[Federal Register Volume 67, Number 41 (Friday, March 1, 2002)]
[Rules and Regulations]
[Pages 9556-9579]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-5071]



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Part V





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; Correction of Certain Calendar Year 2002 Payment 
Rates Under the Hospital Outpatient Prospective Payment System and the 
Pro Rata Reduction on Transitional Pass-Through Payments; Correction of 
Technical and Typographical Errors; Final Rule

  Federal Register / Vol. 67, No. 41 / Friday, March 1, 2002 / 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-F4]
RIN 0938-AK54


Medicare Program; Correction of Certain Calendar Year 2002 
Payment Rates Under the Hospital Outpatient Prospective Payment System 
and the Pro Rata Reduction on Transitional Pass-Through Payments; 
Correction of Technical and Typographical Errors

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

ACTION: Final rule.

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SUMMARY: This final rule corrects inadvertent technical errors that 
affect the amounts and factors used to determine the payment rates for 
services paid under the Medicare hospital outpatient prospective 
payment system as published in the November 30, 2001 final rule 
entitled ``Changes to the Hospital Outpatient Prospective Payment 
System for Calendar Year 2002.'' In addition, this final rule corrects 
the amount of the uniform reduction to be applied to transitional pass-
through payments for CY 2002. This final rule also corrects other 
technical and typographical errors that appeared in the November 30, 
2001 final rule.

EFFECTIVE DATE: This final rule is effective on April 1, 2002. The 
effective date for Sec. 419.32(b)(1)(iii), revised at 66 FR 59856, 
published on November 30, 2001 and Sec. 419.62(d), added at 66 FR 
55865, published on November 2, 2001, is April 1, 2002.

FOR FURTHER INFORMATION CONTACT: Robert Braver, (410) 786-0378.

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I. Background

    On November 30, 2001, we published a final rule announcing the 
final ambulatory payment classification (APC) groups, relative weights, 
and payment rates under the hospital outpatient prospective payment 
system (OPPS) for calendar year (CY) 2002 (66 FR 59856). As discussed 
in detail in that final rule, in setting the APC relative weights, we 
incorporated 75 percent of the estimated transitional pass-through 
costs for devices eligible for transitional pass-through payments in CY 
2002 into the costs of the APC groups associated with the use of the 
devices (66 FR 59906).
    After publication of the November 30, 2001 final rule, we 
discovered that the final rule reflected several inadvertent technical 
errors in which we incorrectly associated specific devices approved for 
transitional pass-through payments with particular procedures. The 
magnitude of these errors was significant enough to affect not only the 
estimate of total transitional pass-through payments and the uniform 
reduction percentage to be applied to transitional pass-through 
payments in 2002, but also the payment rates for all procedure-related 
APCs. (Procedure-related APCs are those other than the APCs for pass-
through drugs and devices, new technology, and partial 
hospitalization.) Using rates that reflected these errors would have 
inappropriately affected payments to hospitals. Thus, we determined 
that it would be inappropriate to allow the payment rates published on 
November 30, 2001 to become effective without further changes. In order 
to ensure that there were no other errors that might also have 
significant implications for OPPS payments, we decided to undertake an 
intensive review of the relevant data files. Because of the time needed 
for this review, we were unable to complete it and recalculate the 
rates before the previously published effective date of January 1, 2002 
announced in the November 30, 2001 final rule. We therefore decided to 
continue to pay for services covered under the OPPS after January 1, 
2002 and until no later than April 1, 2002 under the rates in effect on 
December 31, 2001. In addition, we decided to make transitional pass-
through payments during that period without applying the uniform 
reduction announced on November 30, 2001.
    Therefore, on December 31, 2001, we published a final rule, 
entitled ``Prospective Payment System for Hospital Outpatient Services; 
Delay in Effective Date of Calendar Year 2002 Payment Rates and the Pro 
Rata Reduction on Transitional Pass-Through Payments' (66 FR 67494), 
that announced we would indefinitely delay the effective date for 
Secs. 419.32(b)(1)(iii) and 419.62(d) of the regulations. We also 
announced that we were delaying until no later than April 1, 2002, the 
effective date of the updated OPPS payment rates and the uniform 
reduction of transitional pass-through payments that we published in 
the preamble and addenda of the November 30, 2001 final rule.
    We did not delay the following provisions of the November 30, 2001 
final rule:
     Medicare, Medicaid, and SCHIP Benefits Improvement and 
Protection Act of 2000 coinsurance limit.
     Limitation of copayment amount to inpatient hospital 
deductible amount.
     Changes in services covered within the scope of OPPS.
     Categories of hospitals subject to, and excluded from, the 
OPPS.
     Criteria for new technology APCs.
     Provider-based issues.
     Change to the definition of ``single-use devices'' for 
transitional pass-through payments.
    We have also discovered typographical and other technical errors in 
the preamble and addenda to the November 30, 2001 final rule. These 
errors involve the incorrect assignment of status indicators (SIs) to 
certain Physicians' Current Procedural Terminology (CPT) codes, 
inconsistencies between the preamble and addenda in the assignment of 
codes to APC groups, and similar matters. Correction of these 
typographical and technical errors does not involve any changes in the 
policies announced in the November 30, 2001 final rule. Corrections to 
the preamble text are listed below. The appropriate corrections are 
incorporated into the new addenda A, B, C, and D. The corrected addenda 
A and D are printed at the end of this rule. Addenda B and C are 
available on our Web site: http://www.cms.hhs.gov. Tables 2 and 3 below 
summarize the corrections to the errors in addenda A and B.

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II. Correction of Errors

    In the FR Doc. 01-29621 published November 30, 2001 (66 FR 59856), 
we are making the corrections described below.

A. Corrections of Device Cost Assignments to APCs

    Since publication of the December 31, 2001 final rule, we have 
conducted an intensive internal review of device costs associated with 
specific CPT codes. We have also considered information concerning the 
use of devices brought to our attention from hospitals, manufacturers, 
and other such sources. As a result of this review, we determined that 
we had inadvertently associated device(s) with certain procedures for 
which no devices are used, incorrectly identified device(s) used with 
certain other procedures, or failed to associate one or more devices 
with procedures requiring the use of those devices. The following APCs 
were affected:
     APC 0084  Level I Electrophysiologic Evaluation
     APC 0085  Level II Electrophysiologic Evaluation
     APC 0090  Insertion/Replacement of Pacemaker/Pulse 
Generator
     APC 0091  Level I Vascular Ligation
     APC 0104  Transcatheter Placement of Intracoronary Stents
     APC 0229  Transcatheter Placement of Intravascular Shunts
     APC 0237  Level III Posterior Segment Eye Procedures
     APC 0241  Level IV Repair and Plastic Eye Procedures
     APC 0242  Level V Repair and Plastic Eye Procedures
     APC 0246  Cataract Procedures with IOL Insert
     APC 0248  Laser Retinal Procedures
     APC 0312  Radioelement Applications
     APC 0313  Brachytherapy

The changes in the assignment of device costs associated with these 13 
APCs resulted in a net reduction in the estimate of total transitional 
pass-through payments for CY 2002.
    In addition, the changes in the assignment of device costs 
associated with these 13 APCs have caused changes to the median costs 
for these APCs. (Median costs are used to set the relative weights of 
each APC. The relative weight of each APC is the ratio of its median 
cost to the median cost of APC 601, Mid-level clinic visit, adjusted by 
the ``scalar'' that is discussed below.) We found that the changes in 
the assignment of device costs and the resulting changes in the median 
costs of the 13 associated APC groups affected the relative payment 
weights for all procedure-related APCs as well as the estimate of 
aggregate CY 2002 payments.
    The changes in relative payment weights resulting from revisions in 
the assignment of device costs associated with the 13 APCs identified 
above required that we recalculate the ``scalar,'' which is the factor 
that we use to ensure compliance with section 1833(t)(9)(B) of the 
Social Security Act (the Act). That section of the Act provides that 
APC reclassification and recalibration changes (and wage index changes) 
must be made in a manner so that the estimated aggregate payments under 
the OPPS for a particular year are neither greater nor less than the 
estimated aggregate payments would have been without these changes. The 
corrections, as well as appropriate adjustments made under the 
authority of section 1833(t)(2)(E) of the Act, have the overall effect 
of revising the scalar from 0.945, which we announced in the November 
30, 2001 final rule (66 FR 59886), to 0.951. This revised scalar has 
the effect of slightly increasing the relative weights of the 
procedure-related APCs (except for those for which we revised the 
device-associated costs).
    We are also revising the target that we set for outlier payments in 
the November 30, 2001 final rule from 2.0 percent to 1.5 percent, and 
thus we are revising the threshold for outlier payments from 3 times 
the applicable APC payment for a service to 3.5 times the applicable 
payment amount for a service. These adjustments ensure that the payment 
rate for every procedure-related APC is at least equal to and in no 
case lower than the rate published in the November 30, 2001 final rule 
(except for those APCs for which we revised the device-associated 
costs). The conversion factor is reduced by 1.5 percent (rather than 
2.0 percent) to reflect the revised outlier target and 0.5 percent for 
the adjustments described above that are due to changes in relative 
payment weights resulting from revisions in the assignment of device 
costs. The overall effect of these adjustments does not change the 
conversion factor announced in the November 2, 2001 final rule. The 
conversion factor remains $50.904.
    Recalculation of the scalar changes the offset amounts that we 
published in Table 5 in the November 30, 2001 final rule. Certain APC 
rates increased as a result of the incorporation of 75 percent of the 
pass-through costs of devices eligible for pass-through payments. Those 
amounts were deducted from the pass-through payments for those devices, 
so that the increases to the APC rates were offset by the simultaneous 
reduction of the associated pass-through costs, as described in the 
November 30, 2001 final rule (66 FR 59904-59906). The recalculated 
offset amounts are listed in Table 1 below, which parallels Table 5 of 
the November 30, 2001 final rule (66 FR 59907). Column 3 shows the 
device costs already included in the rates for 25 APCs before we 
incorporated 75 percent of the pass-through device costs into the 
rates. The label ``NA'' in column 3 means that there were no device 
costs associated with the APC before incorporating 75 percent of pass-
through device costs into the rates. In Table 1, the amounts in column 
3 have not changed since the November 30, 2001 final rule. In Table 1, 
the amounts in column 5, which are the sum of columns 3 and 4, have 
changed to account for the corrections in column 4.

 Table 1.--Offsets To Be Applied for Each APC That Contains Device Costs
------------------------------------------------------------------------
                                      Device
                                      costs      Additional     Total
                                     (before       device     offset for
   APC          Description          fold-in)      costs        device
                                    reflected   folded into     costs
                                   in APC rate    APC rate
1         2......................            3            4            5
------------------------------------------------------------------------
   0032   Insertion of Central          $73.79      $279.97      $353.76
           Venous/Arterial
           Catheter..............
   0046   Open/Percutaneous                 NA       100.29       100.29
           Treatment Fracture or
           Dislocation...........
   0048   Arthroplasty with                 NA       514.64       514.64
           Prosthesis............
   0057   Bunion Procedures......           NA       162.89       162.89
   0070   Thoracentesis/Lavage              NA        26.47        26.47
           Procedures............
   0080   Diagnostic Cardiac            164.27       134.39       298.66
           Catheterization.......

