                TC 99M albumin aggr,         1094  ...........       $33.09  ...........        $4.25
                            1.0 mCi.
   C1095  D                TC 99M Depreotide,           1095  ...........       $38.00  ...........        $5.44
                            per vial.
   C1096  G                TC 99M exametazime,          1096  ...........      $445.31  ...........       $63.75
                            per dose.
   C1097  G                TC 99M mebrofenin,           1097  ...........       $51.44  ...........        $7.36
                            per vial.
   C1098  G                TC 99M pentetate,            1098  ...........       $22.43  ...........        $2.88
                            per vial.
   C1099  G                TC 99M                       1099  ...........       $39.11  ...........        $5.60
                            pyrophosphate,per
                            vial.
   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  ...........       $26.48  ...........        $3.79
   C1188  G                I-131 cap, per 1-5           1188  ...........      $117.25  ...........       $15.06
                            mCi.
   C1200  G                TC 99M Sodium                1200  ...........       $22.61  ...........        $3.24
                            Glucoheptonat.
   C1201  G                TC 99M succimer, per         1201  ...........      $135.66  ...........       $19.42
                            vial.
   C1202  G                TC 99M sulfur                1202  ...........       $76.00  ...........        $9.76
                            colloid, dose.
   C1207  G                Octreotide acetate           1207  ...........      $138.08  ...........       $19.77
                            depot 1 mg.
   C1300  T                Hyperbaric oxygen...         0971  ...........       $75.00  ...........       $15.00
   C1305  G                Apligraf............         1305  ...........    $1,157.81  ...........      $165.75
   C1348  G                I-131 sol, per 1-6           1348  ...........      $146.57  ...........       $18.82
                            mCi.
   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                Brachytxseed, 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  D                Cath, ablation, non-  ...........  ...........  ...........  ...........  ...........
                            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              1730  ...........  ...........  ...........  ...........
                            fewer 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,                        1752  ...........  ...........  ...........  ...........
                            hemodialysis,short-
                            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                Cath, ureteral......         1758  ...........  ...........  ...........  ...........

[[Page 60050]]

 
   C1759  H                Cath, intra                  1759  ...........  ...........  ...........  ...........
                            echocardiography.
   C1760  H                Closure dev, vasc,           1760  ...........  ...........  ...........  ...........
                            imp/insert.
   C1762  H                Conn tiss, human             1762  ...........  ...........  ...........  ...........
                            (inc 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  ...........  ...........  ...........  ...........
   C1770  H                Imaging coil, MR,            1770  ...........  ...........  ...........  ...........
                            insertable.
   C1771  H                Rep dev, urinary, w/         1771  ...........  ...........  ...........  ...........
                            sling.
   C1772  H                Infusion pump,               1772  ...........  ...........  ...........  ...........
                            programmable.
   C1773  H                Retrieval dev,               1773  ...........  ...........  ...........  ...........
                            insert.
   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  ...........  ...........  ...........  ...........
   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/no-           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, imp..         1879  ...........  ...........  ...........  ...........
   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/                       1893  ...........  ...........  ...........  ...........
                            sheath,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 sys.
   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         7.15      $363.96      $200.17       $72.79
   C8901  S                MRA w/o cont, abd...         0336         6.29      $320.19      $176.10       $64.04
   C8902  S                MRA w/o fol w/cont,          0337         8.54      $434.72      $239.09       $86.94
                            abd.
   C8903  S                MRI w/cont, breast,          0284         7.15      $363.96      $200.17       $72.79
                            uni.
   C8904  S                MRI w/o cont,                0336         6.29      $320.19      $176.10       $64.04
                            breast, uni.
   C8905  S                MRI w/o fol w/cont,          0337         8.54      $434.72      $239.09       $86.94
                            brst, uni.
   C8906  S                MRI w/cont, breast,          0284         7.15      $363.96      $200.17       $72.79
                            bi.
   C8907  S                MRI w/o cont,                0336         6.29      $320.19      $176.10       $64.04
                            breast, bi.

[[Page 60051]]

 
   C8908  S                MRI w/o fol w/cont,          0337         8.54      $434.72      $239.09       $86.94
                            breast, bi.
   C8909  S                MRA w/cont, chest...         0284         7.15      $363.96      $200.17       $72.79
   C8910  S                MRA w/o cont, chest.         0336         6.29      $320.19      $176.10       $64.04
   C8911  S                MRA w/o fol w/cont,          0337         8.54      $434.72      $239.09       $86.94
                            chest.
   C8912  S                MRA w/cont, lwr ext.         0284         7.15      $363.96      $200.17       $72.79
   C8913  S                MRA w/o cont, lwr            0336         6.29      $320.19      $176.10       $64.04
                            ext.
   C8914  S                MRA w/o fol w/cont,          0337         8.54      $434.72      $239.09       $86.94
                            lwr ext.
   C9000  G                Na chromatecr51, per         9000  ...........         $.52  ...........         $.07
                            0.25mCi.
   C9001  D                Linezolid inj, 200           9001  ...........       $24.13  ...........        $3.45
                            mg.
   C9002  D                Tenecteplase, 50 mg/         9002  ...........    $2,612.50  ...........      $374.00
                            vial.
   C9003  G                Palivizumab, per 50          9003  ...........      $664.49  ...........       $95.13
                            mg.
   C9004  D                Gemtuzumab                   9004  ...........    $1,929.69  ...........      $276.25
                            ozogaminicin inj,
                            5m.
   C9006  D                Tacrolimus inj, per          9006  ...........      $113.15  ...........       $16.20
                            5 mg.
   C9007  G                Baclofen intrathecal         9007  ...........       $79.80  ...........       $11.42
                            kit-1amp.
   C9008  G                Baclofen Refill Kit-         9008  ...........       $11.69  ...........        $1.67
                            500 mcg.
   C9009  G                Baclofen Refill Kit-         9009  ...........       $49.12  ...........        $7.03
                            2000 mcg.
   C9010  G                Baclofen refill kitu         9010  ...........       $43.08  ...........        $6.17
                            per 4000 mcg.
   C9011  D                Caffeine Citrate,            9011  ...........        $3.05  ...........         $.44
                            inj, 1ml.
   C9012  D                Injection, arsenic           9012  ...........       $23.75  ...........        $3.40
                            trioxide.
   C9013  G                Co 57 cobaltous              9013  ...........       $81.10  ...........       $10.41
                            chloride.
   C9018  D                Botulinum tox B, per         9018  ...........        $8.79  ...........        $1.26
                            100 u.
   C9019  G                Caspofungin acetate,         9019  ...........       $34.20  ...........        $4.90
                            per 5 mg.
   C9020  G                Sirolimus tablet, 1          9020  ...........        $6.51  ...........         $.93
                            mg.
   C9100  G                Iodinated I-131              9100  ...........       $10.34  ...........        $1.48
                            Albumin.
   C9102  G                51 Na Chromate,              9102  ...........       $64.84  ...........        $9.28
                            50mCi.
   C9103  G                Na Iothalamate I-            9103  ...........       $17.18  ...........        $2.46
                            125, 10 uCi.
   C9104  D                Anti-thymocyct               9104  ...........      $325.09  ...........       $46.54
                            globulin, 25 mg.
   C9105  G                Hep B imm glob, per          9105  ...........      $133.00  ...........       $17.08
                            1 ml.
   C9108  G                Thyrotropin alfa,            9108  ...........      $531.05  ...........       $76.02
                            1.1 mg.
   C9109  G                Tirofiban hcl, 6.25          9109  ...........      $207.81  ...........       $29.75
                            mg.
   C9110  G                Alemtuzumab, per 10          9110  ...........      $486.88  ...........       $69.70
                            mg/ml.
  *C9111  G                Inj, bivalirudin,            9111  ...........      $397.81  ...........       $56.95
                            250 mg vial.
  *C9112  G                Perflutren lipid             9112  ...........      $148.20  ...........       $21.22
                            micro, 2ml.
  *C9113  G                Inj pantoprazole             9113  ...........       $22.80  ...........        $3.26
                            sodium, vial.
  *C9114  G                Nesiritide, per 1.5          9114  ...........      $433.20  ...........       $62.02
                            mg vial.
  *C9115  G                Inj, zoledronic              9115  ...........      $406.78  ...........       $58.23
                            acid, 2 mg.
  *C9200  G                Orcel, per 36 cm2...         9200  ...........    $1,135.25  ...........      $162.52
  *C9201  G                Dermagraft, per 37.5         9201  ...........      $577.60  ...........       $82.69
                            sq cm.
   C9503  K                Fresh frozen plasma,         9503         1.56       $79.41  ...........       $15.88
                            ea unit.
   C9506  D                Granulocytes,                9506        27.75    $1,412.59  ...........      $282.52
                            pheresis.
   C9700  D                Water induced thermo         0977  ...........    $1,125.00  ...........      $225.00
   C9701  T                Stretta procedure...         0980  ...........    $1,875.00  ...........      $375.00
   C9702  D                Chkmate/Novost/              0981  ...........    $2,250.00  ...........      $450.00
                            Galileo Brach.
  *C9703  T                Bard Endoscopic              0979  ...........    $1,625.00  ...........      $325.00
                            Suturing Sys.
   C9708  T                Preview Tx Planning          0975  ...........      $625.00  ...........      $125.00
                            Software.
   C9711  T                H.E.L.P. Apheresis           0978  ...........    $1,375.00  ...........      $275.00
                            System.
   D0120  E                Periodic oral         ...........  ...........  ...........  ...........  ...........
                            evaluation.
   D0140  E                Limit oral eval       ...........  ...........  ...........  ...........  ...........
                            problm focus.
   D0150  S                Comprehensve oral            0330        10.97      $558.42  ...........      $111.68
                            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        10.97      $558.42  ...........      $111.68
                            film.
   D0250  S                Extraoral first film         0330        10.97      $558.42  ...........      $111.68
   D0260  S                Extraoral ea                 0330        10.97      $558.42  ...........      $111.68
                            additional film.
   D0270  S                Dental bitewing              0330        10.97      $558.42  ...........      $111.68
                            single film.
   D0272  S                Dental bitewings two         0330        10.97      $558.42  ...........      $111.68
                            films.
   D0274  S                Dental bitewings             0330        10.97      $558.42  ...........      $111.68
                            four films.
   D0277  S                Vert bitewings-sev           0330        10.97      $558.42  ...........      $111.68
                            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        10.97      $558.42  ...........      $111.68
   D0470  E                Diagnostic casts....  ...........  ...........  ...........  ...........  ...........
   D0472  S                Gross exam, prep &           0330        10.97      $558.42  ...........      $111.68
                            report.
   D0473  S                Micro exam, prep &           0330        10.97      $558.42  ...........      $111.68
                            report.

[[Page 60052]]

 
   D0474  S                Micro w exam of surg         0330        10.97      $558.42  ...........      $111.68
                            margins.
   D0480  S                Cytopath smear prep          0330        10.97      $558.42  ...........      $111.68
                            & report.
   D0501  S                Histopathologic              0330        10.97      $558.42  ...........      $111.68
                            examinations.
   D0502  S                Other oral pathology         0330        10.97      $558.42  ...........      $111.68
                            procedu.
   D0999  S                Unspecified                  0330        10.97      $558.42  ...........      $111.68
                            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        10.97      $558.42  ...........      $111.68
                            unilat.
   D1515  S                Fixed bilat space            0330        10.97      $558.42  ...........      $111.68
                            maintainer.
   D1520  S                Remove unilat space          0330        10.97      $558.42  ...........      $111.68
                            maintain.
   D1525  S                Remove bilat space           0330        10.97      $558.42  ...........      $111.68
                            maintain.
   D1550  S                Recement space               0330        10.97      $558.42  ...........      $111.68
                            maintainer.
   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.

[[Page 60053]]

 
   D2791  E                Crown full cast base  ...........  ...........  ...........  ...........  ...........
                            metal.
   D2792  E                Crown full cast       ...........  ...........  ...........  ...........  ...........
                            noble metal.
   D2799  E                Provisional crown...  ...........  ...........  ...........  ...........  ...........
   D2910  E                Dental recement       ...........  ...........  ...........  ...........  ...........
                            inlay.
   D2920  E                Dental recement       ...........  ...........  ...........  ...........  ...........
                            crown.
   D2930  E                Prefab stnlss steel   ...........  ...........  ...........  ...........  ...........
                            crwn pri.
   D2931  E                Prefab stnlss steel   ...........  ...........  ...........  ...........  ...........
                            crown pe.
   D2932  E                Prefabricated resin   ...........  ...........  ...........  ...........  ...........
                            crown.
   D2933  E                Prefab stainless      ...........  ...........  ...........  ...........  ...........
                            steel crown.
   D2940  E                Dental sedative       ...........  ...........  ...........  ...........  ...........
                            filling.
   D2950  E                Core build-up incl    ...........  ...........  ...........  ...........  ...........
                            any pins.
   D2951  E                Tooth pin retention.  ...........  ...........  ...........  ...........  ...........
   D2952  E                Post and core cast +  ...........  ...........  ...........  ...........  ...........
                            crown.
   D2953  E                Each addtnl cast      ...........  ...........  ...........  ...........  ...........
                            post.
   D2954  E                Prefab post/core +    ...........  ...........  ...........  ...........  ...........
                            crown.
   D2955  E                Post removal........  ...........  ...........  ...........  ...........  ...........
   D2957  E                Each addtnl prefab    ...........  ...........  ...........  ...........  ...........
                            post.
   D2960  E                Laminate labial       ...........  ...........  ...........  ...........  ...........
                            veneer.
   D2961  E                Lab labial veneer     ...........  ...........  ...........  ...........  ...........
                            resin.
   D2962  E                Lab labial veneer     ...........  ...........  ...........  ...........  ...........
                            porcelain.
   D2970  S                Temporary- fractured         0330        10.97      $558.42  ...........      $111.68
                            tooth.
   D2980  E                Crown repair........  ...........  ...........  ...........  ...........  ...........
   D2999  S                Dental unspec                0330        10.97      $558.42  ...........      $111.68
                            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        10.97      $558.42  ...........      $111.68
                            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        10.97      $558.42  ...........      $111.68
   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        10.97      $558.42  ...........      $111.68
                            quadrant.
   D4263  S                Bone replce graft            0330        10.97      $558.42  ...........      $111.68
                            first site.
   D4264  S                Bone replce graft            0330        10.97      $558.42  ...........      $111.68
                            each add.
   D4266  E                Guided tiss regen     ...........  ...........  ...........  ...........  ...........
                            resorble.
   D4267  E                Guided tiss regen     ...........  ...........  ...........  ...........  ...........
                            nonresorb.
   D4268  S                Surgical revision            0330        10.97      $558.42  ...........      $111.68
                            procedure.
   D4270  S                Pedicle soft tissue          0330        10.97      $558.42  ...........      $111.68
                            graft pr.
   D4271  S                Free soft tissue             0330        10.97      $558.42  ...........      $111.68
                            graft proc.
   D4273  S                Subepithelial tissue         0330        10.97      $558.42  ...........      $111.68
                            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        10.97      $558.42  ...........      $111.68
                            debridement.
   D4381  S                Localized chemo              0330        10.97      $558.42  ...........      $111.68
                            delivery.
   D4910  E                Periodontal maint     ...........  ...........  ...........  ...........  ...........
                            procedures.

[[Page 60054]]

 
   D4920  E                Unscheduled dressing  ...........  ...........  ...........  ...........  ...........
                            change.
   D4999  E                Unspecified           ...........  ...........  ...........  ...........  ...........
                            periodontal proc.
   D5110  E                Dentures complete     ...........  ...........  ...........  ...........  ...........
                            maxillary.
   D5120  E                Dentures complete     ...........  ...........  ...........  ...........  ...........
                            mandible.
   D5130  E                Dentures immediat     ...........  ...........  ...........  ...........  ...........
                            maxillary.
   D5140  E                Dentures immediat     ...........  ...........  ...........  ...........  ...........
                            mandible.
   D5211  E                Dentures maxill part  ...........  ...........  ...........  ...........  ...........
                            resin.
   D5212  E                Dentures mand part    ...........  ...........  ...........  ...........  ...........
                            resin.
   D5213  E                Dentures maxill part  ...........  ...........  ...........  ...........  ...........
                            metal.
   D5214  E                Dentures mandibl      ...........  ...........  ...........  ...........  ...........
                            part metal.
   D5281  E                Removable partial     ...........  ...........  ...........  ...........  ...........
                            denture.
   D5410  E                Dentures adjust       ...........  ...........  ...........  ...........  ...........
                            cmplt maxil.
   D5411  E                Dentures adjust       ...........  ...........  ...........  ...........  ...........
                            cmplt mand.
   D5421  E                Dentures adjust part  ...........  ...........  ...........  ...........  ...........
                            maxill.
   D5422  E                Dentures adjust part  ...........  ...........  ...........  ...........  ...........
                            mandbl.
   D5510  E                Dentur repr broken    ...........  ...........  ...........  ...........  ...........
                            compl bas.
   D5520  E                Replace denture       ...........  ...........  ...........  ...........  ...........
                            teeth complt.
   D5610  E                Dentures repair       ...........  ...........  ...........  ...........  ...........
                            resin base.
   D5620  E                Rep part denture      ...........  ...........  ...........  ...........  ...........
                            cast frame.
   D5630  E                Rep partial denture   ...........  ...........  ...........  ...........  ...........
                            clasp.
   D5640  E                Replace part denture  ...........  ...........  ...........  ...........  ...........
                            teeth.
   D5650  E                Add tooth to partial  ...........  ...........  ...........  ...........  ...........
                            denture.
   D5660  E                Add clasp to partial  ...........  ...........  ...........  ...........  ...........
                            denture.
   D5710  E                Dentures rebase       ...........  ...........  ...........  ...........  ...........
                            cmplt maxil.
   D5711  E                Dentures rebase       ...........  ...........  ...........  ...........  ...........
                            cmplt mand.
   D5720  E                Dentures rebase part  ...........  ...........  ...........  ...........  ...........
                            maxill.
   D5721  E                Dentures rebase part  ...........  ...........  ...........  ...........  ...........
                            mandbl.
   D5730  E                Denture reln cmplt    ...........  ...........  ...........  ...........  ...........
                            maxil ch.
   D5731  E                Denture reln cmplt    ...........  ...........  ...........  ...........  ...........
                            mand chr.
   D5740  E                Denture reln part     ...........  ...........  ...........  ...........  ...........
                            maxil chr.
   D5741  E                Denture reln part     ...........  ...........  ...........  ...........  ...........
                            mand chr.
   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        10.97      $558.42  ...........      $111.68
                            sectional.
   D5912  S                Facial moulage               0330        10.97      $558.42  ...........      $111.68
                            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.

[[Page 60055]]

 
   D5959  E                Intraoral con def     ...........  ...........  ...........  ...........  ...........
                            mod palat.
   D5960  E                Modify speech aid     ...........  ...........  ...........  ...........  ...........
                            prosthesis.
   D5982  E                Surgical stent......  ...........  ...........  ...........  ...........  ...........
   D5983  S                Radiation applicator         0330        10.97      $558.42  ...........      $111.68
   D5984  S                Radiation shield....         0330        10.97      $558.42  ...........      $111.68
   D5985  S                Radiation cone               0330        10.97      $558.42  ...........      $111.68
                            locator.
   D5986  E                Fluoride applicator.  ...........  ...........  ...........  ...........  ...........
   D5987  S                Commissure splint...         0330        10.97      $558.42  ...........      $111.68
   D5988  E                Surgical splint.....  ...........  ...........  ...........  ...........  ...........
   D5999  E                Maxillofacial         ...........  ...........  ...........  ...........  ...........
                            prosthesis.
   D6010  E                Odontics endosteal    ...........  ...........  ...........  ...........  ...........
                            implant.
   D6020  E                Odontics abutment     ...........  ...........  ...........  ...........  ...........
                            placement.
   D6040  E                Odontics eposteal     ...........  ...........  ...........  ...........  ...........
                            implant.
   D6050  E                Odontics transosteal  ...........  ...........  ...........  ...........  ...........
                            implnt.
   D6055  E                Implant connecting    ...........  ...........  ...........  ...........  ...........
                            bar.
   D6056  E                Prefabricated         ...........  ...........  ...........  ...........  ...........
                            abutment.
   D6057  E                Custom abutment.....  ...........  ...........  ...........  ...........  ...........
   D6058  E                Abutment supported    ...........  ...........  ...........  ...........  ...........
                            crown.
   D6059  E                Abutment supported    ...........  ...........  ...........  ...........  ...........
                            mtl crown.
   D6060  E                Abutment supported    ...........  ...........  ...........  ...........  ...........
                            mtl crown.
   D6061  E                Abutment supported    ...........  ...........  ...........  ...........  ...........
                            mtl crown.
   D6062  E                Abutment supported    ...........  ...........  ...........  ...........  ...........
                            mtl crown.
   D6063  E                Abutment supported    ...........  ...........  ...........  ...........  ...........
                            mtl crown.
   D6064  E                Abutment supported    ...........  ...........  ...........  ...........  ...........
                            mtl crown.
   D6065  E                Implant supported     ...........  ...........  ...........  ...........  ...........
                            crown.
   D6066  E                Implant supported     ...........  ...........  ...........  ...........  ...........
                            mtl crown.
   D6067  E                Implant supported     ...........  ...........  ...........  ...........  ...........
                            mtl crown.
   D6068  E                Abutment supported    ...........  ...........  ...........  ...........  ...........
                            retainer.
   D6069  E                Abutment supported    ...........  ...........  ...........  ...........  ...........
                            retainer.
   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.

[[Page 60056]]

 
   D6920  S                Dental connector bar         0330        10.97      $558.42  ...........      $111.68
   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        10.97      $558.42  ...........      $111.68
                            tooth.
   D7120  S                Each add tooth               0330        10.97      $558.42  ...........      $111.68
                            extraction.
   D7130  S                Tooth root removal..         0330        10.97      $558.42  ...........      $111.68
   D7210  S                Rem imp tooth w              0330        10.97      $558.42  ...........      $111.68
                            mucoper flp.
   D7220  S                Impact tooth remov           0330        10.97      $558.42  ...........      $111.68
                            soft tiss.
   D7230  S                Impact tooth remov           0330        10.97      $558.42  ...........      $111.68
                            part bony.
   D7240  S                Impact tooth remov           0330        10.97      $558.42  ...........      $111.68
                            comp bony.
   D7241  S                Impact tooth rem             0330        10.97      $558.42  ...........      $111.68
                            bony w/comp.
   D7250  S                Tooth root removal..         0330        10.97      $558.42  ...........      $111.68
   D7260  S                Oral antral fistula          0330        10.97      $558.42  ...........      $111.68
                            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        10.97      $558.42  ...........      $111.68
                            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.

[[Page 60057]]

 
   D7850  E                Tmj meniscectomy....  ...........  ...........  ...........  ...........  ...........
   D7852  E                Tmj repair of joint   ...........  ...........  ...........  ...........  ...........
                            disc.
   D7854  E                Tmj excisn of joint   ...........  ...........  ...........  ...........  ...........
                            membrane.
   D7856  E                Tmj cutting of a      ...........  ...........  ...........  ...........  ...........
                            muscle.
   D7858  E                Tmj reconstruction..  ...........  ...........  ...........  ...........  ...........
   D7860  E                Tmj cutting into      ...........  ...........  ...........  ...........  ...........
                            joint.
   D7865  E                Tmj reshaping         ...........  ...........  ...........  ...........  ...........
                            components.
   D7870  E                Tmj aspiration joint  ...........  ...........  ...........  ...........  ...........
                            fluid.
   D7871  E                Lysis + lavage w      ...........  ...........  ...........  ...........  ...........
                            catheters.
   D7872  E                Tmj diagnostic        ...........  ...........  ...........  ...........  ...........
                            arthroscopy.
   D7873  E                Tmj arthroscopy       ...........  ...........  ...........  ...........  ...........
                            lysis adhesn.
   D7874  E                Tmj arthroscopy disc  ...........  ...........  ...........  ...........  ...........
                            reposit.
   D7875  E                Tmj arthroscopy       ...........  ...........  ...........  ...........  ...........
                            synovectomy.
   D7876  E                Tmj arthroscopy       ...........  ...........  ...........  ...........  ...........
                            discectomy.
   D7877  E                Tmj arthroscopy       ...........  ...........  ...........  ...........  ...........
                            debridement.
   D7880  E                Occlusal orthotic     ...........  ...........  ...........  ...........  ...........
                            appliance.
   D7899  E                Tmj unspecified       ...........  ...........  ...........  ...........  ...........
                            therapy.
   D7910  E                Dent sutur recent     ...........  ...........  ...........  ...........  ...........
                            wnd to 5cm.
   D7911  E                Dental suture wound   ...........  ...........  ...........  ...........  ...........
                            to 5 cm.
   D7912  E                Suture complicate     ...........  ...........  ...........  ...........  ...........
                            wnd > 5 cm.
   D7920  E                Dental skin graft...  ...........  ...........  ...........  ...........  ...........
   D7940  S                Reshaping bone               0330        10.97      $558.42  ...........      $111.68
                            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.  ...........  ...........  ...........  ...........  ...........

[[Page 60058]]

 
   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        10.97      $558.42  ...........      $111.68
                            medicaments.
   D9910  E                Dent appl             ...........  ...........  ...........  ...........  ...........
                            desensitizing med.
   D9911  E                Appl desensitizing    ...........  ...........  ...........  ...........  ...........
                            resin.
   D9920  E                Behavior management.  ...........  ...........  ...........  ...........  ...........
   D9930  S                Treatment of                 0330        10.97      $558.42  ...........      $111.68
                            complications.
   D9940  S                Dental occlusal              0330        10.97      $558.42  ...........      $111.68
                            guard.
   D9941  E                Fabrication athletic  ...........  ...........  ...........  ...........  ...........
                            guard.
   D9950  S                Occlusion analysis..         0330        10.97      $558.42  ...........      $111.68
   D9951  S                Limited occlusal             0330        10.97      $558.42  ...........      $111.68
                            adjustment.
   D9952  S                Complete occlusal            0330        10.97      $558.42  ...........      $111.68
                            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.
   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.
  *E0169  A                Seatlift incorp       ...........  ...........  ...........  ...........  ...........
                            commodechair.
   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...  ...........  ...........  ...........  ...........  ...........