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   0081   Non-Coronary                  307.06       362.95       670.01
           Angioplasty or
           Atherectomy...........
   0082   Coronary Atherectomy...       242.95     1,214.06     1,457.01
   0083   Coronary Angioplasty...       528.64       383.31       911.95
   0085   Level II                          NA     1,578.03     1,578.03
           Electrophysiologic
           Evaluation............
   0086   Ablate Heart Dysrhythm            NA     1,320.96     1,320.96
           Focus.................
   0087   Cardiac                           NA     1,980.16     1,980.16
           Electrophysiologic
           Recording/Mapping.....
   0088   Thrombectomy...........       162.72       261.14       423.86
   0089   Insertion/Replacement       3,175.70     3,286.36     6,462.06
           of Permanent Pacemaker
           and Electrodes........
   0090   Insertion/Replacement       2,921.06     2,123.20     5,044.26
           of Pacemaker Pulse
           Generator.............
   0094   Resuscitation and                 NA        19.34        19.34
           Cardioversion.........
   0103   Miscellaneous Vascular            NA       207.18       207.18
           Procedures............
   0104   Transcatheter Placement       428.16     1,256.31     1,684.47
           of Intracoronary
           Stents................
   0106   Insertion/Replacement/        657.59     1,049.13     1,706.72
           Repair of Pacemaker
           and/or Electrodes.....
   0107   Insertion of                6,803.85    11,099.62    17,903.47
           Cardioverter-
           Defibrillator.........
   0108   Insertion/Replacement/      6,940.27    19,607.20    26,547.47
           Repair of Cardioverter-
           Defibrillator Leads...
   0111   Blood Product Exchange.           NA       209.72       209.72
   0115   Cannula/Access Device             NA       127.26       127.26
           Procedures............
   0117   Chemotherapy                      NA        30.03        30.03
           Administration by
           Infusion Only.........
   0118   Chemotherapy                      NA        28.50        28.50
           Administration by Both
           Infusion and Other
           Technique.............
   0119   Implantation of Devices           NA     3,348.98     3,348.98
   0120   Infusion Therapy Except           NA        35.12        35.12
           Chemotherapy..........
   0121   Level I Tube Changes              NA         6.10         6.10
           and Repositioning.....
   0122   Level II Tube Changes          72.55       214.82       287.37
           and Repositioning.....
   0124   Revision of Implanted             NA     3,308.76     3,308.76
           Infusion Pump.........
   0144   Diagnostic Anoscopy....           NA       128.28       128.28
   0151   Endoscopic Retrograde          60.92         0.00        60.92
           Cholangio-
           Pancreatography (ERCP)
   0152   Percutaneous Biliary          107.61         0.00       107.61
           Endoscopic Procedures.
   0153   Peritoneal and                    NA        41.23        41.23
           Abdominal Procedures..
   0154   Hernia/Hydrocele              108.11       378.73       486.84
           Procedures............
   0161   Level II                          NA        11.20        11.20
           Cystourethroscopy and
           other Genitourinary
           Procedures............
   0162   Level III                         NA       319.68       319.68
           Cystourethroscopy and
           other Genitourinary
           Procedures............
   0163   Level IV                          NA       901.51       901.51
           Cystourethroscopy and
           other Genitourinary
           Procedures............
   0179   Urinary Incontinence              NA     3,400.90     3,400.90
           Procedures............
   0182   Insertion of Penile         2,238.90       569.11     2,808.14
           Prosthesis............
   0202   Level VIII Female             505.32     1,233.41     1,738.73
           Reproductive Proc.....
   0203   Level V Nerve                     NA       420.98       420.98
           Injections............
   0207   Level IV Nerve                    NA        63.63        63.63
           Injections............
   0222   Implantation of             4,458.57     9,599.99    14,058.56
           Neurological Device...
   0223   Implantation of Pain          421.33     3,330.14     3,751.47
           Management Device.....
   0225   Implantation of             1,182.00    11,941.06    13,123.06
           Neurostimulator
           Electrodes............
   0226   Implantation of Drug              NA     3,363.74     3,363.74
           Infusion Reservoir....
   0227   Implantation of Drug        3,810.46     2,395.55     6,206.01
           Infusion Device.......
   0229   Transcatherter              1,074.41       842.97     1,917.38
           Placement of
           Intravascular Shunts..
   0246   Cataract Procedures           146.82         0.00       146.82
           with IOL Insert.......
   0259   Level VI ENT Procedures    12,407.52     3,836.13    16,243.65
   0264   Level II Miscellaneous            NA        61.59        61.59
           Radiology Procedures..
   0312   Radioelement                      NA     5,897.22     5,897.22
           Applications..........
   0313   Brachytherapy..........           NA       998.23       998.23
   0685   Level III Needle Biopsy/          NA       210.75       210.75
           Aspiration Except Bone
           Marrow................
   0686   Level V Skin Repair....           NA       465.77       465.77
   0687   Revision/Removal of               NA     1,444.65     1,444.65
           Neurostimulator
           Electrodes............
   0688   Revision/Removal of               NA     6,238.79     6,238.79
           Neurostimulator Pulse
           Generator Receiver....
   0692   Electronic Analysis of            NA       644.44       644.44
           Neurostimulator Pulse
           Generators............
------------------------------------------------------------------------

    As noted above, the estimates of transitional pass-through payments 
for devices, and of total pass-through payments for all eligible items, 
have decreased because of the corrections of device costs associated 
with specific procedures. After we incorporated 75 percent of the 
estimated pass-through device costs into the APCs, the remaining 
estimate of total pass-through payments for CY 2002 is 1.20 billion, 
which results in a uniform reduction in pass-through payments for 2002 
of 63.6 percent.
    During the first quarter of CY 2002, payments to hospitals for 
outpatient services are based on the rates and Healthcare Common 
Procedure Coding System (HCPCS) codes that were in effect for CY 2001, 
and a uniform reduction of transitional pass-through payments does not 
apply. Hospitals have thus received the advantage of much higher pass-
through payments during the first quarter of CY 2002 than they would 
have, had we proceeded with implementation of the revised CY 2002 rates 
and the requisite uniform reduction for services furnished on or after 
January 1, 2002.

[[Page 9559]]

    We are making four revised addenda available. Revised Addendum A 
and Addendum D are printed at the end of this preamble. Addendum A 
shows the corrected relative weights and payment rates, as well as the 
national unadjusted copayment and minimum unadjusted copayment amounts 
that are effective April 1, 2002. Addendum D incorporates several 
corrections to the payment status indicator addendum that was published 
on November 30, 2001.
    Revised Addendum B and Addendum C are available on our Web site at 
http://www.cms.hhs.gov. Addendum B shows payment rates, weights, APC 
assignment, and payment status by HCPCS code. Addendum C lists the 
HCPCS codes in each APC group.
    On December 31, 2001, we published a final rule that delayed the 
effective date of the payment rates and the uniform reduction to the 
transitional pass-through payments under the OPPS announced in the 
November 30, 2001 final rule until no later than April 1, 2002. We also 
announced that payment under the OPPS would continue to be made under 
the payment rates in effect on December 31, 2001, and that we would not 
apply a uniform reduction to payments for transitional pass-through 
items. This final rule implements the revised payment rates in Addendum 
A effective for services furnished on or after April 1, 2002. Also, 
effective for services furnished on or after April 1, 2002, a uniform 
reduction of 63.6 percent applies to transitional pass-through payments 
made under the OPPS. In addition, effective for services furnished on 
or after April 1, 2002, the threshold for determining outlier payments 
is when service costs are 3.5 times greater than the applicable APC 
payment amount. Also, effective for services furnished on or after 
April 1, 2002, payment will be made for new 2002 HCPCS codes and 
modifiers that are payable under the OPPS.

B. Correction of Technical and Typographical Errors in the Preamble and 
the Regulations Text of the November 30, 2001 Final Rule

    We are correcting the following typographical and technical errors 
in the preamble and regulations text of the November 30, 2001 final 
rule. As we have stated previously, these corrections do not involve 
any changes in the policies announced in that rule.
    1. On page 59863, in column two, the heading ``Level I Nerve 
Injections (to include Trigger Point, Joint, Other Injections, and 
Lower Complexity Nerve Blocks)'' is corrected to read ``Level VI Nerve 
Injections (APC 204) (to include Trigger Point, Joint, Other 
Injections, and Lower Complexity Nerve Blocks).''
    2. On page 59863, in column two, the chart that will be under the 
revised heading (see item 1 above) ``Level VI Nerve Injections (APC 
204) (to include Trigger Point, Joint, Other Injections, and Lower 
Complexity Nerve Blocks)'' is revised to read:

------------------------------------------------------------------------
                                                              Reassigned
                                                               CPT Code
                                                               from APC
------------------------------------------------------------------------
27096......................................................        (\1\)
62270......................................................         0210
62272......................................................         0210
62273......................................................         0212
62310-62319................................................        0212
------------------------------------------------------------------------
\1\ Currently packaged.

    3. On page 59863, in column two, the heading ``Level II Nerve 
Injections (to include Moderate Complexity Nerve Blocks and 
Epidurals):'' is corrected to read ``Level III Nerve Injections (APC 
206) (to include Moderate Complexity Nerve Blocks and Epidurals):''.
    4. On page 59863, in column two and continuing to the top of column 
three, the heading ``Level III Nerve Injections (to include Moderately 
High Complexity Epidurals, Facet Blocks, and Disk Injections):'' is 
corrected to read ``Level IV Nerve Injections (APC 207) (to include 
Moderately High Complexity Epidurals, Facet Blocks, and Disk 
Injections):''.
    5. On page 59863, in column three, the heading ``Level IV Nerve 
Injections (to include High Complexity Lysis of Adhesions, Neurolytic 
Procedures, Removal of Implantable Pumps and Stimulators):'' is 
corrected to read ``Level V Nerve Injections (APC 203) (to include High 
Complexity Lysis of Adhesions, Neurolytic Procedures, Removal of 
Implantable Pumps and Stimulators):''.
    6. On page 59868, in column two, the first and second complete 
sentences beginning at line five from the top of the page are corrected 
to read ``We would note that payment for IMRT planning includes payment 
for the following CPT codes: 77300, 77336, 77370, 77280-77295, 77305-
77321. The only CPT codes that may be billed in addition to 77301 (IMRT 
planning) are the CPT codes 77332-77334.''
    7. On page 59870, in column one, the last sentence is corrected to 
read ``According to our methodology for pricing new technology 
services, these services will be reassigned to APC 0714, New 
Technology--Level IX ($1250-$1500), which results in a payment rate of 
$1,375 with a status indicator of `S,' indicating that the multiple 
procedure discount is not applied.''
    8. On page 59883, in column two, on line 17 from the top of the 
page, ``G0224,'' is corrected to read ``G0244.''
    9. On page 59883, in column two, beginning at the bottom of the 
page and continuing to the top of column three, the list of acceptable 
diagnosis codes for chest pain is corrected to read as follows:

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

    10. On page 59883, in column three, the list of acceptable 
diagnosis codes for congestive heart failure is corrected to read as 
follows:

For Congestive Heart Failure:

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

    11. On page 59883, in column three, the second-to-last sentence is 
corrected to read ``For asthma, a peak expiratory flow rate (PEFR) (CPT 
code 94010), or pulse oximetry (CPT codes 94760 or 94761).''
    12. We are also making revisions to our regulations under 42 CFR 
Part 419, specifically Sec. 419.32 ``Calculation of prospective payment 
rates for hospital outpatient services,'' and Sec. 419.62 
``Transitional pass-through payments: General rules.'' At 
Secs. 419.32(b)(1)(iii) and 419.62(d), we are revising our language to 
specify that the provisions

[[Page 9560]]

under these sections are applicable to a portion of CY 2002 and not 
necessarily the entire year for 2002.

C. Correction of Technical and Typographical Errors in Addenda A, B, C, 
and D

    Addenda A, B, and D as published in the November 30, 2001 final 
rule contain a number of typographical and technical errors that do not 
involve any changes in the policies announced in that rule. Addenda A 
and D at the end of this document reflect the corrections of these 
errors. Corrected addenda B and C are available on our Web site at 
http://www.cms.hhs.gov.
1. Corrections to Addendum A
    Table 2, Corrections to Addendum A of the November 30, 2001 final 
rule, shows the APC listings for which corrections are required. It 
provides the data as published in that final rule and the additions and 
corrections to these data.
BILLING CODE 4120-01-P

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[[Page 9562]]


[GRAPHIC] [TIFF OMITTED] TR01MR02.001


[[Page 9563]]


2. Corrections to Addendum B of the November 30, 2001 Final Rule
    Table 3, Corrections to Addendum B of the November 30, 2001 final 
rule shows the APC assignments for which corrections are required. It 
provides the data as published in that final rule and the additions and 
corrections to these data.

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[GRAPHIC] [TIFF OMITTED] TR01MR02.003


[[Page 9566]]


[GRAPHIC] [TIFF OMITTED] TR01MR02.004

BILLING CODE 4120-01-C

[[Page 9567]]

3. Corrections to Addendum D of the November 30, 2001 Final Rule
    On page 60091, there are two corrections to Addendum D as published 
in the November 30, 2001 final rule.
    a. Under the status column for Screening Mammography, ``Lower of 
Charges or National Rate'' is revised to read ``Physician Fee 
Schedule.''
    b. We are adding a status indicator that was inadvertently omitted. 
In the indicator column we are adding, where it should appear 
alphabetically, status indicator ``D'', ``Deleted Code'' under the 
service column, and ``Codes Are Deleted Effective with the Beginning of 
the Calendar Year'' under the status column.

III. Waiver of Notice of Proposed Rulemaking

    We ordinarily publish a notice of proposed rulemaking in the 
Federal Register and invite public comment on the proposed rule. The 
notice of proposed rulemaking includes a reference to the legal 
authority under which the rule is proposed, and the terms and 
substances of the proposed rule or a description of the subjects and 
issues involved. This procedure can be waived, however, if an agency 
finds good cause that a notice-and-comment procedure is impracticable, 
unnecessary, or contrary to the public interest and incorporates a 
statement of the finding and its reasons in the rule issued. The rates 
in this final rule incorporate the correction of errors that were 
identified in connection with the rates published in the November 30, 
2001 final rule.
    We find that it is in the general public interest to proceed with 
implementing the corrected rates without proposed rulemaking and public 
comment. The delay in implementing the 2002 rates was necessary to 
correct identified inadvertent technical errors and to allow us to 
review our data files to ensure that other errors could also be 
identified and corrected. As a matter of good public policy, we do not 
believe that the necessary delay in implementing the CY 2002 OPPS rates 
should result in continued uncertainty among hospitals, beneficiaries, 
and others regarding CY 2002 payment rates for OPPS services. The 
public is expecting the corrected OPPS update for CY 2002 to be made 
effective no later than April 1, 2002. Thus, there is an urgent need, 
effective for services furnished on or after April 1, 2002, to 
implement the corrected rate update and new 2002 HCPCS codes for 
Medicare payments under the OPPS. There is not sufficient time to 
provide notice of proposed rulemaking without further delaying the 
effective date of the rates. Therefore, we find that it is contrary to 
the public interest to continue to delay the effective date of the 
rates.

IV. Collection of Information Requirements

    This document does not impose information collection and record-
keeping requirements. Consequently, the Office of Management and Budget 
need not review it under the authority of the Paperwork Reduction Act 
of 1995.

V. Regulatory Impact Statement

    We have examined the impacts of this rule as required by Executive 
Order 12866 (September 1993, Regulatory Planning and Review) and the 
Regulatory Flexibility Act (RFA) (September 19, 1980 Pub. L. 96-354). 
Executive Order 12866 directs agencies to assess all costs and benefits 
of available regulatory alternatives and, if regulation is necessary, 
to select regulatory approaches that maximize net benefits (including 
potential economic, environmental, public health and safety effects, 
distributive impacts, and equity). A regulatory impact analysis (RIA) 
must be prepared for major rules with economically significant effects 
($100 million or more annually).
    As discussed above in this preamble, this final rule corrects 
inadvertent technical errors in the November 30, 2001 final rule that 
implemented the CY 2002 payments for the hospital OPPS. We note that 
the November 30, 2001 final rule was not a major rule. As we also 
discussed above in the preamble, this final rule corrects the estimate 
of the transitional pass-through payments for CY 2002 and the resulting 
uniform reduction that is required for that year, the median costs for 
several APCs, the scalar used to adjust the relative payment weights 
for the effects of recalibration, and device cost assignment to device-
related APCs. We also note that on November 2, 2001, we published a 
final rule that announced the updated conversion factor for payments 
under the OPPS (66 FR 55857).
    The RFA requires agencies to analyze options for regulatory relief 
of small businesses. 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 between $5 
million and $25 million (for details see the Small Business 
Administration's final rule that set forth size standards for health 
care industries at 65 FR 69432). 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 for any final rule that may have a 
significant impact on the operations of a substantial number of small 
rural hospitals. Such an analysis must conform to the provisions of 
section 604 of the RFA. With the exception of hospitals located in 
certain New England counties, for purposes of section 1102(b) of the 
Act, we define a small rural hospital as a hospital with not more than 
100 beds that is located outside of a Metropolitan Statistical Area 
(MSA) or New England County Metropolitan Area (NECMA). Section 601(g) 
of the Social Security Amendments of 1983 (Pub. L. 98-21) designated 
hospitals in certain New England counties as belonging to the adjacent 
NECMA. Thus, for purposes of the PPS, we classify these hospitals as 
urban hospitals. See the November 30, 2001 final rule for the 
regulatory impact analysis related to the updated CY 2002 hospital OPPS 
payments.
    Section 202 of the Unfunded Mandates Reform Act of 1995 also 
requires that agencies assess anticipated costs and benefits before 
issuing any rule that may result in an expenditure in any 1 year by 
State, local, or tribal governments, in the aggregate, or by the 
private sector, of $110 million. This final rule will not have a 
significant economic effect on these governments or the private sector.
    Executive Order 13132 establishes certain requirements that an 
agency must meet when it promulgates a final rule that imposes 
substantial direct compliance costs on State and local governments, 
preempts State law, or otherwise has Federalism implications. This 
final rule will not have a substantial effect on States or local 
governments.
    Because the November 30, 2001 final rule includes the relevant 
impact analysis for the changes to the hospital OPPS, we are not 
preparing analyses for either the RFA or section 1102(b) of the Act.
    In accordance with the provisions of Executive Order 12866, this 
regulation was reviewed by the Office of Management and Budget.

List of Subjects 42 CFR Part 419

    Hospitals, Medicare, Reporting and recordkeeping requirements.

    For the reasons set forth in the preamble, 42 CFR part 419 is 
corrected

[[Page 9568]]

by making the following correcting amendments:

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

    1. The authority citation 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).


Sec. 419.32  [Corrected]

    2. In Sec. 419.32, paragraph (b)(1)(iii) is corrected by removing 
the phrase ``For calendar year 2002,'' and adding in its place the 
phrase ``For the portion of calendar year 2002 that is affected by 
these rules,''.


Sec. 419.62  [Corrected]

    In Sec. 419.62, paragraph (d) is corrected by removing the phrase 
``For CY 2002'' and adding in its place ``For the portion of CY 2002 
affected by these rules,''.

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

    Dated: February 27, 2002.
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.
    Approved: February 27, 2002.
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                               1.04       $52.94       $27.08       $10.59
          Aspiration.
   0004  Level I Needle Biopsy/      T                               2.48      $126.24       $32.57       $25.25
          Aspiration Except Bone
          Marrow.
   0005  Level II Needle Biopsy /    T                               4.05      $206.16       $90.71       $41.23
          Aspiration Except Bone
          Marrow.
   0006  Level I Incision &          T                               2.19      $111.48       $33.95       $22.30
          Drainage.
   0007  Level II Incision &         T                               6.79      $345.64       $72.03       $69.13
          Drainage.
   0008  Level III Incision and      T                              10.99      $559.43      $113.67      $111.89
          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                               1.48       $75.34       $27.88       $15.07
          Lesion.
   0012  Level I Debridement &       T                               0.66       $33.60        $9.18        $6.72
          Destruction.
   0013  Level II Debridement &      T                               1.37       $69.74       $17.66       $13.95
          Destruction.
   0015  Level IV Debridement &      T                               2.08      $105.88       $31.20       $21.18
          Destruction.
   0016  Level V Debridement &       T                               3.04      $154.75       $65.00       $30.95
          Destruction.
   0017  Level VI Debridement &      T                               9.73      $495.30      $227.84       $99.06
          Destruction.
   0018  Biopsy of Skin/Puncture of  T                               1.06       $53.96       $17.66       $10.79
          Lesion.
   0019  Level I Excision/ Biopsy..  T                               4.24      $215.83       $78.91       $43.17
   0020  Level II Excision/ Biopsy.  T                               8.49      $432.17      $130.53       $86.43
   0021  Level IV Excision/ Biopsy.  T                              11.89      $605.25      $236.51      $121.05
   0022  Level V Excision/ Biopsy..  T                              13.99      $712.15      $292.94      $142.43
   0023  Exploration Penetrating     T                               2.09      $106.39       $40.37       $21.28
          Wound.
   0024  Level I Skin Repair.......  T                               2.29      $116.57       $41.97       $23.31
   0025  Level II Skin Repair......  T                               3.41      $173.58       $65.57       $34.72
   0026  Level III Skin Repair.....  T                              12.69      $645.97      $277.92      $129.19
   0027  Level IV Skin Repair......  T                              18.12      $922.38      $383.10      $184.48
   0028  Level I Breast Surgery....  T                              14.08      $716.73      $303.74      $143.35
   0029  Level II Breast Surgery...  T                              23.90    $1,216.61      $632.64      $243.32
   0030  Level III Breast Surgery..  T                              34.40    $1,751.10      $763.55      $350.22
   0032  Insertion of Central        T                              12.71      $646.99  ...........      $129.40
          Venous/Arterial Catheter.
   0033  Partial Hospitalization...  P                               4.17      $212.27       $48.17       $42.45
   0035  Placement of Arterial or    T                               0.13        $6.62        $2.91        $1.32
          Central Venous Catheter.
   0041  Level I Arthroscopy.......  T                              23.74    $1,208.46      $580.06      $241.69
   0042  Level II Arthroscopy......  T                              35.97    $1,831.02      $804.74      $366.20
   0043  Closed Treatment Fracture   T                               4.07      $207.18  ...........       $41.44
          Finger/Toe/Trunk.
   0044  Closed Treatment Fracture/  T                               2.54      $129.30       $38.08       $25.86
          Dislocation Except Finger/
          Toe/Trunk.
   0045  Bone/Joint Manipulation     T                              11.74      $597.61      $277.12      $119.52
          Under Anesthesia.
   0046  Open/Percutaneous           T                              27.86    $1,418.19      $535.76      $283.64
          Treatment Fracture or
          Dislocation.
   0047  Arthroplasty without        T                              26.51    $1,349.47      $537.03      $269.89
          Prosthesis.
   0048  Arthroplasty with           T                              43.44    $2,211.27      $725.94      $442.25
          Prosthesis.
   0049  Level I Musculoskeletal     T                              15.93      $810.90      $356.95      $162.18
          Procedures Except Hand
          and Foot.
   0050  Level II Musculoskeletal    T                              20.75    $1,056.26      $507.15      $211.25
          Procedures Except Hand
          and Foot.
   0051  Level III Musculoskeletal   T                              28.73    $1,462.47      $675.24      $292.49
          Procedures Except Hand
          and Foot.
   0052  Level IV Musculoskeletal    T                              36.15    $1,840.18      $930.91      $368.04
          Procedures Except Hand
          and Foot.
   0053  Level I Hand                T                              11.76      $598.63      $253.49      $119.73
          Musculoskeletal
          Procedures.
   0054  Level II Hand               T                              19.95    $1,015.53      $472.33      $203.11
          Musculoskeletal
          Procedures.
   0055  Level I Foot                T                              15.52      $790.03      $355.34      $158.01
          Musculoskeletal
          Procedures.
   0056  Level II Foot               T                              18.95      $964.63      $405.81      $192.93
          Musculoskeletal
          Procedures.
   0057  Bunion Procedures.........  T                              24.49    $1,246.64      $496.65      $249.33
   0058  Level I Strapping and Cast  S                               1.28       $65.16       $19.27       $13.03
          Application.
   0059  Level II Strapping and      S                               2.23      $113.52       $29.59       $22.70
          Cast Application.
   0060  Manipulation Therapy......  S                               0.23       $11.71  ...........        $2.34
   0068  CPAP Initiation...........  S                               3.04      $154.75       $85.11       $30.95