[[Page 60059]]

 
   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....  ...........  ...........  ...........  ...........  ...........
  *E0221  A                Infrared heating pad  ...........  ...........  ...........  ...........  ...........
                            system.
   E0225  A                Hydrocollator unit..  ...........  ...........  ...........  ...........  ...........
   E0230  A                Ice cap or collar...  ...........  ...........  ...........  ...........  ...........
  *E0231  A                Wound warming device  ...........  ...........  ...........  ...........  ...........
  *E0232  A                Warming card for NWT  ...........  ...........  ...........  ...........  ...........
   E0235  A                Paraffin bath unit    ...........  ...........  ...........  ...........  ...........
                            portable.
   E0236  A                Pump for water        ...........  ...........  ...........  ...........  ...........
                            circulating p.
   E0238  A                Heat pad non-         ...........  ...........  ...........  ...........  ...........
                            electric moist.
   E0239  A                Hydrocollator unit    ...........  ...........  ...........  ...........  ...........
                            portable.
   E0241  E                Bath tub wall rail..  ...........  ...........  ...........  ...........  ...........
   E0242  E                Bath tub rail floor.  ...........  ...........  ...........  ...........  ...........
   E0243  E                Toilet rail.........  ...........  ...........  ...........  ...........  ...........
   E0244  E                Toilet seat raised..  ...........  ...........  ...........  ...........  ...........
   E0245  E                Tub stool or bench..  ...........  ...........  ...........  ...........  ...........
   E0246  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  D                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.
  *E0316  A                Bed safety enclosure  ...........  ...........  ...........  ...........  ...........
   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.

[[Page 60060]]

 
   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.
  *E0481  A                Intrpulmnry percuss   ...........  ...........  ...........  ...........  ...........
                            vent sys.
  *E0482  A                Cough stimulating     ...........  ...........  ...........  ...........  ...........
                            device.
   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.
   E0602  E                Breast pump.........  ...........  ...........  ...........  ...........  ...........
  *E0603  A                Electric breast pump  ...........  ...........  ...........  ...........  ...........
  *E0604  A                Hosp grade elec       ...........  ...........  ...........  ...........  ...........
                            breast pump.
   E0605  A                Vaporizer room type.  ...........  ...........  ...........  ...........  ...........
   E0606  A                Drainage board        ...........  ...........  ...........  ...........  ...........
                            postural.
   E0607  A                Blood glucose         ...........  ...........  ...........  ...........  ...........
                            monitor home.
   E0608  A                Apnea monitor.......  ...........  ...........  ...........  ...........  ...........
   E0609  D                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.
  *E0620  A                Cap bld skin          ...........  ...........  ...........  ...........  ...........
                            piercing laser.
   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.
  *E0752  E                Neurostimulator       ...........  ...........  ...........  ...........  ...........
                            electrode.
   E0753  D                Neurostimulator       ...........  ...........  ...........  ...........  ...........
                            electrodes.

[[Page 60061]]

 
  *E0754  A                Pulsegenerator pt     ...........  ...........  ...........  ...........  ...........
                            programmer.
   E0755  E                Electronic salivary   ...........  ...........  ...........  ...........  ...........
                            reflex s.
   E0756  E                Implantable pulse     ...........  ...........  ...........  ...........  ...........
                            generator.
   E0757  E                Implantable RF        ...........  ...........  ...........  ...........  ...........
                            receiver.
   E0758  A                External RF           ...........  ...........  ...........  ...........  ...........
                            transmitter.
  *E0759  A                Replace rdfrquncy     ...........  ...........  ...........  ...........  ...........
                            transmittr.
   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  E                Non-programble        ...........  ...........  ...........  ...........  ...........
                            infusion pump.
   E0783  E                Programmable          ...........  ...........  ...........  ...........  ...........
                            infusion pump.
   E0784  A                Ext amb infusn pump   ...........  ...........  ...........  ...........  ...........
                            insulin.
   E0785  E                Replacement impl      ...........  ...........  ...........  ...........  ...........
                            pump cathet.
   E0786  E                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.
   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  A                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  A                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.

[[Page 60062]]

 
   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  A                Whelchr fxd full      ...........  ...........  ...........  ...........  ...........
                            length arms.
   E1060  A                Wheelchair            ...........  ...........  ...........  ...........  ...........
                            detachable arms.
   E1065  E                Wheelchair power      ...........  ...........  ...........  ...........  ...........
                            attachment.
   E1066  E                Wheelchair battery    ...........  ...........  ...........  ...........  ...........
                            charger.
   E1069  E                Wheelchair deep       ...........  ...........  ...........  ...........  ...........
                            cycle batter.
   E1070  A                Wheelchair            ...........  ...........  ...........  ...........  ...........
                            detachable foot r.
   E1083  A                Hemi-wheelchair       ...........  ...........  ...........  ...........  ...........
                            fixed arms.
   E1084  A                Hemi-wheelchair       ...........  ...........  ...........  ...........  ...........
                            detachable a.
   E1085  A                Hemi-wheelchair       ...........  ...........  ...........  ...........  ...........
                            fixed arms.
   E1086  A                Hemi-wheelchair       ...........  ...........  ...........  ...........  ...........
                            detachable a.
   E1087  A                Wheelchair lightwt    ...........  ...........  ...........  ...........  ...........
                            fixed arm.
   E1088  A                Wheelchair            ...........  ...........  ...........  ...........  ...........
                            lightweight det a.
   E1089  A                Wheelchair lightwt    ...........  ...........  ...........  ...........  ...........
                            fixed arm.
   E1090  A                Wheelchair            ...........  ...........  ...........  ...........  ...........
                            lightweight det a.
   E1091  A                Wheelchair youth....  ...........  ...........  ...........  ...........  ...........
   E1092  A                Wheelchair wide w/    ...........  ...........  ...........  ...........  ...........
                            leg rests.
   E1093  A                Wheelchair wide w/    ...........  ...........  ...........  ...........  ...........
                            foot rest.
   E1100  A                Whchr s-recl fxd arm  ...........  ...........  ...........  ...........  ...........
                            leg res.
   E1110  A                Wheelchair semi-recl  ...........  ...........  ...........  ...........  ...........
                            detach.
   E1130  A                Whlchr stand fxd arm  ...........  ...........  ...........  ...........  ...........
                            ft rest.
   E1140  A                Wheelchair standard   ...........  ...........  ...........  ...........  ...........
                            detach a.
   E1150  A                Wheelchair standard   ...........  ...........  ...........  ...........  ...........
                            w/ leg r.
   E1160  A                Wheelchair fixed      ...........  ...........  ...........  ...........  ...........
                            arms.
   E1170  A                Whlchr ampu fxd arm   ...........  ...........  ...........  ...........  ...........
                            leg rest.
   E1171  A                Wheelchair amputee w/ ...........  ...........  ...........  ...........  ...........
                            o leg r.
   E1172  A                Wheelchair amputee    ...........  ...........  ...........  ...........  ...........
                            detach ar.
   E1180  A                Wheelchair amputee w/ ...........  ...........  ...........  ...........  ...........
                             foot r.
   E1190  A                Wheelchair amputee w/ ...........  ...........  ...........  ...........  ...........
                             leg re.
   E1195  A                Wheelchair amputee    ...........  ...........  ...........  ...........  ...........
                            heavy dut.
   E1200  A                Wheelchair amputee    ...........  ...........  ...........  ...........  ...........
                            fixed arm.
   E1210  A                Whlchr moto ful arm   ...........  ...........  ...........  ...........  ...........
                            leg rest.
   E1211  A                Wheelchair motorized  ...........  ...........  ...........  ...........  ...........
                            w/ det.
   E1212  A                Wheelchair motorized  ...........  ...........  ...........  ...........  ...........
                            w full.
   E1213  A                Wheelchair motorized  ...........  ...........  ...........  ...........  ...........
                            w/ det.
   E1220  A                Whlchr special size/  ...........  ...........  ...........  ...........  ...........
                            constrc.
   E1221  A                Wheelchair spec size  ...........  ...........  ...........  ...........  ...........
                            w foot.
   E1222  A                Wheelchair spec size  ...........  ...........  ...........  ...........  ...........
                            w/ leg.
   E1223  A                Wheelchair spec size  ...........  ...........  ...........  ...........  ...........
                            w foot.
   E1224  A                Wheelchair spec size  ...........  ...........  ...........  ...........  ...........
                            w/ leg.
   E1225  A                Wheelchair spec sz    ...........  ...........  ...........  ...........  ...........
                            semi-recl.
   E1226  E                Wheelchair spec sz    ...........  ...........  ...........  ...........  ...........
                            full-recl.
   E1227  E                Wheelchair spec sz    ...........  ...........  ...........  ...........  ...........
                            spec ht a.
   E1228  A                Wheelchair spec sz    ...........  ...........  ...........  ...........  ...........
                            spec ht b.
   E1230  A                Power operated        ...........  ...........  ...........  ...........  ...........
                            vehicle.
   E1240  A                Whchr litwt det arm   ...........  ...........  ...........  ...........  ...........
                            leg rest.
   E1250  A                Wheelchair lightwt    ...........  ...........  ...........  ...........  ...........
                            fixed arm.
   E1260  A                Wheelchair lightwt    ...........  ...........  ...........  ...........  ...........
                            foot rest.
   E1270  A                Wheelchair            ...........  ...........  ...........  ...........  ...........
                            lightweight leg r.
   E1280  A                Whchr h-duty det arm  ...........  ...........  ...........  ...........  ...........
                            leg res.
   E1285  A                Wheelchair heavy      ...........  ...........  ...........  ...........  ...........
                            duty fixed.
   E1290  A                Wheelchair hvy duty   ...........  ...........  ...........  ...........  ...........
                            detach a.
   E1295  A                Wheelchair heavy      ...........  ...........  ...........  ...........  ...........
                            duty fixed.
   E1296  A                Wheelchair special    ...........  ...........  ...........  ...........  ...........
                            seat heig.
   E1297  A                Wheelchair special    ...........  ...........  ...........  ...........  ...........
                            seat dept.
   E1298  A                Wheelchair spec seat  ...........  ...........  ...........  ...........  ...........
                            depth/w.
   E1300  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.
  *E1500  A                Centrifuge..........  ...........  ...........  ...........  ...........  ...........
   E1510  A                Kidney dialysate      ...........  ...........  ...........  ...........  ...........
                            delivry sys.
   E1520  A                Heparin infusion      ...........  ...........  ...........  ...........  ...........
                            pump for di.
   E1530  A                Air bubble detector   ...........  ...........  ...........  ...........  ...........
                            for dial.

[[Page 60063]]

 
   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.
  *E1637  A                Hemostats for         ...........  ...........  ...........  ...........  ...........
                            dialysis, each.
  *E1638  A                Peri dialysis         ...........  ...........  ...........  ...........  ...........
                            heating pad.
  *E1639  A                Dialysis scale......  ...........  ...........  ...........  ...........  ...........
   E1640  D                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.
  *E1801  A                SPS elbow device....  ...........  ...........  ...........  ...........  ...........
   E1805  A                Adjust wrist ext/     ...........  ...........  ...........  ...........  ...........
                            flex device.
  *E1806  A                SPS wrist device....  ...........  ...........  ...........  ...........  ...........
   E1810  A                Adjust knee ext/flex  ...........  ...........  ...........  ...........  ...........
                            device.
  *E1811  A                SPS knee device.....  ...........  ...........  ...........  ...........  ...........
   E1815  A                Adjust ankle ext/     ...........  ...........  ...........  ...........  ...........
                            flex device.
  *E1816  A                SPS ankle device....  ...........  ...........  ...........  ...........  ...........
  *E1818  A                SPS forearm device..  ...........  ...........  ...........  ...........  ...........
   E1820  A                Soft interface        ...........  ...........  ...........  ...........  ...........
                            material.
  *E1821  A                Replacement           ...........  ...........  ...........  ...........  ...........
                            interface SPSD.
   E1825  A                Adjust finger ext/    ...........  ...........  ...........  ...........  ...........
                            flex devc.
   E1830  A                Adjust toe ext/flex   ...........  ...........  ...........  ...........  ...........
                            device.
  *E1840  A                Adj shoulder ext/     ...........  ...........  ...........  ...........  ...........
                            flex device.
   E1900  D                Speech communication  ...........  ...........  ...........  ...........  ...........
                            device.
  *E1902  A                AAC non-electronic    ...........  ...........  ...........  ...........  ...........
                            board.
  *E2000  A                Gastric suction pump  ...........  ...........  ...........  ...........  ...........
                            hme mdl.
  *E2100  A                Bld glucose monitor   ...........  ...........  ...........  ...........  ...........
                            w voice.
  *E2101  A                Bld glucose monitor   ...........  ...........  ...........  ...........  ...........
                            w lance.
   G0001  A                Drawing blood for     ...........  ...........  ...........  ...........  ...........
                            specimen.
   G0002  N                Temporary urinary     ...........  ...........  ...........  ...........  ...........
                            catheter.
   G0004  E                ECG transm phys       ...........  ...........  ...........  ...........  ...........
                            review & int.
   G0005  X                ECG 24 hour                  0097         0.84       $42.76       $23.51        $8.55
                            recording.
   G0006  X                ECG transmission &           0097         0.84       $42.76       $23.51        $8.55
                            analysis.
   G0007  N                ECG phy review &      ...........  ...........  ...........  ...........  ...........
                            interpret.
   G0008  K                Admin influenza              0354         0.10        $5.09  ...........  ...........
                            virus vac.
   G0009  K                Admin pneumococcal           0354         0.10        $5.09  ...........  ...........
                            vaccine.
   G0010  N                Admin hepatitis b     ...........  ...........  ...........  ...........  ...........
                            vaccine.
   G0015  X                Post symptom ECG             0097         0.84       $42.76       $23.51        $8.55
                            tracing.
   G0016  D                Post symptom ECG md   ...........  ...........  ...........  ...........  ...........
                            review.
   G0025  N                Collagen skin test    ...........  ...........  ...........  ...........  ...........
                            kit.
   G0026  A                Fecal leukocyte       ...........  ...........  ...........  ...........  ...........
                            examination.
   G0027  A                Semen analysis......  ...........  ...........  ...........  ...........  ...........
   G0030  S                PET imaging prev PET         0285        18.72      $952.92      $415.21      $190.58
                            single.
   G0031  S                PET imaging prev PET         0285        18.72      $952.92      $415.21      $190.58
                            multple.
   G0032  S                PET follow SPECT             0285        18.72      $952.92      $415.21      $190.58
                            78464 singl.
   G0033  S                PET follow SPECT             0285        18.72      $952.92      $415.21      $190.58
                            78464 mult.
   G0034  S                PET follow SPECT             0285        18.72      $952.92      $415.21      $190.58
                            76865 singl.
   G0035  S                PET follow SPECT             0285        18.72      $952.92      $415.21      $190.58
                            78465 mult.
   G0036  S                PET follow cornry            0285        18.72      $952.92      $415.21      $190.58
                            angio sing.
   G0037  S                PET follow cornry            0285        18.72      $952.92      $415.21      $190.58
                            angio mult.
   G0038  S                PET follow myocard           0285        18.72      $952.92      $415.21      $190.58
                            perf sing.
   G0039  S                PET follow myocard           0285        18.72      $952.92      $415.21      $190.58
                            perf mult.
   G0040  S                PET follow stress            0285        18.72      $952.92      $415.21      $190.58
                            echo singl.
   G0041  S                PET follow stress            0285        18.72      $952.92      $415.21      $190.58
                            echo mult.
   G0042  S                PET follow                   0285        18.72      $952.92      $415.21      $190.58
                            ventriculogm sing.
   G0043  S                PET follow                   0285        18.72      $952.92      $415.21      $190.58
                            ventriculogm mult.
   G0044  S                PET following rest           0285        18.72      $952.92      $415.21      $190.58
                            ECG singl.
   G0045  S                PET following rest           0285        18.72      $952.92      $415.21      $190.58
                            ECG mult.

[[Page 60064]]

 
   G0046  S                PET follow stress            0285        18.72      $952.92      $415.21      $190.58
                            ECG singl.
   G0047  S                PET follow stress            0285        18.72      $952.92      $415.21      $190.58
                            ECG mult.
   G0050  S                Residual urine by            0265         0.95       $48.36       $26.59        $9.67
                            ultrasound.
   G0101  V                CA screen;pelvic/            0600         0.86       $43.78  ...........        $8.76
                            breast exam.
   G0102  N                Prostate ca           ...........  ...........  ...........  ...........  ...........
                            screening; dre.
   G0103  A                Psa, total screening  ...........  ...........  ...........  ...........  ...........
   G0104  S                CA screen;flexi              0159         2.33      $118.61       $29.65       $23.72
                            sigmoidscope.
   G0105  T                Colorectal scrn; hi          0158         6.55      $333.42       $83.36       $66.68
                            risk ind.
   G0106  S                Colon CA                     0157         1.98      $100.79       $22.19       $20.16
                            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.
  *G0117  S                Glaucoma scrn hgh            0230         0.61       $31.05       $14.28        $6.21
                            risk direc.
  *G0118  S                Glaucoma scrn hgh            0230         0.61       $31.05       $14.28        $6.21
                            risk direc.
   G0120  S                Colon ca scrn;               0157         1.98      $100.79       $22.19       $20.16
                            barium enema.
   G0121  T                Colon ca scrn not hi         0158         6.55      $333.42       $83.36       $66.68
                            rsk ind.
   G0122  E                Colon ca scrn;        ...........  ...........  ...........  ...........  ...........
                            barium enema.
   G0123  A                Screen cerv/vag thin  ...........  ...........  ...........  ...........  ...........
                            layer.
   G0124  A                Screen c/v thin       ...........  ...........  ...........  ...........  ...........
                            layer by MD.
   G0125  T                PET image pulmonary          0976  ...........      $875.00  ...........      $175.00
                            nodule.
   G0126  D                Lung image (PET)      ...........  ...........  ...........  ...........  ...........
                            staging.
   G0127  T                Trim nail(s)........         0009         0.63       $32.07        $8.34        $6.41
   G0128  E                CORF skilled nursing  ...........  ...........  ...........  ...........  ...........
                            service.
   G0129  P                Partial hosp prog            0033         4.17      $212.27       $48.17       $42.45
                            service.
   G0130  X                Single energy x-ray          0261         1.21       $61.59       $33.87       $12.32
                            study.
   G0131  S                CT scan, bone                0288         1.17       $59.56       $32.75       $11.91
                            density study.
   G0132  S                CT scan, bone                0288         1.17       $59.56       $32.75       $11.91
                            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  D                Pet for rec of        ...........  ...........  ...........  ...........  ...........
                            colorectal ca.
   G0164  D                Pet for lymphoma      ...........  ...........  ...........  ...........  ...........
                            staging.
   G0165  D                Pet,rec of melanoma/  ...........  ...........  ...........  ...........  ...........
                            met ca.
   G0166  T                Extrnl counterpulse,         0972  ...........      $150.00  ...........       $30.00
                            per tx.
   G0167  E                Hyperbaric oz tx;no   ...........  ...........  ...........  ...........  ...........
                            md reqrd.
   G0168  T                Wound closure by             0970  ...........       $25.00  ...........        $5.00
                            adhesive.
   G0173  S                Stereo                       0721  ...........    $5,500.00  ...........    $1,100.00
                            radoisurgery,comple
                            te.
   G0174  D                Intensitymodulatedra  ...........  ...........  ...........  ...........  ...........
                            diation.
   G0175  V                OPPS Service,sched           0602         1.38       $70.25  ...........       $14.05
                            team conf.
   G0176  P                OPPS/PHP;activity            0033         4.17      $212.27       $48.17       $42.45
                            therapy.
   G0177  P                OPPS/PHP; train &            0033         4.17      $212.27       $48.17       $42.45
                            educ serv.
   G0178  D                Intensitymodulatedra  ...........  ...........  ...........  ...........  ...........
                            diation.
   G0179  E                MD recertification    ...........  ...........  ...........  ...........  ...........
                            HHA PT.
   G0180  E                MD certification HHA  ...........  ...........  ...........  ...........  ...........
                            patient.
   G0181  E                Home health care      ...........  ...........  ...........  ...........  ...........
                            supervision.
   G0182  E                Hospice care          ...........  ...........  ...........  ...........  ...........
                            supervision.
   G0184  D                Ocular photdynamicTx         0235         5.57      $283.54       $78.91       $56.71
                            2nd eye.
   G0185  T                Transpuppillary              0235         5.57      $283.54       $78.91       $56.71
                            thermotx.
   G0186  T                Dstry eye lesn,fdr           0235         5.57      $283.54       $78.91       $56.71
                            vssl tech.
   G0187  T                Dstry mclr                   0235         5.57      $283.54       $78.91       $56.71
                            drusen,photocoag.
   G0188  D                Xray lwr extrmty-            0261         1.21       $61.59       $33.87       $12.32
                            full lngth.
   G0190  D                Immunization          ...........  ...........  ...........  ...........  ...........
                            administration.
   G0191  D                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.

[[Page 60065]]

 
   G0198  A                Patientadapation&tra  ...........  ...........  ...........  ...........  ...........
                            inforspe.
   G0199  A                Reevaluationofpatien  ...........  ...........  ...........  ...........  ...........
                            tusespec.
   G0200  A                Evalofpatientprescip  ...........  ...........  ...........  ...........  ...........
                            ofvoicep.
   G0201  A                Modifortraininginuse  ...........  ...........  ...........  ...........  ...........
                            voicepro.
   G0202  A                Screeningmammography  ...........  ...........  ...........  ...........  ...........
                            digital.
   G0203  D                Screenmammographyfil  ...........  ...........  ...........  ...........  ...........
                            mdigital.
   G0204  S                Diagnosticmammograph         0707  ...........       $75.00  ...........       $15.00
                            ydigital.
   G0205  D                Diagnosticmammograph  ...........  ...........  ...........  ...........  ...........
                            yfilmpro.
   G0206  S                Diagnosticmammograph         0707  ...........       $75.00  ...........       $15.00
                            ydigital.
   G0207  D                Diagnostic            ...........  ...........  ...........  ...........  ...........
                            mammography film.
   G0210  S                PET img wholebody            0712  ...........      $875.00  ...........      $175.00
                            dxlung ca.
   G0211  S                PET img wholebody            0712  ...........      $875.00  ...........      $175.00
                            init lung.
   G0212  S                PET img wholebod             0712  ...........      $875.00  ...........      $175.00
                            restag lung.
   G0213  S                PET img wholebody dx         0712  ...........      $875.00  ...........      $175.00
                            colorec.
   G0214  S                PET img wholebod             0712  ...........      $875.00  ...........      $175.00
                            init colore.
   G0215  S                PETimg wholebod              0712  ...........      $875.00  ...........      $175.00
                            restag colre.
   G0216  S                PET img wholebod dx          0712  ...........      $875.00  ...........      $175.00
                            melanoma.
   G0217  S                PET img wholebod             0712  ...........      $875.00  ...........      $175.00
                            init melano.
   G0218  S                PET img wholebod             0712  ...........      $875.00  ...........      $175.00
                            restag mela.
   G0219  S                PET img wholbod              0712  ...........      $875.00  ...........      $175.00
                            melano nonco.
   G0220  S                PET img wholebod dx          0712  ...........      $875.00  ...........      $175.00
                            lymphoma.
   G0221  S                PET imag wholbod             0712  ...........      $875.00  ...........      $175.00
                            init lympho.
   G0222  S                PET imag wholbod             0712  ...........      $875.00  ...........      $175.00
                            resta lymph.
   G0223  S                PET imag wholbod reg         0712  ...........      $875.00  ...........      $175.00
                            dx head.
   G0224  S                PET imag wholbod reg         0712  ...........      $875.00  ...........      $175.00
                            ini hea.
   G0225  S                PET whol restag              0712  ...........      $875.00  ...........      $175.00
                            headneck onl.
   G0226  S                PET img wholbody dx          0712  ...........      $875.00  ...........      $175.00
                            esophagl.
   G0227  S                PET img wholbod ini          0712  ...........      $875.00  ...........      $175.00
                            esophage.
   G0228  S                PET img wholbod              0712  ...........      $875.00  ...........      $175.00
                            restg esopha.
   G0229  S                PET img metabolic            0712  ...........      $875.00  ...........      $175.00
                            brain pres.
   G0230  S                PET myocard                  0712  ...........      $875.00  ...........      $175.00
                            viability post s.
  *G0231  S                PET WhBD colorec;            0712  ...........      $875.00  ...........      $175.00
                            gamma cam.
  *G0232  S                PET WhBD lymphoma;           0712  ...........      $875.00  ...........      $175.00
                            gamma cam.
  *G0233  S                PET WhBD melanoma;           0712  ...........      $875.00  ...........      $175.00
                            gamma cam.
  *G0234  S                PET WhBD pulm nod;           0712  ...........      $875.00  ...........      $175.00
                            gamma cam.
  *G0236  S                digital film convert         0706  ...........       $25.00  ...........        $5.00
                            diag ma.
  *G0237  T                Therapeutic procd            0970  ...........       $25.00  ...........        $5.00
                            strg endur.
  *G0238  T                Oth resp proc, indiv         0970  ...........       $25.00  ...........        $5.00
  *G0239  T                Oth resp proc, group         0970  ...........       $25.00  ...........        $5.00
   G0240  A                Critic care by MD     ...........  ...........  ...........  ...........  ...........
                            transport.
   G0241  A                Each additional 30    ...........  ...........  ...........  ...........  ...........
                            minutes.
  *G0242  S                Multisource photon           0714  ...........    $1,375.00  ...........      $275.00
                            ster plan.
  *G0243  S                Multisour photon             0721  ...........    $5,500.00  ...........    $1,100.00
                            stereo treat.
  *G0244  X                Observ care by               0339         6.85      $348.69  ...........       $69.74
                            facility topt.
   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.
   G9009  E                MCCD, risk adj,       ...........  ...........  ...........  ...........  ...........
                            level 3.
   G9010  E                MCCD, risk adj,       ...........  ...........  ...........  ...........  ...........
                            level 4.
   G9011  E                MCCD, risk adj,       ...........  ...........  ...........  ...........  ...........
                            level 5.
   G9012  E                Other Specified Case  ...........  ...........  ...........  ...........  ...........
                            Mgmt.
   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.
   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.

[[Page 60066]]

 
   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.
  *H1000  A                Prenatal care atrisk  ...........  ...........  ...........  ...........  ...........
                            assessm.
  *H1001  A                Antepartum            ...........  ...........  ...........  ...........  ...........
                            management.
  *H1002  A                Carecoordination      ...........  ...........  ...........  ...........  ...........
                            prenatal.
  *H1003  A                Prenatal at risk      ...........  ...........  ...........  ...........  ...........
                            education.
  *H1004  A                Follow up home visit/ ...........  ...........  ...........  ...........  ...........
                            prental.
  *H1005  A                Prenatalcare          ...........  ...........  ...........  ...........  ...........
                            enhanced srv pk.
   J0120  N                Tetracyclin           ...........  ...........  ...........  ...........  ...........
                            injection.
   J0130  G                Abciximab injection          1605  ...........      $513.02  ...........       $73.44
                            [10 mg].
   J0150  K                Adenosine, 6 mg.....         0917         0.34       $17.31  ...........        $3.46
   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 per 10
                            units.
   J0207  G                Amifostine 500 mg...         7000  ...........      $392.06  ...........       $56.13
   J0210  N                Methyldopate hcl      ...........  ...........  ...........  ...........  ...........
                            injection.
   J0256  G                Alpha 1 proteinase           0901  ...........        $2.09  ...........         $.30
                            inhibitor 10 mg.
   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 50 mg.
   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  D                Nandrolon             ...........  ...........  ...........  ...........  ...........
                            phenpropionate inj.
   J0350  G                anistreplase per 30          1606  ...........    $2,693.80  ...........      $385.64
                            u.
   J0360  N                Hydralazine hcl       ...........  ...........  ...........  ...........  ...........
                            injection.
   J0380  N                Inj metaraminol       ...........  ...........  ...........  ...........  ...........
                            bitartrate.
   J0390  N                Chloroquine           ...........  ...........  ...........  ...........  ...........
                            injection.
   J0395  N                Arbutamine HCl        ...........  ...........  ...........  ...........  ...........
                            injection.
   J0400  D                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  D                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  ...........         $.63
                            per unit.
  *J0587  G                Botulinum toxin B,           9018  ...........        $8.79  ...........        $1.26
                            per 100 u.
   J0590  D                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  ...........        $4.15  ...........         $.38
                            injection per 50 mg.
   J0670  N                Inj mepivacaine HCL/  ...........  ...........  ...........  ...........  ...........
                            10 ml.
   J0690  N                Cefazolin sodium      ...........  ...........  ...........  ...........  ...........
                            injection.
  *J0692  N                Cefepime HCl for      ...........  ...........  ...........  ...........  ...........
                            injection.
   J0694  N                Cefoxitin sodium      ...........  ...........  ...........  ...........  ...........
                            injection.
   J0695  D                Cefonocid sodium      ...........  ...........  ...........  ...........  ...........
                            injection.

[[Page 60067]]

 
   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.
  *J0706  G                Caffeine citrate             9011  ...........        $3.05  ...........         $.44
                            injection.
   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  D                Chlorpheniramin       ...........  ...........  ...........  ...........  ...........
                            maleate inj.
   J0735  N                Clonidine             ...........  ...........  ...........  ...........  ...........
                            hydrochloride.
   J0740  N                Cidofovir injection.  ...........  ...........  ...........  ...........  ...........
   J0743  N                Cilastatin sodium     ...........  ...........  ...........  ...........  ...........
                            injection.
  *J0744  N                Ciprofloxacin iv....  ...........  ...........  ...........  ...........  ...........
   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  D                Cortisone injection.  ...........  ...........  ...........  ...........  ...........
   J0835  N                Inj cosyntropin per   ...........  ...........  ...........  ...........  ...........
                            0.25 MG.
   J0850  G                Cytomegalovirus imm          0903  ...........      $370.50  ...........       $47.58
                            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.
  *J1056  E                MA/EC                 ...........  ...........  ...........  ...........  ...........
                            contraceptiveinject
                            ion.
   J1060  N                Testosterone          ...........  ...........  ...........  ...........  ...........
                            cypionate 1 ML.
   J1070  N                Testosterone          ...........  ...........  ...........  ...........  ...........
                            cypionat 100 MG.
   J1080  N                Testosterone          ...........  ...........  ...........  ...........  ...........
                            cypionat 200 MG.
   J1090  D                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  ...........      $194.52  ...........       $24.98
                            injection per 250
                            mg.
   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         0.34       $17.31  ...........        $3.46
                            injection, per 10
                            mg.
   J1250  N                Inj dobutamine HCL/   ...........  ...........  ...........  ...........  ...........
                            250 mg.
   J1260  G                Dolasetron mesylate,         0750  ...........       $16.45  ...........        $2.11
                            per 10 mg.
  *J1270  N                Injection,            ...........  ...........  ...........  ...........  ...........
                            doxercalciferol.
   J1320  N                Amitriptyline         ...........  ...........  ...........  ...........  ...........
                            injection.
   J1325  G                Epoprostenol                 7003  ...........       $12.04  ...........        $1.72
                            injection 0.5 mg.
   J1327  G                Eptifibatide                 1607  ...........       $11.31  ...........        $1.45
                            injection, 5 mg.
   J1330  N                Ergonovine maleate    ...........  ...........  ...........  ...........  ...........
                            injection.
   J1362  D                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,per 300 mg.
   J1438  G                Etanercept                   1608  ...........      $141.01  ...........       $20.19
                            injection, 25 mg.
   J1440  G                Filgrastim 300 mcg           0728  ...........      $179.08  ...........       $23.00
                            injection.
   J1441  G                Filgrastim 480 mcg           7049  ...........      $285.38  ...........       $36.65
                            injection.
   J1450  N                Fluconazole.........  ...........  ...........  ...........  ...........  ...........
   J1452  N                Intraocular           ...........  ...........  ...........  ...........  ...........
                            Fomivirsen na.
   J1455  N                Foscarnet sodium      ...........  ...........  ...........  ...........  ...........
                            injection.
   J1460  N                Gamma globulin 1 CC   ...........  ...........  ...........  ...........  ...........
                            inj.

[[Page 60068]]

 
   J1470  E                Gamma globulin 2 CC   ...........  ...........  ...........  ...........  ...........
                            inj.
   J1480  E                Gamma globulin 3 CC   ...........  ...........  ...........  ...........  ...........
                            inj.
   J1490  E                Gamma globulin 4 CC   ...........  ...........  ...........  ...........  ...........
                            inj.
   J1500  E                Gamma globulin 5 CC   ...........  ...........  ...........  ...........  ...........
                            inj.
   J1510  E                Gamma globulin 6 CC   ...........  ...........  ...........  ...........  ...........
                            inj.
   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  ...........       $35.63  ...........        $3.23
                            mg.
   J1563  E                IV immune globulin..  ...........  ...........  ...........  ...........  ...........
   J1565  G                RSV-IVIG 50 mg......         0906  ...........       $15.51  ...........        $1.99
   J1570  K                Ganciclovir sodium           0907         0.42       $21.38  ...........        $4.28
                            injection 500 mg.
   J1580  N                Garamycin gentamicin  ...........  ...........  ...........  ...........  ...........
                            inj.
  *J1590  N                Gatifloxacin          ...........  ...........  ...........  ...........  ...........
                            injection.
   J1600  N                Gold sodium           ...........  ...........  ...........  ...........  ...........
                            thiomaleate inj.
   J1610  N                Glucagon              ...........  ...........  ...........  ...........  ...........
                            hydrochloride/1 MG.
   J1620  G                Gonadorelin hydroch/         7005  ...........      $192.37  ...........       $27.54
                            100 mcg.
   J1626  G                Granisetron HCL              0764  ...........       $18.54  ...........        $2.65
                            injection 100 mcg.
   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  E                Inj enoxaparin        ...........  ...........  ...........  ...........  ...........
                            sodium.
  *J1655  N                Tinzaparin sodium     ...........  ...........  ...........  ...........  ...........
                            injection.
   J1670  G                Tetanus immune               0908  ...........      $102.60  ...........       $13.18
                            globulin inj up to
                            250 units.
   J1690  D                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  D                Hydroxyprogesterone   ...........  ...........  ...........  ...........  ...........
                            cap 125.
   J1741  D                Hydroxyprogesterone   ...........  ...........  ...........  ...........  ...........
                            cap 250.
   J1742  N                Ibutilide fumarate    ...........  ...........  ...........  ...........  ...........
                            injection.
   J1745  G                Infliximab injection         7043  ...........       $63.24  ...........        $9.05
                            10 mg.
   J1750  N                Iron dextran........  ...........  ...........  ...........  ...........  ...........
  *J1755  N                Iron sucrose          ...........  ...........  ...........  ...........  ...........
                            injection.
   J1785  G                Injection                    0916  ...........        $3.75  ...........         $.54
                            imiglucerase /unit.
   J1790  N                Droperidol injection  ...........  ...........  ...........  ...........  ...........
   J1800  N                Propranolol           ...........  ...........  ...........  ...........  ...........
                            injection.
   J1810  E                Droperidol/fentanyl   ...........  ...........  ...........  ...........  ...........
                            inj, up to 2 ml.
   J1820  N                Insulin injection...  ...........  ...........  ...........  ...........  ...........
   J1825  G                Interferon beta-1a;          0909  ...........      $225.22  ...........       $32.24
                            33 mcg.
   J1830  G                Interferon beta-1b /         0910  ...........       $68.40  ...........        $9.79
                            .25 MG.
  *J1835  N                Intraconazole         ...........  ...........  ...........  ...........  ...........
                            injection.
   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  D                Propiomazine          ...........  ...........  ...........  ...........  ...........
                            injection.
   J1940  N                Furosemide injection  ...........  ...........  ...........  ...........  ...........
   J1950  G                Leuprolide acetate /         0800  ...........       $93.47  ...........       $12.00
                            3.75 mg.
   J1955  E                Inj levocarnitine     ...........  ...........  ...........  ...........  ...........
                            per 1 gm.
   J1956  N                Levofloxacin          ...........  ...........  ...........  ...........  ...........
                            injection.
   J1960  N                Levorphanol tartrate  ...........  ...........  ...........  ...........  ...........
                            inj.
   J1970  D                Methotrimeprazine     ...........  ...........  ...........  ...........  ...........
                            injection.
   J1980  N                Hyoscyamine sulfate   ...........  ...........  ...........  ...........  ...........
                            inj.
   J1990  N                Chlordiazepoxide      ...........  ...........  ...........  ...........  ...........
                            injection.
   J2000  N                Lidocaine injection.  ...........  ...........  ...........  ...........  ...........
   J2010  N                Lincomycin injection  ...........  ...........  ...........  ...........  ...........
  *J2020  G                Linezolid inj, 200           9001  ...........       $24.13  ...........        $3.45
                            mg.
   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  D                Metocurine iodide     ...........  ...........  ...........  ...........  ...........
                            injection.
   J2250  N                Inj midazolam         ...........  ...........  ...........  ...........  ...........
                            hydrochloride.
   J2260  K                Milrinone lactate /          7007         0.44       $22.40  ...........        $4.48
                            5 ml.
   J2270  N                Morphine sulfate      ...........  ...........  ...........  ...........  ...........
                            injection.
   J2271  N                Morphine so4          ...........  ...........  ...........  ...........  ...........
                            injection 100 mg.
   J2275  G                Morphine sulfate             7010  ...........        $1.02  ...........         $.09
                            injection, per 10
                            mg.

[[Page 60069]]

 
   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  D                Thiothixene           ...........  ...........  ...........  ...........  ...........
                            injection.
   J2350  D                Niacinamide/niacin    ...........  ...........  ...........  ...........  ...........
                            injection.
   J2352  G                Octreotide acetate           7031  ...........      $138.08  ...........       $19.77
                            injection.
   J2355  G                Oprelvekin                   7011  ...........      $245.81  ...........       $35.19
                            injection, 5 mg.
   J2360  N                Orphenadrine          ...........  ...........  ...........  ...........  ...........
                            injection.
   J2370  N                Phenylephrine hcl     ...........  ...........  ...........  ...........  ...........
                            injection.
   J2400  N                Chloroprocaine hcl    ...........  ...........  ...........  ...........  ...........
                            injection.
   J2405  G                Ondansetron HCL              0768  ...........        $6.09  ...........         $.78
                            injection, per 1 mg.
   J2410  N                Oxymorphone hcl       ...........  ...........  ...........  ...........  ...........
                            injection.
   J2430  G                Pamidronate disodium         0730  ...........      $265.87  ...........       $38.06
                            /30 mg.
   J2440  N                Papaverin hcl         ...........  ...........  ...........  ...........  ...........
                            injection.
   J2460  N                Oxytetracycline       ...........  ...........  ...........  ...........  ...........
                            injection.
   J2480  D                Hydrochlorides of     ...........  ...........  ...........  ...........  ...........
                            opium inj.
   J2500  N                Paricalcitol........  ...........  ...........  ...........  ...........  ...........
   J2510  N                Penicillin g          ...........  ...........  ...........  ...........  ...........
                            procaine inj.
   J2512  D                Inj pentagastrin per  ...........  ...........  ...........  ...........  ...........
                            2 ML.
   J2515  N                Pentobarbital sodium  ...........  ...........  ...........  ...........  ...........
                            inj.
   J2540  N                Penicillin g          ...........  ...........  ...........  ...........  ...........
                            potassium inj.
   J2543  N                Piperacillin/         ...........  ...........  ...........  ...........  ...........
                            tazobactam.
   J2545  A                Pentamidine           ...........  ...........  ...........  ...........  ...........
                            isethionte/300 mg.
   J2550  N                Promethazine hcl      ...........  ...........  ...........  ...........  ...........
                            injection.
   J2560  N                Phenobarbital sodium  ...........  ...........  ...........  ...........  ...........
                            inj.
   J2590  N                Oxytocin injection..  ...........  ...........  ...........  ...........  ...........
   J2597  N                Inj desmopressin      ...........  ...........  ...........  ...........  ...........
                            acetate.
   J2640  D                Prednisolone sodium   ...........  ...........  ...........  ...........  ...........
                            ph inj.
   J2650  N                Prednisolone acetate  ...........  ...........  ...........  ...........  ...........
                            inj.
   J2670  N                Totazoline hcl        ...........  ...........  ...........  ...........  ...........
                            injection.
   J2675  D                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  ...........        $1.17  ...........         $.11
                            injection up to 10
                            mg.
   J2770  G                Quinupristin/                1024  ...........      $102.05  ...........       $13.11
                            dalfopristin.
   J2780  N                Ranitidine            ...........  ...........  ...........  ...........  ...........
                            hydrochloride inj.
   J2790  G                Rho d immune                 0884  ...........       $34.11  ...........        $4.38
                            globulin inj [one
                            dose package].
   J2792  G                Rho(d) immune                1609  ...........       $20.55  ...........        $2.64
                            globulin h, sd, 100
                            I.U..
   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, 50 mcg.
   J2860  D                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.
  *J2940  G                Somatrem injection..         7033  ...........      $209.48  ...........       $29.99
  *J2941  G                Somatropin injection         7034  ...........       $39.90  ...........        $5.12
   J2950  N                Promazine hcl         ...........  ...........  ...........  ...........  ...........
                            injeciton.
   J2970  D                Methicillin sodium    ...........  ...........  ...........  ...........  ...........
                            injection.
   J2993  G                Reteplase injection.         9005  ...........    $1,306.25  ...........      $187.00
   J2995  K                Inj streptokinase /          0911         1.66       $84.50  ...........       $16.90
                            250000 IU.
   J2997  K                Alteplase                    7048         0.36       $18.33  ...........        $3.67
                            recombinant, 1 mg.
   J3000  N                Streptomycin          ...........  ...........  ...........  ...........  ...........
                            injection.
   J3010  G                Fentanyl citrate             7014  ...........        $1.23  ...........         $.11
                            injeciton.
   J3030  N                Sumatriptan           ...........  ...........  ...........  ...........  ...........
                            succinate / 6 MG.
   J3070  N                Pentazocine hcl       ...........  ...........  ...........  ...........  ...........
                            injeciton.
   J3080  D                Chlorprothixene       ...........  ...........  ...........  ...........  ...........
                            injection.
  *J3100  G                Tenecteplase, 50 mg/         9002  ...........    $2,612.50  ...........      $374.00
                            vial.
   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.

[[Page 60070]]

 
   J3240  E                Thyrotropin           ...........  ...........  ...........  ...........  ...........
                            injection.
   J3245  G                Tirofiban                    7041  ...........      $436.41  ...........       $62.48
                            hydrochloride 12.5
                            mg.
   J3250  N                Trimethobenzamide     ...........  ...........  ...........  ...........  ...........
                            hcl inj.
   J3260  N                Tobramycin sulfate    ...........  ...........  ...........  ...........  ...........
                            injection.
   J3265  N                Injection torsemide   ...........  ...........  ...........  ...........  ...........
                            10 mg/ml.
   J3270  D                Imipramine hcl        ...........  ...........  ...........  ...........  ...........
                            injection.
   J3280  G                Thiethylperazine             0755  ...........        $4.60  ...........         $.66
                            maleate inj, up to
                            10 mg.
   J3301  N                Triamcinolone         ...........  ...........  ...........  ...........  ...........
                            acetonide inj.
   J3302  N                Triamcinolone         ...........  ...........  ...........  ...........  ...........
                            diacetate inj.
   J3303  N                Triamcinolone         ...........  ...........  ...........  ...........  ...........
                            hexacetonl inj.
   J3305  G                Inj trimetrexate             7045  ...........      $118.75  ...........       $17.00
                            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         6.41      $326.29  ...........       $65.26
                            inj.
   J3370  N                Vancomycin hcl        ...........  ...........  ...........  ...........  ...........
                            injeciton.
   J3390  D                Methoxamine           ...........  ...........  ...........  ...........  ...........
                            injection.
  *J3395  G                Verteporfin for              1203  ...........    $1,458.25  ...........      $208.76
                            injection -15 mg.
   J3400  N                Triflupromazine hcl   ...........  ...........  ...........  ...........  ...........
                            inj.
   J3410  N                Hydroxyzine hcl       ...........  ...........  ...........  ...........  ...........
                            injeciton.
   J3420  N                Vitamin b12           ...........  ...........  ...........  ...........  ...........
                            injection.
   J3430  N                Vitamin k             ...........  ...........  ...........  ...........  ...........
                            phytonadione inj.
   J3450  D                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, per             0925  ...........         $.87  ...........         $.08
                            I.U..
   J7191  G                Factor VIII                  0926  ...........        $2.09  ...........         $.30
                            (porcine).
   J7192  G                Factor viii                  0927  ...........        $1.12  ...........         $.14
                            recombinant, per
                            I.U..
  *J7193  G                Factor IX non-               0931  ...........       $26.13  ...........        $3.74
                            recombinant.
   J7194  G                Factor IX complex            0928  ...........         $.48  ...........         $.04
                            per I.U..
  *J7195  G                Factor IX                    0932  ...........        $1.12  ...........         $.16
                            recombinant.
   J7197  G                Antithrombin iii             0930  ...........        $1.05  ...........         $.15
                            injection per I.U..
   J7198  G                Anti-inhibitor, per          0929  ...........        $1.43  ...........         $.18
                            I.U..
   J7199  E                Hemophilia clot       ...........  ...........  ...........  ...........  ...........
                            factor noc.
   J7300  E                Intraut copper        ...........  ...........  ...........  ...........  ...........
                            contraceptive.
  *J7302  E                Levonorgestrel iu     ...........  ...........  ...........  ...........  ...........
                            contracept.
  *J7308  N                Aminolevulinic acid   ...........  ...........  ...........  ...........  ...........
                            hcl top.
   J7310  G                Ganciclovir long act         0913  ...........    $4,750.00  ...........      $680.00
                            implant, 4.5 mg.
   J7315  D                Sodium hyaluronate           7315  ...........       $26.13  ...........        $3.74
                            injection.
  *J7316  G                Sodium hyaluronate           7315  ...........       $26.13  ...........        $3.74
                            injection.
   J7320  G                Hylan g-f 20                 1611  ...........      $213.87  ...........       $27.47
                            injection, 16 mg.
   J7330  G                Cultured                     1059  ...........   $14,250.00  ...........    $2,040.00
                            chondrocytes
                            implnt, 16 mg.
  *J7340  E                Metabolic active D/E  ...........  ...........  ...........  ...........  ...........
                            tissue.
   J7500  G                Azathioprine oral 50         0886  ...........        $1.25  ...........         $.11
                            mg.
   J7501  G                Azathioprine                 0887  ...........        $1.06  ...........         $.10
                            parenteral 100 mg.
   J7502  G                Cyclosporine oral            0888  ...........        $5.22  ...........         $.67
                            100 mg.
   J7504  G                Lymphocyte immune            0890  ...........      $269.06  ...........       $38.52
                            globulin, 250 mg.
   J7505  G                Muromonab CD3, per 5         7038  ...........      $269.06  ...........       $38.52
                            mg.
   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.
  *J7511  G                Antithymocyte                9104  ...........      $325.09  ...........       $46.54
                            globuln rabbit.
   J7513  G                Daclizumab,                  1612  ...........      $397.29  ...........       $56.88
                            parenteral 25 mg.