[[Page 9569]]

 
   0069  Thoracoscopy..............  T                              23.72    $1,207.44      $591.64      $241.49
   0070  Thoracentesis/Lavage        T                               4.61      $234.67       $79.60       $46.93
          Procedures.
   0071  Level I Endoscopy Upper     T                               1.04       $52.94       $14.22       $10.59
          Airway.
   0072  Level II Endoscopy Upper    T                               1.22       $62.10       $34.16       $12.42
          Airway.
   0073  Level III Endoscopy Upper   T                               3.31      $168.49       $74.14       $33.70
          Airway.
   0074  Level IV Endoscopy Upper    T                              11.39      $579.80      $295.70      $115.96
          Airway.
   0075  Level V Endoscopy Upper     T                              17.52      $891.84      $445.92      $178.37
          Airway.
   0076  Endoscopy Lower Airway....  T                               7.61      $387.38      $189.82       $77.48
   0077  Level I Pulmonary           S                               0.39       $19.85       $10.92        $3.97
          Treatment.
   0078  Level II Pulmonary          S                               0.87       $44.29       $19.04        $8.86
          Treatment.
   0079  Ventilation Initiation and  S                               0.60       $30.54       $16.80        $6.11
          Management.
   0080  Diagnostic Cardiac          T                              34.93    $1,778.08      $838.92      $355.62
          Catheterization.
   0081  Non-Coronary Angioplasty    T                              29.42    $1,497.60      $710.91      $299.52
          or Atherectomy.
   0082  Coronary Atherectomy......  T                              92.53    $4,710.15    $1,351.74      $942.03
   0083  Coronary Angioplasty......  T                              59.84    $3,046.10      $794.30      $609.22
   0084  Level I Electrophysiologic  S                               6.90      $351.24      $115.91       $70.25
          Evaluation.
   0085  Level II                    T                              58.28    $2,966.69      $654.48      $593.34
          Electrophysiologic
          Evaluation.
   0086  Ablate Heart Dysrhythm      T                              73.14    $3,723.12    $1,265.37      $744.62
          Focus.
   0087  Cardiac Electrophysiologic  T                              52.77    $2,686.20  ...........      $537.24
          Recording/Mapping.
   0088  Thrombectomy..............  T                              34.57    $1,759.75      $678.68      $351.95
   0089  Insertion/Replacement of    T                             150.39    $7,655.45    $2,246.59    $1,531.09
          Permanent Pacemaker and
          Electrodes.
   0090  Insertion/Replacement of    T                             116.11    $5,910.46    $2,133.88    $1,182.09
          Pacemaker Pulse Generator.
   0091  Level I Vascular Ligation.  T                              21.15    $1,076.62      $348.23      $215.32
   0092  Level II Vascular Ligation  T                              20.02    $1,019.10      $505.37      $203.82
   0093  Vascular Repair/Fistula     T                              14.24      $724.87      $277.34      $144.97
          Construction.
   0094  Resuscitation and           S                               6.12      $311.53      $105.29       $62.31
          Cardioversion.
   0095  Cardiac Rehabilitation....  S                               0.62       $31.56       $16.73        $6.31
   0096  Non-Invasive Vascular       S                               1.72       $87.55       $48.15       $17.51
          Studies.
   0097  Cardiac and Ambulatory      X                               0.85       $43.27       $23.80        $8.65
          Blood Pressure Monitoring.
   0098  Injection of Sclerosing     T                               1.25       $63.63       $20.88       $12.73
          Solution.
   0099  Electrocardiograms........  S                               0.36       $18.33       $10.08        $3.67
   0100  Stress Tests and            X                               1.48       $75.34       $41.44       $15.07
          Continuous ECG.
   0101  Tilt Table Evaluation.....  S                               3.76      $191.40      $105.27       $38.28
   0103  Miscellaneous Vascular      T                              16.04      $816.50      $295.70      $163.30
          Procedures.
   0104  Transcatheter Placement of  T                              96.97    $4,936.16  ...........      $987.23
          Intracoronary Stents.
   0105  Revision/Removal of         T                              14.85      $755.92      $370.40      $151.18
          Pacemakers, AICD, or
          Vascular.
   0106  Insertion/Replacement/      T                              36.85    $1,875.81      $503.07      $375.16
          Repair of Pacemaker and/
          or Electrodes.
   0107  Insertion of Cardioverter-  T                             381.66   $19,428.02    $4,224.27    $3,885.60
          Defibrillator.
   0108  Insertion/Replacement/      T                             576.78   $29,360.41  ...........    $5,872.08
          Repair of Cardioverter-
          Defibrillator Leads.
   0109  Removal of Implanted        T                               6.30      $320.70      $131.49       $64.14
          Devices.
   0110  Transfusion...............  S                               5.34      $271.83      $114.17       $54.37
   0111  Blood Product Exchange....  S                              21.21    $1,079.67      $300.74      $215.93
   0112  Apheresis, Photopheresis,   S                              36.46    $1,855.96      $612.47      $371.19
          and Plasmapheresis.
   0113  Excision Lymphatic System.  T                              15.62      $795.12      $326.55      $159.02
   0114  Thyroid/Lymphadenectomy     T                              29.46    $1,499.63      $493.78      $299.93
          Procedures.
   0115  Cannula/Access Device       T                              21.47    $1,092.91      $506.74      $218.58
          Procedures.
   0116  Chemotherapy                S                               0.91       $46.32  ...........        $9.26
          Administration by Other
          Technique Except Infusion.
   0117  Chemotherapy                S                               4.03      $205.14       $52.69       $41.03
          Administration by
          Infusion Only.
   0118  Chemotherapy                S                               4.22      $214.81       $72.03       $42.96
          Administration by Both
          Infusion and Other
          Technique.
   0119  Implantation of Devices...  T                              80.14    $4,079.45  ...........      $815.89
   0120  Infusion Therapy Except     T                               3.10      $157.80       $42.67       $31.56
          Chemotherapy.
   0121  Level I Tube changes and    T                               2.56      $130.31       $52.53       $26.06
          Repositioning.
   0122  Level II Tube changes and   T                               9.94      $505.99      $114.93      $101.20
          Repositioning.
   0123  Bone Marrow Harvesting and  S                               8.62      $438.79  ...........       $87.76
          Bone Marrow/Stem Cell
          Transplant.
   0124  Revision of Implanted       T                              89.58    $4,559.98  ...........      $912.00
          Infusion Pump.
   0125  Refilling of Infusion Pump  T                               3.01      $153.22  ...........       $30.64
   0130  Level I Laparoscopy.......  T                              26.06    $1,326.56      $659.53      $265.31
   0131  Level II Laparoscopy......  T                              37.85    $1,926.72    $1,001.89      $385.34
   0132  Level III Laparoscopy.....  T                              56.38    $2,869.97    $1,239.22      $573.99
   0140  Esophageal Dilation         T                               5.68      $289.13      $107.24       $57.83
          without Endoscopy.
   0141  Upper GI Procedures.......  T                               7.25      $369.05      $184.67       $73.81
   0142  Small Intestine Endoscopy.  T                               6.98      $355.31      $152.78       $71.06
   0143  Lower GI Endoscopy........  T                               7.31      $372.11      $186.06       $74.42
   0144  Diagnostic Anoscopy.......  T                               4.46      $227.03       $49.32       $45.41

[[Page 9570]]