[[Page 60071]]

 
   J7515  N                Cyclosporine oral 25  ...........  ...........  ...........  ...........  ...........
                            mg.
   J7516  G                Cyclosporin                  0889  ...........       $25.08  ...........        $3.22
                            parenteral 250 mg.
   J7517  G                Mycophenolate                9015  ...........        $2.40  ...........         $.34
                            mofetil oral 250 mg.
   J7520  G                Sirolimus 1 mg/ml...         9106  ...........        $6.51  ...........         $.93
   J7525  G                Tacrolimus injection         9006  ...........      $113.15  ...........       $16.20
   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.
  *J7622  A                Beclomethasome        ...........  ...........  ...........  ...........  ...........
                            inhalatn sol.
  *J7624  A                Betamethasome         ...........  ...........  ...........  ...........  ...........
                            inhalation sol.
  *J7626  A                Budesonide            ...........  ...........  ...........  ...........  ...........
                            inhalation sol.
   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.
  *J7641  A                Flunisolide,          ...........  ...........  ...........  ...........  ...........
                            inhalation sol.
   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, 2 mg.         7015  ...........        $1.91  ...........         $.27
   J8520  G                Capecitabine, oral,          7042  ...........        $2.43  ...........         $.35
                            150 mg.
   J8521  N                Capecitabine, oral,   ...........  ...........  ...........  ...........  ...........
                            500 mg.
   J8530  G                Cyclophosphamide             0801  ...........        $2.03  ...........         $.18
                            oral 25 mg.
   J8560  G                Etoposide oral 50 mg         0802  ...........       $52.43  ...........        $6.73
   J8600  G                Melphalan oral 2 mg.         0803  ...........        $2.29  ...........         $.33
   J8610  G                Methotrexate oral            0826  ...........        $3.45  ...........         $.31
                            2.5 mg.
   J8700  G                Temozolomide, oral 5         1086  ...........        $6.05  ...........         $.87
                            mg.
   J8999  E                Oral prescription     ...........  ...........  ...........  ...........  ...........
                            drug chemo.
   J9000  G                Doxorubicin HCL 10           0847  ...........       $37.46  ...........        $4.81
                            mg.
   J9001  G                Doxorubicin HCL              7046  ...........      $358.95  ...........       $51.39
                            liposome inj, 10 mg.
   J9015  G                Aldesleukin/single           0807  ...........      $672.60  ...........       $96.29
                            use vial.
  *J9017  G                Arsenic trioxide....         9012  ...........       $23.75  ...........        $3.40
   J9020  G                Asparaginase                 0814  ...........       $62.61  ...........        $8.96
                            injection 10,000
                            units.
   J9031  G                Bcg live                     0809  ...........      $166.49  ...........       $21.38
                            intravesical vac
                            [per installation].
   J9040  G                Bleomycin sulfate            0857  ...........      $289.37  ...........       $37.16
                            injection, 15 units.
   J9045  G                Carboplatin                  0811  ...........      $114.46  ...........       $16.39
                            injection, 50 mg.
   J9050  G                Carmustine, 100 mg..         0812  ...........      $117.84  ...........       $16.87
   J9060  G                Cisplatin 10 mg              0813  ...........       $42.18  ...........        $3.82
                            injection.
   J9062  E                Cisplatin 50 MG       ...........  ...........  ...........  ...........  ...........
                            injeciton.
   J9065  G                cladribine per 1 mg.         0858  ...........       $53.39  ...........        $4.83
   J9070  G                Cyclophosphamide 100         0815  ...........        $5.82  ...........         $.75
                            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  ...........        $4.89  ...........         $.63
                            lyophilized, 100 mg.
   J9094  E                Cyclophosphamide      ...........  ...........  ...........  ...........  ...........
                            lyophilized.
   J9095  E                Cyclophosphamide      ...........  ...........  ...........  ...........  ...........
                            lyophilized.
   J9096  E                Cyclophosphamide      ...........  ...........  ...........  ...........  ...........
                            lyophilized.
   J9097  E                Cyclophosphamide      ...........  ...........  ...........  ...........  ...........
                            lyophilized.
   J9100  G                Cytarabine HCL 100           0817  ...........        $6.10  ...........         $.55
                            mg inj.
   J9110  E                Cytarabine hcl 500    ...........  ...........  ...........  ...........  ...........
                            MG inj.
   J9120  G                Dactinomycin                 0818  ...........       $13.87  ...........        $1.99
                            actinomycin 0.5 mg.
   J9130  G                Dacarbazine 100 mg           0819  ...........       $12.68  ...........        $1.15
                            inj.
   J9140  E                Dacarbazine 200 MG    ...........  ...........  ...........  ...........  ...........
                            inj.
   J9150  G                Daunorubicin, 10 mg.         0820  ...........       $76.62  ...........        $6.94

[[Page 60072]]

 
   J9151  G                Daunorubicin citrate         0821  ...........       $64.60  ...........        $9.25
                            liposom, 10 mg.
   J9160  G                Denileukin diftitox,         1084  ...........      $999.88  ...........      $143.14
                            300 MCG.
   J9165  G                Diethylstilbestrol           0822  ...........       $14.41  ...........        $1.30
                            injection, 250 mg.
   J9170  G                Docetaxel, 20 mg....         0823  ...........      $297.83  ...........       $42.64
   J9180  E                Epirubicin HCl        ...........  ...........  ...........  ...........  ...........
                            injection.
   J9181  G                Etoposide 10 mg inj.         0824  ...........       $10.45  ...........         $.95
   J9182  E                Etoposide 100 MG inj  ...........  ...........  ...........  ...........  ...........
   J9185  G                Fludarabine                  0842  ...........      $271.82  ...........       $38.91
                            phosphate inj 50 mg.
   J9190  G                Fluorouracil                 0859  ...........        $2.73  ...........         $.25
                            injection, 500 mg.
   J9200  G                Floxuridine                  0827  ...........      $129.56  ...........       $16.64
                            injection [500 mg].
   J9201  G                Gemcitabine hcl 200          0828  ...........      $106.72  ...........       $15.28
                            mg.
   J9202  G                Goserelin acetate            0810  ...........      $446.49  ...........       $63.92
                            implant, per 3.6 mg.
   J9206  G                Irinotecan                   0830  ...........      $134.25  ...........       $19.22
                            injection, 20 mg.
   J9208  G                Ifosfamide                   0831  ...........      $156.64  ...........       $22.42
                            injection, per 1g.
   J9209  G                Mesna injection, 200         0732  ...........       $36.48  ...........        $3.30
                            mg.
   J9211  G                Idarubicin HCL               0832  ...........      $412.21  ...........       $59.01
                            injection, 5 mg.
   J9212  G                Interferon alfacon-          0833  ...........        $4.10  ...........         $.59
                            1, 1 mcg.
   J9213  G                Interferon alfa-2a           0834  ...........       $34.86  ...........        $4.99
                            inj, 3 million
                            units.
   J9214  G                Interferon alfa-2b           0836  ...........       $11.28  ...........        $1.45
                            inj, 1 million
                            units.
   J9215  G                Interferon alfa-n3           0865  ...........        $7.86  ...........        $1.12
                            inj, 250, 000 I.U..
   J9216  G                Interferon gamma 1-b         0838  ...........      $285.65  ...........       $40.89
                            inj, 3 million
                            units.
   J9217  G                Leuprolide acetate           9217  ...........      $592.60  ...........       $84.84
                            suspnsion, 7.5 mg.
   J9218  G                Leuprolide acetate           0861  ...........       $69.79  ...........        $6.32
                            injection, per 1 mg.
   J9219  G                Leuprolide acetate           7051  ...........    $5,399.80  ...........      $773.02
                            implant, 65 mg.
   J9230  G                Mechlorethamine HCL          0839  ...........       $12.01  ...........        $1.72
                            inj, 10 mg.
   J9245  G                melphalan hydrochl           0840  ...........      $400.74  ...........       $57.37
                            50 mg.
   J9250  G                Methotrexate sodium          0841  ...........         $.45  ...........         $.04
                            inj, 5 mg.
   J9260  E                Methotrexate sodium   ...........  ...........  ...........  ...........  ...........
                            inj.
   J9265  G                Paclitaxel                   0863  ...........      $173.50  ...........       $22.28
                            injection, 30 mg.
   J9266  E                Pegaspargase/singl    ...........  ...........  ...........  ...........  ...........
                            dose vial.
   J9268  G                Pentostatin                  0844  ...........    $1,654.14  ...........      $236.80
                            injection, 10 mg.
   J9270  G                Plicamycin                   0860  ...........       $93.80  ...........       $13.43
                            (mithramycin) inj,
                            2.5 mg.
   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  ...........      $244.21  ...........       $34.96
                            hydrochl per 5 mg.
  *J9300  G                Gemtuzumab                   9004  ...........    $1,929.69  ...........      $276.25
                            ozogamicin inj, per
                            5 mg.
   J9310  G                Rituximab cancer             0849  ...........      $454.55  ...........       $65.07
                            treatment, 100 mg.
   J9320  G                Streptozocin                 0850  ...........      $117.64  ...........       $16.84
                            injection, 1 g.
   J9340  G                Thiotepa injection,          0851  ...........      $116.97  ...........       $10.59
                            15 mg.
   J9350  G                Topotecan, 4 mg.....         0852  ...........      $664.19  ...........       $95.08
   J9355  G                Trastuzumab, 10 mg..         1613  ...........       $52.83  ...........        $7.56
   J9357  G                Valrubicin, 200 mg..         1614  ...........      $423.22  ...........       $60.59
   J9360  G                Vinblastine sulfate          0853  ...........        $4.11  ...........         $.37
                            inj, 1 mg.
   J9370  G                Vincristine sulfate          0854  ...........       $30.16  ...........        $3.87
                            1 mg inj.
   J9375  E                Vincristine sulfate   ...........  ...........  ...........  ...........  ...........
                            2 MG inj.
   J9380  E                Vincristine sulfate   ...........  ...........  ...........  ...........  ...........
                            5 MG inj.
   J9390  G                Vinorelbine tartrate/        0855  ...........       $88.83  ...........       $12.72
                            10 mg.
   J9600  G                Porfimer sodium, 75          0856  ...........    $2,603.66  ...........      $372.74
                            mg.
   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  D                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  D                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.

[[Page 60073]]

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

[[Page 60074]]

 
   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.
   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.
  *L0321  A                Tlso anti-post-cntrl  ...........  ...........  ...........  ...........  ...........
                            prefab.
   L0330  A                Tlso ant-pos-lateral  ...........  ...........  ...........  ...........  ...........
                            control.
  *L0331  A                Tlso ant-post-lat     ...........  ...........  ...........  ...........  ...........
                            cntrl prfb.
   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.

[[Page 60075]]

 
   L0390  A                Tlso a-p-l control    ...........  ...........  ...........  ...........  ...........
                            molded.
  *L0391  A                Tlso ant-post-lat-    ...........  ...........  ...........  ...........  ...........
                            rot cntrl.
   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.
  *L0561  A                Prefab lso..........  ...........  ...........  ...........  ...........  ...........
   L0565  A                Lso a-p-l control     ...........  ...........  ...........  ...........  ...........
                            custom.
   L0600  A                Sacroiliac flex surg  ...........  ...........  ...........  ...........  ...........
                            support.
   L0610  A                Sacroiliac flexible   ...........  ...........  ...........  ...........  ...........
                            custm fa.
   L0620  A                Sacroiliac semi-rig   ...........  ...........  ...........  ...........  ...........
                            w apron.
   L0700  A                Ctlso a-p-l control   ...........  ...........  ...........  ...........  ...........
                            molded.
   L0710  A                Ctlso a-p-l control   ...........  ...........  ...........  ...........  ...........
                            w/ inter.
   L0810  A                Halo cervical into    ...........  ...........  ...........  ...........  ...........
                            jckt vest.
   L0820  A                Halo cervical into    ...........  ...........  ...........  ...........  ...........
                            body jack.
   L0830  A                Halo cerv into        ...........  ...........  ...........  ...........  ...........
                            milwaukee typ.
   L0860  A                Magnetic resonanc     ...........  ...........  ...........  ...........  ...........
                            image comp.
   L0900  A                Torso/ptosis support  ...........  ...........  ...........  ...........  ...........
   L0910  A                Torso & ptosis supp   ...........  ...........  ...........  ...........  ...........
                            custm fa.
   L0920  A                Torso/pendulous abd   ...........  ...........  ...........  ...........  ...........
                            support.
   L0930  A                Pendulous abdomen     ...........  ...........  ...........  ...........  ...........
                            supp custm.
   L0940  A                Torso/postsurgical    ...........  ...........  ...........  ...........  ...........
                            support.
   L0950  A                Post surg support     ...........  ...........  ...........  ...........  ...........
                            custom fab.
   L0960  A                Post surgical         ...........  ...........  ...........  ...........  ...........
                            support pads.
   L0970  A                Tlso corset front...  ...........  ...........  ...........  ...........  ...........
   L0972  A                Lso corset front....  ...........  ...........  ...........  ...........  ...........
   L0974  A                Tlso full corset....  ...........  ...........  ...........  ...........  ...........
   L0976  A                Lso full corset.....  ...........  ...........  ...........  ...........  ...........
   L0978  A                Axillary crutch       ...........  ...........  ...........  ...........  ...........
                            extension.
   L0980  A                Peroneal straps pair  ...........  ...........  ...........  ...........  ...........
   L0982  A                Stocking supp grips   ...........  ...........  ...........  ...........  ...........
                            set of f.
   L0984  A                Protective body sock  ...........  ...........  ...........  ...........  ...........
                            each.
  *L0986  A                Spinal orth abdm pnl  ...........  ...........  ...........  ...........  ...........
                            prefab.
   L0999  A                Add to spinal         ...........  ...........  ...........  ...........  ...........
                            orthosis NOS.
   L1000  A                Ctlso milwauke        ...........  ...........  ...........  ...........  ...........
                            initial model.
  *L1005  A                Tension based         ...........  ...........  ...........  ...........  ...........
                            scoliosis orth.
   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.  ...........  ...........  ...........  ...........  ...........

[[Page 60076]]

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

[[Page 60077]]

 
   L2124  A                Kafo fem fx cast      ...........  ...........  ...........  ...........  ...........
                            synthet mol.
   L2126  A                Kafo fem fx cast      ...........  ...........  ...........  ...........  ...........
                            thermoplas.
   L2128  A                Kafo fem fx cast      ...........  ...........  ...........  ...........  ...........
                            molded to p.
   L2132  A                Kafo femoral fx cast  ...........  ...........  ...........  ...........  ...........
                            soft.
   L2134  A                Kafo fem fx cast      ...........  ...........  ...........  ...........  ...........
                            semi-rigid.
   L2136  A                Kafo femoral fx cast  ...........  ...........  ...........  ...........  ...........
                            rigid.
   L2180  A                Plas shoe insert w    ...........  ...........  ...........  ...........  ...........
                            ank joint.
   L2182  A                Drop lock knee......  ...........  ...........  ...........  ...........  ...........
   L2184  A                Limited motion knee   ...........  ...........  ...........  ...........  ...........
                            joint.
   L2186  A                Adj motion knee jnt   ...........  ...........  ...........  ...........  ...........
                            lerman t.
   L2188  A                Quadrilateral brim..  ...........  ...........  ...........  ...........  ...........
   L2190  A                Waist belt..........  ...........  ...........  ...........  ...........  ...........
   L2192  A                Pelvic band & belt    ...........  ...........  ...........  ...........  ...........
                            thigh fla.
   L2200  A                Limited ankle motion  ...........  ...........  ...........  ...........  ...........
                            ea jnt.
   L2210  A                Dorsiflexion assist   ...........  ...........  ...........  ...........  ...........
                            each joi.
   L2220  A                Dorsi & plantar flex  ...........  ...........  ...........  ...........  ...........
                            ass/res.
   L2230  A                Split flat caliper    ...........  ...........  ...........  ...........  ...........
                            stirr & p.
   L2240  A                Round caliper and     ...........  ...........  ...........  ...........  ...........
                            plate atta.
   L2250  A                Foot plate molded     ...........  ...........  ...........  ...........  ...........
                            stirrup at.
   L2260  A                Reinforced solid      ...........  ...........  ...........  ...........  ...........
                            stirrup.
   L2265  A                Long tongue stirrup.  ...........  ...........  ...........  ...........  ...........
   L2270  A                Varus/valgus strap    ...........  ...........  ...........  ...........  ...........
                            padded/li.
   L2275  A                Plastic mod low ext   ...........  ...........  ...........  ...........  ...........
                            pad/line.
   L2280  A                Molded inner boot...  ...........  ...........  ...........  ...........  ...........
   L2300  A                Abduction bar         ...........  ...........  ...........  ...........  ...........
                            jointed adjust.
   L2310  A                Abduction bar-        ...........  ...........  ...........  ...........  ...........
                            straight.
   L2320  A                Non-molded lacer....  ...........  ...........  ...........  ...........  ...........
   L2330  A                Lacer molded to       ...........  ...........  ...........  ...........  ...........
                            patient mode.
   L2335  A                Anterior swing band.  ...........  ...........  ...........  ...........  ...........
   L2340  A                Pre-tibial shell      ...........  ...........  ...........  ...........  ...........
                            molded to p.
   L2350  A                Prosthetic type       ...........  ...........  ...........  ...........  ...........
                            socket molde.
   L2360  A                Extended steel shank  ...........  ...........  ...........  ...........  ...........
   L2370  A                Patten bottom.......  ...........  ...........  ...........  ...........  ...........
   L2375  A                Torsion ank & half    ...........  ...........  ...........  ...........  ...........
                            solid sti.
   L2380  A                Torsion straight      ...........  ...........  ...........  ...........  ...........
                            knee joint.
   L2385  A                Straight knee joint   ...........  ...........  ...........  ...........  ...........
                            heavy du.
   L2390  A                Offset knee joint     ...........  ...........  ...........  ...........  ...........
                            each.
   L2395  A                Offset knee joint     ...........  ...........  ...........  ...........  ...........
                            heavy duty.
   L2397  A                Suspension sleeve     ...........  ...........  ...........  ...........  ...........
                            lower ext.
   L2405  A                Knee joint drop lock  ...........  ...........  ...........  ...........  ...........
                            ea jnt.
   L2415  A                Knee joint cam lock   ...........  ...........  ...........  ...........  ...........
                            each joi.
   L2425  A                Knee disc/dial lock/  ...........  ...........  ...........  ...........  ...........
                            adj flex.
   L2430  A                Knee jnt ratchet      ...........  ...........  ...........  ...........  ...........
                            lock ea jnt.
   L2435  A                Knee joint            ...........  ...........  ...........  ...........  ...........
                            polycentric joint.
   L2492  A                Knee lift loop drop   ...........  ...........  ...........  ...........  ...........
                            lock rin.
   L2500  A                Thi/glut/ischia wgt   ...........  ...........  ...........  ...........  ...........
                            bearing.
   L2510  A                Th/wght bear quad-    ...........  ...........  ...........  ...........  ...........
                            lat brim m.
   L2520  A                Th/wght bear quad-    ...........  ...........  ...........  ...........  ...........
                            lat brim c.
   L2525  A                Th/wght bear nar m-l  ...........  ...........  ...........  ...........  ...........
                            brim mo.
   L2526  A                Th/wght bear nar m-l  ...........  ...........  ...........  ...........  ...........
                            brim cu.
   L2530  A                Thigh/wght bear       ...........  ...........  ...........  ...........  ...........
                            lacer non-mo.
   L2540  A                Thigh/wght bear       ...........  ...........  ...........  ...........  ...........
                            lacer molded.
   L2550  A                Thigh/wght bear high  ...........  ...........  ...........  ...........  ...........
                            roll cu.
   L2570  A                Hip clevis type 2     ...........  ...........  ...........  ...........  ...........
                            posit jnt.
   L2580  A                Pelvic control        ...........  ...........  ...........  ...........  ...........
                            pelvic sling.
   L2600  A                Hip clevis/thrust     ...........  ...........  ...........  ...........  ...........
                            bearing fr.
   L2610  A                Hip clevis/thrust     ...........  ...........  ...........  ...........  ...........
                            bearing lo.
   L2620  A                Pelvic control hip    ...........  ...........  ...........  ...........  ...........
                            heavy dut.
   L2622  A                Hip joint adjustable  ...........  ...........  ...........  ...........  ...........
                            flexion.
   L2624  A                Hip adj flex ext      ...........  ...........  ...........  ...........  ...........
                            abduct cont.
   L2627  A                Plastic mold recipro  ...........  ...........  ...........  ...........  ...........
                            hip & c.
   L2628  A                Metal frame recipro   ...........  ...........  ...........  ...........  ...........
                            hip & ca.
   L2630  A                Pelvic control band   ...........  ...........  ...........  ...........  ...........
                            & belt u.
   L2640  A                Pelvic control band   ...........  ...........  ...........  ...........  ...........
                            & belt b.
   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.
  *L2768  A                Ortho sidebar         ...........  ...........  ...........  ...........  ...........
                            disconnect.
   L2770  A                Low ext orthosis per  ...........  ...........  ...........  ...........  ...........
                            bar/jnt.
   L2780  A                Non-corrosive finish  ...........  ...........  ...........  ...........  ...........
   L2785  A                Drop lock retainer    ...........  ...........  ...........  ...........  ...........
                            each.

[[Page 60078]]

 
   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.
   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.

[[Page 60079]]

 
   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......  ...........  ...........  ...........  ...........  ...........
  *L3677  A                SO hard plastic       ...........  ...........  ...........  ...........  ...........
                            stabilizer.
   L3700  A                Elbow orthoses elas   ...........  ...........  ...........  ...........  ...........
                            w stays.
   L3710  A                Elbow elastic with    ...........  ...........  ...........  ...........  ...........
                            metal joi.
   L3720  A                Forearm/arm cuffs     ...........  ...........  ...........  ...........  ...........
                            free motio.
   L3730  A                Forearm/arm cuffs     ...........  ...........  ...........  ...........  ...........
                            ext/flex a.
   L3740  A                Cuffs adj lock w/     ...........  ...........  ...........  ...........  ...........
                            active con.
   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.

[[Page 60080]]

 
   L3942  A                Reverse knuckle       ...........  ...........  ...........  ...........  ...........
                            bender.
   L3944  A                Reverse knuckle bend  ...........  ...........  ...........  ...........  ...........
                            w/ outr.
   L3946  A                HFO composite         ...........  ...........  ...........  ...........  ...........
                            elastic.
   L3948  A                Finger knuckle        ...........  ...........  ...........  ...........  ...........
                            bender.
   L3950  A                Oppenheimer w/        ...........  ...........  ...........  ...........  ...........
                            knuckle bend.
   L3952  A                Oppenheimer w/ rev    ...........  ...........  ...........  ...........  ...........
                            knuckle 2.
   L3954  A                Spreading hand......  ...........  ...........  ...........  ...........  ...........
   L3956  A                Add joint upper ext   ...........  ...........  ...........  ...........  ...........
                            orthosis.
   L3960  A                Sewho airplan desig   ...........  ...........  ...........  ...........  ...........
                            abdu pos.
   L3962  A                Sewho erbs palsey     ...........  ...........  ...........  ...........  ...........
                            design abd.
   L3963  A                Molded w/             ...........  ...........  ...........  ...........  ...........
                            articulating elbow.
   L3964  A                Seo mobile arm sup    ...........  ...........  ...........  ...........  ...........
                            att to wc.
   L3965  A                Arm supp att to wc    ...........  ...........  ...........  ...........  ...........
                            rancho ty.
   L3966  A                Mobile arm supports   ...........  ...........  ...........  ...........  ...........
                            reclinin.
   L3968  A                Friction dampening    ...........  ...........  ...........  ...........  ...........
                            arm supp.
   L3969  A                Monosuspension arm/   ...........  ...........  ...........  ...........  ...........
                            hand supp.
   L3970  A                Elevat proximal arm   ...........  ...........  ...........  ...........  ...........
                            support.
   L3972  A                Offset/lat rocker     ...........  ...........  ...........  ...........  ...........
                            arm w/ ela.
   L3974  A                Mobile arm support    ...........  ...........  ...........  ...........  ...........
                            supinator.
   L3980  A                Upp ext fx orthosis   ...........  ...........  ...........  ...........  ...........
                            humeral.
   L3982  A                Upper ext fx          ...........  ...........  ...........  ...........  ...........
                            orthosis rad/ul.
   L3984  A                Upper ext fx          ...........  ...........  ...........  ...........  ...........
                            orthosis wrist.
   L3985  A                Forearm hand fx orth  ...........  ...........  ...........  ...........  ...........
                            w/ wr h.
   L3986  A                Humeral rad/ulna      ...........  ...........  ...........  ...........  ...........
                            wrist fx or.
   L3995  A                Sock fracture or      ...........  ...........  ...........  ...........  ...........
                            equal each.
   L3999  A                Upper limb orthosis   ...........  ...........  ...........  ...........  ...........
                            NOS.
   L4000  A                Repl girdle           ...........  ...........  ...........  ...........  ...........
                            milwaukee orth.
   L4010  A                Replace trilateral    ...........  ...........  ...........  ...........  ...........
                            socket br.
   L4020  A                Replace quadlat       ...........  ...........  ...........  ...........  ...........
                            socket brim.
   L4030  A                Replace socket brim   ...........  ...........  ...........  ...........  ...........
                            cust fit.
   L4040  A                Replace molded thigh  ...........  ...........  ...........  ...........  ...........
                            lacer.
   L4045  A                Replace non-molded    ...........  ...........  ...........  ...........  ...........
                            thigh lac.
   L4050  A                Replace molded calf   ...........  ...........  ...........  ...........  ...........
                            lacer.
   L4055  A                Replace non-molded    ...........  ...........  ...........  ...........  ...........
                            calf lace.
   L4060  A                Replace high roll     ...........  ...........  ...........  ...........  ...........
                            cuff.
   L4070  A                Replace prox & dist   ...........  ...........  ...........  ...........  ...........
                            upright.
   L4080  A                Repl met band kafo-   ...........  ...........  ...........  ...........  ...........
                            afo prox.
   L4090  A                Repl met band kafo-   ...........  ...........  ...........  ...........  ...........
                            afo calf/.
   L4100  A                Repl leath cuff kafo  ...........  ...........  ...........  ...........  ...........
                            prox th.
   L4110  A                Repl leath cuff kafo- ...........  ...........  ...........  ...........  ...........
                            afo cal.
   L4130  A                Replace pretibial     ...........  ...........  ...........  ...........  ...........
                            shell.
   L4205  A                Ortho dvc repair per  ...........  ...........  ...........  ...........  ...........
                            15 min.
   L4210  A                Orth dev repair/repl  ...........  ...........  ...........  ...........  ...........
                            minor p.
   L4350  A                Pneumatic ankle       ...........  ...........  ...........  ...........  ...........
                            cntrl splint.
   L4360  A                Pneumatic walking     ...........  ...........  ...........  ...........  ...........
                            splint.
   L4370  A                Pneumatic full leg    ...........  ...........  ...........  ...........  ...........
                            splint.
   L4380  A                Pneumatic knee        ...........  ...........  ...........  ...........  ...........
                            splint.
   L4392  A                Replace AFO soft      ...........  ...........  ...........  ...........  ...........
                            interface.
   L4394  A                Replace foot drop     ...........  ...........  ...........  ...........  ...........
                            spint.
   L4396  A                Static AFO..........  ...........  ...........  ...........  ...........  ...........
   L4398  A                Foot drop splint      ...........  ...........  ...........  ...........  ...........
                            recumbent.
   L5000  A                Sho insert w arch     ...........  ...........  ...........  ...........  ...........
                            toe filler.
   L5010  A                Mold socket ank hgt   ...........  ...........  ...........  ...........  ...........
                            w/ toe f.
   L5020  A                Tibial tubercle hgt   ...........  ...........  ...........  ...........  ...........
                            w/ toe f.
   L5050  A                Ank symes mold sckt   ...........  ...........  ...........  ...........  ...........
                            sach ft.
   L5060  A                Symes met fr leath    ...........  ...........  ...........  ...........  ...........
                            socket ar.
   L5100  A                Molded socket shin    ...........  ...........  ...........  ...........  ...........
                            sach foot.
   L5105  A                Plast socket jts/     ...........  ...........  ...........  ...........  ...........
                            thgh lacer.
   L5150  A                Mold sckt ext knee    ...........  ...........  ...........  ...........  ...........
                            shin sach.
   L5160  A                Mold socket bent      ...........  ...........  ...........  ...........  ...........
                            knee shin s.
   L5200  A                Kne sing axis fric    ...........  ...........  ...........  ...........  ...........
                            shin sach.
   L5210  A                No knee/ankle joints  ...........  ...........  ...........  ...........  ...........
                            w/ ft b.
   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  D                Bk sach soft cover &  ...........  ...........  ...........  ...........  ...........
                            finish.
  *L5301  A                BK mold socket SACH   ...........  ...........  ...........  ...........  ...........
                            ft endo.
   L5310  D                Knee disart sach      ...........  ...........  ...........  ...........  ...........
                            soft cv/fin.
  *L5311  A                Knee disart, SACH     ...........  ...........  ...........  ...........  ...........
                            ft, endo.
   L5320  D                Ak open end sach      ...........  ...........  ...........  ...........  ...........
                            soft cv/fin.
  *L5321  A                AK open end SACH....  ...........  ...........  ...........  ...........  ...........
   L5330  D                Hip canadian sach     ...........  ...........  ...........  ...........  ...........
                            sft cv/fin.
  *L5331  A                Hip disart canadian   ...........  ...........  ...........  ...........  ...........
                            SACH ft.