 
   0145  Therapeutic Anoscopy......  T                              10.88      $553.84      $179.39      $110.77
   0146  Level I Sigmoidoscopy.....  T                               2.75      $139.99       $64.40       $28.00
   0147  Level II Sigmoidoscopy....  T                               5.74      $292.19      $137.33       $58.44
   0148  Level I Anal/Rectal         T                               2.41      $122.68       $43.59       $24.54
          Procedure.
   0149  Level III Anal/Rectal       T                              13.61      $692.80      $293.06      $138.56
          Procedure.
   0150  Level IV Anal/Rectal        T                              18.19      $925.94      $437.12      $185.19
          Procedure.
   0151  Endoscopic Retrograde       T                              15.39      $783.41      $245.46      $156.68
          Cholangio-Pancreatography
          (ERCP).
   0152  Percutaneous Biliary        T                              16.23      $826.17      $207.38      $165.23
          Endoscopic Procedures.
   0153  Peritoneal and Abdominal    T                              23.70    $1,206.42      $496.31      $241.28
          Procedures.
   0154  Hernia/Hydrocele            T                              31.58    $1,607.55      $556.98      $321.51
          Procedures.
   0155  Level II Anal/Rectal        T                               5.30      $269.79       $99.82       $53.96
          Procedure.
   0156  Level II Urinary and Anal   T                               2.46      $125.22       $37.57       $25.04
          Procedures.
   0157  Colorectal Cancer           S                               1.99      $101.30       $22.19       $20.26
          Screening: Barium Enema.
   0158  Colorectal Cancer           T                               6.59      $335.46       $83.87       $67.09
          Screening: Colonoscopy.
   0159  Colorectal Cancer           S                               2.34      $119.12       $29.78       $23.82
          Screening: Flexible
          Sigmoidoscopy.
   0160  Level I Cystourethroscopy   T                               5.16      $262.66      $105.06       $52.53
          and other Genitourinary
          Procedures.
   0161  Level II Cystourethroscopy  T                              13.80      $702.48      $249.36      $140.50
          and other Genitourinary
          Procedures.
   0162  Level III                   T                              25.23    $1,284.31      $427.49      $256.86
          Cystourethroscopy and
          other Genitourinary
          Procedures.
   0163  Level IV Cystourethroscopy  T                              40.63    $2,068.23      $792.58      $413.65
          and other Genitourinary
          Procedures.
   0164  Level I Urinary and Anal    T                               1.02       $51.92       $15.58       $10.38
          Procedures.
   0165  Level III Urinary and Anal  T                               5.25      $267.25       $91.76       $53.45
          Procedures.
   0166  Level I Urethral            T                              12.27      $624.59      $218.73      $124.92
          Procedures.
   0167  Level II Urethral           T                              22.41    $1,140.76      $555.84      $228.15
          Procedures.
   0168  Level III Urethral          T                              18.53      $943.25      $405.60      $188.65
          Procedures.
   0169  Lithotripsy...............  T                              39.85    $2,028.52    $1,115.69      $405.70
   0170  Dialysis for Other Than     S                               0.29       $14.76        $3.25        $2.95
          ESRD Patients.
   0179  Urinary Incontinence        T                             140.14    $7,133.69    $3,067.48    $1,426.74
          Procedures.
   0180  Circumcision..............  T                              15.11      $769.16      $304.87      $153.83
   0181  Penile Procedures.........  T                              22.21    $1,130.58      $621.82      $226.12
   0182  Insertion of Penile         T                              88.04    $4,481.59    $1,492.28      $896.32
          Prosthesis.
   0183  Testes/Epididymis           T                              18.97      $965.65      $448.94      $193.13
          Procedures.
   0184  Prostate Biopsy...........  T                               4.86      $247.39      $123.70       $49.48
   0187  Miscellaneous Placement/    X                               4.24      $215.83       $94.96       $43.17
          Repositioning.
   0188  Level II Female             T                               0.81       $41.23       $11.95        $8.25
          Reproductive Proc.
   0189  Level III Female            T                               1.26       $64.14       $18.60       $12.83
          Reproductive Proc.
   0190  Surgical Hysteroscopy.....  T                              17.01      $865.88      $424.28      $173.18
   0191  Level I Female              T                               0.23       $11.71        $3.40        $2.34
          Reproductive Proc.
   0192  Level IV Female             T                               2.52      $128.28       $35.33       $25.66
          Reproductive Proc.
   0193  Level V Female              T                              11.23      $571.65      $171.13      $114.33
          Reproductive Proc.
   0194  Level VI Female             T                              15.95      $811.92      $397.84      $162.38
          Reproductive Proc.
   0195  Level VII Female            T                              20.74    $1,055.75      $483.80      $211.15
          Reproductive Proc.
   0196  Dilation and Curettage....  T                              13.56      $690.26      $338.23      $138.05
   0197  Infertility Procedures....  T                               2.41      $122.68       $49.55       $24.54
   0198  Pregnancy and Neonatal      T                               1.32       $67.19       $32.92       $13.44
          Care Procedures.
   0199  Vaginal Delivery..........  T                               5.12      $260.63       $72.98       $52.13
   0200  Therapeutic Abortion......  T                              11.41      $580.81      $307.83      $116.16
   0201  Spontaneous Abortion......  T                              14.42      $734.04      $329.65      $146.81
   0202  Level VIII Female           T                              63.90    $3,252.77    $1,593.85      $650.55
          Reproductive Proc.
   0203  Level V Nerve Injections..  T                              15.88      $808.36      $363.78      $161.67
   0204  Level VI Nerve Injections.  T                               2.25      $114.53       $43.52       $22.91
   0206  Level III Nerve Injections  T                               3.62      $184.27       $75.55       $36.85
   0207  Level IV Nerve Injections.  T                               5.40      $274.88      $123.69       $54.98
   0208  Laminotomies and            T                              29.29    $1,490.98  ...........      $298.20
          Laminectomies.
   0209  Extended EEG Studies and    S                              10.60      $539.58      $280.58      $107.92
          Sleep Studies, Level II.
   0212  Level II Nervous System     T                               3.79      $192.93       $88.78       $38.59
          Injections.
   0213  Extended EEG Studies and    S                               2.66      $135.40       $70.41       $27.08
          Sleep Studies, Level I.
   0214  Electroencephalogram......  S                               2.11      $107.41       $53.71       $21.48
   0215  Level I Nerve and Muscle    S                               0.66       $33.60       $17.47        $6.72
          Tests.
   0216  Level III Nerve and Muscle  S                               2.63      $133.88       $60.25       $26.78
          Tests.
   0218  Level II Nerve and Muscle   S                               1.04       $52.94       $23.82       $10.59
          Tests.
   0220  Level I Nerve Procedures..  T                              13.68      $696.37      $327.29      $139.27
   0221  Level II Nerve Procedures.  T                              21.55    $1,096.98      $463.62      $219.40
   0222  Implantation of             T                             304.29   $15,489.58  ...........    $3,097.92
          Neurological Device.
   0223  Implantation of Pain        T                              75.83    $3,860.05  ...........      $772.01
          Management Device.
   0224  Implantation of Reservoir/  T                              28.65    $1,458.40      $453.41      $291.68
          Pump/Shunt.
   0225  Implantation of             T                             269.11   $13,698.78  ...........    $2,739.76
          Neurostimulator
          Electrodes.
   0226  Implantation of Drug        T                              76.24    $3,880.92  ...........      $776.18
          Infusion Reservoir.

[[Page 9571]]

 
   0227  Implantation of Drug        T                             140.36    $7,144.89  ...........    $1,428.98
          Infusion Device.
   0228  Creation of Lumbar          T                              54.08    $2,752.89      $696.46      $550.58
          Subarachnoid Shunt.
   0229  Transcatherter Placement    T                              76.09    $3,873.29      $996.86      $774.66
          of Intravascular Shunts.
   0230  Level I Eye Tests &         S                               0.62       $31.56       $14.52        $6.31
          Treatments.
   0231  Level III Eye Tests &       S                               2.05      $104.35       $46.96       $20.87
          Treatments.
   0232  Level I Anterior Segment    T                               3.52      $179.18       $78.84       $35.84
          Eye Procedures.
   0233  Level II Anterior Segment   T                              10.90      $554.85      $266.33      $110.97
          Eye Procedures.
   0234  Level III Anterior Segment  T                              19.20      $977.36      $469.13      $195.47
          Eye Procedures.
   0235  Level I Posterior Segment   T                               5.60      $285.06       $78.91       $57.01
          Eye Procedures.
   0236  Level II Posterior Segment  T                              16.30      $829.74  ...........      $165.95
          Eye Procedures.
   0237  Level III Posterior         T                              32.16    $1,637.07      $818.54      $327.41
          Segment Eye Procedures.
   0238  Level I Repair and Plastic  T                               3.02      $153.73       $58.96       $30.75
          Eye Procedures.
   0239  Level II Repair and         T                               5.84      $297.28      $115.94       $59.46
          Plastic Eye Procedures.
   0240  Level III Repair and        T                              13.91      $708.07      $315.31      $141.61
          Plastic Eye Procedures.
   0241  Level IV Repair and         T                              17.84      $908.13      $384.47      $181.63
          Plastic Eye Procedures.
   0242  Level V Repair and Plastic  T                              24.26    $1,234.93      $597.36      $246.99
          Eye Procedures.
   0243  Strabismus/Muscle           T                              17.81      $906.60      $431.39      $181.32
          Procedures.
   0244  Corneal Transplant........  T                              38.69    $1,969.48      $851.42      $393.90
   0245  Level I Cataract            T                              10.50      $534.49      $251.21      $106.90
          Procedures without IOL
          Insert.
   0246  Cataract Procedures with    T                              20.73    $1,055.24      $495.96      $211.05
          IOL Insert.
   0247  Laser Eye Procedures        T                               4.05      $206.16       $94.83       $41.23
          Except Retinal.
   0248  Laser Retinal Procedures..  T                               4.35      $221.43       $94.05       $44.29
   0249  Level II Cataract           T                              21.93    $1,116.32      $524.67      $223.26
          Procedures without IOL
          Insert.
   0250  Nasal Cauterization/        T                               2.11      $107.41       $37.59       $21.48
          Packing.
   0251  Level I ENT Procedures....  T                               2.44      $124.21       $27.99       $24.84
   0252  Level II ENT Procedures...  T                               5.99      $304.91      $114.24       $60.98
   0253  Level III ENT Procedures..  T                              12.40      $631.21      $284.00      $126.24
   0254  Level IV ENT Procedures...  T                              17.47      $889.29      $272.41      $177.86
   0256  Level V ENT Procedures....  T                              26.76    $1,362.19      $623.05      $272.44
   0258  Tonsil and Adenoid          T                              17.53      $892.35      $437.25      $178.47
          Procedures.
   0259  Level VI ENT Procedures...  T                             378.75   $19,279.89    $9,447.14    $3,855.98
   0260  Level I Plain Film Except   X                               0.70       $35.63       $19.60        $7.13
          Teeth.
   0261  Level II Plain Film Except  X                               1.22       $62.10       $34.15       $12.42
          Teeth Including Bone
          Density Measurement.
   0262  Plain Film of Teeth.......  X                               0.65       $33.09       $10.90        $6.62
   0263  Level I Miscellaneous       X                               1.62       $82.46       $44.53       $16.49
          Radiology Procedures.
   0264  Level II Miscellaneous      X                               3.74      $190.38      $104.71       $38.08
          Radiology Procedures.
   0265  Level I Diagnostic          S                               0.95       $48.36       $26.60        $9.67
          Ultrasound Except
          Vascular.
   0266  Level II Diagnostic         S                               1.55       $78.90       $43.40       $15.78
          Ultrasound Except
          Vascular.
   0267  Vascular Ultrasound.......  S                               2.34      $119.12       $65.52       $23.82
   0269  Level I Echocardiogram      S                               3.87      $197.00      $102.44       $39.40
          Except Transesophageal.
   0270  Transesophageal             S                               5.34      $271.83      $146.79       $54.37
          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                               5.27      $268.26      $128.12       $53.65
   0275  Arthrography..............  S                               2.61      $132.86       $69.09       $26.57
   0276  Level I Digestive           S                               1.49       $75.85       $41.72       $15.17
          Radiology.
   0277  Level II Digestive          S                               2.16      $109.95       $60.47       $21.99
          Radiology.
   0278  Diagnostic Urography......  S                               2.36      $120.13       $66.07       $24.03
   0279  Level I Angiography and     S                               7.77      $395.52      $174.57       $79.10
          Venography except
          Extremity.
   0280  Level II Angiography and    S                              13.63      $693.82      $353.85      $138.76
          Venography except
          Extremity.
   0281  Venography of Extremity...  S                               4.35      $221.43      $115.16       $44.29
   0282  Miscellaneous Computerized  S                               1.59       $80.94       $44.51       $16.19
          Axial Tomography.
   0283  Computerized Axial          S                               4.51      $229.58      $126.27       $45.92
          Tomography with Contrast
          Material.
   0284  Magnetic Resonance Imaging  S                               7.18      $365.49      $201.02       $73.10
          and Magnetic Resonance
          Angiography with Contrast
          Material.
   0285  Positron Emission           S                              18.83      $958.52      $415.21      $191.70
          Tomography (PET).
   0286  Myocardial Scans..........  S                               5.43      $276.41      $152.03       $55.28
   0287  Complex Venography........  S                               4.09      $208.20      $114.51       $41.64
   0288  CT, Bone Density..........  S                               1.18       $60.07       $33.03       $12.01
   0289  Needle Localization for     X                               1.63       $82.97       $44.80       $16.59
          Breast Biopsy.
   0290  Standard Non-Imaging        S                               1.76       $89.59       $49.27       $17.92
          Nuclear Medicine.
   0291  Level I Diagnostic Nuclear  S                               3.52      $179.18       $90.20       $35.84
          Medicine Excluding
          Myocardial Scans.
   0292  Level II Diagnostic         S                               4.22      $214.81      $118.15       $42.96
          Nuclear Medicine
          Excluding Myocardial
          Scans.
   0294  Level I Therapeutic         S                               5.04      $256.56      $141.11       $51.31
          Nuclear Medicine.
   0295  Level II Therapeutic        S                              12.17      $619.50      $340.73      $123.90
          Nuclear Medicine.
   0296  Level I Therapeutic         S                               3.41      $173.58       $95.47       $34.72
          Radiologic Procedures.

[[Page 9572]]

 
   0297  Level II Therapeutic        S                               7.11      $361.93      $172.51       $72.39
          Radiologic Procedures.
   0299  Miscellaneous Radiation     S                               0.21       $10.69        $5.66        $2.14
          Treatment.
   0300  Level I Radiation Therapy.  S                               2.08      $105.88       $47.72       $21.18
   0301  Level II Radiation Therapy  S                               5.18      $263.68  ...........       $52.74
   0302  Level III Radiation         S                              11.23      $571.65      $216.55      $114.33
          Therapy.
   0303  Treatment Device            X                               3.01      $153.22       $69.28       $30.64
          Construction.
   0304  Level I Therapeutic         X                               1.63       $82.97       $41.52       $16.59
          Radiation Treatment
          Preparation.
   0305  Level II Therapeutic        X                               3.74      $190.38       $91.38       $38.08
          Radiation Treatment
          Preparation.
   0310  Level III Therapeutic       X                              14.59      $742.69      $339.05      $148.54
          Radiation Treatment
          Preparation.
   0312  Radioelement Applications.  S                             124.64    $6,344.67  ...........    $1,268.93
   0313  Brachytherapy.............  S                              35.74    $1,819.31  ...........      $363.86
   0314  Hyperthermic Therapies....  S                               3.92      $199.54      $101.77       $39.91
   0320  Electroconvulsive Therapy.  S                               3.90      $198.53       $80.06       $39.71
   0321  Biofeedback and Other       S                               0.93       $47.34       $21.78        $9.47
          Training.
   0322  Brief Individual            S                               1.16       $59.05       $12.40       $11.81
          Psychotherapy.
   0323  Extended Individual         S                               1.74       $88.57       $21.26       $17.71
          Psychotherapy.
   0324  Family Psychotherapy......  S                               2.71      $137.95  ...........       $27.59
   0325  Group Psychotherapy.......  S                               1.38       $70.25       $18.27       $14.05
   0330  Dental Procedures.........  S                              11.04      $561.98  ...........      $112.40
   0332  Computerized Axial          S                               3.26      $165.95       $91.27       $33.19
          Tomography and
          Computerized Angiography
          without Contrast Material.
   0333  Computerized Axial          S                               5.25      $267.25      $146.98       $53.45
          Tomography and
          Computerized Angio w/o
          Contrast Material
          followed by Contrast.
   0335  Magnetic Resonance          S                               5.41      $275.39      $151.46       $55.08
          Imaging, Miscellaneous.
   0336  Magnetic Resonance Imaging  S                               6.32      $321.71      $176.94       $64.34
          and Magnetic Resonance
          Angiography without
          Contrast.
   0337  MRI and Magnetic Resonance  S                               8.60      $437.77      $240.77       $87.55
          Angiography without
          Contrast Material
          followed by Contrast
          Material.
   0339  Observation...............  S                               6.90      $351.24  ...........       $70.25
   0340  Minor Ancillary Procedures  X                               0.85       $43.27       $10.82        $8.65
   0341  Skin Tests and              X                               0.11        $5.60        $3.08        $1.12
          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                               0.27       $13.74        $5.37        $2.75
          Laboratory Procedures.
   0346  Level II Transfusion        X                               0.77       $39.20       $12.03        $7.84
          Laboratory Procedures.
   0347  Level III Transfusion       X                               1.57       $79.92       $20.13       $15.98
          Laboratory Procedures.
   0348  Fertility Laboratory        X                               0.77       $39.20  ...........        $7.84
          Procedures.
   0352  Level I Injections........  X                               0.41       $20.87  ...........        $4.17
   0353  Level II Allergy            X                               0.25       $12.73        $2.92        $2.55
          Injections.
   0354  Administration of           K                               0.11        $5.60  ...........  ...........
          Influenza/Pneumonia
          Vaccine.
   0355  Level I Immunizations.....  K                               0.19        $9.67        $5.05        $1.93
   0356  Level II Immunizations....  K                               1.12       $57.01  ...........       $11.40
   0359  Level II Injections.......  X                               1.80       $91.63  ...........       $18.33
   0360  Level I Alimentary Tests..  X                               1.36       $69.23       $34.62       $13.85
   0361  Level II Alimentary Tests.  X                               3.27      $166.46       $83.23       $33.29
   0362  Fitting of Vision Aids....  X                               0.87       $44.29        $9.63        $8.86
   0363  Otorhinolaryngologic        X                               1.74       $88.57       $32.77       $17.71
          Function Tests.
   0364  Level I Audiometry........  X                               0.58       $29.52       $11.51        $5.90
   0365  Level II Audiometry.......  X                               1.32       $67.19       $20.16       $13.44
   0367  Level I Pulmonary Test....  X                               0.70       $35.63       $17.82        $7.13
   0368  Level II Pulmonary Tests..  X                               1.48       $75.34       $38.42       $15.07
   0369  Level III Pulmonary Tests.  X                               3.51      $178.67       $58.50       $35.73
   0370  Allergy Tests.............  X                               0.81       $41.23       $11.81        $8.25
   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                               1.01       $51.41       $14.39       $10.28
   0374  Monitoring Psychiatric      X                               0.89       $45.30        $9.97        $9.06
          Drugs.
   0600  Low Level Clinic Visits...  V                               0.87       $44.29  ...........        $8.86
   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                               1.24       $63.12       $19.57       $12.62
   0611  Mid Level Emergency Visits  V                               2.16      $109.95       $36.47       $21.99
   0612  High Level Emergency        V                               3.51      $178.67       $54.14       $35.73
          Visits.
   0620  Critical Care.............  S                               8.45      $430.14      $150.55       $86.03
   0685  Level III Needle Biopsy/    T                               9.21      $468.83      $206.28       $93.77
          Aspiration Except Bone
          Marrow.
   0686  Level V Skin Repair.......  T                              24.15    $1,229.33      $565.49      $245.87
   0687  Revision/Removal of         T                              42.58    $2,167.49      $997.05      $433.50
          Neurostimulator
          Electrodes.

[[Page 9573]]

 
   0688  Revision/Removal of         T                             146.12    $7,438.09    $3,644.66    $1,487.62
          Neurostimulator Pulse
          Generator Receiver.
   0689  Electronic Analysis of      S                               0.43       $21.89       $12.03        $4.38
          Cardioverter-
          defibrillators.
   0690  Electronic Analysis of      S                               0.38       $19.34       $10.63        $3.87
          Pacemakers and other
          Cardiac Devices.
   0691  Electronic Analysis of      S                               3.18      $161.87       $89.02       $32.37
          Programmable Shunts/Pumps.
   0692  Electronic Analysis of      S                              14.43      $734.54      $403.99      $146.91
          Neurostimulator Pulse
          Generators.
   0693  Level II Breast             T                              32.00    $1,628.93      $798.17      $325.79
          Reconstruction.
   0694  Level III Excision/Biopsy.  T                               4.01      $204.13       $81.65       $40.83
   0695  Level VII Debridement &     T                              15.87      $807.85      $266.59      $161.57
          Destruction.
   0697  Level II Echocardiogram     S                               2.09      $106.39       $55.32       $21.28
          Except Transesophageal.
   0698  Level II Eye Tests &        S                               1.04       $52.94       $20.64       $10.59
          Treatments.
   0699  Level IV Eye Tests &        T                               6.49      $330.37      $148.66       $66.07
          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     S                        ...........       $25.00  ...........        $5.00
          ($0-$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  ...........        $0.38
          mg.
   0726  Dexrazoxane hcl injection,  G                        ...........      $194.52  ...........       $24.98
          250 mg.
   0727  Etidronate disodium inj     G                        ...........       $63.65  ...........        $9.11
          300 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      G                        ...........       $12.26  ...........        $1.57
          inj, 1000 u.
   0734  Darepoetin alfa, 1 MCG....  G                        ...........        $4.74  ...........        $0.68
   0750  Dolasetron mesylate, 10 mg  G                        ...........       $16.45  ...........        $2.11
   0754  Metoclopramide hcl          G                        ...........        $1.17  ...........        $0.11
          injection up to 10 mg.
   0755  Thiethylperazine maleate    G                        ...........        $4.60  ...........        $0.66
          inj up to 10 mg.
   0762  Dronabinol 2.5mg oral.....  G                        ...........        $3.28  ...........        $0.42
   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   G                        ...........        $6.09  ...........        $0.78
          1 mg.
   0769  Ondansetron hcl 8mg oral..  G                        ...........       $26.41  ...........        $3.39
   0800  Leuprolide acetate, 3.75    G                        ...........       $93.47  ...........       $12.00
          mg.
   0801  Cyclophosphamide oral 25    G                        ...........        $2.03  ...........        $0.18
          mg.
   0802  Etoposide oral 50 mg......  G                        ...........       $52.43  ...........        $6.73
   0803  Melphalan oral 2 mg.......  G                        ...........        $2.29  ...........        $0.33
   0807  Aldesleukin/single use      G                        ...........      $672.60  ...........       $96.29
          vial.
   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    G                        ...........      $114.46  ...........       $16.39
          mg.
   0812  Carmus bischl nitro inj     G                        ...........      $117.84  ...........       $16.87
          100 mg.
   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     G                        ...........        $5.82  ...........        $0.75
          inj.
   0816  Cyclophosphamide            G                        ...........        $4.89  ...........        $0.63
          lyophilized 100 mg.
   0817  Cytarabine hcl 100 mg inj.  G                        ...........        $6.10  ...........        $0.55
   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.