[[Page 60081]]

 
   L5340  D                Hemipelvectomy canad  ...........  ...........  ...........  ...........  ...........
                            cv/fin.
  *L5341  A                Hemipelvectomy        ...........  ...........  ...........  ...........  ...........
                            canadian SACH.
   L5400  A                Postop dress & 1      ...........  ...........  ...........  ...........  ...........
                            cast chg bk.
   L5410  A                Postop dsg bk ea add  ...........  ...........  ...........  ...........  ...........
                            cast ch.
   L5420  A                Postop dsg & 1 cast   ...........  ...........  ...........  ...........  ...........
                            chg ak/d.
   L5430  A                Postop dsg ak ea add  ...........  ...........  ...........  ...........  ...........
                            cast ch.
   L5450  A                Postop app non-wgt    ...........  ...........  ...........  ...........  ...........
                            bear dsg.
   L5460  A                Postop app non-wgt    ...........  ...........  ...........  ...........  ...........
                            bear dsg.
   L5500  A                Init bk ptb plaster   ...........  ...........  ...........  ...........  ...........
                            direct.
   L5505  A                Init ak ischal plstr  ...........  ...........  ...........  ...........  ...........
                            direct.
   L5510  A                Prep BK ptb plaster   ...........  ...........  ...........  ...........  ...........
                            molded.
   L5520  A                Perp BK ptb           ...........  ...........  ...........  ...........  ...........
                            thermopls direct.
   L5530  A                Prep BK ptb           ...........  ...........  ...........  ...........  ...........
                            thermopls molded.
   L5535  A                Prep BK ptb open end  ...........  ...........  ...........  ...........  ...........
                            socket.
   L5540  A                Prep BK ptb           ...........  ...........  ...........  ...........  ...........
                            laminated socket.
   L5560  A                Prep AK ischial       ...........  ...........  ...........  ...........  ...........
                            plast molded.
   L5570  A                Prep AK ischial       ...........  ...........  ...........  ...........  ...........
                            direct form.
   L5580  A                Prep AK ischial       ...........  ...........  ...........  ...........  ...........
                            thermo mold.
   L5585  A                Prep AK ischial open  ...........  ...........  ...........  ...........  ...........
                            end.
   L5590  A                Prep AK ischial       ...........  ...........  ...........  ...........  ...........
                            laminated.
   L5595  A                Hip disartic sach     ...........  ...........  ...........  ...........  ...........
                            thermopls.
   L5600  A                Hip disart sach       ...........  ...........  ...........  ...........  ...........
                            laminat mold.
   L5610  A                Above knee            ...........  ...........  ...........  ...........  ...........
                            hydracadence.
   L5611  A                Ak 4 bar link w/fric  ...........  ...........  ...........  ...........  ...........
                            swing.
   L5613  A                Ak 4 bar ling w/      ...........  ...........  ...........  ...........  ...........
                            hydraul swig.
   L5614  A                4-bar link above      ...........  ...........  ...........  ...........  ...........
                            knee w/swng.
   L5616  A                Ak univ multiplex     ...........  ...........  ...........  ...........  ...........
                            sys frict.
   L5617  A                AK/BK self-aligning   ...........  ...........  ...........  ...........  ...........
                            unit ea.
   L5618  A                Test socket symes...  ...........  ...........  ...........  ...........  ...........
   L5620  A                Test socket below     ...........  ...........  ...........  ...........  ...........
                            knee.
   L5622  A                Test socket knee      ...........  ...........  ...........  ...........  ...........
                            disarticula.
   L5624  A                Test socket above     ...........  ...........  ...........  ...........  ...........
                            knee.
   L5626  A                Test socket hip       ...........  ...........  ...........  ...........  ...........
                            disarticulat.
   L5628  A                Test socket           ...........  ...........  ...........  ...........  ...........
                            hemipelvectomy.
   L5629  A                Below knee acrylic    ...........  ...........  ...........  ...........  ...........
                            socket.
   L5630  A                Syme typ expandabl    ...........  ...........  ...........  ...........  ...........
                            wall sckt.
   L5631  A                Ak/knee disartic      ...........  ...........  ...........  ...........  ...........
                            acrylic soc.
   L5632  A                Symes type ptb brim   ...........  ...........  ...........  ...........  ...........
                            design s.
   L5634  A                Symes type poster     ...........  ...........  ...........  ...........  ...........
                            opening so.
   L5636  A                Symes type medial     ...........  ...........  ...........  ...........  ...........
                            opening so.
   L5637  A                Below knee total      ...........  ...........  ...........  ...........  ...........
                            contact.
   L5638  A                Below knee leather    ...........  ...........  ...........  ...........  ...........
                            socket.
   L5639  A                Below knee wood       ...........  ...........  ...........  ...........  ...........
                            socket.
   L5640  A                Knee disarticulat     ...........  ...........  ...........  ...........  ...........
                            leather so.
   L5642  A                Above knee leather    ...........  ...........  ...........  ...........  ...........
                            socket.
   L5643  A                Hip flex inner        ...........  ...........  ...........  ...........  ...........
                            socket ext fr.
   L5644  A                Above knee wood       ...........  ...........  ...........  ...........  ...........
                            socket.
   L5645  A                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  D                Socket insert w lock  ...........  ...........  ...........  ...........  ...........
                            lower.
   L5668  A                Socket insert w/o     ...........  ...........  ...........  ...........  ...........
                            lock lower.
   L5669  D                Below knee socket w/  ...........  ...........  ...........  ...........  ...........
                            o lock.
   L5670  A                Bk molded             ...........  ...........  ...........  ...........  ...........
                            supracondylar susp.
  *L5671  A                BK/AK locking         ...........  ...........  ...........  ...........  ...........
                            mechanism.
   L5672  A                Bk removable medial   ...........  ...........  ...........  ...........  ...........
                            brim sus.
   L5674  A                Bk suspension sleeve  ...........  ...........  ...........  ...........  ...........
   L5675  A                Bk heavy duty susp    ...........  ...........  ...........  ...........  ...........
                            sleeve.

[[Page 60082]]

 
   L5676  A                Bk knee joints        ...........  ...........  ...........  ...........  ...........
                            single axis p.
   L5677  A                Bk knee joints        ...........  ...........  ...........  ...........  ...........
                            polycentric p.
   L5678  A                Bk joint covers pair  ...........  ...........  ...........  ...........  ...........
   L5680  A                Bk thigh lacer non-   ...........  ...........  ...........  ...........  ...........
                            molded.
   L5682  A                Bk thigh lacer glut/  ...........  ...........  ...........  ...........  ...........
                            ischia m.
   L5684  A                Bk fork strap.......  ...........  ...........  ...........  ...........  ...........
   L5686  A                Bk back check.......  ...........  ...........  ...........  ...........  ...........
   L5688  A                Bk waist belt         ...........  ...........  ...........  ...........  ...........
                            webbing.
   L5690  A                Bk waist belt padded  ...........  ...........  ...........  ...........  ...........
                            and lin.
   L5692  A                Ak pelvic control     ...........  ...........  ...........  ...........  ...........
                            belt light.
   L5694  A                Ak pelvic control     ...........  ...........  ...........  ...........  ...........
                            belt pad/l.
   L5695  A                Ak sleeve susp        ...........  ...........  ...........  ...........  ...........
                            neoprene/equa.
   L5696  A                Ak/knee disartic      ...........  ...........  ...........  ...........  ...........
                            pelvic join.
   L5697  A                Ak/knee disartic      ...........  ...........  ...........  ...........  ...........
                            pelvic band.
   L5698  A                Ak/knee disartic      ...........  ...........  ...........  ...........  ...........
                            silesian ba.
   L5699  A                Shoulder harness....  ...........  ...........  ...........  ...........  ...........
   L5700  A                Replace socket below  ...........  ...........  ...........  ...........  ...........
                            knee.
   L5701  A                Replace socket above  ...........  ...........  ...........  ...........  ...........
                            knee.
   L5702  A                Replace socket hip..  ...........  ...........  ...........  ...........  ...........
   L5704  A                Custom shape covr     ...........  ...........  ...........  ...........  ...........
                            below knee.
   L5705  A                Custm shape cover     ...........  ...........  ...........  ...........  ...........
                            above knee.
   L5706  A                Custm shape cvr knee  ...........  ...........  ...........  ...........  ...........
                            disart.
   L5707  A                Custm shape cover     ...........  ...........  ...........  ...........  ...........
                            hip disart.
   L5710  A                Kne-shin exo sng axi  ...........  ...........  ...........  ...........  ...........
                            mnl loc.
   L5711  A                Knee-shin exo mnl     ...........  ...........  ...........  ...........  ...........
                            lock ultra.
   L5712  A                Knee-shin exo frict   ...........  ...........  ...........  ...........  ...........
                            swg & st.
   L5714  A                Knee-shin exo         ...........  ...........  ...........  ...........  ...........
                            variable frict.
   L5716  A                Knee-shin exo mech    ...........  ...........  ...........  ...........  ...........
                            stance ph.
   L5718  A                Knee-shin exo frct    ...........  ...........  ...........  ...........  ...........
                            swg & sta.
   L5722  A                Knee-shin pneum swg   ...........  ...........  ...........  ...........  ...........
                            frct exo.
   L5724  A                Knee-shin exo fluid   ...........  ...........  ...........  ...........  ...........
                            swing ph.
   L5726  A                Knee-shin ext jnts    ...........  ...........  ...........  ...........  ...........
                            fld swg e.
   L5728  A                Knee-shin fluid swg   ...........  ...........  ...........  ...........  ...........
                            & stance.
   L5780  A                Knee-shin pneum/      ...........  ...........  ...........  ...........  ...........
                            hydra pneum.
   L5785  A                Exoskeletal bk        ...........  ...........  ...........  ...........  ...........
                            ultralt mater.
   L5790  A                Exoskeletal ak ultra- ...........  ...........  ...........  ...........  ...........
                            light m.
   L5795  A                Exoskel hip ultra-    ...........  ...........  ...........  ...........  ...........
                            light mate.
   L5810  A                Endoskel knee-shin    ...........  ...........  ...........  ...........  ...........
                            mnl lock.
   L5811  A                Endo knee-shin mnl    ...........  ...........  ...........  ...........  ...........
                            lck ultra.
   L5812  A                Endo knee-shin frct   ...........  ...........  ...........  ...........  ...........
                            swg & st.
   L5814  A                Endo knee-shin        ...........  ...........  ...........  ...........  ...........
                            hydral swg ph.
   L5816  A                Endo knee-shin polyc  ...........  ...........  ...........  ...........  ...........
                            mch sta.
   L5818  A                Endo knee-shin frct   ...........  ...........  ...........  ...........  ...........
                            swg & st.
   L5822  A                Endo knee-shin pneum  ...........  ...........  ...........  ...........  ...........
                            swg frc.
   L5824  A                Endo knee-shin fluid  ...........  ...........  ...........  ...........  ...........
                            swing p.
   L5826  A                Miniature knee joint  ...........  ...........  ...........  ...........  ...........
   L5828  A                Endo knee-shin fluid  ...........  ...........  ...........  ...........  ...........
                            swg/sta.
   L5830  A                Endo knee-shin pneum/ ...........  ...........  ...........  ...........  ...........
                            swg pha.
   L5840  A                Multi-axial knee/     ...........  ...........  ...........  ...........  ...........
                            shin system.
   L5845  A                Knee-shin sys stance  ...........  ...........  ...........  ...........  ...........
                            flexion.
   L5846  A                Knee-shin sys         ...........  ...........  ...........  ...........  ...........
                            microprocessor.
  *L5847  A                Microprocessor cntrl  ...........  ...........  ...........  ...........  ...........
                            feature.
   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.

[[Page 60083]]

 
   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.
  *L5989  A                Pylon w elctrnc       ...........  ...........  ...........  ...........  ...........
                            force sensor.
  *L5990  A                User adjustable heel  ...........  ...........  ...........  ...........  ...........
                            height.
   L5999  A                Lowr extremity        ...........  ...........  ...........  ...........  ...........
                            prosthes NOS.
   L6000  A                Par hand robin-aids   ...........  ...........  ...........  ...........  ...........
                            thum rem.
   L6010  A                Hand robin-aids       ...........  ...........  ...........  ...........  ...........
                            little/ring.
   L6020  A                Part hand robin-aids  ...........  ...........  ...........  ...........  ...........
                            no fing.
   L6050  A                Wrst MLd sck flx hng  ...........  ...........  ...........  ...........  ...........
                            tri pad.
   L6055  A                Wrst mold sock w/exp  ...........  ...........  ...........  ...........  ...........
                            interfa.
   L6100  A                Elb mold sock flex    ...........  ...........  ...........  ...........  ...........
                            hinge pad.
   L6110  A                Elbow mold sock       ...........  ...........  ...........  ...........  ...........
                            suspension t.
   L6120  A                Elbow mold doub splt  ...........  ...........  ...........  ...........  ...........
                            soc ste.
   L6130  A                Elbow stump           ...........  ...........  ...........  ...........  ...........
                            activated lock h.
   L6200  A                Elbow mold outsid     ...........  ...........  ...........  ...........  ...........
                            lock hinge.
   L6205  A                Elbow molded w/       ...........  ...........  ...........  ...........  ...........
                            expand inter.
   L6250  A                Elbow inter loc       ...........  ...........  ...........  ...........  ...........
                            elbow forarm.
   L6300  A                Shlder disart int     ...........  ...........  ...........  ...........  ...........
                            lock elbow.
   L6310  A                Shoulder passive      ...........  ...........  ...........  ...........  ...........
                            restor comp.
   L6320  A                Shoulder passive      ...........  ...........  ...........  ...........  ...........
                            restor cap.
   L6350  A                Thoracic intern lock  ...........  ...........  ...........  ...........  ...........
                            elbow.
   L6360  A                Thoracic passive      ...........  ...........  ...........  ...........  ...........
                            restor comp.
   L6370  A                Thoracic passive      ...........  ...........  ...........  ...........  ...........
                            restor cap.
   L6380  A                Postop dsg cast chg   ...........  ...........  ...........  ...........  ...........
                            wrst/elb.
   L6382  A                Postop dsg cast chg   ...........  ...........  ...........  ...........  ...........
                            elb dis/.
   L6384  A                Postop dsg cast chg   ...........  ...........  ...........  ...........  ...........
                            shlder/t.
   L6386  A                Postop ea cast chg &  ...........  ...........  ...........  ...........  ...........
                            realign.
   L6388  A                Postop applicat       ...........  ...........  ...........  ...........  ...........
                            rigid dsg on.
   L6400  A                Below elbow prosth    ...........  ...........  ...........  ...........  ...........
                            tiss shap.
   L6450  A                Elb disart prosth     ...........  ...........  ...........  ...........  ...........
                            tiss shap.
   L6500  A                Above elbow prosth    ...........  ...........  ...........  ...........  ...........
                            tiss shap.
   L6550  A                Shldr disar prosth    ...........  ...........  ...........  ...........  ...........
                            tiss shap.
   L6570  A                Scap thorac prosth    ...........  ...........  ...........  ...........  ...........
                            tiss shap.
   L6580  A                Wrist/elbow bowden    ...........  ...........  ...........  ...........  ...........
                            cable mol.
   L6582  A                Wrist/elbow bowden    ...........  ...........  ...........  ...........  ...........
                            cbl dir f.
   L6584  A                Elbow fair lead       ...........  ...........  ...........  ...........  ...........
                            cable molded.
   L6586  A                Elbow fair lead       ...........  ...........  ...........  ...........  ...........
                            cable dir fo.
   L6588  A                Shdr fair lead cable  ...........  ...........  ...........  ...........  ...........
                            molded.
   L6590  A                Shdr fair lead cable  ...........  ...........  ...........  ...........  ...........
                            direct.
   L6600  A                Polycentric hinge     ...........  ...........  ...........  ...........  ...........
                            pair.
   L6605  A                Single pivot hinge    ...........  ...........  ...........  ...........  ...........
                            pair.
   L6610  A                Flexible metal hinge  ...........  ...........  ...........  ...........  ...........
                            pair.
   L6615  A                Disconnect locking    ...........  ...........  ...........  ...........  ...........
                            wrist uni.
   L6616  A                Disconnect insert     ...........  ...........  ...........  ...........  ...........
                            locking wr.
   L6620  A                Flexion-friction      ...........  ...........  ...........  ...........  ...........
                            wrist unit.
   L6623  A                Spring-ass rot wrst   ...........  ...........  ...........  ...........  ...........
                            w/ latch.
   L6625  A                Rotation wrst w/      ...........  ...........  ...........  ...........  ...........
                            cable lock.
   L6628  A                Quick disconn hook    ...........  ...........  ...........  ...........  ...........
                            adapter o.
   L6629  A                Lamination collar w/  ...........  ...........  ...........  ...........  ...........
                            couplin.
   L6630  A                Stainless steel any   ...........  ...........  ...........  ...........  ...........
                            wrist.
   L6632  A                Latex suspension      ...........  ...........  ...........  ...........  ...........
                            sleeve each.
   L6635  A                Lift assist for       ...........  ...........  ...........  ...........  ...........
                            elbow.
   L6637  A                Nudge control elbow   ...........  ...........  ...........  ...........  ...........
                            lock.
   L6640  A                Shoulder abduction    ...........  ...........  ...........  ...........  ...........
                            joint pai.
   L6641  A                Excursion amplifier   ...........  ...........  ...........  ...........  ...........
                            pulley t.
   L6642  A                Excursion amplifier   ...........  ...........  ...........  ...........  ...........
                            lever ty.
   L6645  A                Shoulder flexion-     ...........  ...........  ...........  ...........  ...........
                            abduction j.
   L6650  A                Shoulder universal    ...........  ...........  ...........  ...........  ...........
                            joint.
   L6655  A                Standard control      ...........  ...........  ...........  ...........  ...........
                            cable extra.
   L6660  A                Heavy duty control    ...........  ...........  ...........  ...........  ...........
                            cable.
   L6665  A                Teflon or equal       ...........  ...........  ...........  ...........  ...........
                            cable lining.
   L6670  A                Hook to hand cable    ...........  ...........  ...........  ...........  ...........
                            adapter.
   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.

[[Page 60084]]

 
   L6690  A                Frame typ sock        ...........  ...........  ...........  ...........  ...........
                            interscap-tho.
   L6691  A                Removable insert      ...........  ...........  ...........  ...........  ...........
                            each.
   L6692  A                Silicone gel insert   ...........  ...........  ...........  ...........  ...........
                            or equal.
   L6693  A                Lockingelbow forearm  ...........  ...........  ...........  ...........  ...........
                            cntrbal.
   L6700  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #3.
   L6705  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #5.
   L6710  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #5x.
   L6715  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #5xa.
   L6720  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #6.
   L6725  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #7.
   L6730  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #7lo.
   L6735  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #8.
   L6740  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #8x.
   L6745  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #88x.
   L6750  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #10p.
   L6755  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #10x.
   L6765  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #12p.
   L6770  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #99x.
   L6775  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model#555.
   L6780  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model #ss555.
   L6790  A                Hooks-accu hook or    ...........  ...........  ...........  ...........  ...........
                            equal.
   L6795  A                Hooks-2 load or       ...........  ...........  ...........  ...........  ...........
                            equal.
   L6800  A                Hooks-aprl vc or      ...........  ...........  ...........  ...........  ...........
                            equal.
   L6805  A                Modifier wrist        ...........  ...........  ...........  ...........  ...........
                            flexion unit.
   L6806  A                Trs grip vc or equal  ...........  ...........  ...........  ...........  ...........
   L6807  A                Term device 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.
   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........  ...........  ...........  ...........  ...........  ...........
  *L6881  A                Autograsp feature ul  ...........  ...........  ...........  ...........  ...........
                            term dv.
  *L6882  A                Microprocessor        ...........  ...........  ...........  ...........  ...........
                            control uplmb.
   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.

[[Page 60085]]

 
   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......  ...........  ...........  ...........  ...........  ...........
  *L8001  A                Breast prosthesis     ...........  ...........  ...........  ...........  ...........
                            bra and form.
  *L8002  A                Brst prsth bra &      ...........  ...........  ...........  ...........  ...........
                            bilat form.
   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.
   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.
  *L8505  A                Artificial larynx,    ...........  ...........  ...........  ...........  ...........
                            accessory.

[[Page 60086]]

 
  *L8507  A                Trach-esoph voice     ...........  ...........  ...........  ...........  ...........
                            pros pt in.
  *L8509  A                Trach-esoph voice     ...........  ...........  ...........  ...........  ...........
                            pros md in.
  *L8510  A                Voice amplifier.....  ...........  ...........  ...........  ...........  ...........
   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  E                Cochlear device/      ...........  ...........  ...........  ...........  ...........
                            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         0.89       $45.30        $9.97        $9.06
                            monitoring.
   M0075  E                Cellular therapy....  ...........  ...........  ...........  ...........  ...........
   M0076  E                Prolotherapy........  ...........  ...........  ...........  ...........  ...........
   M0100  E                Intragastric          ...........  ...........  ...........  ...........  ...........
                            hypothermia.
   M0300  E                IV chelationtherapy.  ...........  ...........  ...........  ...........  ...........
   M0301  E                Fabric wrapping of    ...........  ...........  ...........  ...........  ...........
                            aneurysm.
   M0302  D                Assessment of                0970  ...........       $25.00  ...........        $5.00
                            cardiac output.
   P2028  A                Cephalin floculation  ...........  ...........  ...........  ...........  ...........
                            test.
   P2029  A                Congo red blood test  ...........  ...........  ...........  ...........  ...........
   P2031  E                Hair analysis.......  ...........  ...........  ...........  ...........  ...........
   P2033  A                Blood thymol          ...........  ...........  ...........  ...........  ...........
                            turbidity.
   P2038  A                Blood mucoprotein...  ...........  ...........  ...........  ...........  ...........
   P3000  A                Screen pap by tech w  ...........  ...........  ...........  ...........  ...........
                            md supv.
   P3001  E                Screening pap smear   ...........  ...........  ...........  ...........  ...........
                            by phys.
   P7001  E                Culture bacterial     ...........  ...........  ...........  ...........  ...........
                            urine.
   P9010  K                Whole blood for              0950         1.97      $100.28  ...........       $20.06
                            transfusion.
   P9011  E                Blood split unit....  ...........  ...........  ...........  ...........  ...........
   P9012  K                Cryoprecipitate each         0952         0.66       $33.60  ...........        $6.72
                            unit.
   P9016  K                RBC leukocytes               0954         2.67      $135.91  ...........       $27.18
                            reduced.
   P9017  K                One donor fresh              0955         2.13      $108.43  ...........       $21.69
                            frozn plasma.
   P9019  K                Platelets, each unit         0957         0.93       $47.34  ...........        $9.47
   P9020  K                Plaelet rich plasma          0958         1.10       $55.99  ...........       $11.20
                            unit.
   P9021  K                Red blood cells unit         0959         1.93       $98.24  ...........       $19.65
   P9022  K                Washed red blood             0960         3.60      $183.25  ...........       $36.65
                            cells unit.
   P9023  K                Frozen plasma,               0949         2.78      $141.51  ...........       $28.30
                            pooled, sd.
   P9031  K                Platelets leukocytes         0954         2.67      $135.91  ...........       $27.18
                            reduced.
   P9032  K                Platelets,                   9500         1.68       $85.52  ...........       $17.10
                            irradiated.
   P9033  K                Platelets                    0954         2.67      $135.91  ...........       $27.18
                            leukoreduced irrad.
   P9034  K                Platelets, pheresis.         9501         9.16      $466.28  ...........       $93.26
   P9035  K                Platelet pheres              9501         9.16      $466.28  ...........       $93.26
                            leukoreduced.
   P9036  K                Platelet pheresis            9502         9.94      $505.99  ...........      $101.20
                            irradiated.
   P9037  K                Plt, aph/pher, L/R,          1019         9.11      $463.74  ...........       $92.75
                            irrad.
   P9038  K                RBC irradiated......         9505         2.44      $124.21  ...........       $24.84
   P9039  K                RBC deglycerolized..         9504         4.11      $209.22  ...........       $41.84
   P9040  K                RBC leukoreduced             9504         4.11      $209.22  ...........       $41.84
                            irradiated.
   P9041  K                Albumin(human), 5%,          0961         2.07      $105.37  ...........       $21.07
                            50ml.
   P9042  D                Albumin (human),             0962         1.04       $52.94  ...........       $10.59
                            25%, 10ml.
   P9043  K                Plasma protein               0956         1.19       $60.58  ...........       $12.12
                            fraction.
   P9044  K                Cryoprecipitatereduc         1009         0.82       $41.74  ...........        $8.35
                            edplasma.
  *P9045  K                Albumin (human), 5%,         0963        10.35      $526.86  ...........      $105.37
                            250 ml.
  *P9046  K                Albumin (human),             0964         2.08      $105.88  ...........       $21.18
                            25%, 20 ml.
  *P9047  K                Albumin (human),             0965         5.20      $264.70  ...........       $52.94
                            25%, 50ml.
  *P9048  K                Plasmaprotein                0966         5.95      $302.88  ...........       $60.58
                            fract,5%,250ml.
  *P9050  K                Granulocytes,                9506        27.75    $1,412.59  ...........      $282.52
                            pheresis unit.
   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         1.47       $74.83       $41.15       $14.97
   Q0081  D                Infusion ther other          0120         3.08      $156.78       $42.67       $31.36
                            than che.
   Q0083  S                Chemo by other than          0116         0.91       $46.32  ...........        $9.26
                            infusion.
   Q0084  S                Chemotherapy by              0117         4.01      $204.13       $52.69       $40.83
                            infusion.
   Q0085  S                Chemo by both                0118         4.20      $213.80       $72.03       $42.76
                            infusion and o.
   Q0086  D                Physical therapy      ...........  ...........  ...........  ...........  ...........
                            evaluation/.
   Q0091  T                Obtaining screen pap         0191         0.23       $11.71        $3.40        $2.34
                            smear.
   Q0092  N                Set up port xray      ...........  ...........  ...........  ...........  ...........
                            equipment.
   Q0111  A                Wet mounts/ w         ...........  ...........  ...........  ...........  ...........
                            preparations.

[[Page 60087]]

 
   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  ...........       $12.26  ...........        $1.57
                            alpha inj per 1000
                            units.
   Q0144  D                Azithromycin          ...........  ...........  ...........  ...........  ...........
                            dihydrate, oral.
   Q0160  D                Factor IX non-               0931  ...........       $26.13  ...........        $3.74
                            recombinant.
   Q0161  D                Factor IX                    0932  ...........        $1.12  ...........         $.14
                            recombinant.
   Q0163  G                Diphenhydramine HCL          1400  ...........         $.23  ...........         $.02
                            50 mg.
   Q0164  G                Prochlorperazine             1401  ...........         $.65  ...........         $.06
                            maleate 5 mg.
   Q0165  E                Prochlorperazine      ...........  ...........  ...........  ...........  ...........
                            maleate 10 mg.
   Q0166  G                Granisetron HCL 1 mg         0765  ...........       $44.69  ...........        $6.40
                            oral.
   Q0167  G                Dronabinol 2.5 mg            0762  ...........        $3.28  ...........         $.42
                            oral.
   Q0168  E                Dronabinol 5 mg oral  ...........  ...........  ...........  ...........  ...........
   Q0169  G                Promethazine HCL             1402  ...........         $.01  ...........         $.00
                            12.5 mg oral.
   Q0170  E                Promethazine HCl 25   ...........  ...........  ...........  ...........  ...........
                            mg oral.
   Q0171  G                Chlorpromazine HCL           1403  ...........         $.27  ...........         $.02
                            10 mg oral.
   Q0172  E                Chlorpromazine HCl    ...........  ...........  ...........  ...........  ...........
                            25 mg oral.
   Q0173  G                Trimethobenzamide            1404  ...........         $.38  ...........         $.03
                            HCL 250 mg.
   Q0174  G                Thiethylperazine             1405  ...........         $.56  ...........         $.08
                            maleate 10 mg.
   Q0175  G                Perphenazine 4 mg            1406  ...........         $.62  ...........         $.06
                            oral.
   Q0176  E                Perphenazine 8 mg     ...........  ...........  ...........  ...........  ...........
                            oral.
   Q0177  G                Hydroxyzine pamoate          1407  ...........         $.28  ...........         $.03
                            25 mg.
   Q0178  E                Hydroxyzine pamoate   ...........  ...........  ...........  ...........  ...........
                            50 mg.
   Q0179  G                Ondansetron HCL 8 mg         0769  ...........       $26.41  ...........        $3.39
                            oral.
   Q0180  G                Dolasetron mesylate          0763  ...........       $69.64  ...........        $8.94
                            oral, 100 mg.
   Q0181  E                Unspecified oral      ...........  ...........  ...........  ...........  ...........
                            anti-emetic.
   Q0183  N                Nonmetabolic active   ...........  ...........  ...........  ...........  ...........
                            tissue.
   Q0184  N                Metabolically active  ...........  ...........  ...........  ...........  ...........
                            tissue.
   Q0185  D                Metabolic active D/E  ...........  ...........  ...........  ...........  ...........
                            tissue.
   Q0187  G                Factor VIII                  1409  ...........    $1,596.00  ...........      $228.48
                            recombinant, per
                            1.2 mg.
   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  ...........        $1.43  ...........         $.20
                            per ml.
   Q2003  G                Aprotinin, 10,000            7019  ...........        $2.16  ...........         $.31
                            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  ...........       $10.93  ...........        $1.56
   Q2009  G                Fosphenytoin, 50 mg.         7028  ...........        $5.73  ...........         $.82
   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  ...........       $13.60  ...........        $1.95
                            0.5 mg.
   Q2015  D                Somatrem, 5 mg......         7033  ...........      $209.48  ...........       $29.99
   Q2016  D                Somatropin, 1 mg....         7034  ...........       $39.90  ...........        $5.12
   Q2017  G                Teniposide, 50 mg...         7035  ...........      $222.80  ...........       $31.90
   Q2018  G                Urofollitropin, 75           7037  ...........       $73.29  ...........       $10.49
                            iu.
   Q2019  G                Basiliximab 20 mg...         1615  ...........    $1,437.78  ...........      $205.83
   Q2020  E                Histrelin acetate,    ...........  ...........  ...........  ...........  ...........
                            10 mg.
   Q2021  G                Lepirudin...........         1617  ...........      $131.96  ...........       $18.89
   Q2022  G                VonWillebrandFactrCm         1618  ...........         $.95  ...........         $.14
                            plxperIU.
   Q3001  E                Brachytherapy         ...........  ...........  ...........  ...........  ...........
                            Radioelements.
   Q3002  G                Gallium ga 67, per           1619  ...........       $25.62  ...........        $2.32
                            mCi.
   Q3003  G                Technetium tc99m             1620  ...........      $403.99  ...........       $57.83
                            bicisate.
   Q3004  G                Xenon xe 133........         1621  ...........       $29.93  ...........        $2.71
   Q3005  G                Technetium tc99m             1622  ...........      $137.75  ...........       $19.72
                            mertiatide.
   Q3006  G                Technetium tc99m             1623  ...........       $22.61  ...........        $3.24
                            glucepatate.
   Q3007  G                Sodium phosphate p32         1624  ...........       $54.34  ...........        $7.78
   Q3008  G                Indium 111-in                1625  ...........      $935.75  ...........      $133.96
                            pentetreotide.
   Q3009  G                Technetium tc99m             1626  ...........        $1.47  ...........         $.21
                            oxidronate.
   Q3010  G                Technetium                   1627  ...........       $40.90  ...........        $5.85
                            tc99mlabeledrbcs.
   Q3011  G                Chromic phosphate            1628  ...........      $150.86  ...........       $21.60
                            p32.
   Q3012  G                Co 57, 0.5 Mci......         1089  ...........       $81.10  ...........       $10.41
   Q3013  D                Verteporfin           ...........  ...........  ...........  ...........  ...........
                            injection.
   Q3014  A                Telehealth facility   ...........  ...........  ...........  ...........  ...........
                            fee.
   Q3017  A                Amb srv, ALS assmt,   ...........  ...........  ...........  ...........  ...........
                            no oth als.
   Q4001  A                Cast sup body cast    ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4002  A                Cast sup body cast    ...........  ...........  ...........  ...........  ...........
                            fiberglas.

[[Page 60088]]

 
   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.
   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.
  *T1015  E                Clinic service......  ...........  ...........  ...........  ...........  ...........
   V2020  A                Vision svcs frames    ...........  ...........  ...........  ...........  ...........
                            purchases.

[[Page 60089]]

 
   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.
   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.

[[Page 60090]]

 
   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.
   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.
  *V5241  E                Dispensing fee,       ...........  ...........  ...........  ...........  ...........
                            monaural.
  *V5242  E                Hearing aid,          ...........  ...........  ...........  ...........  ...........
                            monaural, cic.
  *V5243  E                Hearing aid,          ...........  ...........  ...........  ...........  ...........
                            monaural, itc.
  *V5244  E                Hearing aid, prog,    ...........  ...........  ...........  ...........  ...........
                            mon, cic.
  *V5245  E                Hearing aid, prog,    ...........  ...........  ...........  ...........  ...........
                            mon, itc.
  *V5246  E                Hearing aid, prog,    ...........  ...........  ...........  ...........  ...........
                            mon, ite.
  *V5247  E                Hearing aid, prog,    ...........  ...........  ...........  ...........  ...........
                            mon, bte.
  *V5248  E                Hearing aid,          ...........  ...........  ...........  ...........  ...........
                            binaural, cic.

[[Page 60091]]

 
  *V5249  E                Hearing aid,          ...........  ...........  ...........  ...........  ...........
                            binaural, itc.
  *V5250  E                Hearing aid, prog,    ...........  ...........  ...........  ...........  ...........
                            bin, cic.
  *V5251  E                Hearing aid, prog,    ...........  ...........  ...........  ...........  ...........
                            bin, itc.
  *V5252  E                Hearing aid, prog,    ...........  ...........  ...........  ...........  ...........
                            bin, ite.
  *V5253  E                Hearing aid, prog,    ...........  ...........  ...........  ...........  ...........
                            bin, bte.
  *V5254  E                Hearing id, digit,    ...........  ...........  ...........  ...........  ...........
                            mon, cic.
  *V5255  E                Hearing aid, digit,   ...........  ...........  ...........  ...........  ...........
                            mon, itc.
  *V5256  E                Hearing aid, digit,   ...........  ...........  ...........  ...........  ...........
                            mon, ite.
  *V5257  E                Hearing aid, digit,   ...........  ...........  ...........  ...........  ...........
                            mon, bte.
  *V5258  E                Hearing aid, digit,   ...........  ...........  ...........  ...........  ...........
                            bin, cic.
  *V5259  E                Hearing aid, digit,   ...........  ...........  ...........  ...........  ...........
                            bin, itc.
  *V5260  E                Hearing aid, digit,   ...........  ...........  ...........  ...........  ...........
                            bin, ite.
  *V5261  E                Hearing aid, digit,   ...........  ...........  ...........  ...........  ...........
                            bin, bte.
  *V5262  E                Hearing aid, disp,    ...........  ...........  ...........  ...........  ...........
                            monaural.
  *V5263  E                Hearing aid, disp,    ...........  ...........  ...........  ...........  ...........
                            binaural.
  *V5264  E                Ear mold/insert.....  ...........  ...........  ...........  ...........  ...........
  *V5265  E                Ear mold/insert,      ...........  ...........  ...........  ...........  ...........
                            disp.
  *V5266  E                Battery for hearing   ...........  ...........  ...........  ...........  ...........
                            device.
  *V5267  E                Hearing aid supply/   ...........  ...........  ...........  ...........  ...........
                            accessory.
  *V5268  E                ALD Telephone         ...........  ...........  ...........  ...........  ...........
                            Amplifier.
  *V5269  E                Alerting device, any  ...........  ...........  ...........  ...........  ...........
                            type.
  *V5270  E                ALD, TV amplifier,    ...........  ...........  ...........  ...........  ...........
                            any type.
  *V5271  E                ALD, TV caption       ...........  ...........  ...........  ...........  ...........
                            decoder.
  *V5272  E                Tdd.................  ...........  ...........  ...........  ...........  ...........
  *V5273  E                ALD for cochlear      ...........  ...........  ...........  ...........  ...........
                            implant.
  *V5274  E                ALD unspecified.....  ...........  ...........  ...........  ...........  ...........
  *V5275  E                Ear impression......  ...........  ...........  ...........  ...........  ...........
   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.
* Code is new in 2002.

      
  

  

  

  Federal Register / Vol. 66 , No. 231 / Friday, November 30, 2001 / 
Rules and Regulations  

[[Page 60091]]


      

   Addendum D.--Payment Status Indicators for the Hospital Outpatient
                       Prospective Payment System
------------------------------------------------------------------------
    Indicator               Service                     Status
------------------------------------------------------------------------
A                 Pulmonary Rehabilitation    Not Paid Under Outpatient
                   Clinical Trial.             PPS
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 Fee Schedule
                   Laboratory Services.
A                 Physician Services for      Physician Fee Schedule
                   ESRD Patients.
A                 Screening Mammography.....  Lower of Charges or
                                               National Rate
C                 Inpatient Procedures......  Admit Patient
E                 Non-Covered Items and       Not Paid Under Outpatient
                   Services.                   PPS
F                 Acquisition of Corneal      Paid at Reasonable Cost
                   Tissue.
G                 Drug/Biological Pass-       Additional Payment
                   Through.
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
S                 Significant Procedure, Not  Paid Under Outpatient PPS
                   Discounted When Multiple.
T                 Significant Procedure,      Paid Under Outpatient PPS
                   Multiple Procedure
                   Reduction Applies.
V                 Visit to Clinic or          Paid Under Outpatient PPS
                   Emergency 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.

* Code is new in 2002.

[[Page 60091]]

   

[[Page 60092]]



 Addendum E.--CPT Codes Which Would Be Paid Only As Inpatient Procedures
                          [Calender Year 2002]
------------------------------------------------------------------------
  CPT/         Status
  HCPCS       Indicator                      Description
------------------------------------------------------------------------
  *0001T  C                 Endovas repr abdo ao aneurys
  *0002T  C                 Endovas repr abdo ao aneurys
  *0005T  C                 Perc cath stent/brain cv art
  *0006T  C                 Perc cath stent/brain cv art
  *0007T  C                 Perc cath stent/brain cv art
   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
  *0021T  C                 Fetal oximetry, trnsvag/cerv
  *0024T  C                 Transcath cardiac reduction
   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
   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
   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
   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
   01140  C                 Anesth, amputation at pelvis
   01150  C                 Anesth, pelvic tumor surgery
   01190  C                 Anesth, pelvis nerve removal
   01212  C                 Anesth, hip disarticulation
   01214  C                 Anesth, replacement of hip
   01232  C                 Anesth, amputation of femur
   01234  C                 Anesth, radical femur surg
   01272  C                 Anesth, femoral artery surg
   01274  C                 Anesth, femoral embolectomy
   01402  C                 Anesth, replacement of knee
   01404  C                 Anesth, amputation at knee
   01442  C                 Anesth, knee artery surg
   01444  C                 Anesth, knee artery repair
   01486  C                 Anesth, ankle replacement
   01502  C                 Anesth, lwr leg embolectomy
   01632  C                 Anesth, surgery of shoulder
   01634  C                 Anesth, shoulder joint amput

[[Page 60093]]

 
   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
   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
   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

[[Page 60094]]

 
   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 60095]]

 
   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
   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

[[Page 60096]]

 
   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
   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

[[Page 60097]]

 
   27226  C                 Treat hip wall fracture
   27227  C                 Treat hip fracture(s)
   27228  C                 Treat hip fracture(s)
   27232  C                 Treat thigh fracture
   27235  C                 Treat thigh fracture
   27236  C                 Treat thigh fracture
   27240  C                 Treat thigh fracture
   27244  C                 Treat thigh fracture
   27245  C                 Treat thigh fracture
   27248  C                 Treat thigh fracture
   27253  C                 Treat hip dislocation
   27254  C                 Treat hip dislocation
   27258  C                 Treat hip dislocation
   27259  C                 Treat hip dislocation
   27280  C                 Fusion of sacroiliac joint
   27282  C                 Fusion of pubic bones
   27284  C                 Fusion of hip joint
   27286  C                 Fusion of hip joint
   27290  C                 Amputation of leg at hip
   27295  C                 Amputation of leg at hip
   27303  C                 Drainage of bone lesion
   27365  C                 Extensive leg surgery
   27445  C                 Revision of knee joint
   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

[[Page 60098]]

 
   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
   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

[[Page 60099]]

 
   32442  C                 Sleeve pneumonectomy
   32445  C                 Removal of lung
   32480  C                 Partial removal of lung
   32482  C                 Bilobectomy
   32484  C                 Segmentectomy
   32486  C                 Sleeve lobectomy
   32488  C                 Completion pneumonectomy
   32491  C                 Lung volume reduction
   32500  C                 Partial removal of lung
   32501  C                 Repair bronchus add-on
   32520  C                 Remove lung & revise chest
   32522  C                 Remove lung & revise chest
   32525  C                 Remove lung & revise chest
   32540  C                 Removal of lung lesion
   32650  C                 Thoracoscopy, surgical
   32651  C                 Thoracoscopy, surgical
   32652  C                 Thoracoscopy, surgical
   32653  C                 Thoracoscopy, surgical
   32654  C                 Thoracoscopy, surgical
   32655  C                 Thoracoscopy, surgical
   32656  C                 Thoracoscopy, surgical
   32657  C                 Thoracoscopy, surgical
   32658  C                 Thoracoscopy, surgical
   32659  C                 Thoracoscopy, surgical
   32660  C                 Thoracoscopy, surgical
   32661  C                 Thoracoscopy, surgical
   32662  C                 Thoracoscopy, surgical
   32663  C                 Thoracoscopy, surgical
   32664  C                 Thoracoscopy, surgical
   32665  C                 Thoracoscopy, surgical
   32800  C                 Repair lung hernia
   32810  C                 Close chest after drainage
   32815  C                 Close bronchial fistula
   32820  C                 Reconstruct injured chest
   32850  C                 Donor pneumonectomy
   32851  C                 Lung transplant, single
   32852  C                 Lung transplant with bypass
   32853  C                 Lung transplant, double
   32854  C                 Lung transplant with bypass
   32900  C                 Removal of rib(s)
   32905  C                 Revise & repair chest wall
   32906  C                 Revise & repair chest wall
   32940  C                 Revision of lung
   32997  C                 Total lung lavage
   33015  C                 Incision of heart sac
   33020  C                 Incision of heart sac
   33025  C                 Incision of heart sac
   33030  C                 Partial removal of heart sac
   33031  C                 Partial removal of heart sac
   33050  C                 Removal of heart sac lesion
   33120  C                 Removal of heart lesion
   33130  C                 Removal of heart lesion
   33140  C                 Heart revascularize (tmr)
   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

[[Page 60100]]

 
   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
   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

[[Page 60101]]

 
   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
   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

[[Page 60102]]

 
   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
  *33967  C                 Insert ia percut device
   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
  *33979  C                 Insert intracorporeal device
  *33980  C                 Remove intracorporeal 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

[[Page 60103]]

 
   35092  C                 Repair artery rupture, aorta
   35102  C                 Repair defect of artery
   35103  C                 Repair artery rupture, groin
   35111  C                 Repair defect of artery
   35112  C                 Repair artery rupture,spleen
   35121  C                 Repair defect of artery
   35122  C                 Repair artery rupture, belly
   35131  C                 Repair defect of artery
   35132  C                 Repair artery rupture, groin
   35141  C                 Repair defect of artery
   35142  C                 Repair artery rupture, thigh
   35151  C                 Repair defect of artery
   35152  C                 Repair artery rupture, knee
   35161  C                 Repair defect of artery
   35162  C                 Repair artery rupture
   35182  C                 Repair blood vessel lesion
   35189  C                 Repair blood vessel lesion
   35211  C                 Repair blood vessel lesion
   35216  C                 Repair blood vessel lesion
   35221  C                 Repair blood vessel lesion
   35241  C                 Repair blood vessel lesion
   35246  C                 Repair blood vessel lesion
   35251  C                 Repair blood vessel lesion
   35271  C                 Repair blood vessel lesion
   35276  C                 Repair blood vessel lesion
   35281  C                 Repair blood vessel lesion
   35301  C                 Rechanneling of artery
   35311  C                 Rechanneling of artery
   35331  C                 Rechanneling of artery
   35341  C                 Rechanneling of artery
   35351  C                 Rechanneling of artery
   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
   35481  C                 Atherectomy, open
   35482  C                 Atherectomy, open
   35483  C                 Atherectomy, open
   35501  C                 Artery bypass graft
   35506  C                 Artery bypass graft
   35507  C                 Artery bypass graft
   35508  C                 Artery bypass graft
   35509  C                 Artery bypass graft
   35511  C                 Artery bypass graft
   35515  C                 Artery bypass graft
   35516  C                 Artery bypass graft
   35518  C                 Artery bypass graft
   35521  C                 Artery bypass graft
   35526  C                 Artery bypass graft
   35531  C                 Artery bypass graft
   35533  C                 Artery bypass graft
   35536  C                 Artery bypass graft
   35541  C                 Artery bypass graft
   35546  C                 Artery bypass graft
   35548  C                 Artery bypass graft
   35549  C                 Artery bypass graft

[[Page 60104]]

 
   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
   35645  C                 Artery bypass graft
   35646  C                 Artery bypass graft
  *35647  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

[[Page 60105]]

 
   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
   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

[[Page 60106]]

 
   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
  *43313  C                 Esophagoplasty congential
  *43314  C                 Tracheo-esophagoplasty cong
   43320  C                 Fuse esophagus & stomach
   43324  C                 Revise esophagus & stomach
   43325  C                 Revise esophagus & stomach
   43326  C                 Revise esophagus & stomach
   43330  C                 Repair of esophagus
   43331  C                 Repair of esophagus
   43340  C                 Fuse esophagus & intestine
   43341  C                 Fuse esophagus & intestine
   43350  C                 Surgical opening, esophagus
   43351  C                 Surgical opening, esophagus
   43352  C                 Surgical opening, esophagus
   43360  C                 Gastrointestinal repair
   43361  C                 Gastrointestinal repair
   43400  C                 Ligate esophagus veins
   43401  C                 Esophagus surgery for veins
   43405  C                 Ligate/staple esophagus
   43410  C                 Repair esophagus wound
   43415  C                 Repair esophagus wound
   43420  C                 Repair esophagus opening
   43425  C                 Repair esophagus opening
   43460  C                 Pressure treatment esophagus
   43496  C                 Free jejunum flap, microvasc
   43500  C                 Surgical opening of stomach
   43501  C                 Surgical repair of stomach
   43502  C                 Surgical repair of stomach
   43510  C                 Surgical opening of stomach
   43520  C                 Incision of pyloric muscle
   43605  C                 Biopsy of stomach
   43610  C                 Excision of stomach lesion
   43611  C                 Excision of stomach lesion
   43620  C                 Removal of stomach
   43621  C                 Removal of stomach
   43622  C                 Removal of stomach
   43631  C                 Removal of stomach, partial
   43632  C                 Removal of stomach, partial
   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

[[Page 60107]]

 
   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
  *44126  C                 Enterectomy w/taper, cong
  *44127  C                 Enterectomy w/o taper, cong
  *44128  C                 Enterectomy cong, add-on
   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
   44202  C                 Laparo, resect intestine
  *44203  C                 Lap resect s/intestine, addl
  *44204  C                 Laparo partial colectomy
  *44205  C                 Lap colectomy part w/ileum
   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
   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

[[Page 60108]]

 
   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
  *45136  C                 Excise ileoanal reservoir
   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
   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
  *47380  C                 Open ablate liver tumor rf
  *47381  C                 Open ablate liver tumor cryo
   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

[[Page 60109]]

 
   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
   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
   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
   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

[[Page 60110]]

 
   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
   50040  C                 Drainage of kidney
   50045  C                 Exploration of kidney
   50060  C                 Removal of kidney stone
   50065  C                 Incision of kidney
   50070  C                 Incision of kidney
   50075  C                 Removal of kidney stone
   50100  C                 Revise kidney blood vessels
   50120  C                 Exploration of kidney
   50125  C                 Explore and drain kidney
   50130  C                 Removal of kidney stone
   50135  C                 Exploration of kidney
   50205  C                 Biopsy of kidney
   50220  C                 Removal of kidney
   50225  C                 Removal of kidney
   50230  C                 Removal of kidney
   50234  C                 Removal of kidney & ureter
   50236  C                 Removal of kidney & ureter
   50240  C                 Partial removal of kidney
   50280  C                 Removal of kidney lesion
   50290  C                 Removal of kidney lesion
   50300  C                 Removal of donor kidney
   50320  C                 Removal of donor kidney
   50340  C                 Removal of kidney
   50360  C                 Transplantation of kidney
   50365  C                 Transplantation of kidney
   50370  C                 Remove transplanted kidney
   50380  C                 Reimplantation of kidney
   50400  C                 Revision of kidney/ureter
   50405  C                 Revision of kidney/ureter
   50500  C                 Repair of kidney wound
   50520  C                 Close kidney-skin fistula
   50525  C                 Repair renal-abdomen fistula
   50526  C                 Repair renal-abdomen fistula
   50540  C                 Revision of horseshoe kidney
   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

[[Page 60111]]

 
   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
   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
  *53448  C                 Remov/replc ur sphinctr comp
   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
  *54411  C                 Remv/replc penis pros, comp
  *54417  C                 Remv/replc penis pros, compl
   54430  C                 Revision of penis
   54535  C                 Extensive testis surgery

[[Page 60112]]

 
   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
   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

[[Page 60113]]

 
   58770  C                 Create new tubal opening
   58805  C                 Drainage of ovarian cyst(s)
   58822  C                 Drain ovary 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
  *58953  C                 Tah, rad dissect for debulk
  *58954  C                 Tah rad debulk/lymph remove
   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
   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

[[Page 60114]]

 
   61333  C                 Explore orbit/remove lesion
   61334  C                 Explore orbit/remove object
   61340  C                 Relieve cranial pressure
   61343  C                 Incise skull (press relief)
   61345  C                 Relieve cranial pressure
   61440  C                 Incise skull for surgery
   61450  C                 Incise skull for surgery
   61458  C                 Incise skull for brain wound
   61460  C                 Incise skull for surgery
   61470  C                 Incise skull for surgery
   61480  C                 Incise skull for surgery
   61490  C                 Incise skull for surgery
   61500  C                 Removal of skull lesion
   61501  C                 Remove infected skull bone
   61510  C                 Removal of brain lesion
   61512  C                 Remove brain lining lesion
   61514  C                 Removal of brain abscess
   61516  C                 Removal of brain lesion
   61518  C                 Removal of brain lesion
   61519  C                 Remove brain lining lesion
   61520  C                 Removal of brain lesion
   61521  C                 Removal of brain lesion
   61522  C                 Removal of brain abscess
   61524  C                 Removal of brain lesion
   61526  C                 Removal of brain lesion
   61530  C                 Removal of brain lesion
   61531  C                 Implant brain electrodes
   61533  C                 Implant brain electrodes
   61534  C                 Removal of brain lesion
   61535  C                 Remove brain electrodes
   61536  C                 Removal of brain lesion
   61538  C                 Removal of brain tissue
   61539  C                 Removal of brain tissue
   61541  C                 Incision of brain tissue
   61542  C                 Removal of brain tissue
   61543  C                 Removal of brain tissue
   61544  C                 Remove & treat brain lesion
   61545  C                 Excision of brain tumor
   61546  C                 Removal of pituitary gland
   61548  C                 Removal of pituitary gland
   61550  C                 Release of skull seams
   61552  C                 Release of skull seams
   61556  C                 Incise skull/sutures
   61557  C                 Incise skull/sutures
   61558  C                 Excision of skull/sutures
   61559  C                 Excision of skull/sutures
   61563  C                 Excision of skull tumor
   61564  C                 Excision of skull tumor
   61570  C                 Remove foreign body, brain
   61571  C                 Incise skull for brain wound
   61575  C                 Skull base/brainstem surgery
   61576  C                 Skull base/brainstem surgery
   61580  C                 Craniofacial approach, skull
   61581  C                 Craniofacial approach, skull
   61582  C                 Craniofacial approach, skull
   61583  C                 Craniofacial approach, skull
   61584  C                 Orbitocranial approach/skull
   61585  C                 Orbitocranial approach/skull
   61586  C                 Resect nasopharynx, skull
   61590  C                 Infratemporal approach/skull
   61591  C                 Infratemporal approach/skull
   61592  C                 Orbitocranial approach/skull
   61595  C                 Transtemporal approach/skull
   61596  C                 Transcochlear approach/skull
   61597  C                 Transcondylar approach/skull

[[Page 60115]]

 
   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
   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
   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 60116]]

 
   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

[[Page 60117]]

 
   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
   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.
*Code is new in 2002.