[[Page 9574]]

 
   0823  Docetaxel, 20 mg..........  G                        ...........      $297.83  ...........       $42.64
   0824  Etoposide 10 mg inj.......  G                        ...........       $10.45  ...........        $0.95
   0826  Methotrexate Oral 2.5 mg..  G                        ...........        $3.45  ...........        $0.31
   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     G                        ...........        $4.10  ...........        $0.59
          mcg.
   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,   G                        ...........      $285.65  ...........       $40.89
          3 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                        ...........        $0.45  ...........        $0.04
          mg.
   0842  Fludarabine phosphate inj   G                        ...........      $271.82  ...........       $38.91
          50 mg.
   0843  Pegaspargase, singl dose    G                        ...........    $1,225.57  ...........      $179.74
          vial.
   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  ...........        $0.37
          mg.
   0854  Vincristine sulfate 1 mg    G                        ...........       $30.16  ...........        $3.87
          inj.
   0855  Vinorelbine tartrate, 10    G                        ...........       $88.83  ...........       $12.72
          mg.
   0856  Porfimer sodium, 75 mg....  G                        ...........    $2,603.66  ...........      $372.74
   0857  Bleomycin sulfate           G                        ...........      $289.37  ...........       $37.16
          injection 15 u.
   0858  Cladribine, 1mg...........  G                        ...........       $53.39  ...........        $4.83
   0859  Fluorouracil injection 500  G                        ...........        $2.73  ...........        $0.25
          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    G                        ...........      $173.50  ...........       $22.28
          mg.
   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  ...........        $0.11
   0887  Azathioprine parenteral     G                        ...........        $1.06  ...........        $0.10
          100 mg.
   0888  Cyclosporine oral 100 mg..  G                        ...........        $5.22  ...........        $0.67
   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  ...........        $0.42
   0900  Alglucerase injection, per  G                        ...........       $37.53  ...........        $5.37
          10 u.
   0901  Alpha 1 proteinase          G                        ...........        $2.09  ...........        $0.30
          inhibitor, 10 mg.
   0902  Botulinum toxin a, per      G                        ...........        $4.39  ...........        $0.63
          unit.
   0903  Cytomegalovirus imm IV/     G                        ...........      $638.48  ...........       $91.40
          vial.
   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     G                        ...........      $102.60  ...........       $13.18
          inj 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                               1.67       $85.01  ...........       $17.00
          iu.
   0913  Ganciclovir long act        G                        ...........    $4,750.00  ...........      $680.00
          implant 4.5 mg.
   0916  Injection imiglucerase/     G                        ...........        $3.75  ...........        $0.54
          unit.
   0917  Pharmacologic stressors...  K                               0.35       $17.82  ...........        $3.56
   0925  Factor viii per iu........  G                        ...........        $0.87  ...........        $0.08
   0926  Factor VIII (porcine) per   G                        ...........        $2.09  ...........        $0.30
          iu.
   0927  Factor viii recombinant     G                        ...........        $1.12  ...........        $0.14
          per iu.
   0928  Factor ix complex per iu..  G                        ...........        $0.48  ...........        $0.04
   0929  Anti-inhibitor per iu.....  G                        ...........        $1.43  ...........        $0.18
   0930  Antithrombin iii injection  G                        ...........        $1.05  ...........        $0.15
          per iu.
   0931  Factor IX non-recombinant,  G                        ...........        $0.71  ...........        $0.09
          per iu.
   0932  Factor IX recombinant, per  G                        ...........        $1.12  ...........        $0.16
          iu.
   0949  Plasma, Pooled Multiple     K                               2.80      $142.53  ...........       $28.51
          Donor, Solvent/Detergent
          T.
   0950  Blood (Whole) For           K                               1.98      $100.79  ...........       $20.16
          Transfusion.
   0952  Cryoprecipitate...........  K                               0.66       $33.60  ...........        $6.72
   0954  RBC leukocytes reduced....  K                               2.69      $136.93  ...........       $27.39

[[Page 9575]]

 
   0955  Plasma, Fresh Frozen......  K                               2.14      $108.93  ...........       $21.79
   0956  Plasma Protein Fraction...  K                               1.20       $61.08  ...........       $12.22
   0957  Platelet Concentrate......  K                               0.93       $47.34  ...........        $9.47
   0958  Platelet Rich Plasma......  K                               1.11       $56.50  ...........       $11.30
   0959  Red Blood Cells...........  K                               1.95       $99.26  ...........       $19.85
   0960  Washed Red Blood Cells....  K                               3.62      $184.27  ...........       $36.85
   0961  Infusion, Albumin (Human)   K                               2.08      $105.88  ...........       $21.18
          5%, 50 ml.
   0962  Infusion, Albumin (Human)   K                               1.05       $53.45  ...........       $10.69
          25%, 50 ml.
   0963  Albumin (human), 5%, 250    K                              10.35      $526.86  ...........      $105.37
          ml.
   0964  Albumin (human), 25%, 20    K                               2.08      $105.88  ...........       $21.18
          ml.
   0965  Albumin (human), 25%, 50ml  K                               5.20      $264.70  ...........       $52.94
   0966  Plasmaprotein fract, 5%,    K                               5.95      $302.88  ...........       $60.58
          250ml.
   0970  New Technology--Level I     T                        ...........       $25.00  ...........        $5.00
          ($0-$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@ndash;$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).
   1002  Cochlear implant system...  H                        ...........  ...........  ...........  ...........
   1009  Cryoprecip reduced plasma.  K                               0.82       $41.74  ...........        $8.35
   1010  Blood, L/R, CMV-neg.......  K                               2.74      $139.48  ...........       $27.90
   1011  Platelets, HLA-m, L/R,      K                              11.27      $573.69  ...........      $114.74
          unit.
   1012  Platelet concentrate, L/R,  K                               1.83       $93.15  ...........       $18.63
          irradiated, unit.
   1013  Platelet concentrate, L/R,  K                               1.12       $57.01  ...........       $11.40
          unit.
   1014  Platelets, aph/pher, L/R,   K                               8.50      $432.68  ...........       $86.54
          unit.
   1016  Blood, L/R, froz/           K                               6.80      $346.15  ...........       $69.23
          deglycerol/washed.
   1017  Platelets, aph/pher, L/R,   K                               8.86      $451.01  ...........       $90.20
          CMV-neg, unit.
   1018  Blood, L/R, irradiated....  K                               2.98      $151.69  ...........       $30.34
   1019  Platelets, aph/pher, L/R,   K                               9.16      $466.28  ...........       $93.26
          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      G                        ...........       $36.74  ...........        $5.26
          vial.
   1059  Cultured chondrocytes       G                        ...........   $14,250.00  ...........    $2,040.00
          implnt.
   1064  I-131 cap, each add mCi...  G                        ...........        $5.86  ...........        $0.75
   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  ...........        $0.87
   1087  I-123 per 100 uci.........  G                        ...........        $0.65  ...........        $0.06
   1089  Coo 57, 0.5 Mci...........  G                        ...........       $81.10  ...........       $10.41
   1091  IN 111 Oxyquinoline, per    G                        ...........      $427.50  ...........       $61.20
          .5 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      G                        ...........       $51.44  ...........        $7.36
          vial.
   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    G                        ...........      $371.45  ...........       $53.18
          mg.
   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           G                        ...........       $79.17  ...........       $11.33
          disofenin.

[[Page 9576]]

 
   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                        ...........        $0.23  ...........        $0.02
   1401  Prochlorperazine maleate    G                        ...........        $0.65  ...........        $0.06
          5mg.
   1402  Promethazine hcl 12.5mg     G                        ...........        $0.01  ...........  ...........
          oral.
   1403  Chlorpromazine hcl 10mg     G                        ...........        $0.27  ...........        $0.02
          oral.
   1404  Trimethobenzamide hcl       G                        ...........        $0.38  ...........        $0.03
          250mg.
   1405  Thiethylperazine            G                        ...........        $0.56  ...........        $0.08
          maleate10mg.
   1406  Perphenazine 4mg oral.....  G                        ...........        $0.62  ...........        $0.06
   1407  Hydroxyzine pamoate 25mg..  G                        ...........        $0.28  ...........        $0.03
   1409  Factor viia recombinant,    G                        ...........    $1,596.00  ...........      $228.48
          per 1.2 mg.
   1600  Technetium TC 99M           G                        ...........      $121.70  ...........       $17.42
          sestamibi.
   1601  Technetium TC 99M           G                        ...........       $42.18  ...........        $5.42
          medronate.
   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    G                        ...........      $141.01  ...........       $20.19
          mg.
   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                        ...........      $423.22  ...........       $60.59
   1615  Basiliximab, 20 mg........  G                        ...........    $1,437.78  ...........      $205.83
   1616  Histrelin acetate, 10 mgs.  G                        ...........       $14.16  ...........        $2.03
   1617  Lepirudin.................  G                        ...........      $131.96  ...........       $18.89
   1618  Vonwillebrandfactrcmplx,    G                        ...........        $0.95  ...........        $0.14
          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            G                        ...........      $137.75  ...........       $19.72
          mertiatide.
   1623  Technetium tc99m            G                        ...........       $22.61  ...........        $3.24
          glucepatate.
   1624  Sodium phosphate p32......  G                        ...........       $81.10  ...........        $7.78
   1625  Indium 111-in               G                        ...........      $935.75  ...........      $133.96
          pentetreotide.
   1626  Technetium tc99m            G                        ...........        $1.47  ...........        $0.21
          oxidronate.
   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-         H                        ...........  ...........  ...........  ...........
          vascular.
   1727  Cath, bal tis dis, non-vas  H                        ...........  ...........  ...........  ...........
   1728  Cath, brachytx seed adm...  H                        ...........  ...........  ...........  ...........
   1729  Cath, drainage............  H                        ...........  ...........  ...........  ...........
   1730  Cath, EP, 19 or fewer       H                        ...........  ...........  ...........  ...........
          elect.
   1731  Cath, EP, 20 or more elec.  H                        ...........  ...........  ...........  ...........
   1732  Cath, EP, diag/abl, 3D/     H                        ...........  ...........  ...........  ...........
          vect.
   1733  Cath, EP, othr than cool-   H                        ...........  ...........  ...........  ...........
          tip.
   1750  Cath, hemodialysis,long-    H                        ...........  ...........  ...........  ...........
          term.
   1751  Cath, inf, per/cent/        H                        ...........  ...........  ...........  ...........
          midline.
   1752  Cath, hemodialysis,short-   H                        ...........  ...........  ...........  ...........
          term.
   1753  Cath, intravas ultrasound.  H                        ...........  ...........  ...........  ...........
   1754  Catheter, intradiscal.....  H                        ...........  ...........  ...........  ...........
   1755  Catheter, intraspinal.....  H                        ...........  ...........  ...........  ...........
   1756  Cath, pacing, transesoph..  H                        ...........  ...........  ...........  ...........
   1757  Cath, thrombectomy/         H                        ...........  ...........  ...........  ...........
          embolect.
   1758  Cath, ureteral............  H                        ...........  ...........  ...........  ...........