      
  

  

  

  Federal Register / Vol. 66 , No. 231 / Friday, November 30, 2001 / 
Rules and Regulations  

[[Page 60118]]


      

                 Addendum H.--Wage Index for Urban Areas
------------------------------------------------------------------------
                                                                  Wage
              Urban Area  (Constituent Counties)                 Index
------------------------------------------------------------------------
0040  Abilene, TX............................................     0.7983
  Taylor, TX
0060  \2\ Aguadilla, PR......................................     0.4832
  Aguada, PR
  Aguadilla, PR
  Moca, PR
0080  Akron, OH..............................................     0.9876
  Portage, OH
  Summit, OH
0120  Albany, GA.............................................     1.0640
  Dougherty, GA
  Lee, GA
0160  \2\ Albany-Schenectady-Troy, NY........................     0.8547
  Albany, NY
  Montgomery, NY
  Rensselaer, NY
  Saratoga, NY
  Schenectady, NY
  Schoharie, NY
0200  Albuquerque, NM........................................     0.9750
  Bernalillo, NM
  Sandoval, NM
  Valencia, NM
0220  Alexandria, LA.........................................     0.8059
  Rapides, LA
0240  Allentown-Bethlehem-Easton, PA.........................     1.0077
  Carbon, PA
  Lehigh, PA
  Northampton, PA
0280  Altoona, PA............................................     0.9126
  Blair, PA
0320  Amarillo, TX...........................................
  Potter, TX                                                      0.8711
  Randall, TX
0380  Anchorage, AK..........................................     1.2696
  Anchorage, AK
0440  Ann Arbor, MI..........................................     1.1098
  Lenawee, MI
  Livingston, MI
  Washtenaw, MI
0450  Anniston, AL...........................................     0.8276
  Calhoun, AL
0460  Appleton-Oshkosh-Neenah, WI............................     0.9241
  Calumet, WI
  Outagamie, WI
  Winnebago, WI
0470  \2\ Arecibo, PR........................................     0.4832
  Arecibo, PR
  Camuy, PR
  Hatillo, PR
0480  Asheville, NC..........................................     0.9200
  Buncombe, NC
  Madison, NC
0500  Athens, GA.............................................     0.9842
  Clarke, GA
  Madison, GA
  Oconee, GA
0520  \1\Atlanta, GA.........................................     1.0058
  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..................................     1.1293
  Atlantic, NJ
  Cape May, NJ
0580  Auburn-Opelika, AL.....................................     0.8230
  Lee, AL
0600  Augusta-Aiken, GA-SC...................................     0.9970
  Columbia, GA
  McDuffie, GA
  Richmond, GA
  Aiken, SC
  Edgefield, SC
0640  \1\Austin-San Marcos, TX...............................     0.9597
  Bastrop, TX
  Caldwell, TX
  Hays, TX
  Travis, TX
  Williamson, TX
0680  \2\ Bakersfield, CA....................................     0.9659
  Kern, CA
0720  \1\ Baltimore, MD......................................     0.9856
  Anne Arundel, MD
  Baltimore, MD
  Baltimore City, MD
  Carroll, MD
  Harford, MD
  Howard, MD
  Queen Anne's, MD
0733  Bangor, ME.............................................     0.9593
  Penobscot, ME
0743  Barnstable-Yarmouth, MA................................     1.3626
  Barnstable, MA
0760  Baton Rouge, LA........................................     0.8149
  Ascension, LA
  East Baton Rouge, LA
  Livingston, LA
  West Baton Rouge, LA
0840  Beaumont-Port Arthur, TX...............................     0.8442
  Hardin, TX
  Jefferson, TX
  Orange, TX
0860  Bellingham, WA.........................................     1.1826
  Whatcom, WA
0870  \2\ Benton Harbor, MI..................................     0.9000
  Berrien, MI
0875  \1\ Bergen-Passaic, NJ.................................     1.1808
  Bergen, NJ
  Passaic, NJ
0880  Billings, MT...........................................     0.9352
  Yellowstone, MT
0920  Biloxi-Gulfport-Pascagoula, MS.........................     0.8440
  Hancock, MS
  Harrison, MS
  Jackson, MS
0960  \2\ Binghamton, NY.....................................     0.8547
  Broome, NY
  Tioga, NY
1000  Birmingham, AL.........................................     0.8808
  Blount, AL
  Jefferson, AL
  St. Clair, AL
  Shelby, AL
1010  Bismarck, ND...........................................     0.7984
  Burleigh, ND
  Morton, ND
1020  Bloomington, IN........................................     0.8842
  Monroe, IN
1040  Bloomington-Normal, IL.................................     0.9038
  McLean, IL
1080  Boise City, ID.........................................     0.9050
  Ada, ID
  Canyon, ID
1123  1,2 Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH        1.1454
 (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        1.1293
 (NH 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...................................     0.9799
  Boulder, CO
1145   Brazoria, TX..........................................     0.8209
  Brazoria, TX
1150  Bremerton, WA..........................................     1.0758
  Kitsap, WA
1240  Brownsville-Harlingen-San Benito, TX...................     0.9012
  Cameron, TX
1260  Bryan-College Station, TX..............................     0.9328
  Brazos, TX
1280  \1\ Buffalo-Niagara Falls, NY..........................     0.9459
  Erie, NY
  Niagara, NY
1303  Burlington, VT.........................................     0.9883
  Chittenden, VT
  Franklin, VT
  Grand Isle, VT
1310  \2\ Caguas, PR.........................................     0.4832
  Caguas, PR
  Cayey, PR
  Cidra, PR
  Gurabo, PR
  San Lorenzo, PR
1320  Canton-Massillon, OH...................................     0.8956
  Carroll, OH
  Stark, OH

[[Page 60119]]

 
1350  Casper, WY.............................................     0.9496
  Natrona, WY
1360  Cedar Rapids, IA.......................................     0.8699
  Linn, IA
1400  Champaign-Urbana, IL...................................     0.9306
  Champaign, IL
1440  Charleston-North Charleston, SC........................     0.9206
  Berkeley, SC
  Charleston, SC
  Dorchester, SC
1480  Charleston, WV.........................................     0.9264
  Kanawha, WV
  Putnam, WV
1520  \1\ Charlotte-Gastonia-Rock Hill, NC-SC................     0.9407
  Cabarrus, NC
  Gaston, NC
  Lincoln, NC
  Mecklenburg, NC
  Rowan, NC
  Stanly, NC
  Union, NC
  York, SC
1540  Charlottesville, VA....................................     1.0566
  Albemarle, VA
  Charlottesville City, VA
  Fluvanna, VA
  Greene, VA
1560  Chattanooga, TN-GA.....................................     0.9369
  Catoosa, GA
  Dade, GA
  Walker, GA
  Hamilton, TN
  Marion, TN
1580  \2\ Cheyenne, WY.......................................     0.8747
  Laramie, WY
1600  \1\ Chicago, IL........................................     1.1046
  Cook, IL
  DeKalb, IL
  DuPage, IL
  Grundy, IL
  Kane, IL
  Kendall, IL
  Lake, IL
  McHenry, IL
  Will, IL
1620  Chico-Paradise, CA.....................................     0.9856
  Butte, CA
1640  \1\ Cincinnati, OH-KY-IN...............................     0.9473
  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........................     0.8393
  Christian, KY
  Montgomery, TN
1680  \1\ Cleveland-Lorain-Elyria, OH........................     0.9457
  Ashtabula, OH
  Cuyahoga, OH
  Geauga, OH
  Lake, OH
  Lorain, OH
  Medina, OH
1720  Colorado Springs, CO...................................     0.9744
  El Paso, CO
1740  Columbia, MO...........................................     0.8686
  Boone, MO
1760  Columbia, SC...........................................     0.9492
  Lexington, SC
  Richland, SC
1800  Columbus, GA-AL........................................
  Russell, AL                                                     0.8440
  Chattahoochee, GA
  Harris, GA
  Muscogee, GA
1840  \1\ Columbus, OH.......................................     0.9565
  Delaware, OH
  Fairfield, OH
  Franklin, OH
  Licking, OH
  Madison, OH
  Pickaway, OH
1880  Corpus Christi, TX.....................................     0.8341
  Nueces, TX
  San Patricio, TX
1890  Corvallis, OR..........................................     1.1646
  Benton, OR
1900  \2\ Cumberland, MD-WV (MD Hospitals)...................     0.8859
  Allegany, MD
  Mineral, WV
1900  Cumberland, MD-WV (WV Hospital)........................     0.8306
  Allegany, MD
  Mineral, WV
1920  \1\ Dallas, TX.........................................     0.9936
  Collin, TX
  Dallas, TX
  Denton, TX
  Ellis, TX
  Henderson, TX
  Hunt, TX
  Kaufman, TX
  Rockwall, TX
1950  Danville, VA...........................................     0.8613
  Danville City, VA
  Pittsylvania, VA
1960  Davenport-Moline-Rock Island, IA-IL....................     0.8638
  Scott, IA
  Henry, IL
  Rock Island, IL
2000  Dayton-Springfield, OH.................................     0.9225
  Clark, OH
  Greene, OH
  Miami, OH
  Montgomery, OH
2020  Daytona Beach, FL......................................     0.8972
  Flagler, FL
  Volusia, FL
2030  Decatur, AL............................................     0.8775
  Lawrence, AL
  Morgan, AL
2040  \2\ Decatur, IL........................................     0.8053
  Macon, IL
2080  \1\ Denver, CO.........................................     1.0328
  Adams, CO
  Arapahoe, CO
  Denver, CO
  Douglas, CO
  Jefferson, CO
2120  Des Moines, IA.........................................     0.8779
  Dallas, IA
  Polk, IA
  Warren, IA
2160  \1\ Detroit, MI........................................     1.0487
  Lapeer, MI
  Macomb, MI
  Monroe, MI
  Oakland, MI
  St. Clair, MI
  Wayne, MI
2180  Dothan, AL.............................................     0.7988
  Dale, AL
  Houston, AL
2190  Dover, DE..............................................     1.0296
  Kent, DE
2200  Dubuque, IA............................................     0.8519
  Dubuque, IA
2240  Duluth-Superior, MN-WI.................................     1.0284
  St. Louis, MN
  Douglas, WI
2281  Dutchess County, NY....................................     1.0532
  Dutchess, NY
2290  \2\ Eau Claire, WI.....................................     0.9068
  Chippewa, WI
  Eau Claire, WI
2320  El Paso, TX............................................     0.9215
  El Paso, TX
2330  Elkhart-Goshen, IN.....................................     0.9638
  Elkhart, IN
2335  \2\ Elmira, NY.........................................     0.8547
  Chemung, NY
2340  Enid, OK...............................................     0.8357
  Garfield, OK
2360  Erie, PA...............................................     0.8716
  Erie, PA
2400  Eugene-Springfield, OR.................................     1.1471
  Lane, OR
2440  \2\ Evansville-Henderson, IN-KY (IN Hospitals).........     0.8721
  Posey, IN
  Vanderburgh, IN
  Warrick, IN
  Henderson, KY
2440  Evansville-Henderson, IN-KY (KY Hospitals).............     0.8514
  Posey, IN
  Vanderburgh, IN
  Warrick, IN
  Henderson, KY
2520  Fargo-Moorhead, ND-MN..................................     0.9267
  Clay, MN
  Cass, ND
2560  Fayetteville, NC.......................................     0.9027
  Cumberland, NC
2580  Fayetteville-Springdale-Rogers, AR.....................     0.8445
  Benton, AR
  Washington, AR
2620  Flagstaff, AZ-UT.......................................     1.0556
  Coconino, AZ
  Kane, UT
2640  Flint, MI..............................................     1.0913
  Genesee, MI
2650  Florence, AL...........................................     0.7889
  Colbert, AL
  Lauderdale, AL
2655  Florence, SC...........................................     0.8722

[[Page 60120]]

 
  Florence, SC
2670  Fort Collins-Loveland, CO..............................     1.0045
  Larimer, CO
2680  \1\ Ft. Lauderdale, FL.................................     1.0784
  Broward, FL
2700  Fort Myers-Cape Coral, FL..............................     0.9374
  Lee, FL
2710  Fort Pierce-Port St. Lucie, FL.........................     1.0214
  Martin, FL
  St. Lucie, FL
2720  Fort Smith, AR-OK......................................     0.8053
  Crawford, AR
  Sebastian, AR
  Sequoyah, OK
2750  Fort Walton Beach, FL..................................     0.9002
  Okaloosa, FL
2760  Fort Wayne, IN.........................................     0.9203
  Adams, IN
  Allen, IN
  De Kalb, IN
  Huntington, IN
  Wells, IN
  Whitley, IN
2800  \1\ Forth Worth-Arlington, TX..........................     0.9394
  Hood, TX
  Johnson, TX
  Parker, TX
  Tarrant, TX
2840  Fresno, CA.............................................     0.9984
  Fresno, CA
  Madera, CA
2880  Gadsden, AL............................................     0.8792
  Etowah, AL
2900  Gainesville, FL........................................     0.9481
  Alachua, FL
2920  Galveston-Texas City, TX...............................     1.0313
  Galveston, TX
2960  Gary, IN...............................................     0.9530
  Lake, IN
  Porter, IN
2975  \2\ Glens Falls, NY....................................     0.8547
  Warren, NY
  Washington, NY
2980  Goldsboro, NC..........................................     0.8709
  Wayne, NC
2985  Grand Forks, ND-MN.....................................     0.9119
  Polk, MN
  Grand Forks, ND
2995  Grand Junction, CO.....................................     0.9774
  Mesa, CO
3000  \1\ Grand Rapids-Muskegon-Holland, MI..................     1.0048
  Allegan, MI
  Kent, MI
  Muskegon, MI
  Ottawa, MI
3040  Great Falls, MT........................................     0.9195
  Cascade, MT
3060  Greeley, CO............................................     0.9495
  Weld, CO
3080  Green Bay, WI..........................................     0.9357
  Brown, WI
3120  \1\ Greensboro-Winston-Salem-High Point, NC............     0.9539
  Alamance, NC
  Davidson, NC
  Davie, NC
  Forsyth, NC
  Guilford, NC
  Randolph, NC
  Stokes, NC
  Yadkin, NC
3150  Greenville, NC.........................................     0.9289
  Pitt, NC
3160  Greenville-Spartanburg-Anderson, SC....................     0.9217
  Anderson, SC
  Cherokee, SC
  Greenville, SC
  Pickens, SC
  Spartanburg, SC
3180  \2\ Hagerstown, MD.....................................     0.8859
  Washington, MD
3200  Hamilton-Middletown, OH................................     0.9287
  Butler, OH
3240  Harrisburg-Lebanon-Carlisle, PA........................     0.9425
  Cumberland, PA
  Dauphin, PA
  Lebanon, PA
  Perry, PA
3283  1,2Hartford, CT........................................     1.2077
  Hartford, CT
  Litchfield, CT
  Middlesex, CT
  Tolland, CT
3285  \2\ Hattiesburg, MS....................................     0.7528
  Forrest, MS
  Lamar, MS
3290  Hickory-Morganton-Lenoir, NC...........................     0.9367
  Alexander, NC
  Burke, NC
  Caldwell, NC
  Catawba, NC
3320  Honolulu, HI...........................................     1.1544
  Honolulu, HI
3350  Houma, LA..............................................     0.7975
  Lafourche, LA
  Terrebonne, LA
3360  \1\ Houston, TX........................................     0.9631
  Chambers, TX
  Fort Bend, TX
  Harris, TX
  Liberty, TX
  Montgomery, TX
  Waller, TX
3400  Huntington-Ashland, WV-KY-OH...........................     0.9616
  Boyd, KY
  Carter, KY
  Greenup, KY
  Lawrence, OH
  Cabell, WV
  Wayne, WV
3440  Huntsville, AL.........................................     0.8883
  Limestone, AL
  Madison, AL
3480  \1\ Indianapolis, IN...................................     0.9698
  Boone, IN
  Hamilton, IN
  Hancock, IN
  Hendricks, IN
  Johnson, IN
  Madison, IN
  Marion, IN
  Morgan, IN
  Shelby, IN
3500  Iowa City, IA..........................................     0.9859
  Johnson, IA
3520  Jackson, MI............................................     0.9257
  Jackson, MI
3560  Jackson, MS............................................     0.8491
  Hinds, MS
  Madison, MS
  Rankin, MS
3580  Jackson, TN............................................     0.9013
  Madison, TN
  Chester, TN
3600  \1\ Jacksonville, FL...................................     0.9223
  Clay, FL
  Duval, FL
  Nassau, FL
  St. Johns, FL
3605  \2\ Jacksonville, NC...................................     0.8535
  Onslow, NC
3610  \2\ Jamestown, NY......................................     0.8547
  Chautauqua, NY
3620  Janesville-Beloit, WI..................................     0.9739
  Rock, WI
3640  Jersey City, NJ........................................     1.1178
  Hudson, NJ
3660  Johnson City-Kingsport-Bristol, TN-VA..................     0.8617
  Carter, TN
  Hawkins, TN
  Sullivan, TN
  Unicoi, TN
  Washington, TN
  Bristol City, VA
  Scott, VA
  Washington, VA
3680  Johnstown, PA..........................................     0.8723
  Cambria, PA
  Somerset, PA
3700  Jonesboro, AR..........................................     0.8425
  Craighead, AR
3710  Joplin, MO.............................................     0.8727
  Jasper, MO
  Newton, MO
3720  Kalamazoo-Battlecreek, MI..............................     1.0639
  Calhoun, MI
  Kalamazoo, MI
  Van Buren, MI
3740  Kankakee, IL...........................................     0.9889
  Kankakee, IL
3760  \1\ Kansas City, KS-MO.................................     0.9536
  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............................................     0.9568
  Kenosha, WI
3810  \2\ Killeen-Temple, TX.................................     0.7714
  Bell, TX
  Coryell, TX
3840  Knoxville, TN..........................................     0.8890
  Anderson, TN
  Blount, TN
  Knox, TN
  Loudon, TN
  Sevier, TN

[[Page 60121]]

 
  Union, TN
3850  Kokomo, IN.............................................     0.9184
  Howard, IN
  Tipton, IN
3870  La Crosse, WI-MN.......................................     0.9250
  Houston, MN
  La Crosse, WI
3880  Lafayette, LA..........................................     0.8544
  Acadia, LA
  Lafayette, LA
  St. Landry, LA
  St. Martin, LA
3920  Lafayette, IN..........................................     0.9121
  Clinton, IN
  Tippecanoe, IN
3960  Lake Charles, LA.......................................     0.7765
  Calcasieu, LA
3980  Lakeland-Winter Haven, FL..............................     0.9067
  Polk, FL
4000  Lancaster, PA..........................................     0.9296
  Lancaster, PA
4040  Lansing-East Lansing, MI...............................     0.9653
  Clinton, MI
  Eaton, MI
  Ingham, MI
4080  Laredo, TX.............................................     0.7849
  Webb, TX
4100  \2\ Las Cruces, NM.....................................     0.8676
  Dona Ana, NM
4120  \1\ Las Vegas, NV-AZ...................................     1.1182
  Mohave, AZ
  Clark, NV
  Nye, NV
4150  Lawrence, KS...........................................     0.7812
  Douglas, KS
4200  Lawton, OK.............................................     0.8682
  Comanche, OK
4243  Lewiston-Auburn, ME....................................     0.9287
  Androscoggin, ME
4280  Lexington, KY..........................................     0.8791
  Bourbon, KY
  Clark, KY
  Fayette, KY
  Jessamine, KY
  Madison, KY
  Scott, KY
  Woodford, KY
4320  Lima, OH...............................................     0.9470
  Allen, OH
  Auglaize, OH
4360  Lincoln, NE............................................     1.0173
  Lancaster, NE
4400  Little Rock-North Little Rock, AR......................     0.8955
  Faulkner, AR
  Lonoke, AR
  Pulaski, AR
  Saline, AR
4420  Longview-Marshall, TX..................................     0.8571
  Gregg, TX
  Harrison, TX
  Upshur, TX
4480  \1\ Los Angeles-Long Beach, CA.........................     1.1961
  Los Angeles, CA
4520  \1\ Louisville, KY-IN..................................     0.9529
  Clark, IN
  Floyd, IN
  Harrison, IN
  Scott, IN
  Bullitt, KY
  Jefferson, KY
  Oldham, KY
4600  Lubbock, TX............................................     0.8463
  Lubbock, TX
4640  Lynchburg, VA..........................................     0.9103
  Amherst, VA
  Bedford, VA
  Bedford City, VA
  Campbell, VA
  Lynchburg City, VA
4680  Macon, GA..............................................     0.8971
  Bibb, GA
  Houston, GA
  Jones, GA
  Peach, GA
  Twiggs, GA
4720  Madison, WI............................................     1.0367
  Dane, WI
4800  Mansfield, OH..........................................     0.8726
  Crawford, OH
  Richland, OH
4840  Mayaguez, PR...........................................     0.4860
  Anasco, PR
  Cabo Rojo, PR
  Hormigueros, PR
  Mayaguez, PR
  Sabana Grande, PR
  San German, PR
4880  McAllen-Edinburg-Mission, TX...........................     0.8378
  Hidalgo, TX
4890   Medford-Ashland, OR...................................     1.0314
  Jackson, OR
4900  Melbourne-Titusville-Palm Bay, FL......................     0.9913
  Brevard, Fl
4920  \1\ Memphis, TN-AR-MS..................................     0.8978
  Crittenden, AR
  DeSoto, MS
  Fayette, TN
  Shelby, TN
  Tipton, TN
4940  Merced, CA.............................................     0.9947
  Merced, CA
5000  \1\ Miami, FL..........................................     0.9950
  Dade, FL
5015  \1\ Middlesex-Somerset-Hunterdon, NJ...................     1.1469
  Hunterdon, NJ
  Middlesex, NJ
  Somerset, NJ
5080  \1\ Milwaukee-Waukesha, WI.............................     0.9971
  Milwaukee, WI
  Ozaukee, WI
  Washington, WI
  Waukesha, WI
5120  \1\ Minneapolis-St. Paul, MN-WI........................     1.0930
  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...........................................     0.9364
  Missoula, MT
5160  Mobile, AL.............................................     0.8084
  Baldwin, AL
  Mobile, AL
5170  Modesto, CA............................................     1.0820
  Stanislaus, CA
5190  \1\ Monmouth-Ocean, NJ.................................     1.1257
  Monmouth, NJ
  Ocean, NJ
5200  Monroe, LA.............................................     0.8201
  Ouachita, LA
5240  \2\ Montgomery, AL.....................................     0.7400
  Autauga, AL
  Elmore, AL
  Montgomery, AL
5280  Muncie, IN.............................................     0.9939
  Delaware, IN
5330  Myrtle Beach, SC.......................................     0.8771
  Horry, SC
5345  Naples, FL.............................................     0.9699
  Collier, FL
5360  \1\ Nashville, TN......................................     0.9754
  Cheatham, TN
  Davidson, TN
  Dickson, TN
  Robertson, TN
  Rutherford TN
  Sumner, TN
  Williamson, TN
  Wilson, TN
5380  \1\ Nassau-Suffolk, NY.................................     1.3643
  Nassau, NY
  Suffolk, NY
5483  \1\ New Haven-Bridgeport-Stamford-Waterbury-...........     1.2294
  Danbury, CT
  Fairfield, CT
  New Haven, CT
5523  \2\ New London-Norwich, CT.............................     1.2077
  New London, CT
5560  \1\ New Orleans, LA....................................     0.9036
  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.......................................     1.4427
  Bronx, NY
  Kings, NY
  New York, NY
  Putnam, NY
  Queens, NY
  Richmond, NY
  Rockland, NY
  Westchester, NY
5640  \1\ Newark, NJ.........................................     1.1622
  Essex, NJ
  Morris, NJ
  Sussex, NJ
  Union, NJ
  Warren, NJ
5660  Newburgh, NY-PA........................................     1.1113

[[Page 60122]]