[[Page 9577]]

 
   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,              H                        ...........  ...........  ...........  ...........
          programmable.
   1773  Retrieval dev, insert.....  H                        ...........  ...........  ...........  ...........
   1775  FDG, per dose (4-40 mCi/    G                        ...........      $475.00  ...........       $68.00
          ml).
   1776  Joint device (implantable)  H                        ...........  ...........  ...........  ...........
   1777  Lead, AICD, endo single     H                        ...........  ...........  ...........  ...........
          coil.
   1778  Lead, neurostimulator.....  H                        ...........  ...........  ...........  ...........
   1779  Lead, pmkr, transvenous     H                        ...........  ...........  ...........  ...........
          VDD.
   1780  Lens, intraocular.........  H                        ...........  ...........  ...........  ...........
   1781  Mesh (implantable)........  H                        ...........  ...........  ...........  ...........
   1782  Morcellator...............  H                        ...........  ...........  ...........  ...........
   1784  Ocular dev, intraop, det    H                        ...........  ...........  ...........  ...........
          ret.
   1785  Pmkr, dual, rate-resp.....  H                        ...........  ...........  ...........  ...........
   1786  Pmkr, single, rate-resp...  H                        ...........  ...........  ...........  ...........
   1787  Patient progr, neurostim..  H                        ...........  ...........  ...........  ...........
   1788  Port, indwelling, imp.....  H                        ...........  ...........  ...........  ...........
   1789  Prosthesis, breast, imp...  H                        ...........  ...........  ...........  ...........
   1813  Prosthesis, penile,         H                        ...........  ...........  ...........  ...........
          inflatab.
   1815  Pros, urinary sph, imp....  H                        ...........  ...........  ...........  ...........
   1816  Receiver/transmitter,       H                        ...........  ...........  ...........  ...........
          neuro.
   1817  Septal defect imp sys.....  H                        ...........  ...........  ...........  ...........
   1874  Stent, coated/cov w/del     H                        ...........  ...........  ...........  ...........
          sys.
   1875  Stent, coated/cov w/o del   H                        ...........  ...........  ...........  ...........
          sy.
   1876  Stent, non-coa/no-cov w/    H                        ...........  ...........  ...........  ...........
          del.
   1877  Stent, non-coat/cov w/o     H                        ...........  ...........  ...........  ...........
          del.
   1878  Matrl for vocal cord......  H                        ...........  ...........  ...........  ...........
   1879  Tissue marker, imp........  H                        ...........  ...........  ...........  ...........
   1880  Vena cava filter..........  H                        ...........  ...........  ...........  ...........
   1881  Dialysis access system....  H                        ...........  ...........  ...........  ...........
   1882  AICD, other than sing/dual  H                        ...........  ...........  ...........  ...........
   1883  Adapt/ext, pacing/neuro     H                        ...........  ...........  ...........  ...........
          lead.
   1885  Cath, translumin angio      H                        ...........  ...........  ...........  ...........
          laser.
   1887  Catheter, guiding.........  H                        ...........  ...........  ...........  ...........
   1891  Infusion pump, non-prog,    H                        ...........  ...........  ...........  ...........
          perm.
   1892  Intro/sheath, fixed, peel-  H                        ...........  ...........  ...........  ...........
          away.
   1893  Intro/sheath, fixed, non-   H                        ...........  ...........  ...........  ...........
          peel.
   1894  Intro/sheath, non-laser...  H                        ...........  ...........  ...........  ...........
   1895  Lead, AICD, endo dual coil  H                        ...........  ...........  ...........  ...........
   1896  Lead, AICD, non sing/dual.  H                        ...........  ...........  ...........  ...........
   1897  Lead, neurostim test kit..  H                        ...........  ...........  ...........  ...........
   1898  Lead, pmkr, other than      H                        ...........  ...........  ...........  ...........
          trans.
   1899  Lead, pmkr/AICD             H                        ...........  ...........  ...........  ...........
          combination.
   2615  Sealant, pulmonary, liquid  H                        ...........  ...........  ...........  ...........
   2616  Brachytx seed, Yttrium-90.  H                        ...........  ...........  ...........  ...........
   2617  Stent, non-cor, tem w/o     H                        ...........  ...........  ...........  ...........
          del.
   2618  Probe, cryoablation.......  H                        ...........  ...........  ...........  ...........
   2619  Pmkr, dual, non rate-resp.  H                        ...........  ...........  ...........  ...........
   2620  Pmkr, single, non rate-     H                        ...........  ...........  ...........  ...........
          resp.
   2621  Pmkr, other than sing/dual  H                        ...........  ...........  ...........  ...........
   2622  Prosthesis, penile, non-    H                        ...........  ...........  ...........  ...........
          inf.
   2625  Stent, non-cor, tem w/del   H                        ...........  ...........  ...........  ...........
          sys.
   2626  Infusion pump, non-prog,    H                        ...........  ...........  ...........  ...........
          temp.
   2627  Cath, suprapubic/           H                        ...........  ...........  ...........  ...........
          cystoscopic.
   2628  Catheter, occlusion.......  H                        ...........  ...........  ...........  ...........
   2629  Intro/sheath, laser.......  H                        ...........  ...........  ...........  ...........
   2630  Cath, EP, cool-tip........  H                        ...........  ...........  ...........  ...........
   2631  Rep dev, urinary, w/o       H                        ...........  ...........  ...........  ...........
          sling.
   7000  Amifostine, 500 mg........  G                        ...........      $392.06  ...........       $56.13

[[Page 9578]]

 
   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  ...........        $0.09
          (preservative free) 10 mg.
   7011  Oprelvekin injection, 5 mg  G                        ...........      $245.81  ...........       $35.19
   7014  Fentanyl citrate injection  G                        ...........        $1.23  ...........        $0.11
   7015  Busulfan, oral, 2 mg......  G                        ...........        $1.91  ...........        $0.27
   7019  Aprotinin, 10,000 kiu.....  G                        ...........        $2.16  ...........        $0.31
   7022  Elliot's B solution, per    G                        ...........        $1.43  ...........        $0.20
          ml.
   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    G                        ...........       $39.73  ...........        $5.69
          mg.
   7027  Fomepizole, 15 mg.........  G                        ...........       $10.93  ...........        $1.56
   7028  Fosphenytoin, 50 mg.......  G                        ...........        $5.73  ...........        $0.82
   7029  Glatiramer acetate, per     G                        ...........       $30.07  ...........        $4.30
          dose.
   7030  Hemin, per 1 mg...........  G                        ...........        $0.99  ...........        $0.14
   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                               6.44      $327.82  ...........       $65.56
   7037  Urofollitropin, 75 iu.....  G                        ...........       $73.29  ...........       $10.49
   7038  Muromonab-CD3, 5 mg.......  G                        ...........      $269.06  ...........       $38.52
   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  ...........        $0.35
   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.
   7047  Droperidol/fentanyl inj...  G                        ...........        $6.67  ...........        $0.95
   7048  Alteplase recombinant.....  K                               0.36       $18.33  ...........        $3.67
   7049  Filgrastim 480 mcg          G                        ...........      $285.38  ...........       $36.65
          injection.
   7050  Prednisone oral...........  G                        ...........        $0.07  ...........        $0.01
   7051  Leuprolide acetate          G                        ...........    $5,399.80  ...........      $773.02
          implant, 65 mg.
   7052  Somatrem injection........  G                        ...........       $41.90  ...........        $6.00
   7315  Sodium hyaluronate          G                        ...........      $130.63  ...........       $18.70
          injection, 20mg.
   7316  Sodium hyaluronate          G                        ...........       $26.13  ...........        $3.74
          injection, 5mg.
   9000  Na chromate Cr51, per       G                        ...........        $0.52  ...........        $0.07
          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 inj,  G                        ...........    $1,929.69  ...........      $276.25
          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  ...........        $0.44
   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  ...........        $0.34
          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  ...........        $0.93
   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  ...........        $0.93
   9108  Thyrotropin alfa, per 1.1   G                        ...........      $531.05  ...........       $76.02
          mg.
   9109  Tirofliban hcl, per 6.25    G                        ...........      $207.81  ...........       $29.75
          mg.
   9110  Alemtuzumab, per ml.......  G                        ...........      $486.88  ...........       $69.70

[[Page 9579]]

 
   9111  Inj, bivalirudin, per       G                        ...........      $397.81  ...........       $56.95
          250mg vial.
   9112  Perflutren lipid micro,     G                        ...........      $148.20  ...........       $21.22
          per 2ml.
   9113  Inj pantoprazole sodium,    G                        ...........       $22.80  ...........        $3.26
          vial.
   9114  Nesiritide, per 1.5 mg      G                        ...........      $433.20  ...........       $62.02
          vial.
   9115  Inj, zoledronic acid, per   G                        ...........      $406.78  ...........       $58.23
          2 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                               1.69       $86.03  ...........       $17.21
   9501  Platelets, pheresis.......  K                               9.22      $469.33  ...........       $93.87
   9502  Platelet pheresis           K                              10.00      $509.04  ...........      $101.81
          irradiated.
   9503  Fresh frozen plasma, ea     K                               1.57       $79.92  ...........       $15.98
          unit.
   9504  RBC deglycerolized........  K                               4.14      $210.74  ...........       $42.15
   9505  RBC irradiated............  K                               2.45      $124.71  ...........       $24.94
   9506  Granulocytes, pheresis....  K                              28.14    $1,432.44  ...........      $286.49
----------------------------------------------------------------------------------------------------------------


          Addendum D.--Payment Status Indicators for the Hospital Outpatient Prospective Payment System
----------------------------------------------------------------------------------------------------------------
         Indicator                       Service                                    Status
----------------------------------------------------------------------------------------------------------------
A.........................  Pulmonary Rehabilitation          Not Paid Under Outpatient PPS.
                             Clinical Trial.
A.........................  Durable Medical Equipment,        DMEPOS Fee Schedule.
                             Prosthetics and Orthotics.
A.........................  Physical, Occupational and        Physician Fee Schedule.
                             Speech Therapy.
A.........................  Ambulance.......................  Ambulance Fee Schedule.
A.........................  EPO for ESRD Patients...........  National Rate.
A.........................  Clinical Diagnostic Laboratory    Laboratory Fee Schedule.
                             Services.
A.........................  Physician Services for ESRD       Physician Fee Schedule.
                             Patients.
A.........................  Screening Mammography...........  Physician Fee Schedule.
C.........................  Inpatient Procedures............  Admit Patient; Bill as Inpatient.
D.........................  Deleted Code....................  Codes are deleted effective with the beginning of
                                                               the calendar year.
E.........................  Non-Covered Items and Services..  Not Paid Under Outpatient PPS.
F.........................  Acquisition of Corneal Tissue...  Paid at Reasonable Cost.
G.........................  Drug/Biological Pass-Through....  Additional Payment.
H.........................  Device Pass-Through.............  Additional Payment.
K.........................  Non Pass-Through Drug/Biological  Paid Under Outpatient PPS.
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, Multiple   Paid Under Outpatient PPS.
                             Procedure Reduction Applies.
V.........................  Visit to Clinic or Emergency      Paid Under Outpatient PPS.
                             Department.
X.........................  Ancillary Service...............  Paid Under Outpatient PPS.
----------------------------------------------------------------------------------------------------------------

[FR Doc. 02-5071 Filed 2-28-02; 8:45 am]
BILLING CODE 4120-01-P