 
  Orange, NY
  Pike, PA
5720  \1\ Norfolk-Virginia Beach-Newport News, VA-NC.........     0.8579
  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........................................     1.5319
  Alameda, CA
  Contra Costa, CA
5790  Ocala, FL..............................................     0.9556
  Marion, FL
5800  Odessa-Midland, TX.....................................     1.0104
  Ector, TX
  Midland, TX
5880  \1\ Oklahoma City, OK..................................     0.8694
  Canadian, OK
  Cleveland, OK
  Logan, OK
  McClain, OK
  Oklahoma, OK
  Pottawatomie, OK
5910   Olympia, WA...........................................     1.1350
  Thurston, WA
5920  Omaha, NE-IA...........................................     0.9712
  Pottawattamie, IA
  Cass, NE
  Douglas, NE
  Sarpy, NE
  Washington, NE
5945  \1\ Orange County, CA..................................     1.1246
  Orange, CA
5960  \1\ Orlando, FL........................................     0.9642
  Lake, FL
  Orange, FL
  Osceola, FL
  Seminole, FL
5990  Owensboro, KY..........................................     0.8334
  Daviess, KY
6015   Panama City, FL.......................................     0.9061
  Bay, FL
6020  Parkersburg-Marietta, WV-OH (WV Hospitals).............     0.8133
  Washington, OH
  Wood, WV
6020  \2\ Parkersburg-Marietta, WV-OH (OH Hospitals).........     0.8668
  Washington, OH
  Wood, WV
6080  \2\ Pensacola, FL......................................     0.8794
  Escambia, FL
  Santa Rosa, FL
6120  Peoria-Pekin, IL.......................................     0.8773
  Peoria, IL
  Tazewell, IL
  Woodford, IL
6160  \1\ Philadelphia, PA-NJ................................     1.0947
  Burlington, NJ
  Camden, NJ
  Gloucester, NJ
  Salem, NJ
  Bucks, PA
  Chester, PA
  Delaware, PA
  Montgomery, PA
  Philadelphia, PA
6200  \1\ Phoenix-Mesa, AZ...................................     0.9638
  Maricopa, AZ
  Pinal, AZ
6240  Pine Bluff, AR.........................................     0.7895
  Jefferson, AR
6280  \1\ Pittsburgh, PA.....................................     0.9560
  Allegheny, PA
  Beaver, PA
  Butler, PA
  Fayette, PA
  Washington, PA
  Westmoreland, PA
6323  \2\ Pittsfield, MA.....................................     1.1454
  Berkshire, MA
6340  Pocatello, ID..........................................     0.9448
  Bannock, ID
6360  Ponce, PR..............................................     0.5218
  Guayanilla, PR
  Juana Diaz, PR
  Penuelas, PR
  Ponce, PR
  Villalba, PR
  Yauco, PR
6403  Portland, ME...........................................     0.9427
  Cumberland, ME
  Sagadahoc, ME
  York, ME
6440  \1\ Portland-Vancouver, OR-WA..........................     1.1150
  Clackamas, OR
  Columbia, OR
  Multnomah, OR
  Washington, OR
  Yamhill, OR
  Clark, WA
6483  \1\ Providence-Warwick-Pawtucket, RI...................     1.0805
  Bristol, RI
  Kent, RI
  Newport, RI
  Providence, RI
  Washington, RI
6520  Provo-Orem, UT.........................................     0.9843
  Utah, UT
6560  \2\ Pueblo, CO.........................................     0.8811
  Pueblo, CO
6580  Punta Gorda, FL........................................     0.9015
  Charlotte, FL
6600  Racine, WI.............................................     0.9333
  Racine, WI
6640  \1\ Raleigh-Durham-Chapel Hill, NC.....................     0.9818
  Chatham, NC
  Durham, NC
  Franklin, NC
  Johnston, NC
  Orange, NC
  Wake, NC
6660  Rapid City, SD.........................................     0.8869
  Pennington, SD
6680  Reading, PA............................................     0.9583
  Berks, PA
6690  Redding, CA............................................     1.1155
  Shasta, CA
6720  Reno, NV...............................................     1.0421
  Washoe, NV
6740  Richland-Kennewick-Pasco, WA...........................     1.0960
  Benton, WA
  Franklin, WA
6760  Richmond-Petersburg, VA................................     0.9678
  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.......................     1.1112
  Riverside, CA
  San Bernardino, CA
6800  Roanoke, VA............................................     0.8371
  Botetourt, VA
  Roanoke, VA
  Roanoke City, VA
  Salem City, VA
6820  Rochester, MN..........................................     1.1462
  Olmsted, MN
6840  \1\ Rochester, NY......................................     0.9347
  Genesee, NY
  Livingston, NY
  Monroe, NY
  Ontario, NY
  Orleans, NY
  Wayne, NY
6880  Rockford, IL...........................................     0.9204
  Boone, IL
  Ogle, IL
  Winnebago, IL
6895  Rocky Mount, NC........................................     0.9109
  Edgecombe, NC
  Nash, NC
6920  \1\ Sacramento, CA.....................................     1.1831
  El Dorado, CA
  Placer, CA
  Sacramento, CA
6960  Saginaw-Bay City-Midland, MI...........................     0.9590
  Bay, MI
  Midland, MI
  Saginaw, MI
6980  St. Cloud, MN..........................................     0.9919
  Benton, MN
  Stearns, MN
7000  St. Joseph, MO.........................................     0.7899
  Andrew, MO
  Buchanan, MO
7040  \1\ St. Louis, MO-IL...................................     0.8931
  Clinton, IL
  Jersey, IL
  Madison, IL
  Monroe, IL
  St. Clair, IL
  Franklin, MO
  Jefferson, MO

[[Page 60123]]

 
  Lincoln, MO
  St. Charles, MO
  St. Louis, MO
  St. Louis City, MO
  Warren, MO
7080  \2\ Salem, OR..........................................     1.0033
  Marion, OR
  Polk, OR
7120  Salinas, CA............................................     1.4684
  Monterey, CA
7160  \1\ Salt Lake City-Ogden, UT...........................     0.9863
  Davis, UT
  Salt Lake, UT
  Weber, UT
7200  San Angelo, TX.........................................     0.8193
  Tom Green, TX
7240  \1\ San Antonio, TX....................................     0.8584
  Bexar, TX
  Comal, TX
  Guadalupe, TX
  Wilson, TX
7320  \1\ San Diego, CA......................................     1.1265
  San Diego, CA
7360  \1\ San Francisco, CA..................................     1.4140
  Marin, CA
  San Francisco, CA
  San Mateo, CA
7400  \1\ San Jose, CA.......................................     1.4193
  Santa Clara, CA
7440  1,2San Juan-Bayamon, PR................................     0.4832
  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
  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.............     1.0990
  San Luis Obispo, CA
7480  Santa Barbara-Santa Maria-Lompoc, CA...................     1.0802
  Santa Barbara, CA
7485  Santa Cruz-Watsonville, CA.............................     1.3970
  Santa Cruz, CA
7490  Santa Fe, NM...........................................     1.0194
  Los Alamos, NM
  Santa Fe, NM
7500   Santa Rosa, CA........................................     1.3034
  Sonoma, CA
7510  Sarasota-Bradenton, FL.................................     1.0090
  Manatee, FL
  Sarasota, FL
7520  Savannah, GA...........................................     0.9243
  Bryan, GA
  Chatham, GA
  Effingham, GA
7560  Scranton--Wilkes-Barre--Hazleton, PA...................     0.8683
  Columbia, PA
  Lackawanna, PA
  Luzerne, PA
  Wyoming, PA
7600  \1\ Seattle-Bellevue-Everett, WA.......................     1.1361
  Island, WA
  King, WA
  Snohomish, WA
7610  \2\ Sharon, PA.........................................     0.8607
  Mercer, PA
7620  \2\ Sheboygan, WI......................................     0.9068
  Sheboygan, WI
7640  Sherman-Denison, TX....................................     0.9373
  Grayson, TX
7680   Shreveport-Bossier City, LA...........................     0.9050
  Bossier, LA
  Caddo, LA
  Webster, LA
7720  Sioux City, IA-NE......................................     0.8767
  Woodbury, IA
  Dakota, NE
7760  Sioux Falls, SD........................................     0.9139
  Lincoln, SD
  Minnehaha, SD
7800  South Bend, IN.........................................     0.9993
  St. Joseph, IN
7840  Spokane, WA............................................     1.0668
  Spokane, WA
7880  Springfield, IL........................................     0.8676
  Menard, IL
  Sangamon, IL
7920  Springfield, MO........................................     0.8567
  Christian, MO
  Greene, MO
  Webster, MO
8003  \2\ Springfield, MA....................................     1.1454
  Hampden, MA
  Hampshire, MA
8050  State College, PA......................................     0.9133
  Centre, PA
8080  \2\ Steubenville-Weirton, OH-WV (OH Hospitals).........     0.8668
  Jefferson, OH
  Brooke, WV
  Hancock, WV
8080  Steubenville-Weirton, OH-WV (WV Hospitals).............     0.8637
  Jefferson, OH
  Brooke, WV
  Hancock, WV
8120  Stockton-Lodi, CA......................................     1.0988
  San Joaquin, CA
8140  \2\ Sumter, SC.........................................     0.8512
  Sumter, SC
8160  Syracuse, NY...........................................     0.9621
  Cayuga, NY
  Madison, NY
  Onondaga, NY
  Oswego, NY
8200  Tacoma, WA.............................................     1.1616
  Pierce, WA
8240  \2\ Tallahassee, FL....................................     0.8794
  Gadsden, FL
  Leon, FL
8280  \1\ Tampa-St. Petersburg-Clearwater, FL................     0.8925
  Hernando, FL
  Hillsborough, FL
  Pasco, FL
  Pinellas, FL
8320  \2\ Terre Haute, IN....................................     0.8721
  Clay, IN
  Vermillion, IN
  Vigo, IN
8360  Texarkana,AR-Texarkana, TX.............................     0.8327
  Miller, AR
  Bowie, TX
8400  Toledo, OH.............................................     0.9809
  Fulton, OH
  Lucas, OH
  Wood, OH
8440  Topeka, KS.............................................     0.8912
  Shawnee, KS
8480   Trenton, NJ...........................................     1.0416
  Mercer, NJ
8520  Tucson, AZ.............................................     0.8976
  Pima, AZ
8560  Tulsa, OK..............................................     0.8902
  Creek, OK
  Osage, OK
  Rogers, OK
  Tulsa, OK
  Wagoner, OK
8600  Tuscaloosa, AL.........................................     0.8171
  Tuscaloosa, AL
8640  Tyler, TX..............................................     0.9641
  Smith, TX
8680  \2\ Utica-Rome, NY.....................................     0.8547
  Herkimer, NY
  Oneida, NY
8720  Vallejo-Fairfield-Napa, CA.............................     1.3562
  Napa, CA
  Solano, CA
8735  Ventura, CA............................................     1.0994
  Ventura, CA
8750  Victoria, TX...........................................     0.8328
  Victoria, TX
8760  Vineland-Millville-Bridgeton, NJ.......................     1.0441
  Cumberland, NJ
8780  \2\ Visalia-Tulare-Porterville, CA.....................     0.9659
  Tulare, CA
8800  Waco, TX...............................................     0.8150
  McLennan, TX
8840  \1\ Washington, DC-MD-VA-WV............................     1.0962
  District of Columbia, DC
  Calvert, MD
  Charles, MD
  Frederick, MD
  Montgomery, MD
  Prince Georges, MD
  Alexandria City, VA

[[Page 60124]]

 
  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...............................     0.8677
  Black Hawk, IA
8940  Wausau, WI.............................................     0.9696
  Marathon, WI
8960  \1\ West Palm Beach-Boca Raton, FL.....................     0.9777
  Palm Beach, FL
9000  \2\ Wheeling, WV-OH (WV Hospitals).....................     0.8067
  Belmont, OH
  Marshall, WV
  Ohio, WV
9000  \2\ Wheeling, WV-OH (OH Hospitals).....................     0.8668
  Belmont, OH
  Marshall, WV
  Ohio, WV
9040  Wichita, KS............................................     0.9606
  Butler, KS
  Harvey, KS
  Sedgwick, KS
9080  Wichita Falls, TX......................................     0.7946
  Archer, TX
  Wichita, TX
9140  Williamsport, PA.......................................     0.8628
  Lycoming, PA
9160  Wilmington-Newark, DE-MD...............................     1.0877
  New Castle, DE
  Cecil, MD
9200  Wilmington, NC.........................................     0.9409
  New Hanover, NC
  Brunswick, NC
9260  Yakima, WA.............................................     1.0567
  Yakima, WA
9270  Yolo, CA...............................................     0.9701
  Yolo, CA
9280  York, PA...............................................     0.9441
  York, PA
9320  Youngstown-Warren, OH..................................     0.9563
  Columbiana, OH
  Mahoning, OH
  Trumbull, OH
9340  Yuba City, CA..........................................     1.0359
  Sutter, CA
  Yuba, CA
9360  Yuma, AZ...............................................     0.8989
  Yuma, AZ
------------------------------------------------------------------------
\1\ Large Urban Area
\2\ Hospitals geographically located in the area are assigned the
  statewide rural wage index for FY 2002.


                 Addemdum I.--Wage Index for Rural Areas
------------------------------------------------------------------------
                                                                  Wage
                        Nonurban Area                            Index
------------------------------------------------------------------------
Alabama......................................................     0.7400
Alaska.......................................................     1.1862
Arizona......................................................     0.8681
Arkansas.....................................................     0.7489
California...................................................     0.9659
Colorado.....................................................     0.8811
Connecticut..................................................     1.2077
Delaware.....................................................     0.9589
Florida......................................................     0.8794
Georgia......................................................     0.8295
Hawaii.......................................................     1.1112
Idaho........................................................     0.8718
Illinois.....................................................     0.8053
Indiana......................................................     0.8721
Iowa.........................................................     0.8147
Kansas.......................................................     0.7812
Kentucky.....................................................     0.7963
Louisiana....................................................     0.7692
Maine........................................................     0.8721
Maryland.....................................................     0.8859
Massachusetts................................................     1.1454
Michigan.....................................................     0.9000
Minnesota....................................................     0.9035
Mississippi..................................................     0.7528
Missouri.....................................................     0.7899
Montana......................................................     0.8655
Nebraska.....................................................     0.8142
Nevada.......................................................     0.9727
New Hampshire................................................     0.9779
New Jersey \1\...............................................  .........
New Mexico...................................................     0.8676
New York.....................................................     0.8547
North Carolina...............................................     0.8535
North Dakota.................................................     0.7879
Ohio.........................................................     0.8668
Oklahoma.....................................................     0.7566
Oregon.......................................................     1.0038
Pennsylvania.................................................     0.8607
Puerto Rico..................................................     0.4832
Rhode Island \1\.............................................  .........
South Carolina...............................................     0.8512
South Dakota.................................................     0.7861
Tennessee....................................................     0.7928
Texas........................................................     0.7714
Utah.........................................................     0.9051
Vermont......................................................     0.9608
Virginia.....................................................     0.8241
Washington...................................................     1.0209
West Virginia................................................     0.8067
Wisconsin....................................................     0.9068
Wyoming......................................................    0.8747
------------------------------------------------------------------------
\1\ All counties within the State are classified as urban.


      Addendum J.--Wage Index for Hospitals That are Rreclassified
------------------------------------------------------------------------
                                                                  Wage
                             Area                                Index
------------------------------------------------------------------------
Abilene, TX..................................................     0.7983
Akron, OH....................................................     0.9876
Albany, GA...................................................     1.0640
Albuquerque, NM..............................................     0.9750
Alexandria, LA...............................................     0.8059
Allentown-Bethlehem-Easton, PA...............................     1.0077
Altoona, PA..................................................     0.9126
Amarillo, TX.................................................     0.8502
Anchorage, AK................................................     1.2696
Ann Arbor, MI................................................     1.1098
Anniston, AL.................................................     0.7841
Asheville, NC................................................     0.9200
Athens, GA...................................................     0.9706
Atlanta, GA..................................................     1.0058
Augusta-Aiken, GA-SC.........................................     0.9970
Austin-San Marcos, TX........................................     0.9597
Barnstable-Yarmouth, MA......................................     1.3423
Baton Rouge, LA..............................................     0.8149
Bellingham, WA...............................................     1.1296
Benton Harbor, MI............................................     0.9000
Bergen-Passaic, NJ...........................................     1.1808
Billings, MT.................................................     0.9352
Biloxi-Gulfport-Pascagoula, MS...............................     0.8105
Binghamton, NY...............................................     0.8607
Birmingham, AL...............................................     0.8808
Bismarck, ND.................................................     0.7984
Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH.............     1.1293
Burlington, VT (VT Hospitals)................................     0.9608
Burlington, VT (NY Hospitals)................................     0.9606
Caguas, PR...................................................     0.4832
Casper, WY...................................................     0.9346
Champaign-Urbana, IL.........................................     0.9140
Charleston-North Charleston, SC..............................     0.9206
Charleston, WV...............................................     0.8902
Charlotte-Gastonia-Rock Hill, NC-SC..........................     0.9407
Chattanooga, TN-GA...........................................     0.9181
Chicago, IL..................................................     1.0917
Cincinnati, OH-KY-IN.........................................     0.9473
Clarksville-Hopkinsville, TN-KY..............................     0.8393
Cleveland-Lorain-Elyria, OH..................................     0.9457
Columbia, MO.................................................     0.8686
Columbia, SC.................................................     0.9168
Columbus, GA-AL..............................................     0.8440
Columbus, OH.................................................     0.9565
Corpus Christi, TX...........................................     0.8238
Dallas, TX...................................................     0.9936
Davenport-Moline-Rock Island, IA-IL..........................     0.8538
Dayton-Springfield, OH.......................................     0.9225
Denver, CO...................................................     1.0328
Des Moines, IA...............................................     0.8779
Dothan, AL...................................................     0.7988
Dover, DE....................................................     1.0003
Duluth-Superior, MN-WI.......................................     1.0284
Eau Claire, WI...............................................     0.9068
Elkhart-Goshen, IN...........................................     0.9517
Erie, PA.....................................................     0.8716
Eugene-Springfield, OR.......................................     1.1006
Fargo-Moorhead, ND-MN........................................     0.9166
Fayetteville, NC.............................................     0.8869
Flagstaff, AZ-UT.............................................     1.0105
Flint, MI....................................................     1.0810
Florence, AL.................................................     0.7889
Florence, SC.................................................     0.8722
Fort Collins-Loveland, CO....................................     1.0045
Ft. Lauderdale, FL...........................................     1.0784
Fort Pierce-Port St. Lucie, FL...............................     1.0114
Fort Smith, AR-OK............................................     0.7857
Fort Walton Beach, FL........................................     0.8828
Fort Wayne, IN...............................................     0.9203
Forth Worth-Arlington, TX....................................     0.9394
Gadsden, AL..................................................     0.8386
Gainesville, FL..............................................     0.9481
Grand Forks, ND-MN...........................................     0.9119
Grand Junction, CO...........................................     0.9774

[[Page 60125]]

 
Grand Rapids-Muskegon-Holland, MI............................     0.9939
Great Falls, MT..............................................     0.9195
Greeley, CO..................................................     0.9495
Green Bay, WI................................................     0.9357
Greensboro-Winston-Salem-High Point, NC......................     0.9395
Greenville, NC...............................................     0.9289
Greenville-Spartanburg-Anderson, SC..........................     0.9217
Harrisburg-Lebanon-Carlisle, PA..............................     0.9425
Hartford, CT.................................................     1.1571
Hattiesburg, MS..............................................     0.7528
Hickory-Morganton-Lenoir, NC.................................     0.9367
Honolulu, HI.................................................     1.1544
Houston, TX..................................................     0.9631
Huntington-Ashland, WV-KY-OH.................................     0.9238
Huntsville, AL...............................................     0.8696
Indianapolis, IN.............................................     0.9698
Iowa City, IA................................................     0.9708
Jackson, MS..................................................     0.8491
Jackson, TN..................................................     0.8843
Jacksonville, FL.............................................     0.9223
Johnson City-Kingsport-Bristol, TN-VA........................     0.8617
Jonesboro, AR................................................     0.8115
Joplin, MO...................................................     0.8528
Kalamazoo-Battlecreek, MI....................................     1.0471
Kansas City, KS-MO...........................................     0.9536
Knoxville, TN................................................     0.8890
Kokomo, IN...................................................     0.9184
Lafayette, LA................................................     0.8395
Lansing-East Lansing, MI.....................................     0.9653
Las Vegas, NV-AZ.............................................     1.1182
Lawton, OK...................................................     0.8281
Lexington, KY................................................     0.8641
Lima, OH.....................................................     0.9470
Lincoln, NE..................................................     0.9843
Little Rock-North Little Rock, AR............................     0.8800
Longview-Marshall, TX........................................     0.8571
Los Angeles-Long Beach, CA...................................     1.1961
Louisville, KY-IN............................................     0.9416
Lubbock, TX..................................................     0.8463
Lynchburg, VA................................................     0.8795
Macon, GA....................................................     0.8971
Madison, WI..................................................     1.0367
Mansfield, OH................................................     0.8726
Medford-Ashland, OR..........................................     1.0033
Memphis, TN-AR-MS............................................     0.8793
Miami, FL....................................................     0.9950
Milwaukee-Waukesha, WI.......................................     0.9865
Minneapolis-St. Paul, MN-WI..................................     1.0930
Missoula, MT.................................................     0.9177
Mobile, AL...................................................     0.8084
Modesto, CA..................................................     1.0820
Monmouth-Ocean, NJ...........................................     1.1257
Monroe, LA...................................................     0.8097
Montgomery, AL...............................................     0.7400
Myrtle Beach, SC.............................................     0.8577
Nashville, TN................................................     0.9552
New Haven-Bridgeport-Stamford-Waterbury-Danbury, CT..........     1.2294
New London-Norwich, CT.......................................     1.1526
New Orleans, LA..............................................     0.9036
New York, NY.................................................     1.4287
Newark, NJ...................................................     1.1622
Newburgh, NY-PA..............................................     1.0797
Oakland, CA..................................................     1.5319
Odessa-Midland, TX...........................................     0.9495
Oklahoma City, OK............................................     0.8694
Omaha, NE-IA.................................................     0.9712
Orange County, CA............................................     1.1246
Orlando, FL..................................................     0.9642
Peoria-Pekin, IL.............................................     0.8773
Philadelphia, PA-NJ..........................................     1.0947
Pine Bluff, AR...............................................     0.7895
Pittsburgh, PA...............................................     0.9419
Pittsfield, MA...............................................     0.9904
Pocatello, ID................................................     0.9159
Portland, ME.................................................     0.9427
Portland-Vancouver, OR-WA....................................     1.1150
Provo-Orem, UT...............................................     0.9843
Raleigh-Durham-Chapel Hill, NC...............................     0.9818
Rapid City, SD...............................................     0.8869
Reading, PA..................................................     0.9216
Redding, CA..................................................     1.1155
Reno, NV.....................................................     1.0421
Richland-Kennewick-Pasco, WA.................................     1.0356
Richmond-Petersburg, VA......................................     0.9678
Roanoke, VA..................................................     0.8371
Rochester, MN................................................     1.1462
Rockford, IL.................................................     0.9042
Sacramento, CA...............................................     1.1831
Saginaw-Bay City-Midland, MI.................................     0.9590
St. Cloud, MN................................................     0.9919
St. Joseph, MO...............................................     0.8121
St. Louis, MO-IL.............................................     0.8931
Salinas, CA..................................................     1.4570
Salt Lake City-Ogden, UT.....................................     0.9863
San Diego, CA................................................     1.1265
Santa Fe, NM.................................................     0.9765
Santa Rosa, CA...............................................     1.2631
Sarasota-Bradenton, FL.......................................     1.0090
Savannah, GA.................................................     0.9243
Seattle-Bellevue-Everett, WA.................................     1.1361
Sherman-Denison, TX..........................................     0.9003
Shreveport-Bossier City, LA..................................     0.9050
Sioux City, IA-NE............................................     0.8767
Sioux Falls, SD..............................................     0.8939
South Bend, IN...............................................     0.9993
Spokane, WA..................................................     1.0668
Springfield, IL..............................................     0.8571
Springfield, MO..............................................     0.8357
Stockton-Lodi, CA............................................     1.0988
Syracuse, NY.................................................     0.9621
Tampa-St. Petersburg-Clearwater, FL..........................     0.8925
Texarkana,AR-Texarkana, TX...................................     0.8327
Toledo, OH...................................................     0.9809
Topeka, KS...................................................     0.8749
Tucson, AZ...................................................     0.8976
Tulsa, OK....................................................     0.8760
Tuscaloosa, AL...............................................     0.8171
Tyler, TX....................................................     0.9359
Victoria, TX.................................................     0.8328
Waco, TX.....................................................     0.8150
Washington, DC-MD-VA-WV......................................     1.0854
Waterloo-Cedar Falls, IA.....................................     0.8677
Wausau, WI...................................................     0.9558
West Palm Beach-Boca Raton, FL...............................     0.9777
Wichita, KS..................................................     0.9237
Wichita Falls, TX............................................     0.7946
Wilmington-Newark, DE-MD.....................................     1.0877
Rural Alabama................................................     0.7528
Rural Florida................................................     0.8794
Rural Illinois (IA Hospitals)................................     0.8147
Rural Illinois (MO Hospitals)................................     0.8053
Rural Kentucky...............................................     0.7963
Rural Louisiana..............................................     0.7692
Rural Minnesota..............................................     0.9035
Rural Missouri...............................................     0.7899
Rural Montana................................................     0.8655
Rural Nebraska...............................................     0.8142
Rural Nevada.................................................     0.9161
Rural Oregon.................................................     1.0038
Rural Texas..................................................     0.7714
Rural Washington.............................................     1.0209
Rural Wisconsin..............................................     0.9068
Rural Wyoming................................................     0.8747
------------------------------------------------------------------------

[FR Doc. 01-29621 Filed 11-29-01; 8:45 am]
BILLING CODE 4120-01-P